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Overview
When someone is diagnosed with cancer, it can be challenging for parents and adults to discuss this with children. However, having a straightforward and open discussion can help children cope.
Children may understand and react to a cancer diagnosis in different ways. This can depend on their age, personality and family experiences.
Find out more about why communication is helpful and what to expect from kids of different ages.
What’s on this page
Talking with kids about cancer can feel overwhelming. Your first reaction may be to keep the news of the diagnosis from children or to delay telling them. Or you may feel an urgent need to tell them straightaway. Research shows that being honest and willing to talk helps children cope with the cancer diagnosis of someone close to them.
This information focuses on when a parent has cancer, but much of it will be useful for anyone who needs to explain a cancer diagnosis to children or teenagers. Mostly, the information is addressed to “you” as a parent with cancer, but it can be read by any adults supporting young people who have a family member with cancer. We have used the terms “kids” and “children” interchangeably, and the term “teenagers” rather than “adolescents”.
Why talk to kids about cancer?
When someone is diagnosed with cancer, adults are sometimes hesitant to discuss the situation with children. Parents and other adults can feel overwhelmed by their own anxiety and fear, and their first reaction may be to protect children from those same uncomfortable emotions.
However, there are many reasons why a straightforward and open discussion can help children. Children who are told about the illness of someone important to them tend to cope better than children who are left to find out through other ways.
You are the expert
As parents and carers, you are the experts on your children and what works for them. To help you discuss the subject of cancer with children, this book outlines evidence-based, practical strategies that can build upon your existing strengths and knowledge. Sometimes it may take a few attempts before you find an approach that suits your family. Use your understanding of your children’s individual personalities and needs to guide you.
Secrecy can make things worse
Children are observant. No matter how hard you try to hide a cancer diagnosis, many children will suspect something is wrong. They may notice changes at home, such as your sadness, whispered conversations and voices behind closed doors. They may also see that their family member looks different or cannot do certain things. These signs may be more obvious to older children and teenagers, but even young children can pick up on change and will work out that a secret exists.
Not knowing the reason for the secret may leave them feeling powerless or left out of family matters. They may also feel that they have done something that has caused this change in the family, or imagine that the situation is worse than it actually is.
How children hear about a diagnosis is important
Ideally, children should hear about a cancer diagnosis from their parents, guardian or a trusted family friend, particularly if it is their own parent or a close relative or friend who has cancer.
If you tell friends and relatives about cancer in the family, but don’t tell your children, there is a chance your kids will learn about the cancer from someone else or overhear a conversation. Children often listen to adult conversations even when it seems like they are not paying attention.
They can feel hurt if they discover they have not been told something that affects their family. They may think they are not important enough to be included in family discussions or that the topic is too terrible for you to talk about. Sharing information shows you trust and value them, which can ease their concerns.
Children may make up their own explanation to fill in the gaps in their understanding. They may feel afraid to ask questions and worry in silence. Teenagers, and even younger children, may pick up on a few key words and search the internet for answers, which can lead them to unreliable information.
Kids can cope
When a family is affected by cancer, it can be an unsettling time for kids. You may wonder how they will get through it, but with good support and age-appropriate information, most children can cope with this difficult situation.
Kids have surprising abilities to respond to life’s challenges. They learn about emotions and how to express them by watching others – especially their parents. Parents can role model how to recognise, talk about and manage a range of emotions. For example, you might say: “I’m feeling sad that Grandma is sick and I think I need to go for a walk.”
We can’t stop kids from feeling sad or worried, but if we share our feelings and give them information about what’s happening, we can support them as they experience a range of emotions.
Children need a chance to talk
Talking to your children about cancer gives them the chance to ask questions. Encourage your kids to share their thoughts and feelings, but don’t be surprised if they don’t want to talk when you do. Younger children may like to draw a picture, while older children may find it helpful to keep a journal to write down questions or thoughts as they come up.
Sometimes, kids, particularly teenagers, may feel guilty about burdening a sick parent with their worries or taking up a carer’s time. Reassure them that their concerns are not a burden. They may also like to speak to a trusted adult who is not their parent (e.g. a grandparent, aunt or uncle) or perhaps another trusted person in their lives, such as a school teacher, counsellor or coach.
Sooner or later, they were going to find out. Why not tell them straightaway? I tell them frankly what is happening. I think they find it much easier to cope because they are ready for things.
How children understand cancer
Children’s understanding of illness and their reactions to news of a cancer diagnosis will vary depending on their age, personality and family experiences. You may find that siblings, even of similar ages, respond differently. As children grow up, their understanding of the world will also develop. As they mature, they may become ready for more in-depth conversations.
Newborns, infants and toddlers 0–3 years
Newborns, infants and toddlers 0–3 years
Very small children have little understanding of illness but may pick up on their parents’ anxiety and other feelings. They are aware of periods of separation from their parents and can get upset when a parent is not there. They may become clingy or unsettled, especially if they need to be weaned from breastfeeding suddenly.
Toddlers may react to physical changes in their parent or relative (such as hair loss) or noticeable side effects (such as vomiting). They may react with more frequent thumb sucking, bedwetting or baby talk.
You can help them cope by:
- maintaining usual routines as much as possible
- giving them plenty of physical comfort
- playing age-appropriate relaxation podcasts or calming music.
Preschoolers 3–5 years
Preschoolers 3–5 years
By the age of 3, children have a basic understanding of illness. Younger children may believe that they caused the illness (e.g. by being naughty or thinking bad thoughts). They may also think they can catch cancer. It is natural for young children to think everything is related to them: Did I cause it? Can I catch it? Who will look after me? They may also express their concerns or feelings through imaginative play.
Young children might become aggressive, or return to behaviour that is developmentally younger than their age, such as thumb sucking, bedwetting or baby talk. They may seek comfort by using security blankets or a special toy, or they might have trouble falling asleep or being separated from their parents. These behaviours are how some kids will communicate their worries and fears if they don’t have the words.
You can help them cope by:
- explaining what they can expect and how schedules may change
- arranging daily opportunities for kids to use up excess energy, anxiety or aggression through sports, the park or using playdough
- using picture books, puppets, dolls or toy medical kits to talk about cancer and provide short explanations about what is happening
- reassuring them that their behaviour or thoughts have not caused the illness, and that they will always be taken care of.
Primary school children 5–12 years
Primary school children 5–12 years
In the early primary school years, children have a basic understanding of sickness, and by later primary years, they are usually ready for more details about cancer. They may use simple cause-and-effect logic to fill gaps in their knowledge. For example, they sometimes feel that their bad behaviour might have caused the disease. They may understand that people, including parents, can die.
Primary school children may feel a range of emotions such as irritability, guilt, envy or sadness. They may lose interest in school and refuse to go, become distant or quiet, or feel separation anxiety at the thought of leaving a parent. They may return to behaviour that is developmentally younger than their age (such as bedwetting or thumb sucking), and be extra concerned about the health of others.
You can help them cope by:
- informing their school about the diagnosis
- regularly asking the child how they feel
- talking about cancer and treatment using age-appropriate material such as books, apps and videos
- discussing dying if kids bring up the issue
- keeping children connected to friends and community through maintaining regular routines and after-school activities
- using sport, art or music to help them express their feelings
- updating them about progress and treatment
- giving them age-appropriate tasks to do around the house.
Teenagers 12–18 years
Teenagers 12–18 years
During the teen years, young people start to think more like adults. They are able to understand complex cause-and-effect relationships, such as illness and symptoms. With increasing maturity, teenagers understand that people get sick, but they may avoid talking about difficult issues and are more likely to deny feeling scared or worried.
Teenagers may also worry about being different and not fitting in. They may not want to tell anyone at school because they want to stay “normal”. There are a range of responses your teenager might have, and these may change over time – from hiding their feelings and withdrawal, to “lashing out” in anger and rebellion. Some may want to help more around the house; others may take risks (e.g. with drugs and alcohol), or stay out late. As teenagers, they are still working out how to respond to strong emotions and big changes.
You can help them cope by:
- encouraging them to talk about their feelings with you or other people they trust (e.g. school counsellors)
- reassuring them with words and acts of kindness to let them know you love them
- chatting about things other than cancer, like school, sport and friends
- providing privacy as needed.
Cancer in different cultures
There are a wide range of beliefs and ideas about cancer. People may believe that cancer is caused by bad luck, that it is contagious or always fatal. Others may believe that the cancer has been sent to test them. It is important to respect different ways of coping with a cancer diagnosis.
You may be reading this section because you work with children who have been affected by a cancer diagnosis. Before talking to someone else’s child about cancer, it’s essential that you understand and respect the wishes of the parents.
If a family wants to keep a diagnosis private, organisations such as Cancer Connect on 13 11 20 or Cancer Hub may be able to suggest ways for children and other family members to discuss their feelings and concerns in a confidential setting.
When you can’t talk about cancer
Some parents don’t want to tell their children about the diagnosis at all and try to keep it secret. People have their own reasons for not sharing the diagnosis with their children, including cultural beliefs or a previous death of a relative from cancer. Sometimes you may want to wait to find out more about the diagnosis before telling your kids.
If you want to share the diagnosis with your children but your fear of saying or doing the wrong thing is keeping you from having this difficult conversation, it may be helpful to talk with a psychologist or social worker about how to approach the conversation.
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