For love’s sake: How to talk to kids about cancer

Telling a child someone they love has cancer is heartbreaking. Here, our experts share their advice on one of the toughest conversations you’ll ever have.

Is there any word in the English language as scary as “cancer”?

Not likely; not once it comes knocking at your door and you have to break the unthinkable news to your children.

You’ve been protecting them their whole lives – now you have to say the words that could shatter their innocence, their wellbeing, their world.

Why open communication matters

Take heart – whether it’s you or your partner who has cancer, leading Australian cancer charities agree being open with children from diagnosis through to prognosis helps them cope better than being kept in the dark.

Canteen clinical psychologist and general manager of services Sandy Cham says it’s our instinct to shield our children from the scary stuff.

“But we have seen, time and time again, that young people desperately want information, and they want it from their parents,” Sandy says.

But how much should you tell them? And when?

And how on earth do you find the right script to calm their fears when you’re most likely still reeling yourself and terrified of what might lie ahead?

Fortunately, there is now a wealth of support available from the likes of Canteen and Cancer Council to help guide the way.

“The experts tell us we can’t stop our kids from feeling sad but if we share our feelings and give them information about what’s happening, we can support them in their sadness,” Cancer Council NSW cancer information manager Jenni Bruce says.

How to talk to younger kids about cancer

Start small

Keep it simple for that first talk, especially for younger kids, Jenni advises.

“Think of it as an ongoing conversation that evolves over time, rather than a one-off discussion,” she says.

Sandy adds it is going to be distressing for you, so don’t “overcook it”.

“Just introduce the concept that ‘Mummy or Daddy is sick and the doctors are working really hard to come up with a great plan to make them better and once we have that plan, we’ll talk it through with you, so you don’t need to worry about that right now’,” Sandy says.

“Stress that it’s not their fault; it’s not because they were naughty or had bad thoughts.”

Be ready for questions

Sandy says to be prepared for the big questions, such as “Who’s going to look after me?”; and also for the small questions, such as “Who’s going to get me lollies?”.

“Understand that what your child is really asking is, ‘Who’s going to look after me if you’re not here anymore? Who’s going to love me like you do?’,” she explains.

When the time is right

Sydney interior designer Suzanne Rumi had to explain her breast cancer diagnosis to her two young sons when they were aged five and six.

“My husband and I didn’t tell the boys for about two months; we waited until I had to go into hospital to have a breast removed,” Suzanne says.

“Their world was so beautifully innocent; I didn’t want them to be scared that they were going to lose their mother.”

Suzanne says she couldn’t use the word “cancer” for a long time.

“But the relief I felt after talking to them was enormous; you just exhale and go, ‘Right, it’s all out in the open, let’s get on with this’,” she says.

“Kids are very simple at that age … their questions were simple things like, ‘Does it hurt?’ and ‘Will the doctor use scissors or a knife?’

“And later, my younger son said to me: ‘Don’t worry, Mummy, it’s just like Nemo’s lucky fin!’

“Not that any time is ever easy but I think the younger they are, the easier it is – without a doubt, it’s harder with teenagers.”

How to talk to teens about cancer

Sandy says older kids frequently close down when a parent has cancer, but she cautions against letting your teen go too quiet.

“It can be tempting to either let a teenage child shut down or ask them too many questions,” she says.

“Instead, it’s really important to acknowledge the silence but give them options.”

For example, Sandy suggests you could say: “You’re really quiet; maybe you need some time to think about this – shall we follow up in a couple of hours or tomorrow and see if it makes more sense for you then?”

She says it’s important to let teens know that you will keep inviting them to talk.

Finding the right words

Perth doctor Shannae Carnell was 17 when her mum Lisa was diagnosed with advanced lung cancer, aged 56.

It was the second time cancer had struck at the heart of the family: her father Bill had survived bowel cancer seven years earlier.

This time, the conversation was infinitely harder.

“Mum was diagnosed in September and died in January,” Dr Carnell says.

“She used a line from one of my favourite movies, The Fault in our Stars (about two teens with cancer), to tell me that she was terminal – she said she had ‘lit up like a Christmas tree’.

“Mum knew I would understand what that meant and (it) made the conversation a little bit easier for us both.”

For parents agonising over how to broach the topic, the Cancer Council offers a free booklet, Talking to Kids about Cancer, packed with suggested scripts and age-appropriate support to steer you from diagnosis to treatment, or if living with incurable cancer.

Remember, it’s OK to cry

Worried about breaking down? Cut yourself some slack.

“The goal isn’t to deliver the news completely digested and processed without getting upset,” Sandy says.

“Absolutely, it’s OK to cry – but if it’s to the point where you know your children will need to comfort you, that’s where you might need to have someone else with you, or practise what you’re going to say first.”

Remember, there’s no one script when it comes to this.

“You don’t need to keep it together; you just need to be across it enough to breathe – it’s OK if it’s clunky,” Sandy says.

When the end is close

When cancer is advanced or terminal, parents face the most heartbreaking discussion there is.

“You can be honest and still offer hope,” Jenni says.

“A parent may now be able to focus on living comfortably for as long as possible or being able to celebrate a special event, and you can share these hopes with children while still acknowledging the reality of the situation and allowing them to prepare for the loss.”

“The rule that has never failed me … is that if your children are asking the question, they’re ready to hear the answer,” Sandy says.

You’re not alone

Here’s where to find support if your family has been impacted by cancer:

Read more on talking to kids about difficult topics:

Written by Amanda Dardanis.