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Talking with Children About Cancer

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Published on July 6, 2020

How do you explain a loved one’s cancer diagnosis to a child? How much, or how little information should you share? Child and adolescent therapist Dr. Sierra Wait, from ECS Psychological Services, discusses how to navigate those difficult conversations. Watch as Dr. Wait gives guidance on timing, setting expectations and being truthful without inducing worry.

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Transcript | Talking with Children About Cancer

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Ruth Fein:

My name is Ruth Fein and I have the pleasure of hosting this session today. And Dr. Wait, Dr. Sierra Wait is a therapist who specializes in children's emotional health. And what we're going to discuss now is children and a cancer diagnosis. So first, as a mental health practitioner, I'd like to get into talking to children about a cancer diagnosis of a loved one. The people, again, who are watching this, who come to Patient Power and rely on them for all kinds of great information might be a parent, a grandparent, a caregiver, with some connection to cancer. So we've been talking about the tools that parents and others can use to help children through all different difficult times. But what about when they're told of a cancer diagnosis of someone they love, without assuming that they don't know what the big C is?

Dr. Wait:

Right. Yeah. I think that that can be a difficult conversation to have. I think you can carry some from our previous conversation over in the sense of really answer their questions that they have and let them lead how much information they really feel like they can handle and that they want to know. And also again showing them, I think especially with cancer, explaining what it is in a broad sense. Explaining that there's a lot of people who know a lot about cancer, who are doing everything they can to keep the family member healthy. And I think it's important to talk to them about expectations.

So maybe a grandmother is going to go through treatment and lose her hair or be really tired or not be around all the time. And so really setting them up for what to expect - kids really like a world that's predictable. And so if it impacts their schedule. Right? Maybe grandma picks them up from school and that's not happening. And so showing them how it's going to impact their world. Kids develop out of being kind of so self-focused, but young kids are very focused on their view of the world. And so really relating it back to them.

I also think showing them what they can do to gain a little bit of control. Right? Maybe they can draw a nice picture, write a note, but also showing them that they can still be kids and they should be playing and they should be focused on doing schoolwork and playing with their friends and going to summer camps and things like that. Again, also that how do we tell them. Right? Do we tell them from a scared place or a place of being truthful and hopefully a positive outlook so that we can model that positive outlook for them.

Ruth Fein:

Right. Thank you. So I was diagnosed with an MPN, which is a myeloproliferative neoplasm, 25 years ago, and it's a rare blood cancer which at the time wasn't called a cancer. It was called a blood disorder. So when my now Manhattanite sons, 30 and 29, when they were young I didn't have the same challenges. I remember several conversations that I had with them as years progressed, but I didn't go through treatments and I didn't have that trauma that so many times we have to deal with. So I think it's really important what you can share with us as non-experts.

And interestingly, someone asked me recently, how did my ... we were speaking about my grandson, Aiden, and I was asked, "Well, how does Aiden handle your cancer diagnosis?" And I said, "He has no clue. I've never told him. There's no reason to. I don't go through treatments. I'm not visibly affected, certainly not when I see him." But that doesn't mean that it wouldn't be helpful for me to have a conversation with him. And I have other grandchildren, so that if the time comes that something does have to be identified or they have to deal with or they see a change in me, it would be better for it not to be a shock, I would imagine. Talk to us a little about that the pros and cons of, like you said earlier, sometimes we don't give kids enough credit and we want to protect them. Where's that line between protecting them and making sure that they're not taken off guard when they need to be aware?

Dr. Wait:

Yeah. I think that's a really hard line to find. In your situation it sounds like if you told Aiden it might be a situation where, and I don't know him, so is he going to worry a lot about it? If he's going to worry and there's really no need to, then telling him is really causing him more harm than good. Right? And so what's the utility of telling him? What's the goal? And so if it's something where you're going to be going through treatment, then telling him and just preparing him so that he isn't caught off guard. Right? Is there a genetic…Is there a test that a family member has to get? I don't know much about that cancer, but I think timing is really important. Right? We don't need to tell people two years in advance about something scary that might happen because then we're just setting them up to worry a lot potentially.

So I do think that that's a really, that's a fine line. I think in my experience a lot of people seek out a therapist to really help them with those conversations if they're pretty serious. Because we do worry that we don't want to overburden, but we also don't want to overprotect. And so I think that line again is a hard one to find sometimes. And I think if you ask yourself, "What is the purpose of this conversation?" And is it going to do more good than harm?" Right? Like if it's current, kids are worrying about COVID already. Like they see the masks, they see things changing. Right? If you were going through any treatment and you were changing your behaviors, your look was changing, he'd be worrying already probably or he'd at least be noticing that something was different. And so putting a name to what he's seeing is important, but if it doesn't really affect him then is this the right time? Maybe not. So waiting until it is the right time.

Ruth Fein:

Yeah. That's what I was thinking. But I wasn't confident about my decision until I was asked about it. So I thought that that's a good thing to share with people, whatever your personal decision is, is fine, but it's great to be based on some expertise which I thank you for. So one last question, what have you learned from children about how they deal with stress and anxiety and what they want to know and don't want to know? Because I think sometimes our listening skills tell us everything we want to know about children and what they're dealing with or not dealing with and how.

Dr. Wait:

Yeah. Wow, I've learned so much from children. They're really a pleasure to work with and be around. I think listening, like you said, is really important. I have lots of parents tell me, "Oh, my kid just before going to bed, they just tell me about the things on their mind. If I ask at dinner they say, 'My day was fine.' If I ask before bed they're relaxed and they just share." Or parents tell me in the car. Right? "We're driving and it's just me and my kid and they just start talking." And I think there's something about not having that focus direct, one on one conversation, eye to eye can be intimidating for a kid. Especially if you're asking them to share something very vulnerable, like their feelings.

So I've learned that giving them that space to share their feelings that's a little bit less direct. So I love sitting kind of next to a kid and just drawing with them and talking, letting them draw and talk to them so that the pressure is taken off and so that they feel a little bit more at ease to share. I think you can gain a lot from listening to kids, like you said. Kids are pretty great because they haven't really learned that talking about our feelings are taboo as some adults have learned. And so just with the right questions here and there, they're really willing to share how they feel and they're motivated to feel better. And so they're really willing to learn the tools to make themselves feel better.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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