How to Tell Your Child You Have Cancer

Getting a cancer diagnosis can be terrifying and life-altering. But for parents, figuring out how to tell your child you have cancer might be one of the hardest parts of grappling with the news. In a video publicly sharing her cancer diagnosis on March 22, Kate Middleton spoke about that very difficulty, saying, “It has taken us time to explain everything to George, Charlotte, and Louis in a way that is appropriate for them, and to reassure them that I am going to be OK.”

It might be tempting to try to avoid the conversation altogether, but it’s essential to be honest about what’s happening, because if a child senses something’s up and they don’t have details, their imagination could take them to even darker places.

“This is one of the hardest, most painful, delicate, but also one of the most important conversations the parents ever have to have with their kids,” says Hadley Maya, LCSW, a clinical social worker with Memorial Sloan Kettering Cancer Center and a coordinator of its Talking With Children about Cancer program. “There is such a strong instinct to protect your child from worry or pain, and that is completely understandable. But we know that open and honest communication is beneficial for both the parent and the child.”

When to Tell Your Child You Have Cancer

It’s best to share news of a cancer diagnosis with your kids as soon as possible. “Children, adolescents, they really pick up on changes so much more than parents think they do,” says Shannon Coon, LMSW, children’s program coordinator at CancerCare, which offers free counseling, support groups, and a helpline for people affected by cancer. “And if they’re not aware [of the diagnosis], they’re either going to be worried that they have done something wrong or come to a worse conclusion themselves.”

Just give yourself a moment to process the news first, and prepare. Before talking to your kids, Coon recommends practicing what you want to say or writing it down so you achieve the tone you want. Consider who you want to be there when you have the conversation, and where you want it to take place: Coon suggests a calm environment, like home.

How to Tell Your Child You Have Cancer

For all ages, experts recommend explicitly using the word “cancer” with your children so there isn’t any confusion. “It’s going to help encourage that conversations moving forward are open and honest,” Coon says. It will also help clarify that the disease is not something they can catch, and that they’re still safe around their parents.

As you talk with them, be sure not to make any false promises. “You can say, ‘I’m doing everything I can to get better, I have all the help and support from my doctors,’ but you don’t want to make any promises that are not within your control,” says Elizabeth Meyer, LICSW, CPCC, a counselor in Massachusetts with expertise in parenting.

And don’t worry about getting emotional as you share the news. “Processing your own emotions first as much as you can is a good idea,” Maya says. “But if you cry when you tell them, that’s you modeling healthy emotional expression and telling them, ‘We’re in this together, and it’s OK to feel sad or scared.'”

Of course, exactly how to tell your child you have cancer in a thoughtful way that helps them cope with the news depends on their age. Read through expert insight on best practices for different stages of development, below.

Toddlers

While toddlers can’t understand the concept of serious illness, they do have a strong fear of separation and abandonment, and will pick up on anything different that’s happening, “especially if the routine changes or the parent who has cancer is not capable of holding the child or picking the child up,” Maya notes.

When talking to this age group, she suggests focusing on just the present day — like what they can expect today, when mommy or daddy will be back home — and giving them lots of physical touch through cuddles and hugs. “Say something very basic, like, ‘Mommy doesn’t feel well today, and mommy’s going to the doctor to get help,'” Meyer suggests.

Children Ages 4-5

Although the concept of cancer is still too complex for children of this age to grasp, Maya says there are lots of picture books and kid-friendly diagrams that can help explain things like what a tumor is. She’s even worked with parents who have used dolls to show how an IV line works. Again, she recommends keeping communication simple: “Something like, ‘Daddy has a bad sickness. The sickness is called cancer. Daddy’s doctors are treating him now, and we truly believe that he’ll get better’ (if that’s true).”

Children Ages 6-8

At this stage, children might be able to generally understand what a cancer diagnosis is, but they will have difficulty with cause and effect. “Younger children believe that their thoughts or wishes can influence the world around them,” Maya explains. “It’s a totally natural part of child development, but it can, in the worst case scenario, cause a child to feel responsible for their parents’ illness or even death.” It’s important to give them constant reassurance that they’re not at fault for the cancer.

Children Ages 9-12

Children at this age can take in more details without getting overwhelmed or confused. Specifically, they can understand cause and effect (like the fact that treatment leads to hair loss) and look toward the future. Give them an expected timeline of the treatment plan so they know what to expect and how it will affect them. “Even creating things like a treatment calendar can really prepare children for any changes, especially in scheduling,” Coon says.

Teenagers

By the time your children become adolescents, they’ve likely heard about or encountered someone with cancer, whether it’s a celebrity or someone they know. So it’s important to clarify the details of your case. Maya also suggests getting them involved as much as they want to be, whether that’s giving them certain responsibilities at home, or offering to ask the doctor their own questions.

After the Conversation

Of course, this isn’t a one-and-done talk. “Continue to keep the door open and encourage your child to come to you with questions,” Maya says. “The truth is you might not have the answer. You can always say, ‘I don’t know, but I promise I’m going to try to find out and I’ll come back to you.'”

Follow your child’s lead on how often you bring up your cancer; just be sure to always keep them in the loop if there are any changes that might affect them. Experts also recommend updating their school as well so that teachers can be there to offer support and keep an eye out for any behavioral changes.

Once a child is old enough to understand the concept of death (around age 8), be prepared for questions about it. Maya suggests validating that, yes, some people do die of cancer. “But then follow that with reassurance, whatever that is,” she says. You could share that the doctors don’t believe you’re dying, or mention how advanced treatments are today, or simply reiterate that the doctors are doing everything they can to make you healthy again.

As nerve-wracking as it can be to talk about a cancer diagnosis with your kids, remember: children are usually far more resilient than we imagine. “Oftentimes, the anxiety that we feel about talking to kids about cancer comes from our own lived experience as adults,” Maya says. “Trust that it has the potential to really, under terrible circumstances, be a conversation that helps families feel closer and helps children learn how to tolerate difficult experiences in life. Not to say that it’s a situation any parent wants to ever be in, but there’s really powerful things that can come out of this.”