Parents are experts when it comes to their children and often can predict how they will react to new and stressful situations. Many times parents can tell how their children are feeling by how they act. When children are upset, they often react with a more dramatic version of how they behave normally. Quiet children may become more withdrawn, loud and active children crank it up a notch, and children with learning problems start doing worse in school. Some kids may have more trouble being apart from a parent. Some begin to have trouble sleeping. Some kids express their emotional stress with physical symptoms like headaches or stomachaches. They may seem tired or sad a lot of the time. Any change in how your child usually behaves may be a red flag that they need some attention.

Because young children usually cannot talk easily about their feelings, their behavior will usually tell you what might be going on. You can learn a lot by watching your child play. Listen to what they say to their dolls, watch what they draw in school, and how they act with their friends. Young children may seem to go backward (regress) instead of forward in learning new tasks. Toilet training may be stalled. Children may be insecure, clingy, or resist your attempts to correct their behavior.

Although teens probably won't regress in such dramatic ways, they may argue more or be more distant as a way of acting out their distress. They may also have trouble in school. Teenagers may have trouble sleeping, or they may seem to sleep all the time. In theory, at least, teens, are able to talk about their feelings. Sometimes that is easier said than done. Try introducing a light topic and leading into a more feelings-related topic. A direct question like "You seem worried, what's going on?" may open up the discussion.

Remember that not all problems are related to the cancer , even though there are times it can feel as if cancer has taken over your family's life. But look closely at your child's behavior and think about what else might be going on. Is your child having trouble adjusting to a new teacher? Are they upset about not being invited to a party? Are they struggling for more independence? While cancer in the family can certainly add a lot of stress, there may be other things going on in your child's life that could explain their behavior. You might not know unless you ask.

Try to get your children to tell you what's troubling them, if they can. A simple "You seem very thoughtful (sad, worried, etc.) these days. Can you tell me why?" may give you new insight to your child's behavior. Check with the school to see if the behavior is also noticed there. Maybe a teacher is incorrectly assuming that because a parent is ill, the child should be treated differently. Often this just makes the child feel more isolated. Check out all of the possibilities before you decide what needs to be done to help your child feel better.

Also remember that a child's personality is an important factor in how they will react to illness in the family. Some children are easy-going and kind of roll with the punches while others tend to make a mountain out of a molehill. Different things work for different children in a family, so think about how you handled each of your kids before cancer was part of your lives. Those same methods will often work again, even though the problems may be different.

It often helps to get as much information as you can about a problem from all possible resources. This means speaking with your child's teacher, guidance counselor, pediatrician, or a counselor or social worker on staff where you are being treated. It's also a good idea to ask your child what you might do to help them feel better. If your child seems distressed and talking about it together doesn't help, the child may need outside help.

Always tell your children that they had nothing to do with causing your illness. As illogical as this idea may seem to adults, experts know from experience with families dealing with cancer that children usually believe, at one time or another that they had something to do with a parent's illness. Also remind them that the focus on the cancer is short term. Life will go back to some kind of routine after treatment is over

Children can become depressed or anxious, just as adults do, though they may not show it in the same ways. For instance, a common sign of depression in a child is a change in behavior, like suddenly getting poor grades in school or losing friends. Most children whose parent has cancer seem able to cope, but there may be times when it gets to be too much. If a child seems to be having trouble, it may mean a more serious problem than a normal, sad response to cancer. Extra help is needed if a child:

• is unable to handle the feelings of sadness
• feels sad all the time
• cannot be comforted
• admits to thinking of suicide
• feels extra irritable
• becomes very angry very quickly
• has changing grades
• withdraws or isolates himself or herself
• acts very different than usual
• has appetite changes
• has low energy
• shows less interest in activities
• has trouble concentrating
• cries a lot
• has trouble sleeping

When a child shows 1 or 2 of these symptoms, it may help to offer more support. But if the usual methods of handling these problems are not working, or if the problem goes on for more than 1 or 2 weeks, the child may need special help. (For more serious problems, such as if the child is planning to hurt himself or herself, urgent help is needed.) It may be useful to talk with the child's pediatrician, school counselor, or with the social worker or counseling staff at the hospital where the parent is being treated. Since these experts know how other children have reacted to illness in the family, they may be able to offer a useful way of looking at the problem. They can evaluate the child and make sure that any needed help is given. They can also suggest books, videos, and children's support groups that may help. Rarely, a child may need to see a psychiatrist for medicines or counseling.

Go back to Helping Children When A Family Member Has Cancer: Understanding Psychosocial Support Services.

Last Medical Review: 05/28/2009
Last Revised: 05/28/2009