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Talking To a Child About Cancer

Healthy & Natural Journal,Feb, 2001byLynnette Wilhardt

By discussing cancer, children can get a more accurate picture of the problem and perhaps

resolve many of their imagined fears.

According to the American Cancer Society, half of all men and one-third of all women will

develop cancer during their lifetimes. Today, millions of people are living with cancer or have

been cured of the disease. Therefore, it is highly probable that cancer will affect your family in

some way.

Would you know how to explain such a disease to your child? Some parents and caregivers try

to avoid topics like cancer for fear they will only scare their children. The problem with this

approach is that children are very smart and intuitive. If someone in the family is dealing with

cancer and it's not being discussed openly, your child's fear and sadness will only increase.

Knowledge is power

How do you start this essential conversation? In my experience, a short science lesson about

healthy cells and cancer cells is an important first step. The following information is accurate,

non-threatening, and can be understood by children of all ages.

Our bodies are made up of millions of cells. As the healthy cells grow, they multiply and divide in

a somewhat uniform pattern. Some of these cells may be cancerous cells and may begin to grow

in an abnormal way. When this cancer cell divides, it mutates and doesn't form this uniform

pattern but instead grows into a blob, a mass, or a tumor, as it is sometimes called. Since they

grow from our bodies, tumors are not always recognized as foreign and escape detection by ourbodies' defense systems.

When someone has a tumor growing inside of him or her and the tumor is cancerous, it needs

to be removed. Sometimes, because of its location, it can't be cut out, so doctors use

chemotherapy and/or radiation therapy to destroy it. Cancer tumors are made up of fast-

growing cells, and chemotherapy was made to kill all fast-growing cells. But we have other fast-

growing cells in our bodies that aren't cancer cells, such as our hair, fingernails and linings of our

mouths and stomachs. When chemotherapy is used to kill the fast-growing cancer cells, it also

kills the good fast-growing cells as well.

Fortunately, the other fast-growing cells are smarter than the cancer cells, and even though

they get damaged from the chemotherapy, they are able to repair themselves. That is why some

people lose their hair during chemotherapy. Hair does grow back when the chemotherapy

treatments are finished. Because chemotherapy is strong medicine, many people get very tired

and sometimes become sick to their stomachs while taking it. They often need lots of rest.

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Radiation therapy works differently. Radiation uses a very strong X-ray that helps destroy the

cancer cells. Doctors target the X-ray beam so it only hits the cancer and won't hurt other parts

of your body. Most people don't feel sick after having a radiation treatment, but they do feel

tired.

Talking about prevention

Once you have explained the science of cancer, many children may ask: "But how did the person

get cancer in the first place?" Although no one really knows how or why some people get cancer,

researchers have found that there are some things you can do to help prevent getting cancer in

the first place. Offer some healthy tips:

* Don't ever smoke cigarettes.

* Eat lots of fruits and vegetables.

* Get regular exercise.

Feelings about cancer

Once you have addressed the science of the disease, it is equally important to help your children

explore their feelings about cancer. Cancer is a scary word for most children.

When a parent has cancer, children usually sense that something is wrong. They assume the

condition is really bad when the adults won't talk about it. Their imagination is often worse than

reality. If cancer is not explained to them, children may begin to believe that perhaps they

caused the disease, it's contagious, or the person with the disease will die. By discussing cancer,

children can get a more accurate picture of the problem and perhaps resolve many of their

imagined fears.

Young children

Most children have many misconceptions regarding cancer and the treatment for this disease.

Children of ages 4 to 7 will sense that something is wrong. However, they cannot cognitively

express their feelings. They are more likely to act out these feelings through tantrums and tears.

At this age, children often act as the barometer in the family. If they are dealing with sadness or

anger, chances are the parents are too, but perhaps not as expressively.

Since the children sense a problem and are acting out, avoiding the issue can make mattersworse. When children of this age are given some knowledge regarding the situation, their

feelings can be validated. They are often best at seeing the "silver lining" of such situations and

will focus on how great it is to have mom or dad home more.

A young child is very malleable and is not bothered by loss of hair and other physical changes. It

is important to try to keep the daily routine as similar as possible, as this will assist young

children in dealing with the stress that cancer puts on the entire family.

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Older children

Children of ages 8 to 12 are usually more cognitively aware of what cancer is and what may

happen to their parent or family member. At this age, children are often dealing with feelings of

sadness, fear and confusion that may cause them to become very clingy to the sick parent. They

may feel that as long as they are near, the parent will be OK. They may experience intenseanxiety over a day at school or a slumber party at a friend's house.

At this age, children need more detailed information regarding a cancer diagnosis. They also

need their feelings discussed thoroughly and repeatedly. It may be difficult for a child of this age

to understand what he or she is feeling. Parents should help interpret the child's actions. A

reassuring phrase often helps: "I understand that going to school is difficult because you worry

something might happen to me. You can call me at your recess and check in with me." In this

way, the child's feelings are validated.

Angry adolescents

Adolescents of ages 13 to 18 usually have a great sense of anger regarding a cancer diagnosis.

They are often angry and embarrassed about the entire situation. It is imperative that children

of this age are given accurate information regarding the diagnosis and prognosis.

Adolescents often need their feelings interpreted as well. A parent should sit with the child and

empathetically validate his or her feelings of anger. Discuss how the disease has changed your

lives. The parents must be careful to not put too many extra responsibilities on the adolescent

and appreciate that older children need time with their peers.

Open communication

If a cancer diagnosis is affecting your family, it is imperative that parents thoroughly explore

their own feelings and seek therapeutic help if necessary. Feelings that are not worked out

within the parent will bubble up in the children, and they will act them out for the parent. If

parents have dealt with their issues and feelings, they can more easily recognize and help their

children with similar feelings.

Lynnette Wilthardt, L.C.S.W., M.S.W, is a licensed clinical social worker in private practice in

Costa Mesa, Calif. She specializes in working with adults, children and families who are dealing

with the psychosocial issues regarding cancer and its treatment.