Talking to a child about cancer: gentle ideas for parents

You do not need to have every answer

Children notice changes in the family: conversations that stop when they enter the room, trips to hospital or worried adults. An honest explanation given in age-appropriate pieces can feel safer than a gap the child tries to fill alone.

The first discussion does not need to explain everything. It is the beginning of a conversation you will return to.

Before the discussion, write down:

• the name of the illness;
• where it is in the body, if you know and if that information is useful for the child;
• what the clinicians say will happen in the near future;
• what may change in the family's routine;
• what you do not know yet.

If several adults are involved, try to use the same basic information. You can ask a psychologist, doctor or nurse in the oncology team for help finding words that fit the child's situation.

Choose a time that allows questions. Start by asking: "What have you noticed?" or "What do you think is happening?" The answer shows you where to begin.

You might say:

"I have found out that I have an illness called cancer. It is in one part of my body. The clinicians are carrying out tests and will tell us which treatment is right. I will tell you what I learn and what changes for us."

Adapt the amount of detail to the child's age and questions. Avoid both highly technical language and explanations so vague that the child cannot understand what is happening.

Some messages are worth saying directly:

• the child did not cause the cancer through anything they did, said or thought;
• cancer cannot be caught through closeness, touch or a hug;
• responsible adults will take care of the child;
• questions can be asked later too;
• it is all right to feel frightened, angry or sad, or to want to play as usual.

If the child asks, "Are you going to die?", the answer depends on what you genuinely know and on the child's age.

You could answer: "That is an important question. I do not want to lie to you. The doctors are explaining the situation and what they can do. I will tell you the truth as we learn more, and you can ask me questions at any time."

If your medical team has given you clear information about the outlook, ask for help expressing it in words that fit the child. Do not say "everything will definitely be fine" simply to end the conversation.

As far as possible, tell the child in advance if:

• an adult will go to hospital more often;
• someone else will take them to school;
• the patient may be more tired;
• physical changes may occur that the medical team has said are possible.

Keep the routines that can remain: school, meals, a bedtime story or time with someone the child trusts. If a routine changes, explain who will be there and what will happen.

The child may ask questions immediately, several days later or through their behaviour. Listen without forcing the discussion. Check periodically what they have understood and gently correct misinformation.

Ask for specialist support if fear, withdrawal, sleep problems, difficulties at school or changes in behaviour persist or affect daily life. The medical team, GP or school can help the family find suitable support.