Helping children cope with cancer in the family

If there are children in the family, the first reaction is often to keep the cancer diagnosis from them. Parents and other adults in the family may feel that the children would not be able to understand, or they may want to protect the children from any distress that the news might bring. For some, it may simply be that they do not know how to talk to the children about it.

Studies have shown that children as young as 18 months old begin to understand the world around them. Children are often able to sense that something is wrong, from changes at home such as increased tension and changed schedules, and will worry more if they feel that certain information is being kept from them. Some may think that something they did might have caused the parent to be ill.

Therefore, it is important to be honest and straightforward with children rather than leave them to imagine and draw conclusions that can be worse than the reality.

What you can do

As the caregiver, you may want to offer support to your loved one during the conversation with their children about cancer. Reassure him/her that sharing this information can help build trust and relationship with their children, and that most of them will be able to cope, given age-appropriate information and good support.

You, or your loved one can:

Ask the child what he/she knows about cancer
Give simple information about the diagnosis (name of the cancer, part of the body where the cancer is, how it will be treated, and how their lives will be affected). Tell it in a way that the child is able to understand.
Provide more details if they ask about it. Be truthful about it. In general, young children up to 8 years old will not need a lot of detailed information whilst older children and teens do.
Explain that the illness is not their fault
Encourage them to share their thoughts, but do not force them if they do not want to. Do take note that it can be more difficult for teenagers to express their thoughts and feelings to you.
Try to stay involved in daily activities and routines as much as you can. Let the child know it’s alright to enjoy him/herself.
Allow the child age-appropriate tasks to help their parent with cancer
Inform the school counsellor about your loved one’s illness.

How do I respond if the child asks if my loved one is going to die?

Admit that it is a scary question for you and the family
Admit that it is a hard question for children to ask
Respond honestly. “What you can be sure of is that I’ll be honest with you about what’s going on. If you can’t stop worrying, please tell me so that we can work on that together.”
Remember that children should be given truthful information when they need it in order to cope well from day to day.
Reassure them that no matter what happens, they will always be cared for.

When to call your cancer care team

Sometimes, despite being honest with the child, some children may react to your loved one’s illness in many different ways. They may:

Be unsure of how to act when they see the treatment’s effects on your loved one
Act out of the norm (e.g. become more withdrawn or more aggressive)
Act clingy or miss the attention they used to get
Show less interest in activities
Has trouble concentrating
Get upset if they are asked to do more chores around the house
Have problems in school (e.g. relating to friends or neglect homework)
Have trouble eating or sleeping
Have signs of self-harm or thoughts of suicide

Please inform your doctor or nurse if you notice any of the above, or if you feel that it is difficult for you or your loved one to speak to the children about cancer. Sometimes kids, especially teenagers, may find it easier to open up to an adult who is not their parent.

If you are a patient with NCCS, you may also call +65 6436 8417 or +65 64368088 to book an appointment to speak to an NCCS medical social worker or clinical psychologist.

Useful resources

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The above contents are made available as part of TEMASEK FOUNDATION- ACCESS (Accessible Cancer Care to Enable Support for Survivors) PROGRAMME, a holistic care programme to support cancer patients during their care and recovery journey.

The contents have been approved by the Cancer Education Information Service, National Cancer Centre Singapore (NCCS), for people with cancer and their families and caregivers. However, this information serves only as a guide and should not be used as a substitute for medical diagnosis, treatment or advice. For specific medical conditions, please seek expert medical advice from your healthcare team.

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