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Talking about cancer with kids is delicate

A single dad found he needed to balance his desire to protect his children with their need to know.

October 10, 2010 at 10:51PM

"I have terminal cancer and will be dead in about a year," a dad informed me. "I need help with my kids, but I don't want them to know about my illness until I'm near death."

I had known this dad for several years, meeting with him occasionally to advise him on problems with his three children.

"I feel so terrible for how this will affect my kids," he said. "They went through a lot when their mom died, and now they will have to deal with this. If there is a God, why would he put them through this?"

Over the course of many sessions, we talked about the following.

Remember moderation.

Whenever you are faced with any issue regarding kids, try to avoid extreme approaches.

This dad naturally wanted to protect his children from having to deal with his illness. However, he would be going through months of treatment for prostate cancer, and it's almost impossible to keep that information secret from his children. They would undoubtedly have questions, concerns and fears about their dad and themselves.

This is a time when the family needed open communication, not deceitfulness masquerading as protection. Some parents go to the other extreme, overinvolving their kids in every aspect of some adult issue. The kids become too enmeshed in things that they cannot understand. Find that delicate balance between overprotection and overinvolvement.

Focus on living, not dying.

I advised the dad to continue as normal a routine as possible.

When one of the kids had done something that typically would have resulted in some punishment, he was reluctant to take any action. Since he wouldn't be around much longer, he wanted to enjoy his kids as much as possible.

After much discussion, dad eventually agreed to discipline his son and to maintain family routines and expectations.

Foster hope.

The dad had avoided regular medical exams for years, and by the time his cancer was detected he was told it was terminal. He embarked on an aggressive treatment, but only for the sake of his kids.

I advised him not to tell his kids that he had only a year to live. Physicians would be the first to acknowledge that they cannot predict the future.

He told the children that his illness was serious and that there was a chance that treatment would fail. He made arrangements for the children in case he died and involved the kids in those discussions.

Throughout a long and difficult ordeal, neither he nor his children ever gave up hope.

This incident happened about 12 years ago. I recently received an e-mail from the dad informing me about his youngest son's graduation from college.

Gregory Ramey is a child psychologist and vice president for outpatient services at the Children's Medical Center of Dayton, Ohio. Read more of his columns at www.childrensdayton.org/ramey.