If you care for young children (ages 3 to 9) as a parent or grandparent, it may be tempting to shield them from the fact that you have breast cancer. Experts agree that this is not a good idea. Even very young children can sense when family members seem stressed or anxious, or when usual routines are disrupted. They will notice changes in your appearance and your energy level, and they will know that you are spending time at the hospital.
Although young children do not need detailed information, they do need honesty and reassurance. Without any direct explanation from you, children may imagine a situation that is actually much worse than reality. Being honest with them builds a sense of trust that will be helpful in facing not only this situation, but also other challenges that life inevitably brings.
- Plan out the conversation in advance. Decide what you are going to say and how you are going to say it. This will give you a framework for the conversation. Involve your partner or another adult the children trust if you think their presence will be helpful.
- Use direct, simple language to define what cancer is, where it is in your body, and how it will be treated. Experts agree that naming the illness is important — “cancer” should not be a forbidden word. Even very young children can grasp simple explanations of what cells are and how they sometimes don’t “follow the rules” and grow as they should. You might also explain that the doctor has to remove all or part of your breast where the cancer is, and then use special strong medicines make sure the cancer is all gone from your body. A doll or stuffed animal could be a useful visual aid.
- Make sure children know that the cancer isn’t their fault and they cannot “catch” it. Young children often see themselves as the center of their worlds. They may worry that the situation is their fault or that they did something to cause the cancer. Also, children tend to associate sickness with catching colds or sharing germs. Be sure to explain that no one can catch cancer from someone else.
- Tell children how treatment for cancer will affect you. Prepare them for the physical side effects of treatment, such as losing a breast, hair loss due to chemotherapy, or feeling sick or tired at times. You might explain that medicines for cancer are powerful, and that side effects show that the medicines are hard at work inside your body. Tell children that you might feel sad, angry, or tired, but that these feelings are not their fault. Always let children know when you will need to be away from home in the hospital or at the doctor’s office.
- Reassure children that their needs will be met. Experts agree that young children need reassurance and consistent routines in times of crisis. Let your children know that you may not always be available to take them to school and special activities, play with them, or prepare their meals. Hugging, lifting, and bathing them may be off-limits for a while, too. Tell them about the trusted friends, relatives, or other care providers who will be helping out until you feel strong again.
- Keep usual limits in place. When there is an air of uncertainty around the house, it can be tempting to let children have more treats, watch more TV, play more computer games, or buy more toys. However, maintaining the same sense of structure you always have is likely to reassure your children more than giving them special privileges or treats. Keep their usual routines as consistent as possible.
- Invite children to ask questions and learn more. Let children know that you will answer any questions they may have. If your children are old enough, you might consider bringing them to one of your doctor’s appointments or allowing a visit during treatment. This can help to take away some of the mystery surrounding cancer and its treatment.
- Let children know you will still make time for them. Carve out a special time in the day just for them. Simple activities like reading a book or watching a movie can help them know that you are still there for them, even when you’re tired or not feeling well.
- Set a positive, optimistic tone without making promises. Even if you are sad or frightened, try to project a positive tone during your conversations with young children. Children may feel overwhelmed if you seem overly anxious or emotional. Make sure they know that your doctors and nurses are doing all they can for you and that most people with breast cancer do get better. Reassure them without making definite promises about the future.
- Let teachers, school counselors, coaches, and other caregivers know what is going on. Other trusted adults who spend time with your child need to know about the diagnosis. Changes at home often cause changes in children’s behavior in other settings. These adults can help you know how your child is doing, and they can become a source of additional care and support.