Should I Tell Them About The Cancer?

I have two children. I don’t want to tell them about my wife’s diagnosis and surgery because I don’t want to upset them. I can barely handle this myself, so how can they cope with the cancer? Should I tell them about the cancer, and if so, how much?

Telling your children about your wife’s cancer diagnosis is one of the most difficult issues you may have to face as a parent. Some people are reluctant to tell their children; whereas, others want to be as open as possible. Research and our professional experience as oncology counselors indicate that telling children the truth from the beginning generally leads to better adjustment.

However, as their parent, you are the expert on your children, and you should keep them as involved only as much as you and they feel comfortable. Furthermore, as the “well” parent or family member, you may be able to play a valuable role in establishing communication with your children, since oftentimes the parent with cancer is unavailable (in the hospital, for example), and you may spend more time with the children due to increased childcare responsibilities when your spouse is not feeling well.

Obviously, the ages of children affect what type and how much information they can comprehend. For example, a 4-year-old will not understand as much detail as a 10-year-old, nor will a 10-year-old under-stand as much as a teenager. However, the following guidelines may be helpful and, unless otherwise stated, are good points to keep in mind for all age groups of children. A grandparent (or other family member) may also find the following information helpful.

Children have a good sense for what is going on with the person with cancer and the family. They often observe subtle changes as well as obvious ones (e.g., concerns about hospital bills or overhearing you or a family member on the phone). Therefore, they may know about the diagnosis anyway, and maybe they should hear it from you or your spouse—the earlier, the better. This is a time to develop trust with your child regarding the diagnosis and treatment.

Because every type of cancer is different, and each person’s treatment is individually tailored, you need to give your children the opportunity to ask about your wife’s cancer and treatments so that they do not get misinformation (from the Internet, gossip, family friends, relatives, or other children).

The word “cancer” is an abstract term that is often hard for children to understand, which can lead to increased fear and misunderstanding. Showing children age-appropriate pictures and diagrams of the body, including where the cancer is located—or especially for younger children, allowing them to draw pictures of it themselves—will help them conceptualize the cancer. One 6-year-old girl drew a picture of her father with a big black dot on his “tummy,” representing the cancer. This picture made it much easier for her to visualize and talk about the cancer with her parents.

Your children may react differently after they discuss the cancer with you and your spouse. Some children, especially very young children, can digest only bits of information at a time. They may not ask questions initially, so make sure that the “big talk” is not just a one-time thing. Continue to check in with your children to see how they are doing and to tell them how you are doing, too. However, if they do not want to talk, do not push them. Instead, explain to them that they can ask you or your wife any questions they like, which gives them control.

Remember that if you have more than one child, each one may react differently. Think about whether you want to talk to your children together or individually. One compromise is to have a family meeting first and then follow up with each child separately.

Children often focus on how cancer will affect their lives, occasionally appearing selfish and expressing anger and frustration. Teenagers and children may resent being asked to help with household duties to help a sick parent. Try to be patient with a child who expresses these feelings and to understand without judgment (which can be difficult). Try to find solutions, such as temporarily hiring a house-keeper or asking family or neighbors to help with household chores so that household routines are less disrupted.

Providing physical reassurance, such as hugs and touch, is important to you and your children, especially infants or toddlers, for whom modes of communication are limited. Your wife may not be able to play “rough” with your children immediately after surgery or because of fatigue, so explain this to your children and substitute other activities and forms of physical connection (such as sitting closely together, watching a video, or reading together). You do not want them to mistake a lack of physical attention as rejection.

Continue (as much as possible) with pre-cancer routines and disciplinary actions. This may be difficult because you have demands on your time, but try to allow your child to remain in his or her activities, see friends, and get up in the morning and go to bed at the same times. Some parents want to be more indulgent, and some more strict; however, this is not going to make your child cope any better. Consistency communicates security to children.

Tip: Be honest and consistent, and reassure your child that the cancer is no one’s fault.