Dr. Ethan Schilling, a postdoctoral psychology fellow and childhood cancer survivor, answers 7 questions about how to be there for a child following a difficult diagnosis.

How should parents handle explaining a child’s cancer diagnosis to them?

Parents and caregivers usually know their child best, including how much information a particular child might be able to handle after a cancer diagnosis. That being said, all kids are going to realize something is wrong and will hear the word “cancer” used by their medical team throughout treatment. It’s tempting for parents to want to hide or sugar-coat certain aspects of their child’s diagnosis, treatment plan and prognosis due to their own fear and not wanting to upset their child further.

However, it’s usually best to be open with kids about what cancer is and what that means for them to help them feel less anxious. When you and your child first learn about a cancer diagnosis from your medical team, it’s usually best to start by asking kids what they understand about that information. This can help to clear up any misunderstandings they might have and give them an opportunity to ask any questions they still have.

You may not know the answers to some of their questions and that’s okay! This a good opportunity to follow-up with your child’s medical team to get the answers you both still need.

What are some of the most appropriate things to say?

This really depends on the developmental level of the child.

For preschoolers, it’s usually best to provide simple, clear descriptions of their condition using child-friendly language and terms. For example, using “sick” or “boo-boo” for cancer will help young children to better understand what their diagnosis means for them using words they already know. Kids this age may also need reassurance that they did not do anything wrong to cause their cancer and that parents and caregivers will be with them to support them through every step of the process.

School-age children are usually able to understand a more detailed explanation of their cancer diagnosis including the need to take medicine and complete treatments to help them feel better. It’s important to recognize that kids at this age have likely already heard messages about cancer from other sources including school, television and the internet. Be willing to have open discussions about any misinformation they might have and always emphasize that everyone’s individual cancer experience is unique.

For teenagers, they are usually able to understand a fairly complex explanation of their cancer diagnosis including making connections between their symptoms, cancer and the role of treatment. They are likely to ask a lot more questions about their diagnosis. Be prepared to help direct them to trusted, reputable sources including their medical team to help answer questions when they come up.

Teenagers with cancer may also be particularly concerned about how their diagnosis and treatment might affect their physical appearance, social life and developing independence. It’s always best to have honest discussions about these very real concerns to the extent possible and help teens see that they can still figure out these important developmental tasks despite any limitations they may face due to their diagnosis and treatment.

What should parents or loved ones avoid saying?

We often want to reassure, encourage or tell them everything is going to be okay. While providing a sense of hope can be helpful for some kids, especially if they are overly pessimistic or negative in looking at their cancer journey ahead, it’s also okay to help normalize the negative emotions and the bad days that inevitably come along the way. Sometimes just sitting with your child through the storm is what they need.

Do you have other recommendations for parents as they help a child with a cancer diagnosis?

There’s no handbook or checklist for what to do when a child receives a cancer diagnosis. I’m a firm believer that every family does their best to support their child through treatment given their own unique circumstances. If there’s one piece of advice I have for parents and caregivers going through this process with a child, it’s to also take time for self-care when you can and when you need it. Caregiver burnout is real! Accept help when you can, occasionally treat yourself to something special and take that needed break when possible.

What advice do you have for helping siblings cope with a cancer diagnosis in the family?

Other children in the family of a child going through cancer treatment can play a big role in supporting their sibling throughout this process. This could be as a playmate who provides a sense of normalcy during otherwise “unnormal” times, someone to talk to other than parents or caregivers when needed, or even just someone to have a good laugh with.

Some siblings of children going through cancer treatment feel ignored by family members while so much attention is understandably on the sick child and helping them feel better. It’s important that they are aware of how valued they are also during this time.

What can friends of a child do to provide comfort during their friend’s cancer treatment?

Friends of a child going through cancer treatment can be supportive in a variety of ways. Often, it’s helpful for the child with cancer just to know that their friends are still thinking about them when they are away from school or in the hospital. This could be in the form of calling or texting, sending cards, or in-person visits when possible or allowed.

Can you share any anecdotes from your cancer experience that were memorable?

As a childhood cancer survivor myself, I’ll always be appreciative of the support I received from my loved ones during that time. It makes a big difference! And I know all the kids I’ve worked with here would agree. I really think finding and connecting with others who have been through something similar can be a huge source of support for kids and families going through the cancer journey. The hospital is a great place to start to make those connections. Local childhood cancer organizations in the Richmond area including the ASK Childhood Cancer Foundation and Connor’s Heroes are also great resources for families.