The diagnosis of cancer is never considered a good news. This is regardless of age, but if a patient is a child, then the matter becomes even more sensitive. The news of cancer diagnosis stirs up a swarm of questions for parents and caregivers: ‘Will my child get well?’, ‘What will happen to our family?’, ‘Did I do something wrong?’ or ‘Would we be able to pay the bills for the treatment?’

The global incidence of cancer among children and teens has risen in the recent past, adding up to approximating 300,000 new cases every year worldwide. (Source: IARC, 2016)

A child being diagnosed with cancer can be draining and challenging for the caregivers. It involves not just the child’s physical or medical needs, but also the psychological and emotional consequences for the entire family.

Helping Children Understand their Illness

When diagnosed with cancer, the question arises if the family should share the condition and related implications with the child. Experts say that the child's awareness of the illness plays a vital role in the treatment process.

The child must know that he or she is in for long-term care and that frequent visits to the hospital should be expected. Doctors, medicines, injections may appear threatening, but they are there to help the child feel better soon. Preparing them accurately about the consequences of treatment, medicines, surgical and radiation procedures may help them anticipate and accept the discomfort their bodies may undergo.

Talk to your child in a way that he or she can understand. Children are inquisitive and smart, and they want clear answers to their questions. Avoid making statements like ‘This won’t hurt much’, 'The medicine doesn't taste as bad as you think’, ‘The injections won’t hurt’ etc.; instead be honest about what is involved in the process, and reduce the child’s fears. As a caregiver, you also need to reassure that the negative side of cancer is temporary and that it will get better soon. Where families find it difficult to speak to the child, they can take help of the medical team including treating doctors, nurses and psycho-oncologists available at the hospital.

Working Though Difficult Emotions

During the treatment for cancer, the child’s body undergoes a number of physical changes. In such situations, children need to speak out their thoughts and feelings during and after the treatment process. Children do not always understand how to work through difficult emotions caused during the various stages of their illness. It is a common tendency to blame oneself for falling ill, especially amongst children. They might hold themselves responsible for the wrong-doings. ‘I lied to mummy, that’s why I fell ill’, ‘God is punishing me for scoring low marks in exams’, ‘I was a bad boy or a girl’, ‘I did not eat vegetables, that’s why I’m here’ are some of the common array of thoughts that they experience.

Children need to be reassured that they are not accountable in any way for their illness. They need to be explained the medical causes underlying their condition. Children tend to get irritable and angry and they need to realise that ‘It’s OK’ to experience these feelings. These emotional reactions need to be recognized by the parents. Children undergoing treatment for cancer often get scared and fearful as well. Just like adults, they need love, care and affection that makes them feel secure.

At the same time, it is important for the caregivers not to spoil their wards and to maintain normality, despite the current medical situation. Unreasonable demands of the child need to be discouraged by the parents. These are likely to create an over-indulgent, over-protective and a pampered child, further making it difficult for the child to return to normalcy after the treatment is over.

Family Dynamics

Being a carer for someone diagnosed with cancer is not easy. The journey from treatment to recovery is not just for the child alone, but the entire family to go through. All the members of the family are tested in such a situation. The entire course is a mix of good and the not so good days.

It’s recommended that you gather enough support during your child’s illness. Being in regular contact with school teachers and counsellors and updating them frequently keeps them aware of the situation and they are able to assist the child make up for the missed classes and syllabus. It could also be beneficial to talk to parents of your child’s friends about his or her health in efforts to enhance their sensitivity and support for your child.

Need for Self Care

The following points could be beneficial while working with childhood cancer:

* Break bigger problems into smaller parts- Dealing with a diagnosis of childhood cancer can be a big hurdle for you and your family, and could often lead to a feeling of being lost. Instead, try to take one step at a time, rather than focusing on the future prospects and the possibility of the outcome.

* Social support- Caregiving for cancer in itself is a distressing experience. Your friends and family can be very helpful in your emotional well-being and dealing with this transition.

* Acknowledge feelings- It's very important for us to accept our feelings and emotions. Confronting them allows us to cope with our stress more effectively. This gives us more strength and stamina in the long run.

* Communicate- Bottling up your feelings is not healthy, both for the caregivers as well as the patient. Instead, you could express through ways such as writing, music, art, and so on. It's also important for children, who do not tend to be verbally expressive in comparison to adults. Therefore, they could be encouraged to use creative non-verbal methods such as drawings, make belief play, role playing, music, drama and dance.

* Support groups- Being part of support groups enables you to have a platform where you connect with other people going through similar problems like yours. It helps you share your concerns with someone who may have already gone through a similar experience. This helps you connect with other parents and not feel alone in this journey.

* Professional help- If you feel that your stress or negative feelings are interfering with your daily routine, professional engagements, interactions at home, or your child seems to be depressed, anxious, or withdrawn, do not hesitate to consult a mental health professional or a psycho-oncologist to help deal with the situation.