Kate Middleton's cancer diagnosis raises questions about how to talk to kids about cancer, chemo. Here's what experts say

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Truth be told, I don’t really follow the everyday events of the British royal family. I appreciate a good fascinator pic and I may have binged the last two seasons of "The Crown," but for the most part, the goings on of Buckingham Palace are not on my radar. However, when Kate Middleton announced her cancer diagnosis last week, I was glued to my phone, rewatching her heartfelt announcement multiple times.

Six years ago I was a new mom to a nine month old son hearing those dreaded words: “You have cancer.” Watching Kate speak, I saw a polished princess who looked regal even in her casual striped sweater, but I also saw a scared mom with young kids to protect. As a parent, being able to manage how your child understands and handles what’s going on when you are facing the “big C” can be a daunting undertaking. But when done with contemplation and care, both parents and children will know – as the Princess asserted – they are not alone.

I spoke to several experts about how to talk to children about cancer. Here's what they suggest you should — and shouldn't — do when talking to kids about the sensitive and emotional topic.

Remember, your mental health is a top priority

According to clinical psychologist Dr. Emily Edlynn, who’s worked extensively as a palliative care psychologist, “any parent going through a cancer diagnosis, or other life-threatening condition, needs to prioritize their emotional well-being first so they can then do the same for their child.” Things are shifting for your kids, but they are also drastically changing for you. If you’re normally a happy person, you might find yourself depressed as you sit through doctors appointments and tests.

One of the first things I did when I received my breast cancer diagnosis was reconnect with my therapist, who was also a breast cancer survivor. We set up weekly times to speak and she would text me often to check-in. That outside support was critical during those uncertain early weeks.

You also need to allow yourself the room to be honest with your kids when they come to you with questions and you’re not in the proper mindset to answer. “If you feel too emotionally overwhelmed at times to respond to your child’s questions, that’s okay. Let them know that you will think about their question or concern and get back to them at a better time,” Edlynn tells Yahoo Canada.

When is the best time to tell kids about a cancer diagnosis?

There’s no universal right time to share a cancer diagnosis with your kids. But it’s important to remember that hiding information from them can do more harm than good.

Licensed marriage and family therapist Jeanie Chang, warns parents that “children can detect anxiety and stress, even as babies. Therefore, when something like cancer impacts a parent - the children will detect it.” She encourages parents to be “proactive not reactive,” and let kids know when changes are happening.

New York City-based psychotherapist Brittany Pinto who works with cancer patients and survivors, also supports this proactive approach. She suggests parents and partners work together to make sure they are aligned on how things will be communicated to the children.

“Talk first with your parenting partner if you have one and make sure the two of you are on the same page about what you are going to share and how you are going to share it,” Pinto says.

Pinto was 10 when her own mother was diagnosed with cancer, and applauds her parents for the way they handled the situation. They sat her down with her two older brothers and clearly outlined what was happening. They explained that her mother and father would be traveling out of state for her mother’s treatment and that her grandparents would be moving in, cooking meals and driving her to school. Pinto says she appreciated that her parents were “upfront and gave context on how my world would be changing on an everyday basis.”

Things to be prepared for when explaining cancer to kids

Regardless of a child’s age, Edlynn suggests explaining what’s going on in “as bite-sized a way as possible.”

Use the proper terms, such as cancer, but then explain what it is — “a ‘ball’ in the brain that isn't supposed to be there, for a brain tumour,” Edlynn recommends. She encourages parents to let the kids take the lead and avoid answering questions kids haven’t brought up yet.

“If they don’t ask about whether their parent will die, you don’t need to bring it up, unless it is imminent,” she says.

Be prepared for young kids to ask the same questions over and over again. Just because they repeat questions doesn’t mean you are explaining it wrong or they’re confused. “The repetition helps them process the information,” Edlynn says.

Most importantly, remind kids that you’re still their parent and just because you’re sick or in treatment doesn’t mean you aren’t available to support them. There's a tendency, Edlynn warns, for kids to shut down around a sick parent as they’re afraid to “burden” them with day to day issues. Parents need to check in with their kids regularly and just because they say they’re “fine” doesn’t mean they actually are.

Try saying to your kids: “I want to know how you’re doing…I have a lot of older adults taking care of me, my job is to take care of you.”

For young kids, a picture is worth a thousand words

According to Carissa Hodgson, a certified oncology social worker with experience working with children and families coping with cancer, it’s helpful to have picture books on-hand to explain topics such as chemotherapy or radiation to younger kids. According to Hodgson, the “books give parents words and pictures to explore challenging subject matter and help them to make connections to their unique situation and family.” She also stresses the healing power of play. “Give them lots of time to play, as it helps them to process new information and make sense of what is happening,” she says.

It takes a village

Kids of all ages are keen on routine and can feel unsteady when that routine is disturbed. My son was not even a year old when I had my double mastectomy and he didn’t understand why I couldn’t pick him up or hold him for a few weeks after surgery. He got so angry, screaming and crying. Luckily, my mother-in-law stepped in to provide the day-to-day mothering I couldn’t.

Edlynn advocates reminding kids “‘we have so many people who love us and are going to help us get through this’—and identity who those people are, such as grandparents or close friends.”

Maybe mom won’t be there for pickup on Friday but Grandpa is taking you for pizza to celebrate the end of the week. Having new things and routines to look forward to can help ease kids’ anxiety.

What not to do when talking to kids about cancer

Keep it real when talking with kids about cancer. Pinto says it’s best to avoid saying phrases like “‘everything will be fine’ and ‘it’s nothing to worry about’ as minimizing the situation can invalidate their [kids] feelings of fear and anxiety.”

Edlynn agrees that parents need to be mindful of maintaining a child's trust. If your kids ask if you will be okay, you can respond by saying “the doctors have a really good plan in place with medicine that works for most people so we think my cancer will go away but we don’t know for sure.”

Hodgson says it’s also important to decide exactly who amongst your family and friends will know about your cancer diagnosis.

“Well-intentioned adults like teachers and neighbours may say things to kids. It may be worthwhile to limit information shared with people outside of your immediate family or prepare children for this situation and how they want to handle it,” Hodgson says.

For older kids, be sure to monitor what medical content they’re viewing online. Pinto recommends letting your kids know they can always come to you with any questions and you can discover answers together:

“If you find your child doom scrolling, help them find reputable websites or books that provide accurate information about cancer and its treatment,” she suggests.

With cancer, recurrence is always top of mind

My son was an infant when I went through my surgeries and initial treatments, but he sees my scars and watches me when I administer the monthly shot that helps prevent the cancer from returning.

“Mama, did it hurt?” he always asks.

“A little bit,” I reply.

“OK, well maybe next time it won’t hurt at all,” he reassures me.

As he’s gotten older, I’ve shared with him details of what happened. Now that he’s almost seven, he understands that right now I’m healthy, regularly visiting the doctor for routine tests and checkups. Unfortunately with cancer, especially breast cancer, being cured is never a guarantee. These days it’s lots of bonding over "Bluey" and bike rides, and if the cancer does come back, I know that my family and I will fight it together.

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