Dealing with a cancer diagnosis can be challenging enough without the added worry of how you’ll tell your kids. There is, however, a way to go about the conversation that can minimize familial distress and maximize reassurance, according to Dr. Guy Pelletier, a clinical psychologist in the department of psychosocial and rehabilitation oncology at the Tom Baker Cancer Centre. Here are some of his guidelines for navigating a cancer conversation as a family.
Q: How should you approach your child with the news of your cancer diagnosis?
Progress the type of information [you share] depending on the age of a child. For children four and under, they don’t need to be getting a big story out of it. Just knowing that mom or dad is sick and that it’s nobody’s fault, that it can happen once in a while, and that the parent will be routinely going to the hospital — generally, that’s enough.
[For kids] around Grade 1, you’re going to need to give more information. Using the word “cancer” starting at that age is wise. Around Grades 4 to 6, the child will need more specifics about the kinds of treatment and how long things may be expected to go. If there’s an expectation that the child’s help may be enlisted with doing a few more chores and things like that, it’s a good idea to mention that then.
Q: And how should older kids be told?
Teenagers 15 and older can be informed at an adult level. In fact, I’ve often recommended for the young person to be present at a medical meeting with the parents, because sometimes it’s better if they get the information themselves from a physician, in terms of what should be expected. If a young person doesn’t want to go, that’s understandable, but if they can go, it can be advantageous.
Q: Is it always best to use the word “cancer” when talking to your children about your illness?
Many people are horrified at using the word cancer around children of any age. I tell them children hear about cancer all the time, or [at least] have heard the word already. It’s better for parents to start using the word cancer when it’s apparent that the child has a possibility to understand what the word might imply. I’ve seen many circumstances where there is a lot of clear evidence that a parent is quite unwell. Children will come up with the idea that their mother/father has cancer on their own. That’s why it’s better to approach the child directly — a child’s imagination is often much more cruel than the truth.
Q: Should you address the possibility of dying from cancer with your child?
People are very afraid of what I would call “the big question.” Even at a young age, cancer is associated with death. It all depends on what type of disease and what type of situation the person is facing. If we’re talking about cancer that can be treated and may very well result in a cure, then parents can say something like, “The doctors say the treatments are going to work and we hope that everything is going to be okay.” If the cancer is more aggressive, and the future is quite uncertain, I recommend saying, “We don’t know.” The message [to share] here is that the parent is going to do everything they can to get better.
Q: What kind of reaction should a parent expect after informing their child?
When you talk to kids officially about your cancer, often the response of a younger child [under 10] might be something along the lines of, “Okay, can I go watch TV now?” Many parents find a reaction like that to be rather callous, like the kid doesn’t care. But actually, that’s the response you want. You want the child to hear what the situation is, to understand it as best as possible, and to be so sufficiently reassured that the next thing they want to do is go back to activities that are normal to them.
Q: What are some strategies for addressing a child’s fears while dealing with your own?
One of the best things a patient can do is maintain routines as best as possible. Generally speaking, when the routines in the family are not changing very much, the children calm down. They tend to be less concerned, and they focus on their own lives and on their own activities, rather than worrying about the parent. Depending on the situation, a parent might also require some additional assistance. It’s very difficult on parents, and the atmosphere in the home can get increasingly tense. This is where you can reach out to a professional group like psychosocial oncology at the Tom Baker for help.
Visit albertahealthservices.ca for more information on booking an appointment with the Psychosocial Oncology department.