How to Talk to Kids About Cancer, According to Experts and a Mom Who’s Been There

Design by Channing Smith

Learning how to talk to kids about cancer is something no parent should need to do. Unfortunately, the reality for many families is that they will.

That became abundantly clear in the past two weeks, when two prominent women—both in their early 40s, both young moms—revealed they’d been diagnosed with cancer. First Olivia Munn, 43, shared she’d been diagnosed with breast cancer after taking a breast cancer risk assessment. Then Catherine, Princess of Wales, 42, finally put an end to the internet’s “Where is Kate Middleton?” fever when she, too, shared her cancer diagnosis with the world.

Their announcements followed research published last year that found a troubling trend in cancer rates: They’re rising in young people. Currently, women in the US have a roughly 6% chance of developing cancer before turning 50, per the American Cancer Society. But that number could increase by as much as 30% by the end of the decade, according to estimates.

In other words, the conversations sparked by Middleton and Munn aren’t likely to go away. Because they are young women dealing with the disease, we’re suddenly all talking about cancer screenings in a way that will undoubtedly save lives. And for parents, these high-profile diagnoses are helping to start another vital topic: how to talk to your kids about cancer.

How to talk to your kids about cancer

Samantha Harris, an Emmy-winning TV journalist, certified health coach and mom of two in California, was diagnosed with breast cancer in 2014 after finding a lump just 11 days after a normal mammogram. Three doctors told her it was nothing to worry about before she was ultimately diagnosed with stage 2B invasive breast cancer. She was 40.

While the news was a shock, it was the idea of going home to her two daughters—three and six years old at the time—that felt impossible. “The first thing I did was gather my own thoughts,” says Harris. She asked her husband to meet her at a nearby park. “We needed to talk through this new knowledge of my diagnosis and digest that information before we really formulated how we were going to tell them and what that timeline looked like,” says Harris, who went on to write Your Healthiest Healthy: 8 Easy Ways to Take Control, Help Prevent and Fight Cancer, and Live a Longer, Cleaner, Happier Life.

“The biggest thing I remember is how we told our six-year-old during her younger sister’s nap time, which was the only time she was allowed to watch TV,” she says. “She was more concerned about when her show was going to turn back on. That actually made me feel better. I realized there were so many distractions for them and that helped us manage the next several months when I was in a very fragile state.”

Harris and her husband ultimately told their daughters about Mommy’s cancer leading up to her scheduled double mastectomy, since the surgery and weeks of recovery would impact their routine. They explained (separately and in age appropriate ways) that mom needed to have surgery to take something out of her body that wasn’t supposed to be there and used the words “breast cancer.” “We never wanted them to hear those words [for the first time] from some other kid who maybe overheard their parents talking about my diagnosis,” she says.

After the initial conversation, Harris focused on sharing things her kids could look forward to: getting to have their after-school snack in Mom’s room picnic-style, cuddling for story time, doing art projects in bed with her while she recovered. “I didn't realize what I was doing at the time, but I was creating positive experiences and positive memories over something that so many of us as adults interpret as devastating,” she says. “It flipped the script on what cancer was to our kids—we didn’t make light of something that was serious, but we didn't play the cancer card the way adults interpret it.”

How you talk to a child about the cancer diagnosis of a parent or loved one will differ based on their age and developmental stage—a conversation with a three-year-old will obviously sound different than the conversation you might have with a 13-year-old. But there are several key commonalities to keep in mind, according to experts who counsel cancer patients and their families. “Also remember that you know your child best,” says Heather Valladarez, a senior social work counselor at MD Anderson Cancer Center in Texas. “You know their maturity level and how they tend to cope with things.”

No matter how you have the conversation, the most important thing is that you have the conversation. “Kids tend to understand that something is wrong, and the unknown is often the scariest thing for children,” says Kelsey Largen, PhD, a pediatric oncology psychologist at Hassenfeld Children’s Hospital at NYU Langone. “Sharing information about an illness in a developmentally appropriate manner allows parents to have some control about how their child finds out about their diagnosis and gives kids an opportunity to ask questions about how the illness is going to affect their lives and routines.”

Here’s how the experts advise preparing for the conversation, things to consider, and what to avoid when talking to kids about cancer.

Process it yourself first.

Much like Harris intuitively knew after learning she had cancer, “it is important for parents to have time to process their own diagnosis if possible prior to talking with their child,” says Valladarez. “Processing a diagnosis may come in stages after the initial shock, grieving the diagnosis, and allowing expression of feelings that may arise. This will help with the coping process and will ultimately help the parent when having the conversation with their child.”

For Harris, it was particularly helpful to pause, take a deep breath, and “understand that nothing was going to change in my kids’ lives in the next couple of days, weeks, or potentially months,” she says. Take the time you need to gather your thoughts before sitting kids down.

Have a treatment plan.

When you are ready to talk to your kids, it’s helpful if you already have a treatment plan you can share, says Julie Gralow, MD, chief medical officer for the American Society of Clinical Oncology. “When you start talking about it, you can outline what you’re going to do to get rid of the cancer,” she says. “That's really hard to do right after a biopsy when you don't know what the game plan is.”

Set the tone.

“When preparing to have a conversation with your child, it’s important to establish a safe, calm, quiet space,” says Valladarez. “This will allow the child to be able to ask questions and be fully heard, as well as express any emotions that may arise.”

Sit across from your child, close enough to provide comfort and support while they process. “It can also be helpful to model behavior with your child,” says Valladarez. “The parent can model how they processed and are still processing the diagnosis themselves, as well as showing open communication, answering questions honestly, and normalizing emotions. It’s okay to be angry, sad, scared, or worried, and it’s okay for the child to still be happy and have fun. You want them to know they can still be a child.”

Remember that kids, especially young kids, often take their cues from the emotions of their parents. “If you feel like you are going to break down right away, maybe hold the conversation for a slightly different time,” says Dr. Gralow.

Be hopeful but honest.

“With a serious illness like cancer, we often don't know exactly what to expect,” says Largen.

It's good to be honest about that. “Be as transparent as you can be while remaining hopeful,” Largen continues. “You can say something like, ‘Mommy is going to the doctor and getting some medicine to help her to get better. We are very hopeful that she will get better very soon and be able to go back to regular life.’” If circumstances change, keep kids in the loop. Providing age-appropriate information as it becomes relevant is key for maintaining trust.

Use the “C-word.”

All the experts we spoke to unanimously agreed on the importance of using appropriate terminology when talking to kids about cancer. “Don't sugarcoat the words,” says Dr. Gralow. “Don't come up with other words for cancer or chemotherapy. Use the actual words that they're going to confront. Because somebody at some point is going to use those words, and you don't want them to be surprised.”

It’s especially important for school-age children, adds Largen. “It will get around and maybe other kids in the class say something on the playground like, ‘Everybody with cancer dies,’” she says. “You want them to be able to come back and say, ‘No, that's not true. We've talked about her treatment.’”

Calling cancer by its name also helps kids understand it’s different from other illness they may have encountered—and that it’s not contagious.

Use age-appropriate resources.

With kids in the three to five age range, pictures and drawings can be helpful, says Dr. Gralow. There are also dozens of books written for kids of all ages to help them understand cancer. “One of the books I often use is called The Invisible String by Patrice Karst, which talks about being away from a loved one but always feeling connected,” says Largen. “Another one I use is called How Do You Care for a Very Sick Bear, which helps kids to understand what their role can be in supporting a parent or a sibling who is going through a serious illness.”

For older kids, be aware that they will likely google. “One thing I’ve learned from experts since my diagnosis is that we really want to give teenagers the proper resources online,” says Harris. “Googling a diagnosis often scares the bejesus out of adults. So imagine a teenage brain trying to process all that information.”

Encourage teens to do their research through credible institutions like the ACOS and the American Cancer Society, which share science-backed information without being alarmist.

Talk about what to expect.

“Focus the information you provide on how the cancer will impact the child’s daily routine instead of specific details of diagnosis and treatment,” says Valladarez.

“If you expect physical changes, share that Mom or Dad may look different and what’s causing the changes,” says Largen. “If you’re expecting to have a hospital stay, prepare kids for your absence ahead of time. If kids can understand these changes to their lives from the beginning, it creates a feeling of open communication and helps kids know what to expect.”

Leave space for questions.

Always let kids know that you’re there to answer their questions—no matter how hard they may be. “In the teen years especially, kids may need some time to process,” says Dr. Gralow. “Make sure the window is open so that they can come back and ask more questions.”

And remember, it’s fine if you don’t have all the answers. “It’s okay to say, ‘That’s a great question. I’m not sure, but I can ask the doctor,’” says Valladarez. “This shows the child that there may be questions that the parent doesn't know either, and that’s okay.”

Originally Appeared on Glamour