How to talk to your kids about a scary diagnosis

The number one diagnosis that strikes fear in the hearts of American adults is cancer, a recent Mayo Clinic study found. Obesity, diabetes and heart disease also ranked high on the list of concerns.

But what many adults are even more scared of is talking with their children about their cancer diagnosis. Oncologists report a frequent question after a cancer diagnosis is delivered is: How do I tell my kids?

Openly and honestly, advises Dr. Prashant Joshi, a hematologist-oncologist at Advocate Trinity Hospital in Chicago. It’s the best communication strategy to convey a sense of security to children, who usually suspect their parents are struggling with an important issue.

“Kids can sense that something is wrong by reading parent’s emotions, changes in daily schedules and listening to adults’ conversations,’’ says Dr. Joshi, who has a focus on breast cancer.

He advises parents to be deliberate when talking about the emotional diagnosis, which “often sets off a cascade of events that alter daily life for everyone close to the patient,’’ he says.

The goal is to quiet the fears of children, and many think the worst or blame themselves. Dr. Joshi suggest parents be:

Informed

Educate yourself. “Parents must understand the diagnosis, treatments and prognosis before trying to explain anything children,” Dr. Joshi says.

Honest

Parents may not know how to answer all the questions or where to start the conversation. “If there is a difficult question that you cannot answer, it is always okay to say, ‘I don’t know.’”

Proactive

Even a dire diagnosis should be shared with young family members so they can prepare. “Children need to know the truth,’’ Dr. Joshi says. “They need to participate in certain types of interactions with their parents when they learn of the gravity of their illness. This allows for better closure.”

Second, explain events as they will occur. Dr. Joshi suggests parents describe tests and treatments and adverse effects such as hair loss, rash, nausea and vomiting to lessen fear.

Last, discourage use of the internet, where false or misconstrued information lives. “The child must feel comfortable to approach the parent with questions,” he says.

Appropriate

When talking with children about cancer, the approach needs to be age appropriate. Impending death is difficult to accept, regardless of the age. However, the older children may have a better way to handle it. Younger children need to be eased into the scenario, Dr. Joshi says. The diagnosis, treatment and prognosis may be discussed and explained to them over several days, if possible.

Transparent

Ask for help. “With changes in daily life around the house, children may become more involved. They may want to help care for the parent. It helps with their coping. After all, a child is part of the family. Ultimately, the health of parents will affect the child’s life,” Dr. Joshi says.

Watch this video to see how one Advocate patient’s family supported her during breast cancer treatment.