Coping with Cancer: Explaining advancing cancer

Of all the difficult times coping with cancer, one of the most difficult is finding a way to tell your young children that the cancer treatment is not working, and the cancer is spreading.  Decisions about when to tell the children, how much to tell them, and what to focus on, are all so heart-wrenching and hard.  But just as in the other sections of these notes and tips, it is important to be honest and clear with preschoolers.

First, remember that your young children really won’t understand that stopping treatment means that hope for extended life is diminishing.  In fact, when you tell them that you won’t be getting more chemotherapy, they may be glad, thinking that you won’t be as sick.  They may notice a new level of sadness or fear at home, but if the cancer experience so far has been one of ups and downs, they may not even tune into a parent’s angst.  And there is no rush to tell children everything that you know about the meaning of this current treatment status.  Preschool children have a shortened frame of reference for time, and it is not useful to talk to them about an impending death until it is really near.  You can tell preschool children that someone’s cancer is getting worse, that it is making everybody in the family sad, that the doctor’s do not think they will be able to make the person better, but until the child asks if the person is going to die, that topic does not need to be addressed.  If and when the child does ask that question, it is important to acknowledge that the person in fact may die, and that when people get sicker and sicker, and nothing can make them well, they sometimes die.  Then the next step is to make sure the child knows that as things change, he will be told about the changes.  Also, all young children need to know how their lives will be impacted, and that they will be taken care of and will be safe, no matter what happens.

It is still important to keep a balance between frightening news and some sort of positive expectations.  That might seem like a contradiction; what can be positive when a parent is getting sicker and sicker?  Focus on the small things a child can do, like drawing pictures for the parent, playing a simple game, making cookies.  Also, make little moments count.  Watching a movie together may be the highlight of the day, but it will give the child some special memories.

If the child is old enough to understand the words, he needs to hear that although you are no longer hopeful that the cancer will be cured, you are now hopeful that there will be no pain, or that something fun can happen every day, or that the family will have special times together.  Even when hope of life is gone, there are still important things to hope for, and to share with your child.