I have two children. I don’t want to tell them about my wife’s diagnosis and surgery because I don’t want to upset them. I can barely handle this myself, so how can they cope with the cancer? Should I tell them about the cancer, and if so, how much?

58. I have two children. I don’t want to tell
them about my wife’s diagnosis and surgery
because I don’t want to upset them. I can
barely handle this myself, so how can they
cope with the cancer? Should I tell them
about the cancer, and if so, how much?

Be honest and consistent, and reassure your
child that the cancer is no one’s fault.

Telling your children about your wife’s cancer diagnosis
is one of the most difficult issues you may have to
face as a parent. Some people are reluctant to tell their
children; whereas, others want to be as open as possible.

Research and our professional experience as oncology
counselors indicate that telling children the truth
from the beginning generally leads to better adjustment.

However, as their parent, you are the expert on
your children, and you should keep them as involved
only as much as you and they feel comfortable. Furthermore,
as the “well” parent or family member, you
may be able to play a valuable role in establishing communication
with your children, since oftentimes the
parent with cancer is unavailable (in the hospital, for
example), and you may spend more time with the children
due to increased childcare responsibilities when
your spouse is not feeling well.

Obviously, the ages of children affect what type and
how much information they can comprehend. For
example, a 4-year-old will not understand as much
detail as a 10-year-old, nor will a 10-year-old understand
as much as a teenager. However, the following
guidelines may be helpful and, unless otherwise stated,
are good points to keep in mind for all age groups of
children. A grandparent (or other family member) may
also find the following information helpful.

• Children have a good sense for what is going on
with the person with cancer and the family. They
often observe subtle changes as well as obvious ones
(e.g., concerns about hospital bills or overhearing
you or a family member on the phone). Therefore,
they may know about the diagnosis anyway, and
maybe they should hear it from you or your
spouse—the earlier, the better. This is a time to
develop trust with your child regarding the diagnosis
and treatment.

• Because every type of cancer is different, and each
person’s treatment is individually tailored, you need
to give your children the opportunity to ask about
your wife’s cancer and treatments so that they do
not get misinformation (from the Internet, gossip,
family friends, relatives, or other children).

• The word “cancer” is an abstract term that is often
hard for children to understand, which can lead to
increased fear and misunderstanding. Showing children
age-appropriate pictures and diagrams of the
body, including where the cancer is located—or
especially for younger children, allowing them to
draw pictures of it themselves—will help them
conceptualize the cancer. One 6-year-old girl drew
a picture of her father with a big black dot on his
“tummy,” representing the cancer. This picture
made it much easier for her to visualize and talk
about the cancer with her parents.

• Your children may react differently after they discuss
the cancer with you and your spouse. Some children,
especially very young children, can digest only bits of
information at a time. They may not ask questions
initially, so make sure that the “big talk” is not just a
one-time thing. Continue to check in with your
children to see how they are doing and to tell them
how you are doing, too. However, if they do not
want to talk, do not push them. Instead, explain to
them that they can ask you or your wife any questions
they like, which gives them control. Remember
that if you have more than one child, each one may
react differently. Think about whether you want to
talk to your children together or individually. One
compromise is to have a family meeting first and
then follow up with each child separately.

• Children often focus on how cancer will affect their
lives, occasionally appearing selfish and expressing
anger and frustration. Teenagers and children may
resent being asked to help with household duties to
help a sick parent. Try to be patient with a child
who expresses these feelings and to understand
without judgment (which can be difficult). Try to
find solutions, such as temporarily hiring a housekeeper
or asking family or neighbors to help with
household chores so that household routines are less
disrupted.

• Providing physical reassurance, such as hugs and
touch, is important to you and your children, especially
infants or toddlers, for whom modes of communication
are limited. Your wife may not be able
to play “rough” with your children immediately after
surgery or because of fatigue, so explain this to your
children and substitute other activities and forms of
physical connection (such as sitting closely together,
watching a video, or reading together). You do not
want them to mistake a lack of physical attention as
rejection.

• Continue (as much as possible) with pre-cancer
routines and disciplinary actions. This may be difficult
because you have demands on your time, but try
to allow your child to remain in his or her activities,
see friends, and get up in the morning and go to bed
at the same times. Some parents want to be more
indulgent, and some more strict; however, this is not
going to make your child cope any better. Consistency
communicates security to children.

Tip: Be honest and consistent, and reassure your child that
the cancer is no one’s fault.