When parents get sick: how to deal with the cancer diagnosis with children. The psychiatrist's advice

A cancer diagnosis is always difficult to accept and becomes even more complex when children are involved. Kate Middleton proved it that, in a video, told the world that he has cancer and is in the early stages of chemotherapy treatment. She thus silenced all the gossip that has dotted the press in recent weeks, specifying that she needed a break to process the news, but also to be able to talk about it with her children. “It took time to explain everything to George, Charlotte and Louis in a way that was appropriate for them and to reassure them that I will be fine,” said the Princess of Wales, mother of George, 10, Charlotte, 8, and little Louis, who will turn 6 next month.

When should parents tell their children they have cancer?
“First of all, we need to communicate it and not keep secrets, in an attempt to protect them from painful emotions or from the fear of having to answer difficult questions or appearing too scared,” explained the professor. Claudio Mencacci, psychiatrist and president of the Italian Society of Neuropsychopharmacology. «It is obviously appropriate to give information gradually, defined by age, as soon as possible and, above all, before children have no way of interpreting what is happening with many wrong interpretations or with a progressive sense of isolation or loneliness» .

The risk of failure to communicate is to make them feel left out, scare them even more and increase their sense of guilt. Younger children may wonder what they have done or what their responsibilities are, fueling even more negative fantasies and the circle of lies, which can undermine the relationship with their parents. “Children tolerate the truth better than the uncertainty of not knowing,” added Mencacci. «It is not necessary to say everything, because there are terms and expressions that have no meaning for a child, however, using language suitable for age and development, it is necessary to talk about it openly, every time the child needs it or returns to the 'subject”.

Children are curious and it is necessary to answer their questions, their constant whys, without adding information or burdening them with things they don't ask. The most complex age group to manage is pre-adolescence, between 10 and 13 years. They have all the elements to understand the disease, but they are facing a transition phase, which is already very difficult for them. The youngest children during the therapy process especially perceive the absence of their mother or father, who is busy taking care of themselves. «It is important to help them, depending on their age, to say what they feel. Obviously, a little one tells it with a game or a drawing” and will probably be more focused on himself, on who he will have to be with during his parent's hospitalization, while a teenager could ask questions about the illness.

Anticipate changes
Talk openly about the tumor, answer questions, but also anticipate changes. This is the strategy to follow, because the therapies can have long treatment processes, which are trying for the body of the patient who, for example, can undergo invasive, sometimes mutilating, surgeries or chemotherapy that can lead to hair loss. «You have to be able to anticipate it and pose it as something you will face together. It can be said, for example, that the mother will be forced to be a pirate for a while. The treatment must transform into something acceptable within a very challenging situation,” added Mencacci. “We need to allow children to make meaning of what is happening.”

The principle of hope
Finding an ideal time and place is essential to correctly inform children of their mother or father's illness. «It is an important communication and children must not have distractions, but they must feel free to ask questions and express their emotions. At the same time, without overloading and overwhelming them, parents can also show what they feel”, added Professor Mencacci. The message must also contain a sense of realism. There is a path to take, not easy, but with positive expectations. Not telling lies also means not promising things that, unfortunately, cannot be certain of. “They must not experience the condition of feeling betrayed.” We must take one step at a time, telling an acceptable and communicable truth, leaving the principle of hope open, but not that of reassurance tout court.

And when hope is no longer there? «The words must be chosen very well and above all a sense of continuity must be given. Children and young people need to feel that people love them and that they will love them. Because good is a treasure that we keep inside us, even that of people who are no longer with us. What is really important in life is knowing that you have been loved», concluded the professor.