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Professional Advice on how to Discuss Cancer with Kids

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Kimberly Schlichting (left) and daughter  Jessica Hom pause for a photo. Kimberly was  undergoing chemo treatment at the time. Photo by Jessica Hom

Q: I’ve just been diagnosed with breast cancer. How do I tell my children about my illness?
LS: First, give yourself enough time to adjust to the emotions of your diagnosis. That way, you can be a model of coping for your kids. It is normal and OK to be sad, but you don’t want to completely fall apart in front of your child. If you have a little bit of time to digest the information with a partner or a friend, it can help you feel more prepared to share the information with your child or children. You can also think about and practice what you want to say beforehand to help you feel prepared. The practice may help you work through some of the difficult emotions you may experience in sharing the news with your children.  

Then, once you have had a chance to digest, we recommend you try to tell your children fairly early about the breast cancer. Kids are very smart and pretty intuitive. They’ll sense that something is wrong and, if it’s not talked about, that could make them more anxious. Talking with your kids will help them know what’s going on and make sure they aren’t kept in the dark about it. 

Another thing we recommend is to keep the conversation and language age appropriate. There is often a question of whether or not people should use the word cancer. We favor that you do use the word cancer. For one thing, you get to have the control over how they come to understand what the word cancer means specific to you. This is helpful because there are so many different types of cancer and prognoses. Secondly, hearing it directly from you will reduce anxiety. Anxiety could increase if they instead overhear it being used in reference to Mommy and only having a frightening reference to understand it—for example, a schoolmate’s grandmother died of cancer. With the latter they may assume that Mom is dying, too. Hearing everything from you first allows you to be honest, but also conveys hope about your situation.

 

Q: I have two kids, ages 15 and 8. Do I discuss my illness differently with my teenager than my younger child?
LS: We have a toolkit on our website to help give more specific guidance in this area. Visit: christianacare.org/familytoolkit to find the toolkit. Again, it’s important to use developmentally appropriate language. By the age of 8, a child will understand concrete, factual language because they are really literal. You should avoid euphemisms and not dance around the truth. An 8-year-old might benefit from relating breast cancer to a similar experience, like someone else who was facing a sickness and then got better. They might do better if you explain body parts and functions and explaining the breast area or explaining that Mommy is tired. You can have a more in-depth conversation with an older child, like a teenager who may have more philosophical questions.  

Answer their questions the best you can. Let your child or children of any age know that they can come to you at any time
with questions.

Children of different ages and developmental stages may also need different approaches depending on the prognosis. Speaking with a professional may help guide you in this process, especially for a more advanced diagnosis or poor prognosis. 

 

Q: I worry that my cancer will impact my kids’ ability to do well in school. Should I tell their teachers that I am undergoing treatment?
LS: Telling your children’s teachers or school can be helpful, but you have a personal choice in terms of privacy. You may feel comfortable sharing your diagnosis, or you may choose to keep it private. Either way you can make the school aware that something is going on in your child’s life. If you prefer more privacy, you can be vague and tell the school that you wanted to make them aware that there’s a family matter or a stressor that may impact your child. The extra set of eyes and ears provide more information on how your child is adjusting. The teacher/school should know in case your child’s performance or behavior is affected, but how much private information you share is up to you.

 

Q: My doctor has prescribed chemotherapy. I’m concerned about side effects, such as losing my hair. Any advice for preparing my children on what to expect? 
LS: The key piece of advice is definitely having a conversation with your kids about what to expect before it happens. It’ll make it less scary for them if they are prepared and understand that it is a part of the treatment that the parent is receiving. That way, when Mommy’s hair is falling out or she seems tired all of the sudden, your child understands it’s a side effect of the treatment and not the disease getting worse. You can explain that medicines have side effects like sometimes cough syrups taste yucky, but it helps rid you of your cough. Sometimes kids get worried that they’ll catch cancer or their hair will fall out. Be reassuring that this is not something that is contagious and it’s just something that Mommy’s going through right now.  

 

Q: What can I do to help my kids through this difficult time?
LS: It would depend on the age. Something that might be helpful is preparing them for what may change versus what may stay the same, especially during treatment period. Even if Mommy is not quite feeling the same, make sure your kids know that Mommy still loves them a whole lot. There are lots of creative ways to stay connected, even if you’re not feeling great. For example, if you are tired and can’t run around with the kids, make time to do quiet activities. Also, it’s great to allow your child to help in an age appropriate way—but balance that with reminding the kid that they still should be having fun. Be open to their questions and have conversations about the illness and the treatment throughout the process. 

 

Q: Is there anything you would like to add?
LS: I’d encourage people to visit the toolkit on our website to learn more: christianacare.org/familytoolkit. They can find what to expect in terms of different ages, books, and other resources. Also, support services are available through Christiana Care Health System’s Helen F. Graham Cancer Center & Research Institute. To find out more, call 623-4500.