How to help your kids cope with your cancer

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For people with cancer, deciding how, and what, to tell others about the diagnosis can be a challenge. How do you tell your loved ones, or your employer, that you have cancer?

For parents, there’s another degree of difficulty: What do you say to your children? How much will they understand, and what’s the best approach?

Susan Englander, LICSW, a social worker at Dana-Farber Cancer Institute who specializes in working with young adult patients — many of whom have children — offers these tips to parents with cancer on how to talk to their kids and help them through the process.

Plan your conversation in advance. Think about how you can best meet your son or daughter’s needs, and run your plan by a spouse, close friend, or therapist. Talking to your child “on the fly” is not a good idea.

Be direct. Don’t use soft words or be vague. Age influences much of what kids can understand; if a child is under 7, the most important thing to emphasize is that they didn’t cause your cancer and they can’t catch it. Older kids will be concerned both about your health and the impact of your diagnosis and treatment on their lives.

Let your kids know where they can go with questions. Your children should know they can ask you anything. But for the times they might not feel comfortable, or you’re not available, let them know who else they can talk to – a spouse, close adult family member, teacher, or a close friend’s parent. Make sure everyone is on the same page as to how to answer questions about your treatment.

Provide regular updates. Even if it’s something simple like, “I went to the hospital today and had treatment,” your children will appreciate being informed. They want to know the truth.

Help your kids look ahead. Have a big calendar where you can mark down your appointment dates and any days you might not be feeling well after treatment. Think about your child’s activities and how not to disturb them. Ask what’s important to their week, and then figure out who can help them if you’re not available.

Transfer how you are feeling into your child’s frame of reference. It you know you’re going to be fatigued two days after treatment, for example, you can say something like, “I want to go to your soccer game, but this medicine is going to make me very tired. Why don’t we have some quiet time and play a game instead?” Even older kids have trouble with the abstract; it’s always helpful to translate behavior into concrete ideas: “I care about you, but I just can’t do this today.”

Make a list of instructions. When you’re not home, whoever is there to help your child needs to know that Tuesday is gym day and your daughter needs her shorts and sneakers. Maintain normalcy as much as possible; kids thrive on it.

Talk to your child’s school. Your child might not want anybody at school to know you’re sick, but it’s still important for you to talk to teachers and administrators in confidence. Cancer or illness may come up in the curriculum, so they need to know when to be sensitive to your child’s needs.

Be ready for the ultimate question. No matter what your diagnosis, your kids are likely to ask: “Are you going to die?” The standard answer is to tell them that your doctors are working hard to keep you healthy. Then you should try and find out what prompted their question..

Use books to help you and your kids through the process. One book I highly recommend is Raising an Emotionally Healthy Child When a Parent is Sick. The co-author, Anna (Nina) Muriel, MD, MPH, is a pediatric psychiatrist at Dana-Farber. It’s very parent-friendly and offers tips on how best to talk to kids of every age. A terrific kids’ book is Becky and the Worry Cup by Wendy Harpham, MD. It shows how to make a ritual of your concerns and put them into a worry cup at the end of each day.

Dana-Farber’s website has more suggestions for talking to your kids about cancer. Do you have tips of your own? Please share them in the comments.

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