How do I explain cancer to my children?

hug-girl-mumQ. I am the mother of two children, aged eight and ten. Six weeks ago, I was diagnosed with cancer and that I will need Home Care Assistance. So far I haven’t told my children and have just said to them that I have been a little sick to explain the trips to the doctor. But now I am due to begin chemotherapy, and with all that entails, I realise I should tell them more now. I am trying to be hopeful about the future and my husband is a great support and we are committed to fighting this together. I am wondering about what to tell the children. The older one is a real worrier and I don’t want to upset her, though I think she suspects something is up.

A. A cancer diagnosis is not just a traumatic event for an individual person, it also affects their whole family. Children in particular can be very worried by their parents’ illness and for this reason I think it is right that you are taking some time to think about how best to talk to them about what is happening.

You yourself must be dealing with the upheaval that the diagnosis has created in your life with all the upsetting feelings and worries this can bring. In coping with difficult events, children generally follow the lead of their parents – if you can be realistic and hopeful about what is happening, then you will help them be realistic and hopeful also.

For this reason, it is important that you take time to come to terms with how you are feeling so you can “regroup” and prepare to be there for your children. It is great that you have the support of your husband as this will be a valuable asset for you and your children in the future.

Given that you are starting treatment, this might be a good time to talk to your children. How you might do this depends a lot on your children’s needs. In the past, what has been the best way to give them important news? For some children this could be best as a formal sit down or at a family meeting, or for others it might be best when you are doing something else like going for a walk together.

Each of your children might have different needs in this regard, so though it might be ideal to tell them together so they have the support of each other, it might also be useful to first have individual conversations with them, so you can tailor the information to their needs and give them their own space to respond.

How much you tell them depends a lot on their age and their level of understanding. You want to be truthful but not to overwhelm them with too much information. The key is to find a way that is truthful but also is as hopeful as the facts allow. It can be helpful to rehearse in advance what you might say. For example, “My body has a sickness called cancer. The doctors will be giving me strong medicine to make me better, but it means that you will notice me being unwell at times.” You need also to prepare them for the possible side effects of the treatment (sickness, tiredness, loss of hair, and so on) so they are not surprised by this – a matter-of-fact description might be best.

Once you have told them, give them plenty of space to ask questions and listen carefully to their feelings. Remember that these may only emerge later, so make sure to check in regularly with them about how they are feeling about things. It can be particularly useful if both you and your husband have chats with them in case they are worried about burdening you as their mother with their feelings, especially their angry ones.

Be prepared for difficult questions – in particular, “Will Mummy die because of the cancer?” – and think how you might answer this, once again trying to be optimistic though realistic (depending on your medical prognosis), for example, “ The doctors think that is very unlikely and I should be well by the summer”, or if the prognosis is more severe, “We don’t know for sure, but the doctors say the medicines are very strong so we are all hoping for the best.” Your children may very well get upset by such questions, so be prepared to listen to and comfort them. Promise also to answer any future questions.

As you may have discovered, being optimistic without being in denial is the best stance to take in tackling a major illness and this is the attitude that might best help your children. It can also help to focus them on the positive beneficial things they can do – “Because Mum is sick everyone can help more around the house. We all have to work as a team to help Mum overcome this, so we can all support each other.”

There are some excellent resources and support services for families with a parent dealing with cancer. Ask the medical team treating you for recommendations and also make contact with organisations yourself.

The Irish Cancer Society runs a national helpline at 1800-200700 and website, cancer.ie, which has a helpful downloadable booklet called Talking to Children about Cancer containing lots of useful ideas including creative exercises to help them express their feelings.

There are also many other good sources of information such as kidscope.org, which has a 16-page comic book designed to help children understand their parent’s cancer.

Finally, though a cancer diagnosis is a trauma, it can be a catalyst for bringing a family closer together. Many people with cancer report how it was a life-changing event that made them re-evaluate their lives in a positive way, learning to prioritise what is important and particularly to value their relationships with their nearest and dearest.

Dr. John Sharry, Irish Times, April 2011. John writes in The Irish Times Health+ Family every Tuesday.

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