Talking with Your Child

Discovering your child has cancer is most likely the hardest news you have ever had to handle. As a parent, you must now decide the best way to tell your child. Your first instinct may be to shield your child from this news. But, with increased visits to the doctor, not feeling well and having frightening tests, your child will undoubtedly realize that something is wrong with him or her. Your child is also likely to sense the anxiety and fear of family members and friends.

Children that are not told about their illness often rely on their imagination to explain their symptoms. This can mean that your child will believe that he/she is being punished for something he/she has done. A result can be your child feeling anxious or guilty. Overall, health professionals agree that your child should be told about his or her illness.

The decision of who should tell your child about his/her cancer is a personal decision. You may want to tell your child yourself, or you may want your child's health care provider to explain the illness. No matter who tells your child, it is important that he/she receives plenty of support, encouragement and love.

Since you are the best judge of your child's personality and moods, you are the best person to decide when your child should be told about the cancer. There is no right moment to tell your child but it is important to tell him/her as soon as possible to eliminate some of the fears. When you do decide to tell your child, try to choose a quiet place and a time where you and your child can be alone. If you decide to tell your child yourself, talking to your child's doctor, nurse or social worker can help you determine the best way to explain the illness.

Before speaking with your child, it is important to understand thoroughly the type of cancer your child has and the treatment that will be given. This way, you will be prepared to answer any questions your child might have. By being prepared, you can eliminate many of your child's fears.

It is best to use a gentle, open and honest approach when discussing your child's cancer. Your child's age and maturity will dictate the amount of information he/she can understand. The following guidelines help define the stages of child development and what your child is likely to understand at different ages.

Newborn to Two-Year Olds
Children this young cannot understand cancer. They can't see it or touch it, so it is not real to them. Children at this age are only concerned with what is happening to them. Children older than a year are concerned with how things feel and how to control things around them. Very young children are most afraid of medical procedures and tests. In an attempt to control what is happening, your child might cry, squirm or run away.

After 18 months, children will be more aware of what happens around them. This makes an honest approach about trips to the doctor and medical procedures the best way to deal with your child. Let the child know that a procedure may hurt but it is fine to cry. This lets your child know that you understand his/her feelings, and this honesty helps build trust.

If possible, allow your child to make some decisions about his/her treatment. If your child must take medicine orally, let him/her decide what to mix it in. These small decisions can help your child build confidence and gain a sense of control.

Two- to Seven-Year Olds
Children of this age are better able to understand their illness. They tend to view things from one point of view - their own - and believe that the world revolves around them. At this age, a child will link events to one thing. For instance, the child will link his/her illness to one action, such as staying in bed or bad behavior. Therefore, the child is likely to believe that getting better will happen automatically if he/she follows a set of rules.

Younger children need to be reassured that they did nothing to cause the illness and it is not punishment for something they have done, said or thought. Children this age also need to be told about their illness and medical procedures honestly and be reminded that treatments are done to make them feel better.

Stories that relate cancer to familiar ideas will help explain their illness. These comparisons should be tailored to the child's specific cancer. For example, two- to seven-year olds understand good and bad, so you can explain cancer and treatment in terms of a battle between good and bad.

Seven- to 12-Year Olds
Children ages seven- to 12 years are limited by their own experiences but they are beginning to understand relationships among several events. Thus, they see their illness as a set of symptoms and they can also understand that getting better is a result of taking medications and cooperating with their doctor.

Explaining cancer to children of this age can be more detailed but should still revolve around familiar situations. In this age group, comparisons are useful in explaining cancer to your child.

12-Years and Older
Children 12 years and older are able to understand relationships between events. They are able to think about things that they have not experienced directly. Thus, you can explain cancer as when a few cells malfunction and grow more quickly than normal cells and invade other parts of the body and disrupt normal body functions. The goal of treatment is to kill the malfunctioning cells so the body can function normally again.

Teenagers can understand the relationship between cancer and death. Thus, they need to be reassured that cancer does not always lead to death and that great progress has been made in treating childhood cancer. Teenagers should also know that many children who have cancer survive the disease and live normal lives.