Teaching Kids About Cancer: The Hardest Questions

As parents are teaching their kids about cancer in the family, many parents worry about the kinds of questions their children may have.  Parents tell me that they are afraid they will not know how to answer their child’s questions or worse still, they will break down and have a strong emotional reaction to some of the harder questions.

Let me first reassure you that preschool age children usually ask few or no questions about cancer.  In fact, in order to get any conversation going with young children, you usually have to be the one to ask questions.  Questions such as “Have you ever heard of cancer, and what did you hear?” or “How did you feel when you knew Grandma had a lot of doctor’s appointments?” will help to elicit conversation.  But don’t be surprised if you child just takes in what you tell him or her, and then wants to go play.  As a young child thinks over the information you provide, and as he listens to adults around him talk,  and as various components of his life change, he will probably have questions that will emerge at bedtime or in the car or seemingly out of nowhere.  It is useful for parents to think about and prepare themselves for some of the harder questions that might come up.  And being prepared for the questions will help you to feel more in control and less likely to become emotional during your talks with your child.

So, what are these harder questions?  And how should they be answered?  A few of the more common questions are listed below.

  • What is cancer?
  • Why does (mommy, daddy, grandpa) have cancer?
  • Did I cause cancer?
  • What did cause cancer?
  • Is the cancer my fault?
  • Am I going to get cancer?
  • Are you (healthy parent) going to get cancer?
  • Is the person with cancer going to die?

Let’s look at the categories of questions, and summarize the important points to be considered in each category.  The question about defining cancer has already been discussed in the very first short article, called “What is cancer?” under the headline, Talking To Your Children About Cancer.  Questions about causation should be answered simply and briefly.  We usually don’t know what causes cancer, but we do know that it is nothing the child, parent or grandparent did.  Even when the cause might be connected to certain behaviors such as smoking or eating, or might be genetic, that is more information that a preschool child can understand.  It is important that we do not cast blame on anyone for the onset of an illness, especially when we are dealing with children in the developmental stage of feeling shame and guilt.  And the truth is that not all people who smoke get lung cancer, and not all people with lung cancer are smokers.  So the simplest answer to what causes cancer and did I cause the cancer is that we don’t usually know what actually causes one person to have cancer and not another.  But we do know that you can’t catch it, and one person cannot cause another person to get it.

The question about why someone has cancer is deep and philosophical, and isn’t usually asked by preschool children.  If they do ask, this is a good time to include any faith-based explanation that you as a family chose to endorse.  It is fine to say that nobody knows why one person gets cancer and not another, but if your belief system involves an understanding that God decides who gets sick and who stays well, it is certainly appropriate to share that with your child.

Questions about whom else will get sick, and will the child or the well parent get sick need to be addressed in an honest but reassuring manner.  You cannot promise the child that no one else will get sick, since that is out of your control.  But you can say that everybody is healthy right now, and you are all doing your best to stay healthy, and there is no reason to believe that anyone else will get sick.  And here again you will remind the child that a person cannot catch cancer since that may be the concern behind this type of question.

Finally, the most dreaded question of all is “Are you (or whoever has cancer) going to die?”  This is the point at which parents want to jump in and reassure children that all will be well, because it is what they want to believe in the core of their hearts.  But we know that no one can promise that a person will not die.  All children learn about death, usually in later school age years.  So now your job as a parent is to teach children a little about death at a fairly young age without frightening them or making the situation seem worse than it actually is.  So if they do ask if the person with cancer is going to die, acknowledge that sometimes people do die of cancer but many people who have cancer get well.   Nobody can promise what will happen here, but the sick person is doing everything he can to get better. If it’s true, let children know that right now the doctors and the family all hope and expect that the person will get better.  If the person with cancer is seriously ill, with a poor prognosis, it is important to let the child know that the person is very sick, and sometimes when people are very sick, the doctors can’t find a way to make them better.  How specific you are about the likelihood of death depends on how immediate it might be.  Young children with a limited sense of time cannot deal with impending death very much in advance.  This will be discussed further in the section titled “When Young Children Must Face the Death Of A Loved One” under the headline, Talking To Your Children About Cancer.

For now, the questions about possible death need to be answered with honesty, but also with hope.  And remember that it is as important to acknowledge the feelings and emotions behind the question as it is to answer the questions itself. Your answer might make a statement like “Of course we all worry about these sorts of questions, so what can we do as a family to help each other put aside our worries and go on with our lives?”  These are the plans and ideas which will help your young child cope.