Cancer Institute A national cancer institute
designated cancer center

Coping With the Diagnosis of Cancer

Some practical things that you can do to help during this time include the following:

Helping Children and Youth Cope With Cancer

The following is a list of suggestions for patients, parents, and siblings that may help each individual cope with his/her emotions, depending upon the age of the child with cancer and the age of the siblings:

Infants and very young children (birth to 3 years of age):

Toddlers, pre-school (3 to 5 years of age):

School-aged children (6 to 12 years of age):

Adolescents (13 to 18 years of age and older):

Cancer in the Family - Talking to Kids about Cancer

Few things impact a family more than a diagnosis of cancer. Every member of the family and every aspect of your life will be affected such as relationships, money, time and energy. Parents diagnosed with cancer must not only face their own fears and uncertainty, they must also help their children cope with this life-altering reality.

Communication is key throughout the cancer journey. Understanding children’s developmental stages can help parents understand the way their child views illness. You should also take into account the individual child’s temperament. It is important to remember that children are more resilient than you might anticipate.

This Web site aims to give you the tools you need to help your children cope with your cancer.

Through a Child’s Eyes: Understanding Serious Illness by Age


Infants – under 2 ½

1. Developmental stage/Level of understanding

2. Helping them cope

Toddlers – under 5

1. Developmental stage/Level of understanding

2. Helping them cope

School Age – 5 to 8

1. Developmental stage/Level of understanding

2. Helping them cope


Preteen - 9 to 12

1. Developmental stage/Level of understanding

2. Helping them cope

Teen – 13-18

1. Developmental stage/Level of understanding

2. Helping them cope

Summary

  1. Maintain your child’s routine – sleeping, eating, school and recreation-as much as possible.
  2. Show interest in your child’s life. Pay attention to the small stuff. This makes home feel secure and the child feel important.
  3. Be honest with your child. Keep your promises and maintain your child’s trust. When your child stops believing in what you say, they will try to read between the lines and become even more fearful.
  4. Keep talking. Encourage questions and discussion. Try to understand why your child is asking a particular question. Take your time in answering – it doesn’t have to be immediate – it’s OK to tell the child you don’t know or need to think about the answer.
  5. Make family time a priority. Limit outside intrusion like phone calls and visitors. Avoid constant talk of cancer.
  6. Keep the child informed. Hearing information second-hand confuses a child and leaves them feeling undervalued. It is important that they trust you to give them information.
  7. Ask your children to share what they hear about cancer so that you can correct misinformation to reduce their worry and feeling of isolation.
  8. Keep the school informed. The teacher should be alert to any changes in the child’s behavior and let the child decide how private they want your cancer to be. Ask the teacher to let you know if the child expresses any worries about you or demonstrates any changes in school performance.
  9. Prepare for hospital visits. The child should know what to expect, especially what their parent will look like. Describe what they will see in the room. The adult accompanying them should be willing to leave when the child is ready. Then discuss the visit-talk about what was comfortable, what was difficult, and how the child is feeling.
  10. Seek professional support if the child asks to talk to someone outside the family. Help may be needed if your child is anxious or depressed. Signs include a lack of interest in favorite activities or friends, change in school performance, sleep or appetite disturbances and risk-taking behavior, such as substance abuse or feelings that life is not worth living.

Sources

When a Parent is Sick: helping parents to explain serious illness to Children, by Joan Hamilton, R.N. Pottersfield Press. 2001.

Facing Cancer: a complete guide for people with cancer, their Families and caregivers, by Theodore A stern, M.D. and Mikael Sekeres, M.D., M.S. McGraw-Hill. 2004

Frequently Asked Questions

1. Should I tell my child about my cancer? When should I tell them?

A diagnosis of cancer affects the entire family. While it may be difficult to tell children that you are ill and will be receiving treatment, be aware that children are observant and will sense that something has changed. It is important to explain what is happening in a way that they can understand. Talking to them as soon as possible is the best option; however, taking some time to plan what you are going to say and prepare for questions the children might have is a good idea.

If you are feeling too overwhelmed and/or too emotional, it is a good idea to wait until you feel stronger before telling your children. It is often helpful to have another trusted adult with you when telling your children. Remember, children often have fears that are worse than reality. Talking to them as soon as you can opens the doors for honest and supportive communication that will help you both throughout the cancer experience.

2. What do I tell my children?

Soon after diagnosis, you may not have all the information about your treatment options. Yet it is important to tell your children about your situation. You can say something like, “cancer is a serious, but treatable disease.” As far as treatment, children should be told that the doctors are working to make you better. They should also know what will happen in the next few days or weeks and also about how long treatment will take.

3. Do I use the word “cancer”?

Using the work “cancer” will help you be more open and honest with your children. It will demystify the term, so it will be less upsetting to them when they hear others use it. By talking about “cancer,” you can begin to help them to understand your situation, as well as clear up any pre-existing misinformation or fears they may have. (In most cases it’s helpful to use the word “cancer”; however, there may be reasons you may choose not to use it. Be aware they may over hear this word from others).

4. Do I talk about the possibility of my dying?

You may be worried about dying and so might your children. In general, if your physician is optimistic about your chances for recovery, you do not need to tell your children you could die. Be honest and encourage your children to share their fears and worries with you. Your children may ask you if you could die. Carefully consider your response. Balance honesty with the emotional impact of such news and leave the door open for future questions. Take into account the child’s developmental age and understanding of time when answering this question.

5. What if they ask questions I have already answered?

Asking the same question repeatedly is normal for children. Absorbing the reality of a cancer diagnosis is difficult for everyone. Forgetting information is common for both children and adults in times of great stress. Do not feel like a failure if it seems your children do not understand your explanations. By answering your children’s questions over and over again, you are helping to ease their worries. Sometimes children may test you to see if your answers stay the same. Try a different approach to answer your child’s questions each time they ask.

6. Should I tell others about my cancer? Teachers? Friends?

People vary in the length of time it takes to feel comfortable talking about cancer. It can be a strain for children to feel as if they need to keep your cancer secret. Chances are the news will leak out anyway. Consider who the important people in your child’s life are. Often it is their teachers, coaches, scout leaders, music instructors and the parent’s of their friends. Sharing the news with these people allows them to interact with your children in helpful ways. It will help teachers make sense of any behavior changes.

It is a good idea to stay in close touch with your child’s teachers throughout your illness. Telling the parents of your children’s friends can be a blessing. They can help your child to maintain their normal routines and activities and be a wonderful source of support for you. Many of them will want to help by dong things such as providing transportation, child care and meals.

7. Where can I turn for help?

Books – (in the Health Library)

For Parents

For more local resources discuss this with your oncology health care professions; i.e. physician, nurse, nurse practitioner, social worker, dietician, pharmacist, chaplain, etc.

Hamilton, J. "When a Parent is Sick: helping parents explain serious illness to children" (Pottersfiled Press: 2001)

Harpham, W.S. "When a Parent has Cancer: a guide to caring for your children" (Perennial Currents: 2004)

Heiney, S. , et al. "Cancer in the Family: helping children cope with a parent’s illness" (American Cancer Society: 2001)

Russell, N. "Can I Still Kiss You? Answering your children’s questions about cancer" (Health Communications: 2001)

Stern, T. and Sekeres, M. "Facing Cancer: a complete guide for people with cancer, their families and caregivers"

Van Dernoot, P. "Helping Children Cope with your Cancer: a guide for parents and families" (Hatherleigh Press: 2002)

For Children

Martin, C. "The Rainbow Feelings of Cancer: a book for children
who have a loved one with cancer" (Hohm Press: 2001)

Harpham, W.S. "Becky and the Worry Cup" (Harper Collins: 1997)

Parkinson, Carolyn My Mommy Has Cancer
Yaffe, Risa Once Upon a Hopeful Night

Heegaard, Marge When Someone Has A Very Serious Illness (workbook)

Harpham,WS and Numeroff, Laura Kids Talk: Kids Speak Out About Breast Cancer

Schmidt, Rebecca Coloring Books: My Book About Cancer ( Father with Cancer or Mother with Cancer)

Heiney, Sue et al Quest A Journal for the Teenager Whose Parent has Cancer

Videos

Kids Tell Kids: what it’s like when a family member has cancer (Cancervive:1998)

Talking About your Cancer: a parent’s guide to helping children cope (Fox Chase Cancer Center: 1996)

We Can Cope: when a parent has cancer, Parent, Teen and Child versions, (Inflexxion:2002)

EBooks

Baider, L.; Cooper, C.; Kaplan-DeNour, A. "Cancer and the Family" (John Wiley and Sons, Ltd.: 2000)



Web sites

For BMT
http://bmt.stanford.edu
BMT guidebook under section 4 - Web sites at end of section – can be very general

NCI
Cancer Care
Institute for Health
Institute of Medicine

The various members of the cancer team can assist you and your family, as needed.

Stanford Medicine Resources:

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