Nana Has Cancer

Dear Mamas,

My mother was recently diagnosed with breast cancer. We live nearby and are very close, and it’s been a really hard time for me.

My son is 5 years old, and we’ve tried to shield him from the explicit details of the diagnosis and treatment, but he knows that Nana has cancer and hears me talking about it on the phone.

How much do we tell him? How do we explain ‘cancer’? We do have other friends and family who have had it, but they have all died of the disease and we don’t want to scare him. I’ve looked around for books to help, but they all seem to be about children whose grandparents have died.

I know this is a common problem, why doesn’t anyone talk about it?


Dear Jen,

We’re so sorry to hear about your mother’s illness. A cancer diagnosis in the family shifts your world in an instant, and you’re faced with several challenges at once. Not only are you trying to take care of your mom and cope with your own emotions, but you’re worried about how it’s affecting your little guy, too. You’ve got a lot on your plate.

First, it’s important to realize that your son already knows more than you think. Not only has he heard about his Nana’s illness, and overheard your phone conversations, but chances are he’s heard the word cancer in other places, like TV, movies, and from his friends. Kids are little sponges, and they pick up all kinds of things we parents aren’t aware of.

One of the biggest mistakes parents can make is trying to hide the truth. He may already have ideas about cancer as a life-threatening illness and be more worried than you know. Kids are intuitive and smart, and if you give them too little information they’ll try to figure it out on their own.

Another big mistake is lying to your child. If you lie, he will learn that he can’t turn to you for answers, and you’re the one he needs the most.

How much you tell him, and in what detail, depends on his developmental stage. Most 5-year-olds are still very concrete thinkers. They take what parents say quite literally, and are most concerned with the here and now.

So if you say “Nana is sick”, he’ll picture the last time he had a fever or an ear infection and was down for the count. If your mother is feeling relatively well right now, and doesn’t seem ‘sick’, this can be confusing to him.

You may want to say something like: “Nana has something called ‘cancer’. Cancer is a disease where some of the cells inside your body (you may need to give a short explanation of what cells are) grow too fast and get in the way of the body doing its job. Nana’s cancer is in her breast. She’s going to have an operation to take it out, and then she’ll get medicine to get rid of any tiny cells that didn’t show. The medicine might make her feel yucky … like when you had the flu …”

The idea is to keep it very matter-of-fact and as neutral as you can. Give enough information to address his worry, but not more than he needs. No need to jump ahead to what the future may bring. Answer his questions truthfully and briefly.

At the same time, he’s probably picking up on your upset, and it’s best to be honest about it. It’s OK to tell him that you’re worried about Nana, as long as he knows you’re alright. You’re his touchstone, and he’ll take his cues from you. His biggest concern is that his world stays safe and familiar.

Be careful about those phone calls. You may think he can’t hear you, but kids are exquisitely sensitive to voices that fall to a lower-than-normal volume. Remember, he’s only hearing your end of an adult conversation, and is likely to misinterpret it.

Finally, he may be worried that he’s going to get cancer, or that you or his dad are. You need to reassure him that you’re all healthy, but avoid promising that you’ll never get it. Unfortunately, none of us can swear to that.

Here are some good children’s books on the subject:

When Someone You Love Has Cancer: A Guide to Help Kids Cope by Alaric Lewis and R. W. Alley

Someone I Love is Sick: Helping Very Young Children Cope With Cancer in the Family, by Kathleen McCue and Jenny Campbell

Mom Has Cancer! (Let’s Talk About It) by Jennifer Moore-Mallinos and Marta Fabrega

Hope this helps, and we wish your mom the very best.

~ The Mamas

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Rachel Zahn, MD is a pediatrician turned health writer who had three kids during medical school and pediatric training—crazy, huh?

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