- Why tell the children? Children trust you to tell them the truth. Let your children hear the news from you first, rather than them noticing that something is different and becoming anxious about it, or overhearing it from someone else.
- When to tell them? As early in the process as possible. They will know there is something going on, and it will settle their anxiety if they feel informed. It’s ok if you don’t know all of the answers to their questions—be honest about that and let them know you’ll continue to let them know when you know. Try to have the conversation as a family if possible, with everyone present and with enough time that you won’t be interrupted—don’t answer phones or texts during the conversation—be present!
- What to tell the children? Start with thinking about what they’re association with the word “cancer” will be. Has there been a family member or friend with cancer? Is Terry Fox their only experience with the word? What will they associate with the word? Some children know lots of people who have had cancer and survived, some will have known someone who died. Make sure you use the word “cancer”. Again, if you don’t, you risk them hearing that word from someone else and then worrying about why you didn’t tell them. But also make sure they understand that there are lots of different types of cancers, and lots of people survive cancer and you have hope that you’ll be one of them.
- Children cope best when: they are included; they know what is going on; there are no surprises—if it can be helped; they are kept up to date.
- The Plan: explain surgery, treatment (radiation and/or chemo). Will your appearance change? Will you get sick before you get better? Explain treatment as “medicine” to kill the cancer and make you well. Consider who will look after the children if that is necessary—develop a core group with whom you coordinate childcare. Prepare the children for any changes in routine. Try to keep structure and routine as much as possible. Give the children an idea of how long you’ll be in treatment, using a calendar if necessary—children are very visual. Assure the children that if anything changes, you’ll tell them.
- The “dying question”: your child may associate cancer with death and thus ask if you’re going to die. Do not avoid this question—answer as honestly as you can. For example: “Yes, some people do die from cancer, but my doctor is giving me medicine to make me better and we think I’m going to be ok.” If your child asks you if you’re scared or sad, again be honest. We are models for our children, and they will learn from watching you be honest about your emotions and it will make them feel more comfortable being open with you about how they’re feeling. Many children will not ask these questions as they are afraid of your reaction and/or are trying to protect you. If you perceive that they have something more to say or ask but they are quiet, gently encourage them to be open and honest with you.
- Make sure the children know they can ask questions later and at any time. Also make sure they know who they can talk to about this, be it the other parent, grandparents, aunts or uncles, or a close friend. Tell the children’s school—administration and teachers, if you’re comfortable. Ask them to watch for changes in behaviour or emotions and to keep you informed. Ask the school to provide support as necessary.
- Normal times: schedule family time when no one talks about cancer. A child may occasionally need a day off from school. This allows the child some quality time with the parent who is sick when they are perhaps having a better day. Remind your child that it’s good for everyone to have fun and laugh.
By Heather Shaddick MSW, RSW
Social Worker, London Regional Cancer Program
