How to tell your children you have cancer – after Kate Middleton revealed shock diagnosis and how it took her and William ‘time to explain everything to George, Charlotte and Louis in a way that is appropriate for them’

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Written By Rivera Claudia

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For many parents battling cancer, one of the hardest moments can be telling your children you have the disease.  

The Princess of Wales today revealed how she had to break the devastating news to her three young children following her own shock diagnosis. 

‘It has taken me time to recover from major surgery in order to start my treatment,’ Kate said in a deeply personal, unprecedented and emotional video message, filmed at Windsor.

‘But, most importantly, it has taken us time to explain everything to George (10), Charlotte (8) and Louis (5) in a way that is appropriate for them, and to reassure them that I am going to be ok.’

She’s not alone in grappling with the difficulties of explaining the diagnosis, with the disease estimated to strike one in two people in their lifetime. 

Cancer charities Macmillan Cancer Support and Cancer Research UK (CRUK) advise cancer patients to ‘take time’ to cope with their own feelings before attempting to explain the situation to children.

CRUK advises people to try and say the words ‘I have cancer’ aloud to yourself so it is less of a shock to yourself when you break the news to children. 

Patients can also rehearse with a partner, loved one, or even themselves, as well as writing notes down, according to its advice.  

Both charities advise trying to talk to kids about the diagnosis sooner rather than later, in case they pick up the fact you are unwell, or being secretive, and start to worry.

How might younger children react to a parent having cancer? 

Young children may not be able to use words to say how they are feeling. They often express their feelings through play or their mood instead. So you might see a change in your child’s behaviour. Naughty or unusual behaviour might be their way of showing how upset they are.

Your child might:

  • seem unsettled and more clingy than usual – for example, at bedtime and school or nursery drop offs
  • regress back to old behaviours such as thumb sucking, tantrums or bed wetting
  • appear more withdrawn than usual
  • develop new worries and fears such as being scared of the dark or dogs
  • be extra well behaved to mask how they are feeling
  • develop some physical symptoms such as headaches or stomach pains
  • have trouble sleeping or have nightmares
  • be curious and ask questions about your cancer in a way that might feel insensitive
  • show no reaction at all

Source: CRUK 

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Delaying telling them also risks the children learning from another source, something that can be incredibly distressing for them.  

The charities advise people to be as prepared as they can and have as much information to hand as possible.

‘You may want to think about the questions a child might ask and the words you will use to explain things,’ Macmillan’s advice reads. 

One of the questions parents should be prepared for and think about their response is ‘Are you going to die?’, according to CRUK.

‘It is important not to dismiss this question as most children will be thinking it, even if they don’t say it,’ its advice reads. 

‘But how you answer it will depend a bit on your situation. It is important that you avoid lying to your children.’

In terms of who tells the children, Macmillan advises people to do ‘whatever feels right’.

Sometimes this can be the parent telling them directly, or it can be their partner. 

The parent with cancer may or may not want to be in the room at the time, but the charity advises the news should be broken in place the children feel safe. 

CRUK also advise that people tell children at ‘eye level’ whether ‘on the floor or sat beside them’. Parents can feel free to hold their child’s hand or be physically close to them. 

If you have more than one child, Macmillan advises trying to tell them all simultaneously. 

This, it advises, prevents children from feeling their siblings know more than them, with some kids wondering why they were told last.

The charity also warns against only telling older children, as this can place an additional burden on them.   

Macmillan advises to use this first conversation as a starting point, giving children small digestible pieces of information and reassurance.

From this, then use their reactions and questions to guide the conversation.

The Princess of Wales with her children in her Mother’s Day portrait, which now has added significance given her diagnosis

The Prince and Princess of Wales were seen together last week as William went to the The Commonwealth Day Service at Westminster Abbey

The Prince and Princess of Wales were seen together last week as William went to the The Commonwealth Day Service at Westminster Abbey

The Princess of Wales said her family (pictured together on December 25) 'need some time, space and privacy while I complete my treatment'

The Princess of Wales said her family (pictured together on December 25) ‘need some time, space and privacy while I complete my treatment’

Catherine, Princess of Wales attends the opening of Evelina London's new children's day surgery unit on December 5

Catherine, Princess of Wales attends the opening of Evelina London’s new children’s day surgery unit on December 5

How might teenagers react to a parent having cancer?

Being a teenager can be a time of emotional ups and downs. Teenagers can feel confused and unsure about themselves. This can make the way they deal with a parent’s illness very different from that of a younger child.

Although they might be more able to talk about their feelings than younger kids, they might be less forthcoming. Their reactions can be more intense than an adult’s. It is very important that they have the time to grieve about the illness and be included in what is happening.

Teenagers can find it hard to cope with cancer in the family. Just when they want to get away and become independent, they feel that they ought to be at home. This can make them feel guilty too.

They might want lots of detail about your illness and ask many questions. But some young people may feel afraid to ask too much.

It can be difficult for teenagers to ask for support. They often prefer being with their friends than their family. So they might become distant from their family and talk to their friends instead. Or they may keep it all to themselves.

You might also see a change in your teenager’s behaviour or mood. Your teenager might:

  • become angry, moody and depressed
  • pretend that they are coping very well – but actually they might feeling scared and lonely
  • regress and behave as if they were younger
  • seem more anxious and withdrawn
  • develop some physical symptoms such as headaches or stomach pains
  • seem like they do not care and act as if nothing is happening

Source: CRUK 

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CRUK say younger children may only need a simple explanation, for example ‘Mummy is sick and needs to have some medicine.’

Older children are likely to need more information, as they will have their own questions, such as where the cancer is and what it is.

CRUK say children typically have not learned to fear the word cancer as adults do, those without any experience of it are likely to be curious and ask a few questions. 

Macmillan says parents should avoid one or two word replies to help encourage children to express their thoughts and feelings to the news.   

Most importantly, parents should be honest about what they know about their disease, treatment and prospects.

Macmillan advises that if children sense you are vague or hiding something they may not believe you are telling the truth, increasing their stress.

In this spirit, the charity says it fine to acknowledge that you don’t know the answer to some questions, and to tell children you will find out the answer. 

CRUK also advises parents to tell children on the weekend if possible, rather than on a school day as this gives kids more time to process the news and ask any follow-up questions they might have. 

The charity says you can show you are upset or to cry when telling children about your disease. In fact, it adds this may help children process their own feelings about it.

CRUK adds: ‘Show your children that you love them by telling them and hugging them. And remind them that they will always be looked after.’

Some of the typical concerns young children have are that they have somehow caused the disease or that that cancer is contagious. 

Teenagers will typically understand more about the disease and how it works, the charities say. However, they can be less forthcoming than younger children and be afraid to ask too much. 

Some practical tips for children include having a family calendar that includes your hospital appointments as well as family activities.

CRUK says: ‘This helps them understand the changes, give them a sense of control, and helps them manage their own expectations.’

Another suggestion is to make a ‘worry box’ for children where they can write down and place their worries. 

‘You can ask your children if you are allowed to look at their worries,’ CRUK says. 

Young children can often have separation anxiety with a parent undergoing cancer treatment.

CRUK suggest one potential option is to ‘have a special soft toy that you wrap in your t-shirt for them to cuddle.’

‘Or have two soft toys, and you keep one and they keep the other. It forms a connection that can soothe them.’ 

Kate’s cancer battle in her own words: The Princess of Wales’ emotional video statement in full 

I wanted to take this opportunity to say thank you, personally, for all the wonderful messages of support and for your understanding whilst I have been recovering from surgery.

It has been an incredibly tough couple of months for our entire family, but I’ve had a fantastic medical team who have taken great care of me, for which I am so grateful.

In January, I underwent major abdominal surgery in London and at the time, it was thought that my condition was non-cancerous. The surgery was successful. However, tests after the operation found cancer had been present. My medical team therefore advised that I should undergo a course of preventative chemotherapy and I am now in the early stages of that treatment.

This of course came as a huge shock, and William and I have been doing everything we can to process and manage this privately for the sake of our young family.

As you can imagine, this has taken time. It has taken me time to recover from major surgery in order to start my treatment. But, most importantly, it has taken us time to explain everything to

George, Charlotte and Louis in a way that is appropriate for them, and to reassure them that I am going to be ok.

As I have said to them; I am well and getting stronger every day by focusing on the things that will help me heal; in my mind, body and spirits.

Having William by my side is a great source of comfort and reassurance too. As is the love, support and kindness that has been shown by so many of you. It means so much to us both.

We hope that you will understand that, as a family, we now need some time, space and privacy while I complete my treatment. My work has always brought me a deep sense of joy and I look forward to being back when I am able, but for now I must focus on making a full recovery.

At this time, I am also thinking of all those whose lives have been affected by cancer. For everyone facing this disease, in whatever form, please do not lose faith or hope. You are not alone.

Kate MiddletonCancer

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