Helping Children When A Family Member Has Cancer: Dealing With Recurrence or Progressive Illness

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How will I know if my children need extra help?

Parents usually understand the behavior of their children and how they usually react to stress. We all tend to react the same way to upsetting events, and parents can usually predict how their children will respond. 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 Quiet children may become more withdrawn, loud and active children crank it up a notch, and children with learning problems start doing worse in school.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 children complain of physical illnesses or may seem sad or lonely much of the time. Any type of change that persists for weeks may be a sign that the child needs more attention.

Pay attention to how and what your kids are doing.

It may be useful to watch how your children play with their friends, what they say to their dolls and action figures, or what they draw in school. Because young children usually cannot talk easily about their feelings, their behavior will usually tell you what might be going on. We’ve talked before about the tendency of young children to regress in their development during times of stress. For example, a young child might have trouble maintaining his or her toilet training. Teens probably won’t regress in such dramatic ways, but they may argue more or be more distant as a way of acting out their distress.

Cancer may not be causing all the problems.

Remember that all problems are not necessarily related to the cancer. Sometimes it can feel as if cancer has totally taken over a family’s life. People may need to work very hard to look beyond cancer as the source of all problems. This is especially tough when the disease has progressed, because everyone will be more upset than usual. 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? Although 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 may 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 what’s happening?” may give you new insight into your child’s behavior. Check with the school to see if the behavior also has been 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 you need to do 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 “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 children before cancer was part of your lives. Those same methods will often work again, even though the problems may be different.

Find out as much as you can about any problem the child has.

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. Don’t forget to remind them that they had nothing to do with your getting sick or your cancer coming back. 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 they had something to do with a parent’s illness. If your child seems distressed and talking about it together doesn’t help, the child may need outside help. Children can become depressed or anxious just like adults, but they might not show it in the same ways.

Depression in children can look different from depression in adults. 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 parents have 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 or of hurting herself or himself
  • 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 ways of handling these problems are not working, or if the problem goes on for more than a couple of weeks, the child may need extra 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 useful ways to look 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 medicine or counseling.

Last Medical Review: 07/20/2012
Last Revised: 07/20/2012