It is natural for families facing a new diagnosis of cancer to be upset and worried about how they will deal with this crisis in their lives. For families of young children or adolescents, these concerns may be greater as they wonder how their children will cope with the uncertainty a cancer diagnosis produces.

How a child reacts to a cancer diagnosis will very much depend on how their parents or other close adults handle the crisis. Children understand through their parents what is happening in their world.

While parents know this, it can be very stressful as they deal with their own very powerful feelings of fear and uncertainty. However, parents and their children can and do learn to cope with cancer and its treatments.

"Children are quite remarkable," says Terri Ades, RN, ACON, director of quality of life and health promotion strategy at the American Cancer Society (ACS). "They can cope with difficult life situations if given the chance. We must remember, though, that children see things very differently than adults because they have not had the same life experiences.

"And as a result their responses to a diagnosis of cancer might be different," she says. "It is not a good idea to try to keep cancer a secret. Children do find out — either by overhearing parents and family members talking about it or by hearing something from their friends at school."

A child's age is an important factor in deciding what and how much you should tell about a new diagnosis. The guiding principle should be to tell the truth in such a way that the child is able to understand and prepare him or herself for the changes that will happen in the family.

Children thrive on routine — it helps them feel safe. When life becomes unpredictable, they will need help in adjusting to the changes.

In addition to the illness itself, there are other worries children have about cancer. The most common of these is that something they did or didn't do may have caused the parent's illness. While we know this isn't true, most children believe this at some point during the experience.

Other things children worry about are that cancer is contagious or that they can catch it, that everyone dies from it, or that they or the other parent will get it. It's a good idea to correct these ideas before the child has a chance to worry.

Children can become confused about how people get sick. A common worry is that cancer can be passed from one person to another. Parents can explain that cancer is a different kind of illness and the child doesn't have to worry that someone passed it on to mom or dad or that they will get it.

Parents may not be able to offer the kind of reassurance they would like to at the beginning of their experience with cancer. This is because no one really knows at that point how they will respond to treatment.

In spite of this, there are things that parents can do to help their children begin coping with this new reality. Parents can say that even though they can't see into the future, they can promise that the children will be cared for. If the parent is feeling sick, they will arrange for someone else to fill in.

The most important psychological issue for children is their own sense of security and safety. Children depend on their parents for their basic physical and emotional needs. A parent's cancer diagnosis can make families feel that their lives are totally out of control emotionally.

Parents can tell their children that there will be times when they will need to cry about the situation as that helps them to feel better. Parents can assure them that "you will stop crying" and that crying does not mean that the situation is worse.

This also gives children permission to express their very normal angry and scared feelings. Everyone deals with problems in a different way and it will be important for parents to give themselves permission and time to figure out what is best for them and their families.