To Tell or Not to Tell

That really isn’t the question anymore. At first, some parents may not want to tell their young children that mom or dad has cancer, fearing they will worry more if they know the facts. Parents have a natural desire to protect their children from unpleasantness, but time and experience have taught us that keeping cancer a secret only makes things harder.

For one thing, cancer is nearly an impossible secret to keep. Children tend to eavesdrop on conversations and will likely hear something. With their limited life experience and their considerable imaginations, they may well misunderstand and leap to conclusions that are far worse than the reality. And this can result in unnecessary worry and fear.

It can be even worse if a child hears the news from someone else, such as a curious neighbor or classmate. This can destroy the natural trust that children have in their parents.

Instead, it is best for parents to share information about the diagnosis and to do it as early as possible.

Breaking the News Calmly

How your children react to your cancer diagnosis will in part depend on how you handle the situation. They will take their cue from your behavior. That’s why it’s good to wait until the initial wave of intense emotions has passed before talking to them. This is not to say that you should pretend there is nothing to worry about. You can admit that this is an upsetting time and that cancer can be very scary, but reassure them that it is not a hopeless illness.

Telling the Truth in a Way a Child Will Understand

Young children can't process a lot of detail, so avoid overwhelming them with too much information.

Generally speaking, children need the following basic information:

• The name of the cancer, such as "prostate cancer" or "lymphoma"
• The part of the body where the cancer is
• How the cancer will be treated

All of this can be said as simply as this:

Our bodies are made up of lots of different parts. When someone gets cancer, it means that something has gone wrong with one of these parts. That’s when doctors go to work to make that part of the body right again. That is called treatment.

OR

My doctor told me I am sick with cancer. The doctor is going to do what he/she can to make me better. I may have to go to the doctor a lot to get a special kind of medicine, so I might not be able to spend as much time with you. Sometimes the medicine might make me feel bad, so I might not feel like playing as much, but I want you to know how much I still love you.

Regardless of the words used, one of the most important things for parents to communicate is their desire to tell the truth. This does not mean that you should tell your children everything you know as soon as you know it. It simply means that children should be given truthful information when they need to have it in order to cope well. To that end, you may wish to also say something like: “I want you to ask me any questions you have and I'll do my best to answer them."

The Importance of Reassurance

Unfortunately, you probably cannot offer blanket reassurance that everything will be fine, because you may not know yourself. In spite of this, there are things you can do to help your children cope with your diagnosis:

• Reassure them that no matter what, they will always be cared for – they will be safe and secure.
• Assure them that, even if you will be in the hospital for a while, they will see you every day.
• Prepare them for the possibility that certain changes may need to be made in the family routine, but that life will go on as normally as possible.
• Confirm that no one in the family is happy that life seems turned upside down right now, but it will not last forever.
• Tell them over and over again that you love them and their needs will be met.
• Let them know that it is normal to feel angry and upset right now and that you want them to tell you how they are feeling.
• Tell them that there may be times when they feel like crying and that it is very normal and may make them feel better. You may even want to add that you like to have a good cry every once in a while.
• Reassure them that it is not their fault. They may not express it in words, but this is a common worry among children. Explain that cancer is no one’s fault and no one can cause someone else to get cancer. 
• Reassure them that it is not contagious. This, too, is a common concern among children. Explain that they do not have to worry that they will get it and that it is highly unlikely that the other parent would get it.
• Emphasize the positive steps that your doctors will be taking to treat your illness.
• Remind them that most people with cancer do not die from it. This is often a big worry for children, especially if another family member has died from cancer.

Fears of Death

Some children will ask outright if you are going to die. Before you decide how to answer this question, it may help to allow yourself to admit that it is a scary question – for you as well as for your family. It is a difficult question for a child to ask and he or she may never have the courage to ask it directly. The issue, however, does need to be addressed.

Whether a child does or does not ask if the parent will die from the cancer, there are a number of different ways to address the issue, depending upon your particular diagnosis. Here are some examples of what other parents have said:

• Sometimes people do die from cancer. I'm not expecting that to happen because the doctors have told me they have very good treatments these days, and my type of cancer usually does go away with treatment.
  
  
• The doctors have told me that my chances of being cured are very good. I'm going to believe that until I have reason to believe something else. I hope you can believe that, too. I'll tell you if I get new or different information.
  
  
• There is no way to know right now what's going to happen. I'll know more after the first treatments are finished. When I know more, I’ll be sure to tell you.
  
  
• There is not a lot known right now about the kind of cancer I have. But I’m going to give it my best shot and do everything I can to get well.
  
  
• My cancer is a hard one to treat but I'm going to do everything I can to get better. It's impossible to know right now what will happen down the road. What you can be sure of is that I'll be honest with you about what is going on. If you can't stop worrying, please tell me so I can make it better.
  
  
• I don't want you to worry about the future at this point. Let's think about what’s going on right now. If that should change, I promise you I will tell you. I will always try to tell you the truth. I want you to ask me any questions you have and I'll do my best to answer them.

There are many books available from the American Cancer Society that are specially geared to children with a loved one with cancer. Call 1-800-ACS-2345 to ask about titles, costs, or to place an order.

Click here to get more information on this subject from the American Cancer Society's online bookstore.