Psychology, family and everyday life

Talking with family and children

Leukemia changes the life of a whole family, not just one person. “How do I tell them?”, “How much should I tell the children?”, “Should I spare my parents the worry?” are some of the hardest questions after a diagnosis. This topic explains in plain language how to talk with a partner, parents, other adults and children of different ages, and what a child and their brothers and sisters need when the child is the one who is ill.

Last updated: 3 October 2026~6 min read

A large and a small glowing translucent sphere side by side on a dark navy background, with warm golden light between them. — **Figure 1.**Concept: a large and a small light side by side, a family together.

01Short answer

Talking openly and honestly with family usually makes things easier for everyone: secrets often create tension and loneliness. Give children simple, truthful information that suits their age: the name of the illness, how treatment will go, what will change in daily life and who will look after them. Tell them that leukemia is not catching and that it is not their fault. When the child is the one who is ill, it is important to talk honestly with them too, at their level, and not to forget their brothers and sisters. The children’s hematology team, a psychologist and a social worker can help with these conversations.

02Simple explanation

Children usually sense quickly that something has changed at home: whispering, tears, hospital trips. When nobody tells them anything, they fill the gap with their own imagination, which is often scarier than the truth.

Prepare for the conversation: think in advance about what you want to say, choose a calm time and, if possible, have your partner or another adult the child trusts with you. You do not need to say everything at once; this is an ongoing conversation.

Name the illness: “leukemia”, “a blood cancer”. Then explain simply: “There are sick cells in my blood, and the doctors will treat them with strong medicines.” Tell the child three important things: it is not catching, it is not your fault, and someone will always look after you.

Be open with adults too. In some families, people want to hide the diagnosis from the person who is ill or from elderly parents. But a person has the right to know about their own illness and to take part in decisions about treatment. You decide whom to tell and how much.

If the child is the one having treatment, they too are spoken to honestly, at their level. Their brothers and sisters may also feel afraid, jealous or forgotten; they need attention and information too.

03Scientific explanation

What do children need? A 2020 review described six key needs of children whose parent has cancer: age-appropriate information, support for family communication, peer support and less isolation, a space to share feelings, a tailored approach and, where needed, bereavement support. Family communication was the need most often supported.

Honesty and age: Macmillan and the American Cancer Society advise telling children the truth in simple, short sentences, asking what they already know, talking more about what is happening now than about the future, and answering questions honestly. Young children need short, concrete explanations; teenagers need a fuller conversation and respect for their need for independence. A 2000 BMJ article also stresses the importance of talking honestly with children about a parent’s illness.

Brothers and sisters: according to the 2015 standards for psychosocial care in children’s cancer, siblings of children with cancer are at risk of psychosocial difficulties. A review that assessed 125 articles made a strong recommendation, based on moderate-quality evidence, that siblings should be offered psychosocial support and that parents should be advised on how to meet their needs.

The family as a whole: according to NCI, childhood cancer affects the whole family, and support services exist for parents, brothers and sisters, and grandparents. According to the American Cancer Society, psychosocial support such as counselling, family therapy and support groups helps families adapt to changes in how they relate to each other.

04What happens in the body?

When is a specialist’s help needed?

If a child has sleep problems, night fears, refusal to go to school, sharp changes in behaviour, constant sadness, refusal to eat or a return to behaviour of a younger age (for example, wetting the bed again) that lasts for weeks, see a psychologist. If a child or teenager talks about harming themselves, it is an emergency: ask for help straight away (103 or 112).

With young children (about 2–6 years)

Speak very briefly and simply: “Mum is ill, and the doctors are treating her.” Books, toys and drawing can help. Keep the daily routine as much as you can. When a parent is in hospital, say clearly who will pick the child up from nursery and who will put them to bed. Questions may come again and again; answer patiently each time.

A small glowing sprout on a dark navy background, with soft teal light curving over it like a protective arch. — **Figure 2.**Young children need a sense of safety most of all.

With school-age children

They want more information: the name of the illness, the medicines, and changes such as hair loss. Prepare them in advance for changes in appearance. Give small tasks suited to their age, but do not load them with big responsibilities. Let the teacher know so they can understand any changes in the child’s behaviour.

With teenagers

Talk to them honestly, as adults, and ask their views when decisions are made. Sometimes they do not want to talk, or they share their feelings with friends; that is normal. Give them the chance to talk to another adult they trust. Support them in keeping up their daily life, studies and friendships.

A fine bridge of light stretching between two glowing spheres on a dark navy background, with small particles of light moving along it. — **Figure 3.**Open conversation builds a bridge between family members.

When the child is the one who is ill

The children’s hematology team, a child psychologist or a child life specialist can help explain treatment to the child at their level. Do not “protect” the child with untruths: instead of “the needle won’t hurt”, say “it will hurt a little, but it will pass quickly”. Set aside special time for brothers and sisters and keep them informed as far as possible.

Questions you can ask the team

Who can help me talk to my children? Is there a child psychologist at the hospital? Can my children visit me in hospital? What should we tell the school? Is there a support programme for brothers and sisters? How should I explain the illness to my parents?

05Steps in a conversation with a child

Not a one-off talk but a dialogue that continues over time.

1PreparationThink about what you will say and who will be with you.

2Simple truthThe name of the illness and the treatment, at their level.

3Three reassurancesNot catching, not your fault, you will be cared for.

4Ongoing dialogueStay open to questions and come back to the talk.

OpennessSecrets make fear grow.

Family togetherEveryone has a role and a place.

A sense of safetyRoutine and care carry on.

06Talking with children by age (simplified)

Age	What they understand	What helps
2–5 years	They sense changes in routine and separation	Few words, routine, saying who will look after them
6–9 years	They understand illness through simple cause and effect and may blame themselves	“It is not your fault”, drawing and play, answering questions
10–12 years	They want more detail and may search online	Honest information, pointing them to reliable sources
Teenagers	They understand like adults but may hide their feelings	Talking as with an adult, involvement in decisions, privacy
The child who is ill	Understands what is happening in their body at their level	Honest explanation together with the team and a psychologist
Brothers and sisters	Fear, jealousy, feeling forgotten	Special time, information, telling the school

* Age bands are approximate; every child is different. A child psychologist and the hematology team can help you.

07Key terms

Age-appropriate information: A truthful explanation at a level the child can understand.
Siblings: The brothers and sisters of a child who is ill; they need support too.
Child life specialist: A professional who helps children understand hospital and treatment through play and explanation.
Family therapy: Psychological work with the whole family.
Psychosocial support: Help with emotional, social and practical needs.
Regression: A child returning to behaviour of a younger age under stress.
Daily routine: Familiar rules that give a child a sense of safety.
Privacy: A person’s right to decide whom to tell about their illness, and what.
Child psychologist: A specialist who works with children’s feelings and behaviour.
Support group: Meetings of families or children in a similar situation.

08Key points

Children sense change; silence does not protect them.
Name the illness and explain it simply.
Leukemia is not catching and it is not the child’s fault.
Tell the child clearly who will look after them.
This is an ongoing conversation, not a one-off.
Talk with teenagers as you would with adults.
Do not forget brothers and sisters.
A psychologist and the team can help with these conversations.

09Frequently asked questions

Can I say nothing to my children to protect them?

Children usually sense that something is happening, and when told nothing they may feel shut out or guilty. Honest information suited to their age often protects them better.

What do I say if my child asks, “Are you going to die?”

Answer honestly and with hope, for example: “My illness is serious, but the doctors are treating me and many people reach remission. Whatever happens, you will always be looked after.” It is fine to say “I don’t know” if you don’t.

Can my children visit me in hospital?

It depends on the hospital’s rules and on your immunity. Children who are unwell should not come. Before a visit, explain what the child will see (a catheter, machines). Video calls are a good alternative too.

I don’t want to tell my parents. Is that all right?

You decide whom to tell and what. But keeping it hidden for a long time is usually hard, and loved ones may feel hurt later. When you are ready, you can ask a doctor or a trusted relative to help.

My child is ill. Should I tell them the diagnosis?

Most specialists advise giving a child honest information suited to their age; it helps them adapt to treatment and trust you. Plan how to tell them together with the children’s hematology team.

The brothers and sisters feel forgotten. What can we do?

Spend special time with each of them, even if it is short, explain what is happening and tell them their feelings are normal. Relatives and teachers can help too. Some centres run special programmes for siblings.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

How would you suggest I tell my children about my diagnosis?
Can my family members come to a meeting with the doctor?
Are there support services for my family?
How can I record who you are allowed to share my information with?

My questions

12Sources

National Cancer Institute (NCI). When Your Parent Has Cancer: A Guide for Teens
National Cancer Institute (NCI). Support for Families: Childhood Cancer
National Cancer Institute (NCI). Support for Caregivers of Cancer Patients
National Cancer Institute (NCI). Taking Time: Support for People With Cancer
American Cancer Society. Helping Children When a Family Member Has Cancer
American Cancer Society. Adjusting to Life With Cancer
American Cancer Society. Therapy, Counseling, and Support Resources for People with Cancer
Macmillan Cancer Support. Talking to children and teenagers
BMJ, 2000. Telling children about a parent’s cancer
European Journal of Cancer Care, 2020. How psychosocial interventions meet the needs of children of parents with cancer: A review and critical evaluation
Pediatric Blood & Cancer, 2015. Supporting Siblings as a Standard of Care in Pediatric Oncology
Pediatric Blood & Cancer, 2015. Standards for the Psychosocial Care of Children With Cancer and Their Families: An Introduction to the Special Issue

Medical disclaimerThis information is for educational purposes only and does not replace medical advice.

Last updated: 3 October 2026← Back to the list

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