How to Tell Pediatric Patients the Truth About Cancer

Parents often want to protect their child by not telling her about her cancer diagnosis. Experts, however, agree that children, no matter how young, should know the truth. Most children will already know that something is wrong, and not knowing what is wrong may cause unnecessary anxiety and fear. Honesty from the start will build a relationship of trust throughout the treatment. Ask the parents to tell the child that she has cancer, as a child needs to hear it from someone she knows and trusts. Details that you share with the patient will depend on her age, and what you think she will be able to understand.

Instructions

• 1

  A pediatric patient younger than 2 years old will not understand the concept of cancer. Her greatest fear is to be separated from her parents and medical procedures she doesn't understand. Instruct the parents to reassure her that they will not abandon her at the hospital and to prepare her for hospital visits by explaining what is going to happen in simple language. Keep the parents close during the treatment to calm and support the child, and try to explain the procedure to her in simple terms.

• 2

  Children between 2 and 7 years often think that cancer was caused by something they did. Explain cancer to the child in clear, simple terms. For example, tell her that cells are needed to make your body function normally, but that cancer cells overcrowd the normal cells and make her sick. These cancer cells need to be removed to make her better. Do not give the disease names like "the big C" or "nasty cancer mouse" but simply call it cancer. Reassure the child that he did not cause the cancer and that he will not be abandoned by his parents during treatments. Tell him that it is not possible to "catch" cancer or to spread it to others like measles. Explain that you are doing everything in your power to make the pain go away, and that certain tests and procedures may hurt but need to be done to make him better.

• 3

  A child of 7 to 12 will understand a more detailed explanation of cancer. Be honest with her about pain that may be incurred during treatments, but inform her about the options for pain control. Explain the meaning of certain medical words and treatments such as a tumor which could be explained as "a lump inside your body," an X-ray as "a picture of the inside of your body" and chemotherapy as "special medicine to get rid of the cancer." Be honest about changes cancer may cause in the child's daily life, such as restrictions in certain sports and activities, and the length of some of the hospital visits. If the child asks whether he is going to die from the cancer, assure him that you will do everything in your power to prevent that from happening.

• 4

  Teenagers typically worry about the effects of cancer on their daily and social activities like sports, school and relationships with their friends. Give a teenager a complex explanation of the disease (without using incomprehensible medical terms) and be prepared to answer detailed questions. Try to involve the teenager in decisions about her treatment and explain the pros and cons about certain treatments in detail. A teenager might be very concerned about her appearance, so be honest about side effects such as hair loss and weight loss.