Experts say how to talk to children about a cancer diagnosis

In the time Catherine, Princess of Wales spent away from the public eye before announcing her cancer diagnosis, one of her biggest priorities was finding the right way to tell her children, she said.

“Most importantly, we needed time to explain everything to George, Charlotte and Louis in a way that was appropriate for them and to reassure them that I will be fine,” she said in a video statement released on Friday.

After weeks of speculation about why the princess hasn’t been seen in public since her abdominal surgery in January, Kate released the video in which she explained that she was recovering in preparation for preventive chemotherapy.

It’s important to talk to children about their parent’s or loved one’s cancer diagnosis, and while families may have the instinct to protect their child from the scary feelings associated with it, clear communication is helpful for children, Dr. Claudia Gold, a pediatrician and early relational health specialist in Massachusetts.

Exactly how to have conversations about cancer depends on the individual child and family, but there are guidelines that can help adults, said Hadley Maya, a clinical social worker at the Center for Young Onset Colorectal and Gastrointestinal Cancers at Memorial Sloan Kettering.

“This is one of the most difficult conversations parents and adults will ever have to have with their children in their lives,” said Maya, who is also one of the coordinators of Talking with Children about Cancer, which provides support and guidance to parents and families who are faced with a cancer diagnosis.

Conversations by age

Consider the child’s age when talking to a young person about a parent’s cancer diagnosis, experts say.

Preschool and younger

According to the American Cancer Society, children under three are most concerned about separation, abandonment and changes in their daily lives.

“As their routine changes, babies and toddlers may easily become confused, become more clingy, and change their usual sleeping, eating, or other daily habits,” the society says on its website.

Suggestions include frequent cuddling and hugging, having someone close to the child to keep his or her daily routine as normal as possible, and allowing the child to see a parent in the hospital in real time via video, telephone or other technological means to see.

Kindergarten and early elementary school

For children between the ages of 4 and 6 – Prince Louis is 5 – illness is often equated with a cold or other contagious disease. Therefore, the child may fear that he or she “might get cancer,” the company said. Children this age may also feel that the sadness and grief the family is feeling may be in some way their fault.

Routine is still very important, as is a familiar, reliable caregiver. Always use clear and simple language when communicating with children in this age group. Consider using playtime and art to help them understand the concept of cancer. Next, encourage the child to role-play with toys that may hide misunderstandings or misunderstandings.

Children of primary school age

Children between the ages of 7 and 12 – Princess Charlotte is 8 and Prince George is 10 – are more likely to understand the concept of cancer and be able to predict the future, the society said. However, they may also hide their feelings so as not to upset their loved ones further.

“For older children, more detailed information about the cancer may be provided. Try not to overwhelm them with information, but rather be open and honest in answering any questions they may have,” the website says.

“Pay attention to questions not asked, particularly about your child’s own health and well-being. It is okay for the child to see the parent crying or angry if the child understands that he or she is not to blame for these feelings. Try to help them understand that it is normal to have strong feelings and that it is good to express them.”

If possible, keep the child in school and extracurricular activities and inform any teachers, coaches or school staff about the illness, the society recommends. Tell the news to your friends’ families and reassure the child that it’s okay to have fun.


Because they are old enough to understand the significance of a cancer diagnosis and the possibilities for the future, teens may be more worried and need to reassure themselves that nothing they did or said caused the disease. Like younger children, they may also try to hide their sadness, anger, or fear to avoid causing further pain to others. Routine is still helpful, as is honest and open information about the parent’s illness.

“Provide detailed information about the parents’ condition, symptoms, possible side effects of treatment, what they might expect and other information if they are interested,” the agency said. “Keep lines of communication open and let them know they can talk to you and ask questions at any time.”

At this age, friends and social influences are crucial, so a teenager may use the Internet or rely on friends for help. Ask a friend or relative to pay special attention to each teenager in the family and reassure the child that it is okay to have fun and not to feel guilty about it.

“Teens experiencing stress may act out, withdraw from friends and family, and feel overwhelmed. Reassure them that it is OK to have these feelings and encourage them to learn how to respond and cope in healthy ways,” the society suggested.

Will you be okay?

One of the most difficult and perhaps most pressing questions a child may ask when they learn that their loved one has cancer is, “Will you be okay?”

Even as an adult, you may not know the answer to this question.

“You can always say, I’m not ready to answer that question right now, or I don’t know right now, but I promise I’ll come and get back to you,” Maya said.

“The most important thing you can give your child with this answer is the reassurance that they will be loved and protected no matter what happens,” she said, showing that it’s OK to be uncertain and have difficult feelings sit.

“That’s the most important thing because it’s really hard to sit with uncertainty. “It’s such a scary feeling,” Maya said.

You don’t have to say the “right thing.”

Parents often turn to Maya looking for a script that has the right message, but the truth is, there’s no one perfect way to talk about it, she said.

In fact, it’s often better if you don’t know exactly what to say and instead listen and respond to how your child reacts, Gold added.

And don’t worry about having all the answers or addressing every feeling in the first conversation, because it’s just that — the first of many conversations, Maya said.

Some families like to schedule regular check-ins together after doctor’s appointments to catch up. Others like to meet one-on-one to discuss concerns or questions. And some children are eager to participate — by sending written questions to doctors or seeing pictures of their toys at the treatment center or at the doctor’s office, she added.

“The most important thing is to take your cue from your child and maintain an open-door policy so they know they can still turn to you for support and love,” Maya said.

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