Medical Oncologist
Before you start
Telling your family and children before you start
Tell them before treatment starts, in plain words pitched to their age. Say that someone is ill, that the medicine is strong and will cause tiredness and visible change, that it is nobody's fault, that it is not catching, and that the child will be looked after. Saying nothing almost always backfires.
NG
Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
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The short answer
What do we tell the children, and when?
Tell them before treatment starts, in plain words, pitched to their age. Say that someone is ill, that the medicine is strong and will make them tired and change how they look, that it is nobody's fault, that it is not catching, and that the child will be looked after.
The instinct to protect children by saying nothing almost always backfires. They know something is wrong from the whispering and the hospital visits, and what they invent in the silence is reliably worse and more frightening than the truth.
Use the real word
Say cancer. Children hear it eventually — from a neighbour, a cousin, a classmate — and hearing it from outside after being told nothing damages their trust in you at exactly the moment they most need it.
Tell the household one story
In a joint family, decide together what is being said and by whom. The most common cause of distress is a child hearing three different versions from three relatives and concluding that everyone is lying.
Tell the school. A teacher who knows can explain a sudden change in a child's behaviour rather than punishing it.Age by age
What to say, depending on how old they are
- Under five
- Keep it very simple and about routine. "Amma is ill and the doctor is giving strong medicine. She will be tired and will sleep a lot. You did not cause it and you cannot catch it. Nanna will take you to school." Expect clinginess and some going backwards in habits.
- Five to nine
- They want the name and the mechanics. Say cancer, say where it is, say the medicine kills the bad cells but also makes hair fall and causes sickness. Answer exactly what is asked and no more. Repeat it, because they take it in slowly.
- Ten to twelve
- Old enough to search online and find the worst of it, so give them real information first. Expect the frightening question about dying. Be honest without predicting: this is serious, the doctors are treating it, we will tell you if anything changes.
- Teenagers
- Tell them properly, close to how you would tell an adult. They resent being managed more than they resent bad news. Watch for the opposite problem: taking on far too much of the caring and hiding their own distress.
- Adult children living away
- Tell them early rather than after the first cycle. Being informed late is a common and lasting hurt. Give them a real job — insurance, records, phone calls — because helplessness at a distance is hard to bear.
- Elderly parents
- Many families hide it entirely. Consider whether that is protection or your own discomfort. Most older people notice anyway, and being excluded from the truth in their own household is its own kind of pain.
Not sure whether this applies to you?
Ask an oncologistHow to have the conversation
What makes it go better
The setting and the follow-up matter as much as the words.
Pick the moment deliberately
Somewhere quiet, with time afterwards. Not at bedtime, not just before school, not in the middle of a family gathering. Children need room to react and to come back with questions an hour later.
Avoid
- Telling them and then leaving for the hospital
- Letting them overhear it first
Say the three things that actually worry them
It is not your fault. You cannot catch it. You will be looked after. Children worry about causes and about themselves before they worry about prognosis, and these three sentences settle most of it.
Describe what they will see
Hair falling out, weight change, vomiting, days in bed, hospital visits. Naming these in advance stops each one arriving as a fresh shock, and it is the part adults most often leave out.
Also tell them
- Who will collect them from school
- What stays exactly the same
Keep the conversation open
One talk is not enough. Say clearly that they can ask anything at any time, and that you will tell them if things change. Then actually do that, including when the news is not good.
The hard ones
Questions children ask, and honest answers
They ask
You can say
"Are you going to die?"
"It is serious. The doctors are treating it. I will always tell you the truth."
"Did I make you ill?"
"No. Nothing you did or thought caused this. Nobody caused it."
"Will I get it too?"
"You cannot catch cancer from me, and children very rarely get this."
"Why do you look like that?"
"The medicine makes my hair fall out. It grows back after."
"Can I still hug you?"
"Yes, always. Just wash your hands first, like we all do now."
"Who will look after me?"
Name the person, for each day of the week, out loud.
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Being straight with you
What this page cannot tell you
It cannot give you the words for your own family. You know your children, your household and what your relatives can bear. Take what is useful here and change the rest, because a script delivered stiffly is less reassuring than your own plain words.
It also cannot tell you what to say about the outcome, because nobody knows it yet. Honest and vague is better than confident and wrong: "the doctors are treating it, and I will tell you if anything changes" holds up in every direction the news might go.
Watch for the signs afterwards
Sleep trouble, stomach aches, falling marks, a child who becomes suddenly perfect and helpful, a teenager who stops going out. These are common and worth acting on. Tell the school, and ask your hospital whether a counsellor can see the child.
What to do next
Agree with the household what is being said and by whom. Tell the children before cycle one, not after. Say the three sentences that matter: not your fault, not catching, you will be looked after. Tell the school. And leave the conversation open.
Commonly believed
Four instincts to resist
"They are too young to understand, so we will say nothing."
Even small children sense the change in the house and fill the silence with something worse, often that they caused it. What changes with age is the amount of detail, not whether they are told at all.
"Better to say it is a stomach problem and protect them."
The truth reaches children eventually, usually from outside the family, and then they learn both the diagnosis and that they were lied to. That second part is what does the lasting damage to their trust in you.
"Crying in front of them will frighten them."
Seeing an adult upset and then recovering teaches a child that sadness is survivable. What frightens them is a household of forced cheerfulness that plainly does not match what is happening around them.
"Our eldest is coping wonderfully and helping with everything."
The child who becomes suddenly perfect is often the one struggling most, and this happens especially to eldest daughters. Ask them directly how they are, give them permission to be a child, and watch for it.
Questions we are asked
Common questions about telling the family
Should we use the word cancer?
Yes, with children old enough to talk. They hear it eventually from a neighbour or a classmate, and learning it from outside after being told nothing costs you their trust when they most need to rely on you.
When is the right time to tell them?
Before treatment starts, so the visible changes are explained in advance rather than after they appear. Choose a quiet moment with time afterwards, not bedtime and not just before leaving for the hospital.
What if my child asks whether I am going to die?
Do not promise what you cannot know, and do not deflect. Something like "it is serious, the doctors are treating it, and I will always tell you the truth" is honest and holds up whichever way things go.
Should we tell the school?
Yes, and early. A teacher who knows can make sense of a sudden change in behaviour or marks rather than treating it as misbehaviour, and can quietly keep an eye on how the child is doing.
My in-laws want it kept secret. What do we do?
The decision belongs to the patient and the parents. Try to agree one story for the household rather than several, since children hearing different versions conclude that everyone is lying. Ask the hospital counsellor to help if the disagreement is stuck.
Should we hide it from elderly parents?
Consider carefully whose comfort the secrecy serves. Most older people sense it anyway, and being excluded in their own home is painful. If you decide to tell them, do it gently and with someone else present.
Can children visit during treatment?
Usually yes, when they are well. Keep away any child with a cough, cold, fever or loose motions, and check with the team about any recent live vaccine. Contact is good for both of them.
Where can we get help with this conversation?
Ask your hospital whether a counsellor or medical social worker can see the family. Most units have one and few people are offered one. Ask for the explanation in Telugu or whichever language the household uses.
Meet the Specialists
17+ senior cancer specialists. One panel for your case.
Trained at AIIMS, Tata Memorial, and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them — together.
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Sources
- Cancer Research UK — Talking to children about cancer
- Macmillan Cancer Support — Talking to children and teenagers
- National Cancer Institute — Support for Families When a Parent Has Cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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