Key points
- Children, even from the age of 18 months, notice that something at home has changed; telling the truth is better than letting them imagine the worst [1].
- Children often know something serious has happened and want to be told honestly [3]; parents usually underestimate how much the illness affects their children [7].
- Use simple words that suit their age; for younger children, short conversations repeated over time work better [2].
- Three key messages: "It is not your fault", "Cancer is not catching" and "Whatever happens, you will be looked after" [1, 2].
- Keeping daily routines, going to school and playing, and telling teachers, all help children [1, 2].
- When a family works well together and talks openly, children cope better [5, 6].
Why talk to children about it?
You may want to protect your children from worry. But even young children sense when something is wrong: they see that you are not well, that you are away from home more or that you spend less time with them [1]. If they are not told anything, they may make up a story in their heads that is scarier than the truth; experts say telling the truth is better [2].
Research reviews show that children are often aware that something serious is happening and want honest information [3], that they need information suited to their age, and that they need help to talk with their parents, family and doctors [4]. Parents talking with their children is one of the most important ways of supporting them [7].
Key messages for children of any age
"Cancer is not catching"
You cannot catch cancer from another person; and one person in the family having cancer does not mean that everyone else will get it [2]. (Is cancer contagious?)
"Having cancer does not mean dying"
Having cancer does not mean someone will die from it; many people live with cancer for a long time, and scientists are finding many new ways to treat it [1].
"Whatever you feel is OK"
"You will be looked after"
"You can't make me better, but you can help"
Making me well is not your job, but small things such as drawing a picture, washing the dishes or tidying your room make me feel better [1].
"You are not alone"
Other children have parents with cancer too; and there are other grown-ups, such as teachers, relatives or a faith leader, whom you can talk to [1].
Matching the conversation to your child's age
| Age | How to talk |
|---|---|
| 2 to 5 years | Talk for a very short time and keep it simple; drawing a picture of what is happening can help. Tell them about changes to their routine today and in the next few days, and that they can ask questions any time [2]. |
| 6 to 9 years | Talk for a short time and over several conversations, and use examples, such as a time when they were ill and a doctor helped them get better. Talk about things that will happen soon, because children this age cannot picture weeks or months ahead. Tell them who will look after them. If they turn to something else in the middle of the talk, that is fine; it is their way of dealing with their feelings [2]. |
| 10 to 12 years | Talk for a little longer and let your child set the pace. First find out what they have heard and correct anything that is wrong. Give simple, concrete explanations (for example, there is a lump in the body that needs to be removed) and talk about the future too, such as how the illness may affect holidays and family plans [2]. |
| 13 to 18 years | Tell them the facts about the illness, and as much as they want to know. They may avoid the subject or want to be alone or with friends; accept this. Ask for their opinion and, if possible, involve them in decisions. If they look things up themselves, make sure their sources are reliable and apply to your situation [1, 2]. |
| Adult children | They may help you with treatment decisions, housework, going with you to appointments or picking up medicines. Include them in conversations about your treatment, and tell them what care you would want if one day you could not make decisions yourself [1]. |
Young children may ask the same question over and over; this is normal, so answer calmly each time [2].
Tips for the conversation itself
- 1
Choose a calm moment
Pick a time when you feel calmer and have enough time. If possible, have your partner or another close adult with you.
- 2
Explain the illness and treatment simply
Say that cancer is an illness. If the doctors' outlook is good, say that there are good treatments for this kind of cancer. Explain what changes the treatment will bring to everyday life at home [2].
- 3
Prepare them for treatment side effects
Before they see hair loss, vomiting or tiredness, tell them about it so they are not taken by surprise. Explain that you may seem worse for a while; this is part of treatment and does not necessarily mean you will not get better [2]. (Hair loss during chemotherapy)
- 4
Ask and listen
Ask what they think about the illness and what they are worried about, listen patiently and correct anything that is wrong [2].
- 5
You don't need to know all the answers
If you do not know an answer, say so honestly and look for the answer together. You can also ask a doctor or nurse to explain the facts to your children [2].
- 6
Other ways to express feelings
Young children may not find it easy to talk. Drawing a picture of the person who is ill, playing with dolls, writing, music or art can help them show how they feel [2].
What might children feel?
Children react to a parent's cancer in different ways. They may [1, 2]:
- feel confused, scared, lonely or angry
- think something they did or said caused the illness and feel guilty
- get angry when they are asked to be quiet or to do more at home
- miss the attention they used to get and become clingy
- behave as if they were younger
- get into trouble at school or at home, or have problems with eating, sleeping, schoolwork or friendships
Teenagers may have more anxiety and depression, stress, difficulty keeping up with schoolwork, lateness or missed school, and less time for friends. Even if their message is "leave me alone", they still need your attention and support [2].
In studies, children of people with cancer had, on average, more emotional and behavioural symptoms than other children of their age [6]. In a review of 54 studies of adolescents and young adults, most studies found negative effects of a parent's illness, and some also described personal growth after the experience [8]. The most important factor in helping children cope well is a family that works well together; a parent's depression was linked to children coping less well [5, 6]. So looking after your own emotional health also helps your children (Anxiety, depression and fear of cancer coming back).
Routines, school and time together
- 1
Keep daily routines
As far as possible, keep sleep, meals and school as they were. Familiar rituals, such as a bedtime story or checking in with them after school, help children feel safe [2].
- 2
- 3
Tell the teacher
Teachers and school staff need to know what your child is going through; ask the school counsellor for help too [2].
- 4
Special time together
Even 10 minutes of uninterrupted time with each child, reading a story, eating together or a short walk, can make a big difference [2].
- 5
Get help from others
Other adults, such as relatives, teachers or a faith leader, can support your children [1]. If you cannot go to one of your child's events, another adult can go or record it [2]. For your partner or the person caring for you, see the guide for family members and caregivers.
When should I call the doctor?
The reactions above are usually normal, but some children need extra support [2]. Talk to your child's doctor, the school counsellor or a child psychologist if your child:
- has stopped their usual activities, is falling behind at school or is pulling away from friends [2].
- has changes in appetite, sleeps too little or too much, is very tired or low in energy, cries a lot, is restless or has lost interest in their usual activities [10].
- feels worthless or guilty, cannot concentrate or refuses to go to school [10].
- is angrier than usual, has outbursts or keeps getting into trouble [2, 10].
Urgent: if your child talks a lot about death or suicide or is thinking about harming themselves, get help the same day; if they are in immediate danger, call your local emergency number or take them to the nearest emergency department [10].
Frequently asked questions
Wouldn't it be better to keep children out of it?
What do I say if my child asks, "Are you going to die?"
My child doesn't ask any questions. Does that mean they're fine?
Not necessarily. Young children sometimes turn to something else in the middle of a conversation to take in their feelings at their own pace, and teenagers may avoid the subject out of fear or embarrassment [2]. Parents often underestimate how much the illness affects their children [7]. Tell your child they can talk any time, and bring the subject up again later [2].
What if my child thinks it is their fault?
Say clearly, and say it again: "You did not cause the cancer; nothing anyone does, thinks or says causes cancer." Explain simply how cancer develops, read a children's book about it together, or ask a doctor or nurse to explain [2].
Should I tell the school and the teacher?
Yes. It is very important that teachers and school staff know what your child is going through and the extra stress they are dealing with. Ask the teacher or school counsellor how your child is doing at school [2].
Do programmes or counselling for children help?
Research reviews suggest that support programmes for these families probably help children understand the illness better, improve communication in the family and improve children's emotional well-being, although the quality of these studies is still limited [9].
Notes for physicians (for doctors)
Show detailsHide
- Lancet 2019 (Dalton et al.): many adults with a life-threatening condition have children living at home; parents are uncertain how, when and what to tell their children and fear the effect on the family. Evidence shows that children are often aware that something is seriously wrong and want honest information, and health-care professionals have a key role in guiding parents; in the absence of empirically derived guidelines, an expert workshop proposed practical principles for health-care professionals [3].
- Needs and interventions: systematic review (12 articles on needs, 12 intervention studies): children need age-appropriate information, support in communicating with parents, family members and health professionals, and to have their experiences normalised among peers; all interventions reported at least one positive outcome, but only 5 showed significant improvements on validated measures [4]. Umbrella review 2026 (8 systematic reviews, 46 interventions): preliminary benefits for understanding of the illness, family communication and functioning, parenting skills and psychological well-being, with limited confidence because of the low methodological quality of the reviews [9].
- Risk factors: review of 28 studies (2,896 families): better family functioning was associated with better adjustment and parental depressive mood with worse child adjustment; of the illness-related factors, only worse disease status was related to lower adjustment [5]. Multicentre study (235 families, offspring aged 11 to 21 years): emotional and behavioural symptoms above population norms, with general family dysfunction the strongest predictor; screening for child mental health problems and family dysfunction in oncology units was recommended [6].
- Adolescents and young adults: review of 54 studies: 29 reported negative effects, 8 post-traumatic growth and 5 null or mixed findings; communication and information needs were often unmet, and parents wanted guidance on talking with their children [8]. In an integrative review of 49 studies, parents often underestimated the impact of their cancer on their children, and parent-child communication was a key element of support [7].
- When assessing any patient with children under 18, ask about the children, encourage honest, age-appropriate conversations and refer to a child psychologist or social worker when needed [3, 6].
References
10 referencesShow all referencesClose the reference list
Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
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This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.
Printed from the website; the full and up-to-date version: https://drdabiri.com/en/guides/talking-to-children-about-cancer/