Written by Michelle Mattero, MA, Clinical Associate & Child and Adolescent Program Coordinator
For many parents, the initial reaction to a cancer diagnosis is about their children. While a diagnosis and treatment plan may be overwhelming enough, parents have the added stress of continuing to raise children, manage a household and deal with their own reactions to their diagnosis all at the same time. This blog post addresses some of the most common, and challenging, questions and concerns individuals are faced with when parenting during cancer. These principles will help guide you as you discuss your cancer and treatment with your children.
Why, When and What Should I Tell Them?
Oftentimes parents believe they are protecting their children by not sharing, or sharing limited information, about their cancer diagnosis. While this is certainly with good intent, children are far more aware of what is going on around them than we sometimes give them credit for. Furthermore, withholding information may lend children to make up stories to explain a situation they don’t understand. Not only can these explanations they create be incorrect, they are often worse than the reality of the situation. Therefore, I always suggest that parents lead with openness and honesty when it comes to discussing their diagnosis with their children.
Even before you have a treatment plan, it can be helpful to be begin these conversations early about your cancer. Children typically respond better to challenging situations when they have some information ahead time. Talking to your children early on also allows for them to ask questions. It’s okay to not have all of the answers, your children will just appreciate your honesty.
Children are often most concerned with how this diagnosis will affect them. Discussing things like changes in your health and physical appearance, disruptions to usual family routines and who will care for them can ease a child’s worry and concern. They may also be concerned about catching your cancer, feeling responsible for causing it or what happens if the cancer doesn’t get better. These are all important concerns to address and talk through with your child. See the book recommendations below for specific language and tools that may be helpful to use. Older children and teenagers will likely require more detail in their explanations. They may understand more complex explanations, have very specific questions or concerns regarding your treatment and turn to others outside of the family for support.
How Might My Children React and How Can I Respond/Support Them?
It can be difficult to know just how your child may react to your cancer diagnosis and treatment plan. Below details possible reactions your children may have and ways you can respond based on their age and development.
- Fussy and cranky, crying or colic
- Change in sleeping or eating habits
- Signs of regression such as thumb sucking, bedwetting, baby talk, etc.
- Maintain baby’s schedule
- Ask family members and friends to help with household tasks and care
- Give plenty of physical contact
- Observe play for clues to their adjustment
- Provide daily contact to help them feel secure
- Express your feelings and fears with others
- Thumb sucking
- Fear of the dark, monsters, animals, darkness, strangers, etc.
- Nightmares, sleepwalking, sleep talking
- Stuttering or baby talk
- Fear of separation (especially at bedtime)
- Aggression (e.g., hitting, biting)
- Talk about the illness with pictures, dolls, stuffed animals, or books
- Explain what they can expect; how things may change regarding routines, activities, and schedules
- Reassure them that they will be taken care of
- Provide brief and simple explanations. Repeat explanations when necessary
- Assure them that they have not caused your cancer by their behavior or thoughts
- Continue usual discipline and limit setting
- Provide outlets for aggression that are positive
- Assure them they cannot catch your cancer
- Sad, crying
- Anxiety, guilt, jealousy
- Physical complaints: headaches, stomachaches
- Separation anxiety
- Hostile reactions toward sick parent
- Poor concentration, daydreaming, lack of attention
- Difficulty adapting to change
- Sensitivity to shame and embarrassment
- Use books to explain illness, treatment, and potential outcome
- Assure them that they did not cause your cancer by their behaviors or thoughts
- Reassure them about their care and schedule
- Let them know how they can help (and set them up for success)
- Take time to listen and let them know you care about their feelings
- Address concerns of parent dying
- Want to be more independent and treated like adults
- Anger and rebellion
- May criticize how parents handle illness situation
- Depression, anxiety may worsen
- Worry about being different from peers
- Poor judgment
- Physical symptoms
- More likely to turn feelings inward and seek support outside of the family
- Encourage them to talk about their feelings, but realize they may find it easier to confide in friends, teachers, or other trusted people
- Provide plenty of physical and verbal expressions of love
- Talk about role changes in family
- Provide privacy as needed
- Encourage them to maintain activities and relationships
- If problems are noted, provide opportunities for counseling
- Set appropriate limits
- Don’t rely on them to take on too many added responsibilities
- Provide resources for learning more about your cancer and getting support
Think about your own reactions to your diagnosis, treatment and cancer journey. Take time to discuss your concerns, worries or fears with a trusted friend, partner or mental health professional. A cancer journey can often feel like an emotional roller coaster and having time to reflect and process your diagnosis and treatment will help you feel more equipped to support your children and have discussions about your cancer.
Resources and References
Can I Still Kiss You? Answering Your Children’s Questions About Cancer, Russell, Neil, 2001
How to Help Children through a Parents Serious Illness, McCue, Kathleen, 2011
When a Parent Has Cancer: A Guide to Caring for Your Children, Harpham, Wendy Schlesse, 2004