Telling children about advanced cancer

There are many issues in dealing with cancer, particularly if you are told the cancer has become advanced. Parents may be concerned about how their children may react, and whether they should tell them.

Why should children be told?

Children like to know about anything that affects the family. Children will pick up that something is wrong, and if you protect them by saying nothing, they may have fears which are worse than the real situation.

Not talking about cancer may suggest it is a subject too terrible to be discussed. This may lead to your children having an abnormal fear of cancer or other illness.

Children may find out about your cancer from someone else, or get misleading information from other sources.

Avoiding isolation

Children can feel isolated if they are not told. They might feel they are not important enough to be included in a family matter.

Helping your child understand

Children are good at noticing things but poor at understanding what they mean. For example: “Grandad died in hospital. Now Dad has to go into hospital. He is going to die too”, or “I was cross with Mummy when she told me to pick up my toys. Then she was unwell. Maybe I made her ill.”

Children who know the situation can be a comfort to you. You won’t need to feel secretive and isolated in your own family.

Addressing uncertainty

Children have an amazing ability and capacity to deal with truth. Even very sad truths will relieve the anxiety of too much uncertainty. We cannot take their sadness away, but if we share our feelings and give them information about what is happening, we can offer them support.

Coping with cancer in the family can be an opportunity for children to learn about the body, cancer, treatment, and healing. They can learn about feelings and the strength of the human spirit in difficult times.

Reassurance of care

Children need assurance that there will be someone there to look after them when you become more unwell. Talk to your children about the adults who will be there for them.

Let teachers know what is happening

It is important to talk to their teachers about your situation so they are aware of the changing needs of your child and can be prepared to address any questions and concerns your child may have.

Teenage children

Adolescence is a time of exploration, experimentation, and introspection. Teenagers strive to be independent while still wanting to be taken care of by their parents. When a parent is diagnosed with advanced cancer, it presents new and unique challenges to the teenager and family.

Response is unpredictable

You should recognise there is a variety of responses teenagers may have, and keep in mind that teenagers may be uncomfortable with some or all of their feelings and thoughts about your cancer.

Accurate information needed

Teenagers want detailed information. This is especially true when it comes to information about diagnosis, treatment, and prognosis (long term outlook). They may seek out further information on their own, in addition to what you have provided.

Teenagers need to know the truth and may feel particularly sensitive to information they feel is incomplete or inaccurate.

Privacy and reflection

Teenagers need privacy. They may or may not want to talk about the experience with their family. Reassure your teenagers they can receive support from other sources, like an aunt, a friend’s parent, a teacher, somebody from your church, or another member of their extended family/whanau.

Teenagers often write about and reflect on their inner thoughts. Encourage your teenagers to share these feelings and concerns. They can also channel this energy into sport, writing a diary, or other creative arts.

Participation helps

Teenagers who want to contribute should be encouraged to participate in caring. Encourage teenagers who want to accompany their family member to treatment in order to see the facility and meet the treatment team. This can help them feel more in control about how your medical care is provided.

Consistency

Teenagers need consistency. Make an effort to ensure they still attend usual activities and social events.

Ways of coping

Teenagers struggle with the need for independence. A parent’s illness may make this more difficult. Teenagers may need a break from the situation at home; for example, a family holiday, a trip with peers, or a regular night out.

Teens might also find it helpful to connect with others (online or in person) who are going through or have been through a similar experience.

Adult children

Adult children will struggle too, particularly if they do not live in your town. You may feel you have to, or want to, carry on as the head of the family, reassuring everyone that things are the same as always.

Your parents' reaction

It is one of life’s most painful experiences to be the parent of someone with advanced cancer. Your parents are likely to feel overwhelmed with sorrow and helplessness at first. Be aware that it may take them a long time to adjust to the situation.

Related topics

Also see Getting support when you have cancer and Advanced cancer - living with

Support groups

See the support organisations (which include helplines) under Further information and support below.

Original material provided by the Cancer Society of New Zealand, 2008. Reviewed by everybody, July 2010.