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Children & Teens

 

How should we tell them about the diagnosis and treatment?

During and after treatment, children will likely be less anxious and feel more secure when they are included and told the truth. Your children will benefit from being told the news as soon as possible, as they may sense when something is wrong. Have the conversation as soon as you are able to and when you can be clear about what you want to share. Remember that it doesn’t have to be one big conversation. You can support and reassure your children that the initial conversation is the first of many. They do need to hear the truth in language they can understand.

Who should tell them?


Parents are the first line of support for their children. Both parents need to be involved in deciding how and what to tell their children. If either or both parents are unable to agree on what to say, it may be helpful to talk this over with a counsellor. If you feel unable to talk to your children, it is best to select someone who can, and to be present during that conversation. You may find it helpful to write down what you wish to say. If the parent with cancer is not able to be present, the other parent or close family member may take the lead. A family meeting can be one of the best ways to share the news.


How important is it for parents to be open and honest?

While you may want to avoid your children’s sadness, anger, or questions about death, children need the opportunity to ask questions and express fears. This is a time to role model that sometimes things happen that make you feel sad, or scared or mad. Talk with your children and answer their questions truthfully. If you are open, your children will realize they can count on you to be honest with them. They will have a better chance of handling whatever happens in the family and in their lives. It is inevitable that they will overhear something. It takes a lot of valuable energy to keep a secret.


Won’t they worry if we tell them the truth?

Worry is something we all do, including children. As a parent, you cannot protect your children from worry, but you can help to ease their anxieties by giving them accurate information and talking with them about their fears and worries. When they are excluded or told very little, children will sense that something is wrong and become anxious, but they will feel discouraged from asking about their parents’ health or seeking assurance.


Without the truth, your children are likely to imagine something far worse. Remember to give your children time to adjust. Provide more opportunities for them to come back and ask questions or share their feelings.


What do we say about the diagnosis?

Children need to understand basic information about their parent’s diagnosis, and basic facts about cancer. Remember, information needs to match your children’s level of understanding. To ensure this is happening, ask your children what they heard you tell them (or how they might explain it to someone else like a friend or an aunt).


How do we reassure them?

Children are reassured when you let them know that:

  • you will continue to talk with them and answer their questions 
  • you will let them know what will change and what will be the same 
  • you want them to be involved - talk with them about how they can help 
  • they will be looked after no matter what 
  • you will get though this together as a family 
  • everyone in the family needs to adjust to the news 
  • you want them to continue their activities and will help them do this 
  • it is important for them to play and see their friends

 

Tips for talking with your children about a cancer diagnosis

Use simple language, give a brief statement of what has occurred.


Tell your children:

  • the name of the illness
  • what part of the body is affected
  • how it was discovered
  • what will be done to treat your illness

Calling your illness a” boo-boo” may confuse children about common illnesses being as serious as cancer. Ask your children what they know about cancer, and what they want to know.


3 Steps...

  1. Cancer is no one’s fault. Your children have not caused your cancer. Nothing that they have said, done, or thought can cause your cancer.
  2. Your child cannot ‘catch’ your cancer. Cancer is not like a cold or flu.
  3. It is not always clear why cancer develops. Children often need to hear the information again, or may ask the same questions. Remind your children that they can always ask questions if they don’t understand what is happening. Encourage your children’s questions, and reassure them there are no dumb questions. Accept their unwillingness to talk. Children will talk when they are ready.
 

During this time, your teen may need more support. Keep these tips in mind:

  • Maintain consistency as much as possible. Try to keep the same routine and rules in place during this time, though this may be difficult. Most teens thrive within a structured environment and don’t like to be different from their friends.
  • Communicate openly and honestly. Teens are very smart and sensitive, and feel respected when they are informed about what is going on. Encourage them to ask questions and keep cancer and any changes in your family as an open and ongoing topic of conversation.
  • Don’t let them take on too much. Make sure that your teen does not assume an adult role during this time, but still has time for age-appropriate activities. 
  • Respect their privacy. Teens may have very different ways of processing what is happening, and may want to do this alone.
  • Encourage them to journal, create art or music, and take as much quiet time as they need.
  • Encourage teens in their independent life. Ensure that they maintain a healthy social life and involvement in sports and other activities of interest.
  • Model behaviors that you would like your teen to have. Practice dealing with your emotions in safe ways, and eating healthy meals.
  • Make memories and laugh about the little things! It is important to have fun during this season as well. Make light out of humorous situations that might happen during this time, and try to make time to celebrate little occasions together.
  • Encourage teens to find support outside of the home. Make sure your teen has at least one good listening ear--be it a good friend, school counselor, or other adult who can be a confidante.
 
Questions children and teens may ask

What if...?

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. They 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.


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, flu or like feeling bad for a few days.
  • There are many different types of cancer.
  • Some cancers 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.

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.
  • Why did my parent get cancer?
  • In most cases, no one knows why it happens to anybody.

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

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

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
  • 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!

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

Who else should we tell about the diagnosis?

It your decision who you want to share information with. Telling others can be a longer process that allows you time to absorb the news as a family and make decisions about what information you want to share outside the family. Open communication can be one of the most important activities that support your family’s coping. It decreases the chance of confusion for those that support you. Friends and family can then offer support and understanding, and you can ask for their help.


Keep people informed on a regular basis, or select a spokesperson for this task. Inform your children’s school and after-school communities so that their teachers, guidance counsellor, or school principal can provide support and communicate concerns to you.


Other points to consider

Try to keep your family life as normal as possible. All children benefit from having a sense of stability and routine. Outside help is often necessary. You can help to meet your children’s everyday physical and emotional needs by enlisting people who can help with meals, laundry, carpooling, homework, sleepovers, play times, outings, and attending your children’s special events when needed.


In addition to family and friends, consider asking your health care team or other organizations (service, social services, and home health agencies) and communities (neighbourhood, school, religious) for support.


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  Learn more

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)
  • Learn more

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!

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
 

Handouts:

Information to help parents and caregivers when discussing a cancer diagnosis and treatment go to our Resources page


Online for children & teens:

BCCA information & services:

Some information here has been adapted from our publication, Reaching Out to Your Children: When Cancer Comes to Your Family: A guide for parents. Slakov, J. (2007) Vancouver, BC Cancer Agency. It can be ordered from the C & W Bookstore - go to the finding resources section.

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