How to Tell Your Child They Have Cancer

No parent is ever prepared to learn that their child has cancer. Not only is it overwhelming to deal with your fear and confusion as a parent, but you also instinctively want to protect your child.

You may debate whether to tell your daughter about her leukemia diagnosis or wonder if your son will even understand what a brain tumor is. The conversation with your sick child can be terrifying and tricky. Below, we offer tips to help you prepare and ease the process.

Should I tell my child about their cancer?

Deciding whether to tell your child that they have cancer is challenging. After all, you may be concerned about burdening them. Many parents choose not to disclose and may delay the conversation. Ultimately, this is a personal parental decision.

Bear in mind that your child probably already senses that something is wrong. Their routine has been disrupted; they’re missing school, having frequent doctor visits, and likely not feeling well.

Kids are good at picking up cues. Children will use their imagination to fill in the knowledge gaps when kept in the dark. For example, your daughter may think she did something to cause her sickness. Or your son may blame himself for what’s going on. Often, what they imagine may be worse than reality and cause added stress and fear.

Letting your child learn about their cancer diagnosis from overhearing a conversation may break the parent-child trust. When you initiate the cancer conversation with them, they’re more likely to trust you. They feel more comfortable coming to you with questions.

How do I know what to tell my child about cancer?

Before having the cancer conversation, it’s important to think about how your child may understand the word cancer and what is happening. This depends on your kid’s age and capabilities. Keep the conversation age appropriate.

Use the quick guide below to help you determine what your child is likely to understand based on their age:

Toddlers to age 3

• Don’t understand what cancer is.
• Understand simple time concepts.
• Are afraid of medical procedures.
• May have stranger anxiety.
• May be worried that they will stay in the hospital forever.

What you can say and do:

• Use simple words to describe what’s happening.
• Tell your toddler about upcoming procedures, but not too far in advance.
• Be honest about procedures that may hurt.
• Schedule playtime.
• Use reassuring language.

Ages 3 to 7

• Understand the word cancer and simple facts about treatments.
• Believe that cancer happened because of something they did or thought.
• Are fearful of medical tests and pain.
• Have many questions.

What you can say and do:

• Use simple words to explain cancer and treatments, and use the term cancer in your explanation.
• Provide reassurance that they did not cause the cancer.
• Prepare your child for procedures that may hurt and use distraction if appropriate.
• Don’t give false information or make promises you cannot keep.
• Give clear, simple explanations for tests and procedures.
• Be prepared to answer lots of questions, be honest with your answers but use plain language.

Ages 7 to 12

• Understand cancer in greater detail.
• Understand why they need treatments.
• May hear about cancer from peers or social media.
• May be upset about not being able to go to school or see their classmates.
• May be sad about changes in their physical appearance.
• May ask more direct questions like “Am I going to die?”

What you can say and do:

• Explain cancer and treatments in terms they understand.
• Be attentive to their concerns and provide emotional and social support.
• Start conversations about what they’ve heard about cancer from others and social media.
• Remind them they can trust you and come to you with concerns.
• Provide reassurance about their appearance.
• Answer questions truthfully.
• Discuss a plan for schoolwork during treatment.
• Encourage video chats with their friends.
• Participate in counseling and mental health support.

Teenagers

• May want to learn more about their diagnosis.
• May want to be involved in making decisions about their treatment.
• Are concerned about their physical appearance and may feel isolated.
• May have strong emotional responses.
• May be resentful that cancer has taken their independence away.
• May have fears about their future and death.

What you can say and do:

• Initiate conversations about your teen’s feelings but don’t push.
• Be available to answer questions or help find the answers together.
• Provide your teen with trusted online sources where they can get answers.
• Allow them to be as independent as possible but remind them that you’re available.
• Offer reassurance and help your teen develop positive coping strategies.
• Encourage social media to stay connected with their friends but be mindful of misinformation.
• Observe and listen to verbal and non-verbal cues.
• Encourage your teen to talk to a social worker, counselor, or child life specialist.

Tips to ease the cancer conversation with your child

As you prepare to talk to your child about their cancer diagnosis, here are some helpful tips to make this difficult conversation a little easier:

• Take time to process your emotions as a parent. However, don’t wait too long to have that first talk.
• Decide who will tell your child. Some parents choose to have the oncologist share the news, and they fill in the blanks later. Others want to be in charge of the initial conversation.
• Practice what you’re going to say. You may even try writing down the facts that you want to share. This will help you stay calm and anticipate how you might respond. But remember that it’s perfectly okay to express your emotions and encourage your child to do the same.
• Research child-friendly explanations of medical terms and use visuals, if appropriate, to help explain what’s happening in the body.
• Choose a safe space and have good timing. Schedule to talk to your child in an area familiar to them and that’s free of distractions. Plan so that you have enough time to address your kid’s questions and be present with them for as long as they need.
• Be open, and honest, and provide reassurance. Use age-appropriate words and tools. If you don’t have all the answers – and often you won’t, your cancer care team can help. Assure your child that they can come to you with questions, concerns, or fears. Remind your child that you love them and will be there with them.
• Give your child time to process the information. Children react differently to new information. Watch for cues. For example, they likely have enough information if they change the topic. You can always pick up the conversation again later.
• Encourage your child to ask questions, but don’t push. You may tell them how sad you are that they are sick and allow them the opportunity to express their feelings.
• It’s not a one-and-done conversation. You can always share more information with your child over time.
• Talk to your child about what’s next. Explain any upcoming treatment, test, and hospital stay and what they can expect.
• Seek support. Ask your cancer care team for sources of support. Enlist the help of a counselor, social worker, psychologist, or child life specialist, and participate in a support group.

There is no easy way to cope when your child has cancer. The decision to tell your child about their diagnosis is challenging, and you may want to shield them from the truth. As your child goes through cancer treatment, they will need a trusted individual to turn to, and as a parent, you want that person to be you. This starts by establishing a trusting relationship with your child with an honest and open conversation about their disease. Remember to talk to your child’s siblings too.