Chapter 1, Diagnosis, lists many of the feelings parents may experience after their child’s diagnosis of a solid tumor. It is helpful to remember that children, both the ill child and siblings, are also overwhelmed by strong feelings, and they generally have fewer coping skills than adults. At different times and to varying degrees, children and teens may feel fearful, angry, resentful, powerless, violated, lonely, weird, inferior, incompetent, or betrayed. Children have to learn ways to deal with these strong feelings to prevent “acting out” behaviors (aggression, risk taking) or “acting in” behaviors (depression, withdrawal).

Good communication is the first step toward helping your family identify how cancer is affecting behavior and family functioning, and how family members can work with each other, and with professionals, to restore order and a nurturing climate. Clear and loving communication with your children or teens is the foundation for trust. Children need to know from the very beginning that you will answer questions truthfully and take the time to talk about feelings.

Honesty

Above all else, children need to be able to trust their parents. They can face almost anything, as long as they know their parents will be at their side. Trust requires honesty. For your ill child and her siblings to feel secure, they must always know that they can depend on you to tell them the truth, be it good news or bad. This trust you build with your children reduces feelings of isolation and disconnection within the family.

Listening

Just trying to get through each day consumes most of a parent’s time, attention, and energy. Thus, one of the greatest gifts parents can give their children is time—time when they are fully present in the moment and really focus on what children are saying and the feelings that generate the words. This can be difficult when you are physically and emotionally exhausted, but children notice when you are not really paying attention and are distracted by other thoughts and worries.

Talking

If you are not in the habit of sharing your feelings with your children, it is hard to start doing so during a crisis. But now, more than ever, it is important to try. Parents can create an opening for discussion by simply stating how they are feeling, for example, “I have lots of different feelings at the same time. Sometimes I really get mad at the cancer because it is making your life so tough, but I am also happy that the medicine is working.”

Telling your healthy children what you are feeling can strengthen your connection and reassure them of your love: “I really miss you when I have to take your sister to the hospital. I’ll call you every night just so I can hear your voice,” or “I wish the family didn’t have to be separated so much, and I feel sad that you have to go through this.” Such statements reassure children of your continued love for them and distress about being separated from them; they also create an opportunity for children to share with you how they feel about what is happening to the family.

It is also helpful to tell your sick child how the illness is affecting her siblings, for example, “It is very hard for Jim to stay at home with a babysitter when I bring you to the hospital. Let’s think of something nice to do for him.”