How to Talk With Children About a Breast Cancer Diagnosis

10/03/2012 08:14 am ET | Updated Dec 02, 2012

Having to tell our daughter (who was 4 and three-quarters years old) about my breast cancer diagnosis was daunting, overwhelming and nerve wracking... to say the least. I was quite surprised by how anxious I was about telling her considering the fact that for the past 10 years, I have worked as both an adult and pediatric hospice nurse. In this capacity I have had (way too much!) experience delivering bad news to children.

Now, coping with my personal diagnosis, I found myself on the other side of the bed -- literally. Prior to telling our daughter, I wondered whether all of the advice I have been dispensing for the last decade really works. The Silver Lining is that it DOES!

My personal experience enabled me to be empathetic with the parents who try to hide the truth from children because they assume that "children can't understand what is happening" and because they believe that "children shouldn't be exposed to something so awful." Well, that's 100 percent true: Exposing children to FBC is brutal and heart-wrenching. However, children know when things are haywire in a household (which is an understatement in the face of a cancer diagnosis).

The truth of the matter is that avoiding communication with children sends the message that either they are too unimportant to share the information or that it is so awful that it cannot be discussed. Either way, a child is left alone with the distressing information. How awful is that? Additionally, this isolation forces them to draw inaccurate conclusions or find maladaptive ways of dealing with a cancer diagnosis. While it may seem hard to believe, a child's imagination has the capacity to create things that are far worse than the reality.

Furthermore, if children catch you in a lie of omission or deception (even though lovingly intended), then from that point forward, they will always wonder, "Are Mommy and Daddy not telling me something?" Avoidance may feel better in the short term but has the potential to do long-term damage.

Therefore, including children (of all ages!) in the disease process and treatments, though emotionally burdensome and painful, will ultimately be the greatest gift parents can give their children. Inclusion enables children to have an accurate, healthy and hopeful understanding of the situation and learn adaptive coping mechanisms.

So, where to begin? Based on my clinical experience and the work of Kathleen McCue, I told our daughter:

  1. I am sick.
  2. My sickness is called breast cancer. (Euphemisms are confusing and lead to mixed messages and anxiety. It is imperative to use the exact name of the disease.)
  3. I am going to be cared for by nurses and doctors in a hospital for four sleeps. Then, I will be home. Daddy and I truly believe that I will get better.

At some point or another, there are three questions that children will wonder about a cancer diagnosis in a family:

  1. Is it contagious? At the time of my diagnosis, our daughter has just learned the word contagious. She understood that colds are contagious, for example. She could quickly and easily use associative logic to connect cancer and cold. After all, they both begin with the letter "C." We dispelled this notion immediately.
  2. Did I cause the cancer? This question arises directly from magical thinking. A preschooler could easily surmise that she caused the cancer. Sad, but true. This is the reason that adults have to address this issue head-on and assuage any misconceptions.
  3. Who will take care of me while Mommy is sick? Thanks to their egocentricity, preschoolers are afraid of being left alone. They need to be assured that someone (whom they know) will be there to take care of them while the treatment period takes place. Along these lines, consistency is of utmost importance because it equates to security.

Telling children about a cancer diagnosis in a family is emotionally rotten; however, there are tools to help facilitate the process. I am hopeful that this video will assist you along the way.

To read more about Hollye's holistic and humorous journey over, around, above and below breast cancer, please visit her blog, The Silver Pen ( You may email her at hollye@TheSilverPen or follow her on Twitter @hollyejacobs.

For more inspiring breast cancer stories, click through the slideshow below.

Celebrities Who Have Faced Breast Cancer

For more by Hollye Harrington Jacobs, click here.

For more on breast cancer, click here.