Advice on talking to children

Advice on what to tell siblings and other children and young people (CYP) at diagnosis.

Siblings

We advocate open and honest communication between family members and advise parents/carers to talk to siblings about what is going on as soon as possible. Children and young people (CYP) have a far greater capacity to deal with the truth than is often realised – and many children and young people do not associate negative emotions with the word cancer. CYP will know that something is amiss as soon as the adults around the sibling, friend or classmate are aware of the cancer diagnosis and the truth can often be less worrying than their imagination.

It is much better if they hear the correct medical terminology, with age-appropriate explanations, as soon as possible, with an opportunity to ask questions, rather than overhear adults talking, feel excluded and misinterpret the facts. Siblings and friends who can read and who visit the ward will see words like cancer and chemotherapy all around the units. There are resources to help parents / carers talk to siblings (see below) and unit staff may also offer to help.  

Siblings need to understand why everything has suddenly changed and often admit they feel as if the illness is their fault. They should be constantly reassured that this is not the case, even if they are not vocalising that fear. It is important to reassure siblings that it is nobody’s fault and that they will not be the next one to take ill. 

It is helpful to advise parents/carers to be very factual, for example:

  • “Joe has something wrong with his blood and it is called leukaemia. He needs to stay in the hospital for a while to have medicine to make the leukaemia go away.”
  • “I need to sleep at the hospital with Joe and dad is going to sleep at home with you. I am not sure how many sleeps but I will tell you as soon as I know.”
  • “You can still go to school – Tom’s mum is going to collect you and I will see you as often as I can.”

A younger child could be given something belonging to the parent/carer to 'keep safe' – to feel they have a bit of the absent parent/carer with them. 

Friends and classmates

With the child or young person’s permission, we advocate speaking to friends and classmates about the patient’s diagnosis and treatment using the correct, medical terminology with age-appropriate explanations. It is preferable that they hear this news from an adult in a supportive open environment with the opportunity to ask the questions they will have, rather than have unanswered questions. Open discussion will enable friends and classmates to be prepared for any physical changes there may be in the child or young person, such as hair loss, and assist them in supporting their friend or classmate. Without open discussion, misconceptions may cause them to be fearful or judgmental or display challenging behaviour towards the child or young person who is ill.

Friends report not knowing what to say or worry that they could catch cancer. Children and young people will be understandably anxious and curious as to why their classmate’s hair has fallen out, their appearance has changed and why they need to repeatedly return to hospital. The Clinical Nurse Specialists can assist teachers in this task and there are many resources available. Some examples of common questions and possible answers:

Why did they get ill?

  • We do not know exactly why people get cancer, but we do know you cannot catch it and that it is not their fault, or anyone else’s fault, that they got ill. 

Why have they lost their hair?

  • The medicine that they are given to get rid of the cancer is called chemotherapy and it causes the hair to fall out (children sometimes think you have cancer of the hair).

Why have they got that tube?

  • If it is a central venous line (in the chest) – the line is used to take blood and give medicines.
  • If it is a naso-gastric tube (a tube that passes through the nose to the stomach). This tube is used as the treatment sometimes makes it difficult to eat and drink enough and there are many medicines to take. Food, drink and medicines can be given through the tube directly into the stomach / tummy. 

Will (s)he die?

  • Cancer is a serious illness but the treatment is very good and we hope it will make them better.

Bereavement resources

Child Bereavement UK provides several helpful animation resources for talking to children about death and dying.

Page last updated: March 2026