It's hard to talk about cancer and kids in the same breath.
When facing a cancer diagnosis in the family, many parents are tempted to sugar-coat the situation, especially for younger children. This is understandable, but not necessarily helpful. In fact, if carried too far, silence or camouflage about cancer can actually undermine kids' trust in their parents and inflict lasting harm.
Let's face it: Even young children sense when something in the household has changed. They'll see you whispering, and exchanging furtive looks; they know when you're on the phone more often with your parents, or spending more time at the computer screen than interacting with them.
If they're not told what's going on, they may fill the information void with imaginings that may be far worse than reality. Older children may even jump right ahead to "Is she going to die?" before the prognosis has even been discussed by the medical team.
Talking about reality with kids is about helping them to focus on their own daily lives, preserving trust in their parents to tell them the truth, and minimizing their anxieties about things they can't control. This requires giving them age-appropriate information over time, which means you should:
- Respond to what the child actually wants or needs to know.
Don't assume that you have to give a detailed account of all that's going on. A child's concern, if expressed at all, is more likely to reflect a personal and immediate question, like "Why aren't you spending more time with me?" or "Will I still be able to go fishing with Uncle Ted this weekend?"
- Let the child set the agenda: Give the broad brush overview first, and then let the child probe if he wants more detail.
At first, this might mean saying things like, "You know how we go to see the doctor when you don't feel good? Well, Daddy's been having tummy aches, so the doctor has been doing tests to figure out why and how to help him feel better. When we know more, we'll tell you more." Later or with older children, it might mean explaining, for example, that "Daddy has cancer, a serious disease, but the doctors are doing their best to help him get better."
- Share short and frequent information updates . Kids' attention spans are often short. They want to know that things are OK, but they also want to get on with their own lives. Brief doses of information can reassure them that it's OK to do that.
- Pay attention to healthy family members . Cancer is notoriously greedy with caregivers' time, attention, and emotional energy, especially when one child is in treatment and the prognosis is uncertain.
It's too easy for parents to focus all of their waking energy on the patient and to assume that other family members can fend for themselves for a while. Don't assume that older children, who might say "I'm fine," actually are fine. Sometimes they'll hide their concerns to avoid adding to your stress. Think about arranging for added support for them through existing school resources (teachers, coaches, or counselors) or from a local cancer support program for children of similar ages.
Finally, one of the most important things you can do for your children and for the family member who is facing cancer is to emphasize that cancer isn't contagious. The patient-whether a parent, grandparent, aunt/uncle, cousin, sibling, or family friend-still loves and will still enjoy spending time with the children. In fact, the kids may be a pleasant distraction from treatment and its side effects.
Truth-telling can be gentle, phased, and age-appropriate.
A legislative advocate with the American Cancer Society's Cancer Action Network, Deborah J. Cornwall is the author of Things I Wish I'd Known: Cancer and Kids and Things I Wish I'd Known: Cancer Caregivers Speak Out . Cancer and Kids focuses on what you need to know and do, and where to find resources, when faced with a cancer diagnosis in the family.