First, take into account the child’s age. Older children need more information than younger ones. Essentially, most professionals divide children into two age groups with regard to information about illness.

1. Children under the age of 8 – These children don’t need a lot of detailed information. They should be told that there is a part of the patient’s body that is not working the way that it should and that it will need medicine or an operation to get better. Children this age don’t really need much information beyond this about the disease, but they do need to know how the illness and its treatment will affect their lives. For example, if the cancer is in a parent, they may see big changes at home, and they should be prepared for these. However, if the cancer is in a relative who does not live with you, and for whom you will not be providing regular care, they may need very little further information.
2. Children over the age of 8 – These children can handle, and will expect, more detailed information. But, again, the age of the child must be taken into account. Older children may be scientifically interested in the disease, and may benefit from reading material and pictures aimed at their reading and maturity level. They can also foresee consequences better than younger children – but not as well as an adult. They may have many questions about the future. Encourage them to ask questions, and answer them as honestly as you can. But, don’t plant questions that they may not have had on their own.

It’s important to realize that, to a large degree, your children will react to a diagnosis based on your reaction. If you are obviously worried and upset, they will have more fear than if you are calm and reassuring. This in no way implies that you should lie to your children about the diagnosis. However, you should not plan to talk to your children when you are very upset.

A diagnosis of cancer in your family is not something you should try to hide from your children. They will know that something is going on – and if you hide it, they are likely to think that the situation is very serious. It’s far better to tell them what’s going on from the very beginning; though you may choose to give them pieces of the picture a little at a time.

Be certain to prepare your children for a visit to their loved one, if necessary. If they haven’t paid them a visit for a while, many physical changes may have occurred. For example, a child could be very frightened by a loved one’s sudden hair loss, if they are not prepared for it ahead of time. Remind your child that their loved one is still the same person, but that the medicine and the illness have made them look a little different. Once prepared for such a change, most children handle it quite well.

When the prognosis is of your loved one’s cancer is bleak, it is important to talk with your children about the future. Again, keep the information basic and geared toward their age level, but prepare them for their loved one’s death if it is inevitable and quickly approaching.

As with many parenting challenges, you’ll find that you learn as you go in regards to discussing cancer with your children. Once you’ve given them the basics, let them know that they can ask you questions whenever they have them and then let them take the lead. Some children will want more information than others. Listen to them carefully and follow your instincts. Children are very resilient, and with a little care in how the subject is approached, they will adjust to the new situation appropriately.

Recommended Reading

Their Cancer – Your Journey by Anne Orchard
A helpful guide for family members and friends on coping with practical and emotional issues

More information helpful with Communication Issues.

Further Cancer Book Reviews

Further Resources

Living Sunny Side Up
Helping Children in Families with a Parent Diagnosed with Cancer

When facing a cancer diagnosis, one issue you (and the person who has cancer) will face is the attitudes of other people. There are many different ways that others will handle the news. Some may have difficulty talking about the cancer at all. They may go to great lengths to avoid the subject. You may even find that they seem to be avoiding
you, or the cancer host.
You may feel very hurt at what seems like indifference or lack of compassion. In fact this behaviour probably shows that they have some unresolved issues that make it hard for them to deal with illness. You may have no idea what has happened in their past for them to behave that way. It may not lessen the hurt you feel, but try not to blame them.
Other people may have a ‘poor you’ attitude. They will be pitying in the extreme for the ‘terrible situation’ in which you find yourself. This could feel good in one way. You are getting sympathy for your situation, and it’s nice to know that someone has noticed how awful it is! At least they don’t think the person with cancer is the only one who deserves sympathy. So accept their expression of sympathy the first time. Be especially glad if it is accompanied by genuine offers of practical help or emotional support. But if you find you are on the receiving end of endless streams of pity from some people, be wary. Whilst they may truly care for you, if they belittle your ability to cope with the situation this attitude could rub off on you. Both you and the person with the cancer need to be empowered to deal with the challenges ahead, not brought down to the victim mindset. It may be that you have to tell people, “Thanks for the sympathy, but I know we’ll get through this.” Possibly you could add, “What you can do to help is . . .”. If they continue to be negative, you may choose to limit the time you spend with them.
On the other hand, some people will be absolutely amazing. Firm friendships have appeared seemingly from nowhere in the face of adversity. When my first marriage broke down, my colleague,
Jenny, took me into her home while I looked for somewhere to live.
She talked to me as I made difficult decisions for the future and was the most staunch supporter I had at the time. She was a truly lovely person and a deep friendship came out of that experience. So be prepared to be surprised and delighted by how some people come through for you.
The truth of the matter is that other people’s reactions are just that – theirs! Whilst it is natural to feel happy or sad about how others behave, the fact is that their reaction is not about you. It relates to who they are, the experiences they have gone through and how they handle issues in their own lives. Don’t take it personally. Just make the most of those whose attitude helps you.

As you can see, we all will have many different attitudes to cope with during the cancer journey. You’ll quickly learn who you can count on when you need a shoulder, a hug, or some sound advice. Lean on those people and be appreciative for the support that they have to offer. But, don’t be too hard on those who are unable to support you during this time. You don’t know the road they’ve traveled. And, you never know when your journey might inspire them to explore their own fears and come to terms with whatever prevents them from reaching out.

Recommended Reading

Their Cancer – Your Journey by Anne Orchard
A helpful guide for family members and friends on coping with practical and emotional issues

Further Cancer Book Reviews

More information helpful at Diagnosis.

More information helpful with Communciation Issues.

1. Relax. It may feel like a huge responsibility talking over these kinds of choices with someone who is facing cancer treatment. But the responsibility for the ultimate decision is theirs, so try to relax about your role. You may only need to act as a sounding board so they can explore the options and be more comfortable with their decision.
2. Acknowledge your fears. It will be hard for you to offer an impartial discussion if your thoughts are full of your own fears. You may be terrified that choosing the ‘wrong’ treatment will condemn them to an untimely death, and this could cause you to exert pressure. So talk about your fears – it may be appropriate to do this with someone who is less involved.
3. Ask what else they need to know. The person making the decision may have all the information they need – or there may be some things that are unclear. Do they need a second opinion about the diagnosis or possible treatments? Would some statistics on differing effects of the treatment options on their particular type and severity of cancer make the decision easier to make? Do they need to know what they can do to increase the beneficial results of any treatment? Or do they simply want to know that the treatment recommended by the doctor is what’s best for them?
4. Consider the Pros and Cons. Remember that any treatment option, including complementary and alternative medicine, has both advantages and disadvantages. The decision could be made from a desire to avoid some possibilities (for example losing their hair) or from a wish to achieve certain ends (eg maintain their body image). Only the person with cancer can know what holds more weight for them.
5. Trust their judgement. You might be tempted to think that you know what is good for someone who has cancer. ’Of course they should have chemotherapy’, or ‘of course natural methods would be best for them’. But you don’t know their body – they do. If they have a strong instinct about any particular treatment plan, they are probably right.
6. Remember the benefits of ‘excited belief’. According to Greg Anderson in his book ‘Cancer : 50 Essential Things To Do’, “cancer survivors develop a confidence and an excited belief in their treatment programs that other patients do not possess.” Persuading someone to undertake a treatment they feel reluctant about will not generate that excited belief – it has to come from inside the person making the decision.
7. Back them up. Whatever treatment decisions the person makes in the end, and whether you agree or not, get excited with them. Be one hundred percent positive that whatever the outcome, they have made the best possible decision for them in this set of circumstances.

Having someone to talk over these difficult issues with can be of benefit to someone about to choose and undergo treatment for cancer. Simply by being available and open you will be a great help.

Once people around you know there has been a diagnosis of cancer, there will be an insatiable appetite for information, particularly amongst those who know the family well. If you live with the person who has cancer, you may find yourself endlessly answering the telephone and relating the same details to one relative after another. If you live at a distance, you may be one of the people phoning – and possibly feeling guilty about doing so. It’s important to handle this communication issue, as it can drive the sanest person to distraction.

The most important factor is to set down some boundaries about the best ways to communicate. Is email easier, because you can choose when to reply? Do you, or the person who has cancer, like to chat on the phone – but only at certain times? Would you prefer to update one person, and have them pass the information around the family for you?

If you are the one desperately wanting an update, but find it hard to get information, ask the person with cancer or others in the family what would work best for them.

One way that a family can come together for mutual support at a time like this is to build a private website. This way people with fresh information can update it so that everyone can read it. If you have a question, you can ask it there, and get an answer from anyone who knows what you are seeking. You can share positive stories, family news, happy memories, and even photos. If you have a family member in their teens or twenties, they will probably know how to create this much better than I do – and feel good about being involved. If not, you can learn to set up a website through Wordpress, or use the system provided at www.caringbridge.org.

Developing a family strategy for dealing with communications can help relieve stress on all the family members who are receiving endless calls and requests for information. Taking the time to determine the best way for your family to communicate to others is certainly valuable in the process of relieving stress for everyone during this time. It’s important that people be informed, but it’s just as important that the person with cancer and immediate family have privacy and quiet time when you need it.

It’s a natural instinct to want to help loved ones when they are ill. For most common illnesses, this help is easy to provide, usually involving no more than dispensing medicines and providing comfort where possible. One may be limited to the same palliative procedures when helping a loved one with a diagnosis of cancer, but the frightening aspect of a cancer diagnosis strengthens this instinct to do something more significant.

An acquaintance of mine, let’s call her Lori, was a young mother with two young children when she was confronted with her husband’s cancer. Her husband seemed comfortable with placing his trust in the advice of his medical team. Lori, however, felt driven to become an active participant; to do something positive to help bring about his cure. She discussed her desires with him. They agreed that she should do whatever she felt compelled to do provided it did not interfere with his prescribed treatment.

At one of her husband’s initial chemotherapy sessions, she spoke with his oncologist and asked what changes she could make to his diet to perhaps strengthen his immune system to better fight the disease. She was very disappointed at the doctor’s reaction. He brushed off her suggestion, saying that it would make no difference; that she should simply keep him on his familiar diet.

She was skeptical of that advice. Disappointed, but undaunted, she conducted research on the Internet, and spoke with a nutritionist at the hospital where his treatment was being provided. The nutritionist disagreed with the doctor’s assessment, and his uninterested manner.

She agreed that there was no special diet directed at a cancer cure, but the suggestion that she keep him on the same diet depended upon whether his routine diet was a good one, even if he had been healthy. She also advised Lori that the diet she would recommend depends upon the type of cancer and the prescribed treatment. For example, one whose cancer involved the gastro-intestinal system would require a diet quite different from one she would recommend for other cancers.

She recommended that his diet should include an abundance of protein in whatever form that he could withstand it. She explained that there was also an abundance of evidence that a carefully planned diet could help to reduce the intensity of some of the unfortunate side-effects of chemotherapy.

Armed with new information and enthusiasm, Lori developed a plan of action. She stocked her pantry with yogurt, ice cream, soups, and foods that were high in protein and in calories.

As her husband’s treatment proceeded, his appetite for large meals waned. Incidents of nausea, somewhat controlled by medication, began to interfere with regular eating, and frequent smaller meals and readily available snacks filled the void. Lori was insistent, however, that he finishes his daily protein drink, even if it was spread out over the entire day. Whenever possible, she would encourage him to exercise by taking a short walk about outside.

Her efforts did bear fruit. Her husband managed to maintain a healthy weight during his lengthy course of treatment. Lori’s husband has been cancer-free for over ten years. They both attribute it to excellent medical care and luck, but suspect that Lori’s attention to her husband’s diet played an important role in his recovery.

By focusing on her husband’s diet, Lori learned more about her husband’s cancer. Her active involvement with his treatment elevated her spirits. She felt that she was an active, if auxiliary, member of his medical team. Her efforts also helped her to eat well and maintain her own health during this demanding period.
If you’re not a medical professional, there is little that you can do to direct the medical treatment designed to help your loved one. You can, however, with your loved one’s concurrence, find ways to provide support and comfort as your loved one experiences the side?effects of their treatment.

Anne Orchard

“Shock can make people say the most appalling things.  In the UK we have an expression ‘open mouth and insert foot’ – very strange I know. I’m not sure why we refer to saying something insensitive as ‘putting our foot in it’ (although it may have a farming connection), but we do. Sometimes it doesn’t even have to be caused by shock, just by not thinking before speaking. 

You will probably find that many people say ‘the wrong thing’ to you.  I could quite possibly be one of them.  You could get horribly offended about that.  You could even tell yourself for years about how thoughtless they have been. If this has already happened to you, then pause for a moment. Can you remember a time when you said something you regretted? It could have been in an interview, or the heat of an argument. You probably knew it was the wrong thing to say almost at once. Did you apologise and fix the issue then, or let it fester until later? 

None of us is immune from saying something that could cause offence, so don’t punish someone who makes that mistake. Tell yourself “Oh, they didn’t mean it like that.” Then let it go and move on. If it’s a big issue, and you can’t do that yet, then talk to them. The person may not even realise they offended you, and may quickly be able to make amends. Just be aware of the advice often given to couples. Don’t attack the person for their mistake, this will only put them on the defensive. Instead, talk in terms of how their comments made you feel. Don’t be attached to how they respond, just know that you’ve let it out and let it go. 

Another problem that can occur is if you become scared of saying the wrong thing to your loved one. You may dumb down your conversations with them for fear of offending with your words. Doing this, though, is far worse than making a blunder. What your loved one needs more than ever is to be able to communicate with you. They can’t do this if you are watching your words so much that you don’t say what you really feel.

So please don’t hold on to things that others say to you, especially when emotions are running high. This will free you to speak fearlessly as well. If you have said something you regret, let the person know. Forgive yourself first, and then tell them what you wish you had said or done.”

Extracted from Their Cancer – Your Journey ©2008 Anne Orchard

Maybe you think that what your friend, relative or acquaintance said to you is completely unforgivable, but I hope not. Holding resentment towards another person will do you more harm than them.  If you must, have a moan about their thoughtless words, but then let them go. Then you can concentrate on dealing with your feelings.

Anne Orchard