It is hard enough for adults to comprehend cancer, its various treatments and possible impact on longevity, let alone explaining it to a child. Getting expert advice on what to say, and when and how to say it can be invaluable to a parent or caregiver going through this life-changing experience. We speak to a clinical and oncology social worker to get some helpful tips.

Dr Memory Munodawafa is a clinical and oncology social worker who holds a Masters in Clinical Social Work and a Doctorate in Psychiatry through to the University of Cape Town (UCT). She is part of an interdisciplinary team who consults with professionals, families and individuals who need mental health and oncology-related psycho-social support. She has the following practical tips for us.

Plan ahead

• Choose a time when you are feeling calm and unlikely to break down.
• Set up a quiet time and place to talk where you won’t be disturbed.
• Tell them you need to talk to them about something important, without scaring them, and give them an option to negotiate a time that suits them.
• If you have more than one child, you may want to have the initial discussion with all of them together and then schedule alone time with each child – children will often rely on siblings for support and comfort.
• If possible, have both parents together when you have the first conversation. Failing that, another family member or close family friend can also provide support.
• Think of what you want to say and what possible questions they may ask you. Have as many answers ready as you can.
• Get on the same page with your partner or spouse – agree ahead of time on what you are going to say.

Be real

• Be honest and direct, don’t be afraid to use the term cancer or tumour.
• Encourage your children to ask questions and know that it is okay to say, “I don’t know”.
• Don’t be afraid to address and share sadness and other emotions – explain to your child/ children that it is okay to feel emotions such as fear, anxiety, and anger.
• Encourage your child/ children to come back to you at any time to discuss their emotions and worries.
• Help them to share this information with people they trust e.g. teachers, friends and to understand people’s varying reactions to the news. Not everyone knows how to react to a diagnosis of cancer.

Provide basic and age-appropriate information

• Keep the language as simple as possible, especially for a younger child.
• It is important that children know the basics of the illness such as the name of the cancer, the body part affected, how it will be treated etc.
• Children also need to know how the diagnosis is going to impact their own lives – Who will care for them in the parent’s absence? Is the parent still going to be able to participate in their day-to-day lives?
• The depth of information depends on child’s age and intellectual and emotional maturity.

Deal with common fears

• Younger children engage in “magical thinking” and may believe that they did something wrong to cause their parent’s illness.
• Children may be dealing with guilt e.g. an adolescent may feel guilty about their previous bad behaviour towards the parent or a younger child may feel guilty about a bad thought they had about the parent when they were angry.
• Children may think cancer is contagious and that the other parent may get ill or they themselves will “catch cancer” if they hug their ill parent.
• Children of all ages may worry about abandonment – who will take care of them when the parent is ill?
• The child may believe that everyone with cancer will die. It is important to reassure them that advancements in treatment means that most people with cancer can recover.

 Ways to help your child cope

Emotionally

• Parents should consult an oncology social worker at the time of diagnosis so that they can get help on how to manage the diagnosis in the family. They can then arrange for the children to be seen at a later stage.
• It is important that children understand that it is okay to feel negative emotions such as sadness, anxiety and anger but that they need to express these feelings in a healthy way.
• On the flip side it is also normal for them to feel and to be able to express positive emotions such as happiness and love.
• Add humour and fun to your child’s day – let them know that it is okay to laugh and joke around even though someone in the family is ill.
• Ensure that you get regular feedback from your child/ children on how they are coping.
• Prepare them for a visit with the sick parent/ family member
• Seek help externally by using support groups such as art therapist, play therapist etc. if necessary.

Practically

• Children crave structure so try to stick to as normal a schedule or routine as possible.
• Elicit support from family and friends such as a lift club, play dates, outing with granny, pre-cooked meals etc.
• Encourage children to participate in extra murals or other activities that are a healthy outlet for emotions such as anger.
• Involve children in household chores/ caregiving to help the sick parent – make them feel useful by bringing a glass of water or helping to cook dinner.

Remember, when all is said and done, you know your children best so trust yourself! Be there for them and keep the two-way conversation going. We've prepared a guide to help you, download Guidelines for talking to children about a loved one's cancer diagnosis.

About Life Oncology 

Life Oncology is a dedicated oncology and radiotherapy service under the Life Healthcare network. Our prime objective is to revolutionise the cancer treatment journey by embracing a patient-centric and value-based model, supporting our patients and their families throughout their treatment journeys. To support this journey, we ensure that our care is coordinated, integrated, and personalised.

Check the download section on the Life Oncology page here for more cancer educational information.

The information is shared on condition that readers will make their own determination, including seeking advice from a healthcare professional. E&OE. Life Healthcare Group Ltd does not accept any responsibility for any loss or damage suffered by the reader as a result of the information provided.