No. 117; December 2014
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Almost 3 million children and adolescents in the U.S. have a parent who has or once had cancer. Among newly diagnosed adults, 1 in 5 has children under 18.
Cancer causes emotional strain in a family. Children of parents with cancer are more likely to have emotional problems, difficulty sleeping, increased fights with siblings, crying, and clinginess. Studies have shown that good communication in a family can be helpful.
Explaining cancer to a child is challenging for most parents. Although these are difficult conversations, they are important. There are no "right" or "wrong" ways to talk with children about cancer. However, here are some suggestions that may be helpful:
- Do not keep your diagnosis a secret. Children can usually tell if something is wrong. Without correct information, they may think things are worse than they are. They may also blame themselves for changes in their parents or family.
- Create an open and supportive environment. Encourage children to ask questions. However, do not force children to talk about things unless and until they are ready.
- Keep discussions simple and honest, using age-appropriate language and terms. Children will usually know, or eventually find out, if you are "making things up." This can make it harder for them to trust you or other adults in the future.
- Be reassuring, but do not make promises you cannot keep.
- Let children know about your treatment, including what to expect in terms of side effects (e.g., decreased energy, hair loss, nausea, etc.).
- Be prepared to repeat information and explanations more than one time. Some information may be hard to accept or understand. Asking the same question over and over may also be a way for a child to ask for reassurance.
- Help children find ways to express themselves. Some children may not want to talk about their thoughts, feelings, or fears. They may be more comfortable drawing pictures, playing with toys, or writing stories or poems.
- Keep the family schedule as consistent as possible. This can be reassuring for children, particularly during times of stress.
You can also help your children by taking care of your own mental health during treatment:
- If you feel stressed, anxious, or depressed, get help. Ask your primary care doctor or oncologist to refer you to a trained and qualified mental health professional for appropriate treatment.
- Be realistic. Parents who have been diagnosed with cancer cannot always keep up with all the things they used to do. Let other people know when you need help and be aware that your role in the family may change while you work through your illness.
Watch for changes in your child’s mood or behavior:
- Talk to your child’s teachers. Let them know about your diagnosis and treatment. They can help monitor for changes in your child’s mood, behavior, or school performance.
- Watch for physical symptoms including headaches and stomachaches. Many children express anxiety through physical aches and pains. An increase in those symptoms without a medical cause may be a sign that a child is feeling anxious or overwhelmed.
- Other signs that a child may need additional help include: ongoing sleep disturbances, intrusive thoughts or worries, frequent fighting or arguing, repeated fears about death, leaving parents, or going to school.
If your child has difficulty with mood or behavior that continues, ask your child’s pediatrician, family physician or school counselor to help arrange a referral to a trained and qualified mental health professional.
Having a parent with cancer is not easy for children to understand or accept. Feelings of fear, confusion, and anger are all normal and healthy. Parents can best help by listening and responding in an honest, consistent, and supportive manner. Fortunately, most children are quite resilient. However, by creating an open environment where they feel free to ask questions, we can help them cope, and reduce the risk of lasting emotional difficulties.
For additional information, check out the Parenting at a Challenging Time (PACT) Program and Facts for Families:
#00 Definition of a Child and Adolescent Psychiatry
#4 The Depressed Child
#7 Children Who Won't Go To School
#8 Children and Grief
#47 The Anxious Child
#56 Parenting: Preparing for Adolescence
#66 Helping Teenagers with Stress
#100 Children and Social Networking