Think of chats like jigsaw puzzles. Adding piece by piece. Kids, even teens, can’t take in too much information so keep it short and simple. Then be led by your child. Some kids want to know everything and other don’t.

The key thing is to tell them that you are always there for their questions, and if you don’t know the answers then you can find out and come back to them.

You can be creative and get a big piece of paper, or a jar, so when they think of a question they can write it on the paper, or pop it in the jar (questions and concerns often come up at random mad times so think of this as a management technique!) Once a day or every couple of days you can both discuss what was written.

Be led by your child. Start off light with detail (be honest obviously). Think about what your child will see (and feel). How will your cancer and treatment affect them? Tell them about side-effects you might experience (hair loss, weight gain, fatigue, irritability) so they are prepared.

Let them know dates of chemo cycles so they know you might be too exhausted to do much parenting. Treatment days might also mean changes to your children’s routines, such as who will do the school run. Helping them manage their own expectations is important to ensure they feel secure about the changes in their lives.

Talk to the school. Make sure they know what is happening to you, at home and the extent your child’s life has changed (doing more chores, having more family responsibilities, possible impact of worries about your health on their ability to focus on schoolwork, etc.) School staff will know whether the exams can be deferred or not.

Talk to your child and ask them what they need: perhaps more time and space at school after lessons to revise for example. Ask how they are feeling.

Most children will ask this question. Little ones are likely to say it out loud, and older ones are more likely to keep it inside their heads. So, if you are able to, it is probably best to answer this question without being asked.

You can be vague and simple say ‘Most people think a person with cancer will die. This isn’t true, most people survive their cancer.’ The key thing is that you have opened up the subject, and the kids know it is not a taboo so they can come to you with their concerns or fears.

Always be honest because kids will sense if you are holding things back. In absence of information that is specific to your cancer, they may imagine the worst – which may not be relevant to your circumstances.

You know your child best so be led by them. Here are some general guidelines about what children will understand:

3-5 Years of Age

Can understand something is wrong

“Magical thinking”- may think a parent’s illness is their fault

Struggle with verbal expression of how they feel

Communicate emotions & feelings through play, drawings and behaviour

Need information-but need repeated small chunks of information using simple techniques

6-8 Years of Age

May still show illogical or magical thinking

Begin to anticipate death as illness progresses

Need simple concrete information about the disease-its name, symptoms, treatments and causes

9-13 Years of Age

Use logical thinking to understand cause and effect

More aware of long term implications

Separation anxieties-school refusal

Mood swings

Feeling different

Grow up or regress

Wanting to care for the parent

15 Years and Older

More adult like maturity in thinking about death

Philosophical questions about their own identity

More mature status can be misread by adults- inside may be feeling “small” immature and scared