For many people, including me, the most difficult personal conversations about cancer are with our children. How do you honestly share what is happening in a way that a child can deal with while continuing to trust you?

Naturally, the way you talk to a child will vary with the child’s age. Elena’s daughter was a young adult, and the ways Elena found effective to speak with her are likely different from those you would use when talking with a younger child. On the other hand, it’s easy to underestimate how much even the youngest children sense changes in their routine and are aware of the emotions and behavior of the people around them.

It’s common for parents to want to protect a child by not discussing upsetting things. Yet when a child is aware of something amiss that is not being talked about, his or her imagination can sometimes be worse than the reality. Some children can get the idea that they are the cause of the distress and/or that the problem is so terrible that adults can’t discuss it. Talking about these worries helps them feel less alone because they know there are people who can help them with difficult situations.

Simple honest language can eliminate confusion and misinformation. Many parents have found that using the word cancer helps them maintain a trusting relationship with their child. Consider saying that cancer describes cells growing more quickly than usual.

Recall that it can be easier to cope when you keep in mind the seemingly opposite ideas that a situation can be both scary and hopeful. You may want to acknowledge that the word cancer is scary to some people because there weren’t always as many good ways to manage cancer as there are now. Share your personal treatment plan and the hope it offers. Some people describe the chemo or radiation as ways to slow down the cell growth. Over time, it’s useful to explain that hair loss and other upsetting side effects are reactions to the medicine, not the illness.

As with adults, children’s responses to cancer vary. Some children ask a lot of questions and want to know lots of details. Others clam up or may feel embarrassed. Some jump into caretaking, feeling they should put their lives on hold. Yet others appear to ignore what is happening, throwing themselves into their own lives. As in many other parts of life, it is most constructive to encourage a child to find a balanced middle path that also maintains his or her own life.

Questions may not come all at once, so try your best to stay open to them over time. Listen for misconceptions, such as that cancer is contagious. Some children may ask whether you’re going to die. Again, the goal is to balance hope and honesty. You might acknowledge the reality by saying “All of us will someday, but hopefully not from cancer” or “We hope not, and the doctors are working very hard to help me.”

Cancer by Peter R. Van Dernoot.

Cancer Hates Kisses by Jessica Sliwerski

Cancer Party by Sara Olsher

The Cancer That Wouldn’t Go Away: A Story for Kids about Metastatic Cancer by Hadassah Field

Grandma: A Children’s Cancer Book by Cheryl Lee-White

Jeannie Ann’s Grandma Has Breast Cancer by Diane Davies

Mommy Has Cancer: What I Learned about Cancer and How I Helped my Mommy by Corey L. Stevenson Jr

My Dad is a Cancer Fighting Hero by Chelsey Gomez

My Grandma is a Cancer Fighting Queen by Chelsey Gomez

Nana, What’s Cancer? by Beverlye Hyman Fead and Tessa Mae Hammermesh (American Cancer Society, 2009)

Nowhere Hair by Sue Glader

Someone You Love has Cancer: A Child’s Guide to Understanding by Robin Martin Duttmann 

Someone I Love is Sick: Helping Very Young Children Cope with Cancer in the Family, Grandparent Version by Kathleen McCue (Imagination Press, 2009)

Talking with My Treehouse Friends About Cancer: An Activity Book for Children of Parents with Cancer by Peter R. van Dernoot

What Happens When Someone I Love Has Cancer by Sara Olsher