Talking to Your Child About Cancer - MD Anderson

Talking to Your Child About Cancer

A cancer diagnosis can create a variety of questions for patients who have children. The first question many parents ask is, "How do I talk to my child about cancer?"

Whether you're wondering how to tell your child about your diagnosis, treatment, progression or recurrence, there are quite a few things to consider before beginning these important discussions.

To start, consider your child's age and developmental stage. Some children are too young to verbalize questions and others may be too afraid to ask. Also, what does your child already know about cancer?

What is the best approach?
It's common for parents to protect their children by withholding information that may be upsetting, but research shows the following:

1. A parent's cancer diagnosis affects a child whether or not the child is informed of the condition. 1
2. Anxiety levels are higher in children who aren't informed about their parent's condition, compared to children where the issue is discussed. 2 
3. For parents of teenagers, an important aspect of coping is ongoing communication between the teens and their parents during the course of the illness. 2

So, what does this research mean to parents? Simply put, it means that honest, age-appropriate communication is best. How do I talk to my child about cancer?
First, it's crucial to say the word "cancer." This is essential so the child will not associate the parent's diagnosis with another illness children can catch, like the flu or a cold. The following are common questions many children have, and they're important points to consider while talking with your child:

• Can I catch cancer?
• How does cancer happen?
• Is it my fault my mom or dad got cancer?
• Will my mom or dad die from cancer?

Remember that children may not ask these outright, but many will be wondering about them. Because children pick up on social cues, they may sometimes create scenarios in their heads far worse than reality when not given honest communication about what's happening.

Honest and age-appropriate communication with children models the behavior that it's OK to ask and talk about cancer. 

open access: Children and young adults with parents with cancer: a population-based study

Children and young adults with parents with cancer: a population-based study

Background: 
Today many people are choosing to have children later in life. Additionally, the use of sophisticated diagnostic tools and screening modalities has increased over recent years. Because of these factors, cancer is being diagnosed more frequently during the child-rearing years. Sociodemographic and cancer-related information on families and minor (0–18 years) and young adult (YA) (19–25 years) children experiencing parental cancer is scarce, but this information is vital for healthcare initiatives aimed toward those potentially adversely affected. Therefore, the aim of this study was to describe features of families and minor and YA children affected by parental cancer in a nationwide population.
  
Conclusion: 
Adequate assistance for minor and YA children affected by parental cancer requires knowledge of their number and characteristics. Parental cancer is more common than previously suggested: the annual incidence of parental cancer for children under 18 years of age is 0.3%, whereas approximately 4% of children aged 0–25 years have or have had parents diagnosed with cancer, corresponding to a population prevalence of 1.4%. Around 20% of these children experience parental death, and surveys of live respondents should account for this.

Medscape: 'Children Will Die': Panic in US Over Methotrexate Supplies

Adolescents And Young Adults: Bringing A Neglected Group Into Cancer Research – Health Affairs Blog (ages 7-18rs)

“A child is not a small adult,” but an adolescent is not a large child...."

"Consent and Assent in Children and AYA Cancer Patients
For most IRBs, informed consent can be granted by any prospective human subject over the age of 18.  For minor patients under 7, consent is granted by the parents or guardians.  What to do with patients between the ages of 7 and 18 (or with “intellectual ages” between 7 and 18) is less clear.  While they are still minors and under the care of their parents or guardians, they are also independent human beings capable of judgments, particularly ones with which their parents or guardians may not agree. This is certainly the case when it comes to choosing their friends, making time for school work, selecting extracurricular activities, carefully operating a motor vehicle and experimenting with alcohol, drugs or sex....."

Cancer Barbie: Backers seeking bald doll to help sick kids come to terms with hair loss - NY Daily News

When parents disclose BRCA1/2 test results: Their communication and perceptions of offspring response - Bradbury - 2012 - Cancer

What Parents Tell Their Kids About Breast-Cancer Gene Test Results - Health Blog - WSJ

Blogger's Note: this has been an area of much discussion and debate over many years which not only includes age issues (age of majority-adult) but also ethical dilemmas (eg. because you carry a mutation the risk of a cancer varies and does always mean a cancer diagnosis).
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"If you were tested for the “breast cancer gene” — mutations in the BRCA1 and BRCA2 genes that raise the risk of breast, ovarian and other cancers — would you tell your children?...."

"There isn’t much to do with the information for that age group: kids who learn that a parent carries a BRCA mutation aren’t advised to have the test themselves until at least age 18, and any additional screening resulting from a positive result wouldn’t likely begin until age 25, says Angela Bradbury, lead author of the study and the director of breast and ovarian cancer risk assessment at Fox Chase Cancer Center in Philadelphia......"

selected photos (ovarian cancer survivor participants)

Dr Yi Pan

UK artists Clare and Denise

Participant displays event poster

young participants

Participants

abstract: (small study) Cancer-Related Sources of Stress for Children With Cancer and Their Parents

Note: note differences in participation between mothers and fathers (n); abstract only info does not detail this variance


Objectives
The current study examines reports and correlates of cancer-specific stressors in children with cancer and their parents. Measures
Mothers (n = 191) and fathers (n = 95) reported on their own and their child’s stressors, general perceived stress, and posttraumatic stress symptoms. Children (n = 106) completed self-reports of their own stressors and posttraumatic stress symptoms.

Girl, 4, battles rare ovarian cancer - media

Sex cord stromal tumors of the ovary in children - abstract (sertoli-leydig most aggressive cell type)

CONCLUSIONS: Completeness of resection and histology were important prognostic factors; in our series the Sertoli-Leydig Cell tumor was the most aggressive variety. Hormonal signs (precocious puberty, telarca, menarche) were common in younger patients and led to an early diagnosis. Cisplatin based chemotherapy seemed to be effective for locally advanced tumors.

Surgical management of ovarian disease in infants, children, and adolescents: a 15-year review

RESULTS: A total of 231 patients were evaluated in this study, with a mean age of 12.8 years (range, 3 weeks to 20 years). There were 221 (95.7%) benign lesions and 10 (4.3%) were malignant.

news article: More than a million parents with minor children are cancer survivors

abstract: Parental cancer and the family. Kathryn E. Weaver. 2010; Cancer - Wiley InterScience