When a parent is diagnosed with cancer, it can be hard on the entire family, especially children.

Child coloring

Don’t think you can protect children by not telling them about the cancer.

Your children will see you are not feeling well and are absent from home for treatment. They also may hear other family members or friends talk about the situation and think the worst.

Because imaginations can run wild, honesty is the best approach. No matter what the age, children should be given general information about the cancer, including where it is located in the body and, in general, how doctors will treat it.

Remember, your child will take cues from how you react while talking about the cancer, so it’s important to try to remain as calm as possible. Allow the child to ask questions and watch how he/she responds to your answers.

Consider these approaches.

Plan your conversation.

How you talk to your children will depend on how old they are.

With young children, simple answers are the best. They won’t understand complex medical terms or even the word cancer. They will focus on things they can actually see—when you are not feeling well, if hair loss is occurring, when you are sick or don’t want to eat or play.

For very young children, it may help to use a stuffed toy to show them where the cancer is in your body and explain how doctors are treating your cancer.

You can go into more detail talking with teens or young adults. In this age group, they likely will know more about cancer and, as a result, be more upset or worried. The key is to keep the lines of communication open and to encourage them to ask questions.

Monitor behavior.

Just like you, children may experience a roller coaster of feelings, from sadness to confusion, even anger. Tell your child that these emotions are normal and you experience them, too. Keep an eye on them for lingering reactions to your conversations. They may act out or be unusually quiet. They may not even respond right away when you tell them about the cancer.

It’s okay to have them process some things in their minds, but when you think your child needs help coping with all the challenges of your cancer diagnosis, tell your care team. They will connect you to resources, such as counselors or support groups. They also may encourage participation in programs or retreats specifically designed for children of cancer patients.

Give them something to do.

Empower your children by letting them help you whenever they can. It can be something as simple as picking out a movie to watch together, playing a game, or assisting with chores around the house. Older children who are away at college or living independently can schedule regular times to chat by phone or via a video conference call. They also can help create a personal website (e.g. caringbridge.org) or coordinate volunteers to handle needed tasks.

Answer the big question: “Are you going to die?”

The biggest question of all to handle is when children ask if you are going to die. Even if they don’t ask it out loud, they are thinking about it from time to time, so it’s important to be prepared to answer this question. The reality is that although many people survive a cancer diagnosis, some do not.

Be honest with your children. If there’s a good chance your cancer can be successfully treated, tell them that. Tell them you have good doctors who are doing their best to get rid of the cancer and you believe you will get better. There may be times when you feel terrible, but you are optimistic about getting through the journey.

If your cancer is aggressive or it will be difficult to treat, you can still offer some positive thoughts. Tell them you don’t know what will happen but you and your doctors are doing everything possible to fight the cancer. Reassure them they are loved and they will be cared for no matter what happens.

If you have made arrangements for someone to take your children to and from school or activities while you are being treated for cancer, make sure the kids know in advance so they don’t think something has gone wrong. It’s important for your children to keep to a normal routine as much as possible. That includes going to school or work and spending time with friends.

Make time for your children.

It’s vitally important that a parent spend time with their children throughout cancer treatment. In fact, you can regularly update your family after every treatment (in person or by phone), so they don’t feel you are keeping information secret. Ask them if they have any new questions or concerns, too.

Find a support system.

University of Iowa Health Care Adolescent and Young Adult (AYA) Cancer Program has a dedicated child and family life specialist who helps young families faced with cancer. The family and child life specialist can help your child cope with a diagnosis, make peer-to-peer connections, and can provide activities for the whole family.