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‘Daddy has cancer’

Telling children that a parent or loved one has cancer can be tough. Counsellor Jaime Yeo from Parkway Cancer Centre gives some tips on how to go about it.

Be open and honest

While it is natural to want to protect your children from the difficult news of cancer, being open and honest with them is usually the best approach. However, it is important to consider their age and personality before deciding when, what and how to tell them. As children may hear about cancer through their friends, mass and social media, it is important to find out how much they already know, so that you can correct any misconception or inaccurate information they may have. Being candid yourself, can also encourage children to express their feelings and concerns, which gives you a chance to address them as soon as possible. Children are observant and can suspect when something is wrong, from any sudden changes in their home or family routine. So it is better to be honest with them, rather than leave them guessing, which could make them feel more distressed.

Take your time

You don’t always need to explain everything to your children in one sitting; indeed, it may be more than they are able to handle. Depending on their reactions and level of understanding, you may want to talk to them about the cancer over a few conversations. This will give them time to take in the difficult news, process the information, ask questions, and share their feelings. You may even want to consider having separate discussions if the children are far apart in age or have very different personalities. It also helps to choose the right time and a comfortable place for your discussions.

Use simple language

Always use simple language and avoid medical jargon. For younger children, you may need to repeat certain information to ensure that they have understood you correctly. Generally, the younger the child, the simpler the language you should use. For example, you can tell an older child that “chemotherapy” is needed, but with a younger child, use the term “medicine”. Naturally, older and teenage children will be able to grasp more complex and detailed explanations about the cancer and treatment involved. For younger children, consider using visual tools such as story books, toys or illustrations to explain cancer as well as to encourage them to express their feelings. For example, if a child is familiar with video games, you could liken cancer to the “bad guys” and chemotherapy as the “weapon” to kill the “bad guys”, and explain how sometimes the “good guys” can get injured in the process, producing side effects. Or, you could encourage children to express their feelings through music, art, play or journaling. Whatever you do, don’t lie to children or make promises that you cannot keep. If there is a lack of certain information, assure them that you will tell them the truth as you get more details. Also, don’t be afraid to use words like “death” or “dying” for advanced end-of-life situations. Avoid words like “sleep” and “resting”, because children need to know the permanency of death.

Be mindful of their needs

Children’s needs may differ depending on their age, personality and maturity level. Generally, younger children will need more reassurance that their needs will be taken care of – to help them feel secure, safe and loved. So try to establish a routine as much as possible, and communicate changes to them in a reassuring way. Children may ask questions such as: Will the cancer spread? Did their bad behaviours cause it? Will their parent die? What will their friends think? What should they tell their friends? Where possible, address the concerns that they have as soon as you can. Older children may worry more about their parent’s well-being. So keep them informed as much as possible, and reassure them that both you and they will continue to be cared for. Give them opportunities to talk and to express their feelings. As older children and teenagers will interact more with their friends and others, encourage them to talk to their friends about how they feel about their parent’s or loved one’s condition.

Telling kids about cancer

When to tell them

• Make sure that you are emotionally ready to talk about it yourself, and think sufficiently through what and how you plan to tell your children about cancer.
• Choose a time when there’s no or as little interruptions as possible, such as when the children are attentive and not distracted (e.g. not before a test) or tired (e.g. near bedtime). It may also help to do this in a comfortable place.

  What to tell them

• Provide them with some basic information about your cancer, the treatment you will require and possible side effects that you may experience.
• Find out what they know or think about cancer. For example, some children may think cancer means their parents are going to die. Explain the situation, but don’t give false promises. You could say “Not everyone with this type of cancer will die, the doctor will do the best for me.”
• Assure your children of your love through physical (e.g. hugs and kisses) and verbal expressions.
• Let them know if routines will change and that they will be taken care of, and by whom. You could say “The medicine makes mum tired so she will need to rest more today and can’t send you to school. Auntie Julie will send and pick you up from school instead.”
• Explain to them that their behaviours did not cause the cancer and that the cancer cannot spread to others and to them (e.g. through hugs).
• Admit when you are uncertain about things, but assure them you will inform them when you know.

  How to tell them

• Prepare for questions that they may ask, and think about how you can explain cancer to them openly and accurately. You may want to consider practising how to say it with a partner, friend or relative.
• You do not have to tell your children in a formal conversation; you could do it during an activity, such as while taking a walk. But don’t feel that you have to explain or talk about everything at one go; you can do this over a series of conversations.