How do I tell my children I have cancer?

Even for adults, cancer is a big diagnosis to process. And if you have children, you may be unsure how to help them understand your diagnosis too. From toddlers to teens, telling kids about cancer is one of the conversations that recently diagnosed parents struggle with the most.

While your initial reaction may be to protect your children from your diagnosis, open and honest communication—that’s appropriate for their age—is best from the start.

One gift of being a parent is that you get to be your children’s go-to person. When you include them in the conversation about cancer in a purposeful way, you can be in this tough spot together. Then, you can work through it together too.

Preparing to talk with your kids

When cancer is happening to you, it’s hard to see everything else around you. Before you talk to your children, seek out guidance from trusted medical providers, child life specialists, online support groups or others who have experienced a similar situation.

Talking through your diagnosis and how it affects your kids lets you process your own emotions first and make a plan. You can also anticipate some of the questions children ask and know ahead of time how to respond.

Three of the most common questions you’ll want to prepare for are:

• Can I catch this? Younger kids may not understand where illness comes from, and bigger kids may have questions about genetics and their own risks.

• Did I cause this? Kids are often egocentric and see your diagnosis only from their perspective. You’ll want to help them understand that cancer isn’t caused by something they did.

• Who is going to take care of me? Children thrive on consistency and routine. Talk through the logistical things that may change and how they’ll still be supported.

General guidelines for every age

For kids of all ages, emotional processing and expression are important. It’s OK to express your emotions and give your children permission to express their feelings as well. Parents can help kids identify and express their emotions by saying something like, “I wish I didn’t have cancer, and it makes me feel sad to be sick. You may feel sad sometimes too. It’s OK to feel sad and upset when someone we love is sick. You can talk to mom or dad if you’re feeling sad.”

Especially for younger children, books are a great way to talk through emotions too. Ask your care team and support groups if they have recommendations.

You’ll also want to prepare your children for any physical changes you may experience, like weight loss, hair loss or fatigue. Often, you can find a way to make these changes less scary by doing something fun together. For example, invite them to have a family head-shaving party or let them help you pick out hats or wigs.

Finally, when it comes to timing, talk to your children during the day and avoid bedtime. This gives children plenty of time to process and ask questions before trying to go to sleep.

Tailoring your conversation by age 

In addition to these general guidelines, talking to your children using age-appropriate language is key. Being open and honest doesn’t always mean telling them every detail about your diagnosis. It means helping them understand in a way that makes sense for their development.

A few tips by age include:

Toddlers and preschoolers

• This age group usually doesn’t know what the word “cancer” means. Use words like “big sick” and “little sick” to explain the difference between cancer and a common illness like a cold.
• Let them know that mom or dad may have to be away for a time to get “big medicine” but will come back.
• Your child may not know what to ask. Share answers to the three most common questions even if your child doesn’t bring them up.
• Recognize that your child may regress if they feel stressed or don’t understand.
• Use toys to help them process through play.

Elementary-age children

• At this age, start using the word “cancer.” Your children may hear the word from friends who’ve also had a relative with cancer, so you want to help them understand what it means for you.
• Explain the part of the body affected and use basic medical terms like chemotherapy.
• Kids at this age are starting to process the concept of death. Be open about your prognosis from the beginning.
• Loop in your child’s teacher and counselor at school. They may notice signs that your child is having a hard time processing and needs to talk more.

Pre-teens

• Friends and peer relationships are important at this age. The changes that come with a parent’s diagnosis may make pre-teens feel different or isolated. Talk about these emotions and how to navigate them.
• Suggest that your child talks with someone outside of the family for extra support.
• Let them know it’s OK to ask questions or express emotions. Reassure them that you aren’t going to get upset.
• Answer questions about your diagnosis or treatment using basic medical terms. This age group may have more questions since they know more about how the body works.

Teenagers

• Teens are seeking autonomy from the family and looking to the future. This can be hard if a parent is sick. Help them process this tension between their plans—like leaving for college—versus a desire to help at home.
• Connect them with a person outside of the family for more support.
• Recognize that teenagers may be more aware of genetic causes of cancer and may worry that your diagnosis means they will be at a higher risk for cancer as an adult.
• Give them teen-appropriate jobs so they feel a part of the process, such as caring for a sibling or sitting with you during treatment.
• Teenagers may research information on their own, which could lead to misconceptions about your diagnosis and treatment. Point teenagers to trusted, reliable sources.

Getting additional support

Telling your children that you have cancer is a conversation you never imagined having. It’s OK to acknowledge that this is hard. Take the time to process, wrestle with it and talk to someone if you need help.

At Baylor Scott & White, we have certified and trained child life specialists available at multiple hospital locations for families with serious medical situations. While most child life specialists are located within pediatric hospitals, our role is unique. We provide support to children of seriously ill or injured adults, including patients with cancer and their families.

When you’re still having a hard time finding the right words to talk to your children, know that support is available. You can speak with a child life specialist by calling 214-818-6711. Or find other cancer support near you today.