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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.