How to talk to children about cancer

Figuring out what’s really up with your parents is child’s play. Just check their text messages or eavesdrop on a phone call. That’s what one child whispered during a support group hosted by oncology social worker Krista Nelson at Portland’s Providence Cancer Institute.

“I’m always amazed at how much kids really do know about what’s going on,” Nelson said. “Even when their parents don’t tell them.”

That’s why it’s important to be real with children when it comes to news as important as a family cancer diagnosis. If you don’t tell your children, they’ll likely either sniff it out themselves, or even make up their own facts and explanations about the big mystery at hand.

“Parents are afraid it’s going to be very hard on the children and they don’t want to share,” said surgeon and author Nathalie Johnson of Legacy Cancer Institute and Legacy Breast Health Centers. “But children sense the stress in the home, and their imagination can take them to far darker places than reality often is.”

Young children might blame their own misbehavior, or worry that cancer is “catching.” Adolescent girls may start wondering about their own risk. And, naturally, everyone will worry about the very worst.

“A new cancer diagnosis is a scary and uncertain time for the whole family,” said Susan Stearns of Clark County’s Pink Lemonade Project.

“We usually suggest that parents are honest with their children in an age-appropriate way,” Johnson said.

Fortunately, the overall news about breast cancer is appropriate for any age: “There’s a 99 percent cure rate at this point,” Stearns said. (Other cancers are “trickier,” she added.)

Reading stories

Johnson, who is both a cancer surgeon and a cancer survivor, said a children’s book was the best way she could think of to help parents broach the subject of their diagnosis. Reading stories about peers facing similar problems is an ideal way for children absorb new information and explore difficult feelings, she said.

As she wrote, Johnson enlisted her own 7-year-old daughter to help keep things age-appropriate. Her husband and son contributed too. The result was “Mommy Found a Lump,” a picture book that conveys a bit of basic medical information, but mostly focuses on what the treatment process may be like for the family.

She also wrote a book for older children, “Understanding Breast Cancer for the Young Adult.” Both books are available via LuLu Publishing.

Regardless of intense emotions, household changes and an uncertain future, here’s what children of every age want to hear, according to all these experts: You will be OK. I will make sure that you are always cared for and loved.

“If Mom has been diagnosed in a metastatic state, it might be possible for kids to understand and appreciate the time they have left,” Johnson said. “Kids handle things a lot better when they’re informed.”