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Being diagnosed with a serious illness like cancer can be overwhelming in itself. But parents in this situation face the added challenge of talking about it with their children. The following guidelines can make this difficult process more manageable.
Don’t keep secrets
Adults may think they are protecting their children by not discussing a serious illness. But keeping secrets is the wrong approach, experts say. “Children have a right to know what’s going on—they are part of the family,” says Martha Aschenbrenner, manager of the KNIT (Kids Need Information Too) program at the Children’s Cancer Hospital at M. D. Anderson.
Kids usually know when people are keeping something from them. This breeds distrust and teaches them that it’s okay to not talk about problems. Moreover, they’ll be deeply hurt—and you’ll be stuck playing catch-up—when the truth finally comes out. Instead, Ms. Aschenbrenner suggests talking openly to your children in an age-appropriate way. No one knows them better than you, so rely on your judgment. The important thing is to be hopeful and honest about the situation.
Take a few days to work through your own emotions, educate yourself about your illness, and think about what you want to say to your children. Starting the conversation is the hardest part, says Ms. Aschenbrenner, a cancer survivor who was diagnosed when her son was 4 years old.
Tots, tweens, and teens need different information
When dealing with a younger child, up to about 5 or 6 years old, it’s not wise to simply explain that you are “sick.” Then the child might start to think that even getting the sniffles will mean a trip to the hospital.
Instead, tell the younger child that you have to go to the doctor, and identify the illness by name. Doing this won’t cause fear—to kids at these ages, a word like “cancer” is just a word. Unless you have a communicable disease, they also need to know that they can’t catch it.
Talking with younger children about the possibility of dying can be difficult, and parents should allow children to ask questions as they come up. Even without the parent’s illness, children will eventually experience someone’s death, so it is useful to help even young children understand what “dying” means. Separate this from the illness talk; explain that when something dies, the body stops working. Faith and religious beliefs can be discussed at this point.
“And later, if the parent’s death is imminent, you can refer back to that earlier conversation about what it means to die,” Ms. Aschenbrenner says.
Older children probably have heard broadly about illnesses like “cancer” or “heart disease.” So it’s important to explain your specific type of disease and prognosis. You don’t want a child thinking you are going to die if your chances for recovery are excellent.
It is, however, normal for children between the ages of about 7 and 11 years to ask whether a parent with a serious illness will die. Do not promise that won’t happen. Rather, Ms. Aschenbrenner suggests answering like this: “I hope not. I’m in the best hospital, and the doctors are working hard to get me better. If anything changes, I’ll tell you.” Then, when something does change, follow through.
Teenagers are likely to have many more questions. Again, answer these openly and honestly until their need for information is satisfied. Be forthcoming with older children should the disease worsen, and explain how that changes your prognosis.
But don’t be alarmed if teens don’t seem to have much to say. “Teenagers don’t talk to their parents,” Ms. Aschenbrenner says. “That’s normal developmental behavior. The important thing is to make sure they’re talking to someone.”
Manage the situation for your child’s sake
Children of all ages need assurances that no matter what happens, they will be cared for. Explain who will pick them up from school, for example, should you have to go to the doctor. Such conversations help kids relax and maintain their routines.
-- John LeBas
For more information on this topic or for questions about M. D. Anderson’s treatments, programs, or services, call askMDAnderson at (877) MDA-6789.
Other articles in OncoLog, July/August 2007 issue:
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Parents: Be Hopeful and Honest When Telling Kids about Your Serious Illness 
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