Parents often worry about what to do if their children don’t ask any questions, or if they can’t answer their children’s questions. Kids may not have any questions (right now), they may have many questions and they may need to ask the same questions again and again.

You do not have to have all the answers. You can tell your children that you don’t know the answer right now, but if you can, you will try to find out and get back to them.

1. What is cancer?
2. What causes cancer?
3. Why did my parent get cancer?
4. Is it serious?
5. How is cancer treated?
6. What are “side effects”?
7. Why is my parent crying?
8. Is my parent going to die?
9. If someone in our family has cancer, will I have cancer too?
10. Will my parent get better? When?

1. What is cancer?

The following are some of the basic concepts about cancer that would be helpful in describing this disease to children. Remember, it may take time for children to understand these concepts.

• Cancer is an illness
• Cancer is an unusual disease
• It’s not like a cold or the flu or like feeling bad for a few days
• There are many different types of cancer
• Some are more serious than others
• Some cancers grow very slowly, others grow fast
• Cancer is not something that you can catch from someone else like you can a cold or the flu
• You cannot cause cancer in someone else
• Cancer is a group of over 200 diseases in which cells that are not normal grow and divide quickly, in an uncontrolled way. The cell is the building block of all parts of the body. Cells are tiny – you need a microscope to see them
• The body usually controls the growth of cells into mature cells, but in cancer, the body’s control mechanism doesn’t work properly, and the cancer cells increase in number and can spread
• Cancer cells may group together to form a tumour
• Cancerous tumours are “malignant” and keep growing, crowding out normal cells. They can spread to other places in the body. There are also “benign” tumours that do not spread and are not cancer

2. What causes cancer? Where did it come from?

• Cancer is caused by changes inside the cell
• These changes cause the cell to grow too quickly and crowd out the healthy cells
• This may be caused by some chemicals, radiation, air pollution (smoke), certain viruses and other things inside and outside the body
• There is still a lot we don’t know about how cancer begins and what causes it
• Researchers are studying and working hard to find the answers

3. Why did my parent get cancer?

• In most cases, no one knows why it happens to anybody

4. Is it serious? Is there something that can be done?

• Many cancers can be treated so that the person gets well again
• Most cancers respond to treatment, and many, many people will survive
• Some cancers are cured quickly and easily by treatment, others are not
• Some cancers can be greatly slowed down
• Sometimes treatment does not work, and people do die
• Sometimes the first treatment does not work well enough, and the cancer comes back
• The doctors may then need to give stronger or different treatment

5. How is cancer treated? What are the different types of treatment?

• Cancer treatment is used to remove cancer cells or to stop them from growing and making new cancer cells
• There are many different types of treatment
• Each kind of cancer needs a different kind of treatment
• More than one kind of treatment may be used at the same time or at different times
• Doctors may use surgery, radiation therapy, chemotherapy, biotherapy, hormone therapy, and stem cell transplantation treatment

6. What are “side effects” of treatment?

• “Side effects” of cancer treatment happen because some healthy cells are damaged, usually temporarily
• Some side effects are visible – we can see them (hair loss, mouth sores, change in skin or weight, a scar or change in shape of the body)
• Some are invisible – we can’t tell just by looking at someone (feeling tired, feeling sick to their stomach, wanting to rest more, not being able to work or play normally)

These are some of the ways that you can explain side effects to your children:

• The powerful medicines in the body may upset the stomach and cause Mom or Dad to throw up
• Mom or Dad may be cranky and tired as their body fights the bad cancer cells
• The treatment may make them look different for a while, perhaps swelling up or losing weight, or going bald when they lose some or all their hair from the treatment. With help from doctors and nurses, and when treatment ends, the side effects usually go away. Hair does grow back!

7. Why is my parent crying?

• Understand that it is a normal and healthy response to adjusting to the diagnosis, and to the changes that serious illness can bring to family life
• You can explain that big people cry when they are sad or scared or hurting, just like children
• Your children will see that it is OK to feel and show difficult feelings

Offer reassurance:

• Young children: Tell your child that it is not their fault, you are sad because….
• Preteens: They may be a bit scared. Tell them that you and your health team are working hard
• Teens: Tell teens that it is normal to have unpleasant feelings and you will get extra support to help with feelings and concerns

8. Is my parent going to die?

• Children’s questions and concerns about dying may come up anytime after they hear the news about their parent’s cancer diagnosis
• All children, except very young ones, wonder if cancer means you are going to die, even if they don’t ask the question out loud
• If you change the subject, or answer them with silence, they will sense that it is not acceptable to talk with you about death
• They may be afraid to ask you about death and dying if you haven’t been able to talk about it

9. If someone in our family has cancer, will I have cancer too?

• No, not usually
• Inherited cancer is rare
• Making good health choices can make the chances of getting cancer smaller
• Eat healthy foods
• Protect yourself from too much sun
• Don’t start smoking
• Enjoy exercise and hobbies
• Take quiet times to relax
• Have fun! Laughter is healthy too!

10. Will my parent get better? When?

• It is usually the case that you can say you hope so
• The chance for cure depends on the type and extent of the cancer when it is diagnosed
• If one kind of treatment isn’t working, the doctors may try a stronger or different treatment
• There is always hope for new treatments
• It can seem like a long time before the parent feels better
• Everyone in the family needs to be patient