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What to tell kids when a loved one has cancer

By Krista Robak, certified child life specialist, Sacred Heart Children’s Hospital, Spokane, Washington 

Tyler was on a summer visit with grandparents when he got word that his little sister, Kaylee, was in the hospital. Three days later, he arrived at the pediatric oncology unit, having been told that his sister is “sick and needs medicine to get well again.” At age 10, his parents described him as a caring brother who was very connected to his 6-year-old sister. They were at a loss for how to tell him his sister had leukemia.

When Tyler arrived at the hospital, his parents had a gentle conversation with him. They explained Kaylee had Acute Lymphocytic Leukemia, a form of cancer. They told him there were many medications to help make the cancer go away, but the medications would make Kaylee feel pretty sick at times. They also told Tyler there were things he could do to help Kaylee – like play with her, decorate her hospital room and make her laugh, which he did frequently.

Since the family lived a distance from the hospital, Tyler’s parents had to formulate a plan to make sure Tyler’s needs were met – like getting to school and participating in the sports and other activities he enjoyed. His parents alternated stays at the hospital and at home with Tyler. And sometimes, Tyler’s aunts and uncles saw to his needs. Tyler spent most of his weekends at the hospital with his sister during the intense beginning of her treatment.

Two years later, as Tyler’s sister finished her cancer treatment, he remembers those early days of her illness as a time of stress and confusion. But, he’s glad he was included and able to be with his sister. He also recalls enjoying being at school where he could think about things other than what was going on at the hospital.

This is a typical scenario when a family faces a cancer diagnosis.

What kids want when someone they love has cancer

What’s going on?

Age appropriate information: Children need words to describe their loved one’s illness. They may be clinical words like “brain tumor” or “leukemia.” Or, gentler words like “sick cells” or “the bump in mom’s head.” Most kids will ask about prognosis – and they should get an honest answer. If a prognosis is poor, communicate that with hope and honesty.

Knowledge of plans: Children want to know the plan and how it will affect them and the rest of their family.

Who will take care of me and my siblings?

Security is of utmost importance for children – their physical and emotional survival depends on it! The specifics of who will handle caretaking roles or when their parents will or won’t be available to them might not be clear early on. Still it’s important to assure kids that the adults around them will work it out and there will always be someone available for them.

Kids want to feel connected to what is happening

Cancer in the family becomes part of the family. Kids shouldn’t be excluded from it. They’ll probably cope best if they feel like they’re involved. That could mean talking to their hospitalized parent on the phone every night or maybe being in charge of opening the curtains in their sibling’s room each morning. Or, perhaps they receive an update about what went on at the hospital that day.

If you have questions about how to help a child cope when a family member has cancer, talk to your care team or patient navigator. They can direct you to resources for you and your entire family.

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