How to talk to kids about cancer
Catherine, Princess of Wales, has been diagnosed with cancer and has started preventive chemotherapy, she announced in a video message on Friday.
“It’s been an incredibly tough few months for our entire family,” Catherine said in the video. She said it took time to recover from the surgery to start treatment for her cancer. “But most importantly, it has taken us time to explain everything to George, Charlotte and Louis in a way that suits them, and to reassure them that I will be fine,” she added.
Conversations like the one Catherine has had with her children are among the most important and delicate discussions parents can have, said Kathy Hirsh-Pasek, professor of psychology at Temple University and senior fellow at the Brookings Institution.
Children, especially younger children, look to their parents as a rock, she said. When something disrupts that stability — “even if it’s a manageable cancer — in a child’s ears, wow, that’s scary.”
Dr. Hirsh-Pasek recommended explaining that “there will be times when Mom doesn’t feel as good as other times, but she will be there for you, and she will be close.”
But she clarified, “I’m not saying you’re lying.” Children are very observant, Dr. Hirsh-Pasek said. “If you hide something, children know you are hiding something.”
These conversations naturally bring fear and pain to parents, says Hadley Maya, a clinical social worker at the Center for Young Onset Colorectal and Gastrointestinal Cancer at Memorial Sloan Kettering Cancer Center.
“We try to help parents understand that having these conversations with your child in an honest way can help the child cope and give them the feeling that they are not left alone with their feelings, their concerns and their imaginations, ” she said. Often a child imagines something worse than what happens.
The word cancer “doesn’t scare them as much as it does us as adults,” added Ms. Maya, who also helps coordinate Memorial Sloan Kettering’s Talking with Children about Cancer program. “Not knowing makes them even more afraid.”
Parents may also worry that a child sees them crying. But it’s not a bad thing to show vulnerability, Dr. Hirsh-Pasek and Ms. Maya both said. It’s an opportunity for parents to show that it’s okay to feel unwell, to express emotions and ask for help.
Conversations about serious illness can be very different than they were a few years ago, Dr. Hirsh-Pasek said, because many children have lived through the coronavirus pandemic and still remember it. That does not mean that the discussions become easier, but children may be more aware of what it means to be very ill.
This also means that explaining cancer is more important than ever. Ms. Maya recommends focusing on three “C’s”: catch, cause and cancer. Explain that cancer is not contagious and that they can still hug their parents and share food. Tell children that they didn’t cause the cancer or the circumstances surrounding it (which is a common idea, especially among young children, she said). And be clear: the disease is called cancer, not “boo” or disease.
Let your child take the lead in some conversations, Ms. Maya said. Give them a chance to ask questions and recognize “that even though you may not have all the answers, you will try to figure it out and get back to them.”
In her statement, Catherine shared some of what she said to her children: “As I told them, I am doing well and growing stronger every day by focusing on the things that will help me heal; in my mind, body and spirit.”
That kind of language reassures children, Dr. Hirsh-Pasek said, and it shows them how we can move beyond the things that are difficult.
“I wouldn’t use these kinds of occasions to discuss death and dying,” said Dr. Hirsh-Pasek. “I would use these opportunities to discuss life and living.”