Telling your child you have breast cancer is one of the hardest conversations you will ever have. While it can be emotionally overwhelming, it is important to have an honest and age-appropriate conversation. Children are the first to sense when something is wrong, and clear communication can help reduce confusion, fear, and misunderstandings.

Talking with your child helps them understand why you may be going through health changes, going to appointments more often, or going through changes in your and their daily routines. When children are given difficult information in an empathetic, understanding way, they are better able to cope.
‍
Taking Time to Prepare
‍
Before you talk to your child, take time to consider what you are going to say, and how you are going to say it. Thinking through your words beforehand can help you be more confident and calmer. It might be helpful to rehearse what you are going to say with a trusted family member or friend to help you organize your thoughts and control your emotions.
‍
Choosing the Right Environment
‍
In considering how to communicate your diagnosis to your child, it is important to make sure that you have this discussion somewhere where everyone will be comfortable. Also, choosing a time when you will not be in a rush will make sure you have enough time for them to express emotions, answer any questions, or talk about how they feel. Think about any external tools you might use to help. This includes:
‍
• Visual aids (books, pictures, etc.)
• Dolls
• Internet sources

This is also a good time to decide who will be involved in the conversation. Think about people they are comfortable expressing emotions around: Spouses, grandparents, aunts or uncles, etc.
‍
Start With Simple Information
‍
It is helpful to begin sharing general information about your diagnosis instead of everything at once. Too much detail can be overwhelming, which can cause confusion and negative emotions, especially for younger children. Start with explaining:
‍
• You have an illness called cancer.
• You are going to the doctor for help, and they are doing everything they can to help you feel better.
• There will be treatments or medication that might make you tired or look different for a while.
‍
It is important to remember to use age-appropriate terms that children will understand, especially depending on their age. Iris BCR has provided a glossary to help you explain hard terms in simple definitions. Younger children may know what cancer is, but they might associate it with something bad. This is your opportunity to answer any questions and clear up misconceptions. You can gradually provide more information over time.
‍
Your child may also need extra reassurance at this time. They might worry about things they don't say out loud. It can be helpful to tell them that:
‍
• Your diagnosis is not their fault.
• Cancer is not a germ, and it is not contagious.
• They will be able to continue sports and extracurricular activities.
• They will continue to be cared for and loved.
‍
Encourage Open Communication
‍
Let your child know that they can ask you questions at any time. Reassure them that you are always open to communication and that their feelings – anger, confusion, sadness, or silence—are okay. No two children will react the same. It is okay if you don't know the answer to every question but be sure to tell them you will find out. Continue to check in with them consistently after having the conversation.

Let them guide how much they want to know. Some children want to be really involved and know every detail, while some don’t want to know anything. To not overwhelm them, let them control how much detail they are given.
‍
Be Mindful of Your Tone
‍
Children often take emotional cues from adults, so your tone of voice and facial expressions might influence the way they respond. You do not need to hide your emotions but remember to speak calmly to help your child feel more secure. By having a reassuring tone, you are encouraging them to express their emotions.
‍
Explaining Your Treatment
‍
When explaining your diagnosis and treatment, it is important to talk about how it will affect you. Prepare them for changes in your appearance, energy level, or emotions to reduce negative emotions, such as fear and confusion.
This is also a good time to mention barriers you might face during this time. You might not be able to:

• Attend every event
• Play the same way you used to
• Help with homework assignments
• Keep up daily routines

Instead, try suggesting other activities you can do together. This might be reading a favorite book, watching a television show, or something else they are interested in. They might need a little extra bonding and support at this time.

For all children:

It is important to tailor information based on the age and maturity level of your children. Older children might have a better, complex understanding of breast cancer, while younger children might associate cancer with a normal cold, or other negative experiences. However, across all age groups, there are many ways you can help them cope with your diagnosis.
‍
• It is still okay to be a kid. Most children want to provide extra support, but it is important that you still encourage them to hang out with friends, participate in sports, and participate in any other extracurricular activities as normal.
• Remind them they are not alone. During this time, your family may have to lean on others to help, like family members and friends—and that is okay. They may also benefit from attending support groups with other children whose parents are diagnosed with cancer.
• Encourage emotional expression. Some children refrain from showing their emotions because they believe it might upset their parents or other adults. Or, they might have no reaction at all. Either way, it is important that you welcome and encourage any expression of how they are coping with your diagnosis.
‍
Throughout this journey, remember that you are teaching your children how to be strong and resilient. It is okay to cry and show emotion. If you notice any changes, including behavioral or physical, speak to their doctor for additional support.

Ages 0-4
‍
Children in this age group are probably unaware of what cancer is, but they will definitely notice stress, negative emotions, or any other related behaviors. When telling them about your diagnosis, you can:
‍
• Keep items of comfort around them, including their favorite toy or stuffed animal
• Use dolls, photo books, coloring sheets, etc.
• Use very simple terms and wording that they can understand. It is not necessary to provide overwhelming details.
‍
Children at this age may show age regression, which is performing earlier behaviors. It is also helpful to gently introduce them to the word “cancer,” so they do not start to associate normal sickness with your diagnosis.
‍
Ages 5-9
‍
This age group may have heard of cancer but do not fully understand it. They also tend to associate cancer with common sicknesses or other negative connotations, which can lead to misconceptions. You might want to:
‍
• Provide basic details about your diagnosis. Provide simple details about treatments and side effects that you will be experiencing.
• Correct any misconceptions. At this age, children might believe their behavior or grades in school are causing your cancer. They may also believe that cancer is contagious. Let them know that it is not their fault, nor will they “catch” cancer.
‍
Ages 10-14
‍
Children at this age are likely to have a basic understanding of cancer. During your diagnosis, they might start to direct negative emotions to parents, teachers, siblings, etc., out of fear of expressing their anxiety or concern. At the same time, they may just feel embarrassed because their parent looks different from their friends'.
‍
• Tell them it’s normal to have negative emotions towards cancer. Remind them that although it is okay to be upset, it is not okay to take their emotions out on others.
• Answer any questions they have honestly, without overwhelming them with information.  
• Continue to update them with basic details of treatment or changes.
‍
Ages 15-18
‍
At this age, teenagers fully understand what cancer is, which can cause them to worry a lot more. This age group is struggling for their own independence, while wanting to stay close to family. They might experience stress or anxiety that can cause them to act out more, withdraw from others, or hide what they are feeling. You can:
‍
• Provide more details about your symptoms, medicines, side effects, etc.
• Encourage them to help with more responsibilities, such as cleaning, cooking, etc., while being careful to not to overwhelm them.
• Encourage them to ask questions. Since they are older, it is okay to be open and honest in your responses.
‍
Ages 18+
‍
Adults fully understand cancer, including treatments, side effects, procedures, etc. Adult children often want to take on a more supportive role.
‍
• Lean on them for more support and advice, but not all. Although they are old enough to handle it, managing their emotions with yours might become overwhelming.   
• Be open and transparent about your diagnosis and experience.
• Share your health preferences and decisions, just in case, so they feel prepared and informed.
Approaching your conversation with age-adjusted guidelines can ensure proper support for your children.  

‍