Dr. Bob: How do I talk to my 7-year-old about their grandparent’s cancer diagnosis? I am worried about saying too much, but I want to be honest.
Answer: I completely understand your concern. Let’s first acknowledge one thing – I suspect that you are very worried about this diagnosis yourself. Whether the diagnosis of cancer has occurred in one of your parents or one of our spouse’s parents, this is indeed quite a difficult time for all. Try as best as you can to let yourself feel and express the emotions that are present, doing so with your spouse, siblings, friends or other close folks. It is important to be honest and have an outlet to help you cope with this difficult diagnosis.
Now comes the hard part. I think that it is important to be honest with your children but in a non-explicit way. Something like – “grandma (or grandpa) just went to the doctor and they found out that they are sick. This sickness will be difficult to treat and might involve special medicine and special x-rays. We want to see them as much as we can, but we might need to wear masks when we do or even use FaceTime.” – might help set the stage for the seriousness of the diagnosis and all of the complications and special arrangements that will be needed.
Let’s break down the various components here – 1) Doctor. I think it’s important to emphasize the grandparent is under the care of expert doctor that specializes in this type of sickness; 2) Treatment. This is tricky. Most children think that medical treatments mean that you take a medicine and things get better. It will difficult for them to understand that the grandparent might have to go frequently for treatment and that the treatments might make them sicker in the short term. The IV treatments might seem extreme to children but explain that strong medicine works better that way for this illness. If radiation therapy is needed, just explain that x-rays (just like when you get an x-ray for an injury but much stronger) can help in this illness; 3) Side effects. The medicine and the radiation therapy more than likely will cause side effects to include weakness, fatigue, weight loss and hair loss. Explaining ahead of time that these things might occur can help manage expectations for the grandchildren. The grandparents might end up with a wig, a hat or a bandana; 4) Visiting. Spending time with grandparents is one of the joys of life, however, cancer and its treatments can make it very difficult for the grandparents. They need to be protected from potential infections that can make them worse. Be sure to emphasize good handwashing and wearing a mask if necessary. FaceTime connections might be necessary to protect the grandparent and is a great alternative when there are concerns about colds, the flu, COVID and other illnesses.
Children will hear about other people that have suffered from cancer and possibly passed on. They naturally will assume the worse for their grandparent so it will be important to emphasize how you will be there and let them know how the grandparent is doing. Avoid medical jargon. It just confuses them. Use language that makes sense and simplifies things. Be lovingly frank – “this illness can really make them [the grandparent] sick but we will be there to help in every way possible. I know that you might be scared. Mom and Dad are a little scared also, but we know that together as a family that we can get through this together.”
There will be ups and downs as you deal with cancer in a grandparent. Don’t hide the diagnosis from your child but be careful as you share information.
Dr. Saul is Professor of Pediatrics (Emeritus) at Prisma Health and his website is www.mychildrenschildren.com. Contact Dr. Bob at askdrbobsaul@gmail.com