How do you tell your children you have colon cancer?

You just found out you have cancer. Now you have to decide how to tell your children. You don’t know what to do for the best.

Well first of all realise that this is entirely normal. Those of us that have had cancer have had to face up to sharing this information with our nearest and dearest and it can be extremely stressful. It’s natural to worry about how it will affect them. And that goes quadruple for children.

I have experienced being a child and on the receiving end of bad news. In the 1970s my brother was seriously ill with a congenital heart condition and was expected to die. Although heart surgery is now semi-routine, at the time only one other child had been operated on with this condition, and she had died.

My parents reacted by shipping me and my sister off to our grandparents and decamping to live at the hospital (for two years). They never actually told us what was going on. They believed that by sending us to a supportive environment and hiding the truth from us they were protecting us. In fact, their well-intentioned action caused my sister and I lasting emotional damage. Of course we knew something was wrong – all the adults were whispering about it. There’s nothing worse that knowing everyone else knows something and you don’t. It felt to us as though we weren’t trusted enough to tell us the truth. It was extraordinarily isolating and caused us a lot of anxiety. We were expected to carry on with this breezy pretence that everything was normal – except it wasn’t. This single act – carried out with good intentions – had a lasting negative impact on our relationship with our parents and others.

When I got cancer I was determined not to repeat these mistakes. My children were 13 and 19 at the time. They were old enough to understand, but the 13 year old was particularly vulnerable. Going through teenage anxiety is hard enough, but it’s even harder when you find out your mum has cancer.

I decided that I would make it simple, straightforward and no-nonsense. Importantly, I would not patronise them by telling them things like ‘everything will be okay’ or ‘I’ll be okay, don’t worry’. Firstly, of course they’re going to worry and you have to acknowledge that that’s normal (while showing them how to deal with their worries). Secondly, I couldn’t promise everything would be okay. All I could promise was that I would try and do everything I could do to get fixed, and so would my doctors. I did not put heavy emotional burdens on them (eg “I’m going to fight this all the way because of how much I love you”) and I did not link my survival to my love for them.

I began by saying that the doctor had found out I was ill and I was going to need an operation. Hopefully, the operation would fix me but I might need more treatment. There was a possibility I could die, but I wouldn’t die straight away. I was going to try very hard not to die. That meant I was going to need their help. (I then gave them a few examples of what I needed from them.)

Specifically, I told them I had a tumour that needed to be removed. We named the tumour Colin and that helped to demystify him.

My daughter was shocked. She was sad. She was worried. But she dealt with her emotions really well. (see When Your Mum Gets Cancer You Realise What’s Really Important ). You cannot protect children from sadness and from life’s tragedies – and neither should you. Your job as a loving parent is to teach them resilience. ie how to deal with sad and tragic events in their lives and not fall apart.

I instigated a process of continual communication. I answered their questions fully but simply. I did not hide anything. I also ensured that I thanked them for their support and told them how much I loved them.

For my daughter, I got her school involved. The school were amazingly supportive. I spoke to her pastoral tutor and explained what was happening. Immediately, a well-oiled support machine clicked silently into place. The teachers understood what was happening so they watched out for signs of tearfulness, stress or her not coping. They rang me and gave me regular feedback on how she was doing and what they were doing to support her. If she forgot her homework they understood it was because she had an awful lot going on at home and supported her to get the work done rather than punishing her. Her cookery teacher was amazing and said: “don’t worry about bringing in ingredients, your mother has bigger things to worry about, I’ve got this for the rest of the school year”. (Thank you from the bottom of my heart, cookery teacher!)

When I got cancer it changed the dynamic in my family. My children matured and grew up. They realised what was important in their lives and it gave them a strong determination. As my daughter has explained, there was no avoiding the stress and no hiding it, but it was minimised because of appropriate, supportive and truthful communication. She felt she had grown as a result of her experience.

I know that your biggest fear is going to be dying and leaving your children. Of causing them grief and stress. But please remember that loving is a two-way process. You need to be willing to receive love as well as give it. Allow your children to show kindness, compassion and love to you. These are invaluable lessons to help them grow into wonderful people.

Because I shared my feelings honestly – I’m sad or I’m scared – they felt they could tell me how they felt honestly. This really diffused their stress. Younger children can have irrational fears around serious illness. For example, my sister thought that she had caused my brother’s illness or that we were being punished because she was naughty. (She was 7 at the time and fairly naughty.) You can only stop these irrational fears if you tackle things straightforwardly. They may want to know why you got cancer. My answer was to say that the doctors don’t know why, but sometimes your body breaks and you have to try and fix it (because they were teenagers I explained that with billions of cells in our body it’s a miracle they don’t go wrong more often).

Here are my top tips:

  • tell your children at the same time. Keep the explanation age-appropriate but don’t withhold information from the youngest children while telling the older ones
  • keep it simple but don’t hide the truth
  • answer their questions honestly. If you don’t know, say you don’t know
  • don’t link your love for them with your survival. (“I’m going to fight this because I love you so much”). That’s too pressurising and misses the point. It’s better to say: I don’t want to leave you so I’m going to try my best to get better. And always tell them you love them
  • don’t make promises you may not be able to keep. Do not tell them everything will be okay or alright. It is not okay to have cancer. You cannot guarantee what will happen in the future. This situation is not normal and is not fine. Acknowledge that. Let them know that yes this is a bad time and a bad thing. Ignoring sadness, stress and anxiety makes things worse, not better. Show them how to deal with adversity (with strength, a sense of humour, communication and honesty) by modelling that
  • acknowledge your feelings so they can tell you theirs (“I’m really worried and a bit scared…how about you?”). No-one is meant to be happy all the time. But show them how to find happiness in the middle of tragedy by focusing on nice moments spent together
  • put an alternative support network into place – because they might not want to offload on you, as normal, because they are trying to protect you. And, quite honestly, you might not be best placed to support them at this time. School is a good place to start; talk to your doctor or nurse about available support as well
  • give them actions to do. If they feel they are helping – albeit in a small way – that gives them a way of focusing and coping. It could be really simple: making you cups of tea, arranging your pillows, feeding the cat, choosing some flowers for you etc. When you ask them to do something, you are giving them a mechanism to show they love you and they care. You may fear overburdening them, but under-burdening them can be just as bad.

Please share your experience of telling your children, and what you learnt from it, in the comments section.

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