Over the many years that I have served as a psycho-oncology counselor, the majority of questions I was asked had to do with the painful task of talking to children about a cancer diagnosis. Generally speaking, as in most other life circumstances, honest, open communication is important when families are dealing with a melanoma diagnosis. Children are very intuitive and know immediately when parents and family members are distressed. Discussing the diagnosis in a supportive and age-appropriate manner can actually reduce the children’s anxiety (children may conjure up stories that are much worse than the reality of the situation), strengthen family communication and send the message that you trust your children can handle this news. Here are some suggestions to consider when planning for these difficult conversations.
Before talking with your children, plan what it is you want to communicate. Make it age appropriate, clear and understandable. As Dr. Fran Lewis, a nationally known expert on this topic notes, “The key is how do I care and not scare my child?
If it would be helpful to you, include supportive others, spouse, partner, friend, relative in the conversation. As well, seek the guidance of your doctor or nurse when planning the conversation with your children.
Anticipate what questions your children will ask you. For example, often children will ask, “Are you going to die?” Consider saying something like, “ I am not dying. I am going to have surgery to get rid of my melanoma. I have great doctors and I will get excellent care.”
There is no one “correct” way to speak with children. It’s important to use your usual style of communicating. Start out by asking your children what they know about melanoma. Take advantage of this opportunity to educate your children about melanoma and correct any misperceptions.
Keep the initial conversation brief and age-appropriate. Take your cues from your children as to how much information they need and can process. Let your children know that they can come to you with questions and that you will be talking with them on a regular basis to keep them updated.
For example, “I am sad too, but I know that I am getting the best care possible and together we will get through this.” In this way, you can model and teach your children how to handle their emotions.
It is certainly OK to cry and to show emotion. However, if your emotions are too intense, it is best to postpone the conversation with children so as not to escalate the children’s fear and worry.
Depending on age and developmental level, children may hold certain beliefs such as; blaming themselves for your illness, worrying about who will care for them or thinking that melanoma is contagious. Also, children may appear disinterested because they feel so overwhelmed.
These conversations do not always go according to expectations. It is important to understand that children are often focused on getting their own needs met, especially when they are frightened. This is developmentally appropriate and does not indicate an absence of love and care.
Dr. Arlene Houldin is a member of MIF’s esteemed advisory board. She is a doctorally prepared nurse with a specialty in psycho-oncology nursing. Currently, Dr Houldin is the Executive Director of HEAL (Holistic Enrichment of Adult Living) a home care agency located in Bryn Mawr, PA. And is an Associate Professor Emerita of Psychosocial Oncology Nursing at the University of Pennsylvania, School of Nursing.