1. Should I tell my child I have cancer?

We recognize that this can be a very difficult conversation to have. While your instinct is always to protect your child from difficult information and situations, it has been shown that open and honest communication is beneficial for you and your child. Children can often sense if something is wrong in the home. Without concrete information, they may even imagine something worse than cancer. Being honest with them and providing a clear, reassuring picture of what is happening can enhance your child’s feeling of security and trust.

2. How do I tell my child I have cancer?

There is no perfect or prescribed way to tell your child about your cancer diagnosis. Remember, you know your child best. Some things to think about as you prepare for the discussion are your child’s age and maturity level, any previous experience with or knowledge of cancer, and what has worked during difficult conversations in the past. Refer to these guides based on the child’s age. Here are a few suggested tips for supporting your child in the best way possible:

• Be specific about your diagnosis. In most cases, we recommend that you use the word “cancer.” Specific information will help your child differentiate your cancer from other illnesses they might experience. It is important to explain to a young child that they did not do anything to cause the cancer.
• How you deliver the information is often just as important as what you say. Decide in advance who will be present, perhaps a partner or another close adult in your child’s life. Practice getting comfortable with what you will say. Provide a supportive and reassuring environment, and invite honesty and questions. It is OK if you do not have all the answers. You can tell your child “I don’t know” and reassure them that you will find an answer.
• Be sure to let your child know how their day-to-day life may change or be impacted. Be specific about any adjustments to their routine so they will feel secure despite any disruptions. For example, if you are usually the person who picks up your children from school but cannot because of treatment, be sure to let them know in advance who will pick them up in your place.

3. Is it OK if I start to cry when I tell my child about my cancer?

Having sad feelings or being emotional is normal when discussing cancer, especially with your child. While it is important to have other adults available to you for support when you need it, modeling that you can be sad or tearful without becoming overwhelmed by your emotions is a healthy and important lesson for your child to learn. If your child becomes tearful during the conversation, show them that the feelings are normal. Let them know that you sometimes feel sad, too, and reassure them that the sad feelings will not last forever.

4. How should I respond if my child asks if I am going to die from my cancer?

Children can understand the concept of death by around age 8. Sometimes children will wonder about this but not ask about it, and other times they will ask you directly. This question can be anxiety provoking, so it is helpful to prepare in advance how to respond.

How you answer this question will depend on a few factors. The information you have been given from your doctors about your prognosis will serve as a helpful guide. It is important to be honest with your child in an age-appropriate way about what you know at that time. Try to avoid promises you cannot keep while still offering hope. One possible answer to this question is: “It’s normal to worry about that, but right now the doctors have not told me I am dying. They are doing everything they can to treat my cancer so that I live for many years to come.”

There is no perfect approach to this conversation. What’s most important is that your children understand they can ask you questions and can express their fears. This open dialogue enhances their willingness to have difficult conversations with you moving forward. Understanding their worries and fears allows you to support them as they adjust to your diagnosis. 

5. How do I know if my child is OK? What behaviors should I watch for?

• changes in mood (such as feeling anxious, depressed, sad, angry, or irritable)
• regression of developmental milestones (such as bedwetting, thumb-sucking, clinginess, or separation anxiety)
• changes in academic performance
• physical complaints (such as headaches or stomachaches)
• social withdrawal
• difficulty regulating emotions (such as having tantrums or getting easily frustrated)
• Children will vary on how much they want to talk about your diagnosis. It can be helpful to look for significant changes in their mood or behavior to get a better sense of how they are coping. The following behaviors might suggest that they are having a difficult time adjusting:
• Involving other members of your child’s support network can be helpful. School staff — such as teachers, social workers, psychologists, and guidance counselors — may be able to provide additional insights into how your child is coping outside of the home.

6. What if my child wants to come to the hospital?

If you are admitted to the hospital, your children may wish to visit you. This is encouraged, but it is helpful to prepare them for the experience in advance. Let them know what the hospital looks like and which staff members they may meet. Be open about your hospital room and your physical state. It is important to talk about things like changes in mobility and strength, the hospital environment, and what an IV is before children see it for the first time.

Where can I find additional support?

At MSK, social workers can assist with navigating these difficult conversations and circumstances. Contact your doctor’s office or the Department of Social Work at 212-639-7020.

What if I am not a patient at MSK?

We recommend contacting your doctor’s office to ask about social work support. Many hospitals and cancer clinics have social workers available. If you cannot access a social worker through your doctor’s office, you can find support through the community organizations listed on the Resources page. You can also connect with your child’s guidance counselor or school support staff for further information.