The impact a cancer diagnosis will have on your family is often one of people’s biggest worries.

Research by Macmillan Cancer Support found more than a third of people with cancer (35%) say the possibility of not being there for their family is one of their greatest fears, and around one in four (26%) are afraid of telling their children.

To mark October’s Breast Cancer Awareness Month, Sally Kum, associate director of nursing and health information at Breast Cancer Now, says: “For many people, telling their children they have breast cancer can be the conversation they worry about most, as it can be hard to know how to tell them.

“Everyone will have their own way of approaching these conversations. Deciding how much to tell your children will vary according to your child’s age, their understanding of cancer, and the background or culture of a family,” she adds.

“Even if children don’t fully understand what you’re telling them, evidence suggests they’re less frightened when they’re informed. Children need to feel they can trust their parents, and being honest with them helps them do that.”

Sian Robinson-Brown, cancer information and support service knowledge specialist at Macmillan Cancer Support, says: “Trying to protect children from difficult news is natural. People may have concerns that stop them from doing so.

“See the first conversation as a starting point – it’s the beginning of an ongoing process of gradually giving your children small, relevant pieces of information and reassurance.”

Here, the experts share more advice…

1. Tell them yourself

“Children usually cope better with difficult news if it’s given by someone they love and trust, and in a place where they feel comfortable,” says Kum. However, asking someone you and your children both know well to be there when you break the news can be a vital source of support.

2. Plan what you’re going to say

It’s helpful to think in advance about what, and how, you’re going to tell your children. Kum says: “For some, it can be really helpful to discuss this beforehand with someone else, perhaps a partner or a friend.”

3. Let their questions steer the conversation

Allow the conversation to be directed by your children’s reactions and the questions they ask, suggests Robinson-Brown: “Have all the information you think you need and make sure you understand it. But it’s OK to say, ‘I don’t know the answer to that, but I can find out’.”

4. Listen and keep the conversation open

Ask questions that encourage children to express what they’re thinking, rather than one-word replies.

“Find out what they know and explain anything they’ve misunderstood,” says Robinson-Brown. “An example is that sometimes young children think you can catch cancer, like a cold. But be prepared for them to react in their own way, and ask them if there’s anything else they want to know.”

5. Be careful with language 

Use simple, clear language and short sentences. Robinson-Brown says: “Keep information relevant to the current situation, rather than things that may happen in the future. You’ll need to use words your children will understand, but these will vary depending on their ages.”

6. Remind them of the positives and practicalities

Kum says: “Throughout any conversations, your children need to know everyone’s doing all they can to make you better, that you still love and care for them, and that there are things they can do to help.”

Robinson-Brown adds: “Explain how their lives may be affected, and that the diagnosis isn’t their fault, nor did they cause it, and it’s important to reassure them they’re loved.”

7. Talking to very young children

How you talk about cancer depends on your child’s age, and Kum points out that children under six are unlikely to have much knowledge about it.

She says: “It’s best not to frighten them or overload them with information. For example, you may decide to tell them you have a bad lump in your breast (or whatever word you use for it) and that you’re going to hospital to have it removed.“As well as talking, you may want to show them what’s happening using teddies or by drawing pictures. Books can also help to explain things and prompt questions.”8. Talking to children aged over six years

If you have children at this age or above, try to find out what they know about cancer so you can correct any misunderstandings, advises Kum – for example, if they think everyone who has cancer will die.

“Even if you don’t like using the word ‘cancer’, it’s likely your children will know the word from other people or from the TV or internet,” she says. “They may understand more about it than you realise. A good place to start is to tell them what’s happened and what you and the doctors are going to do about it. You can ask them what they want to know about your diagnosis or treatment and when they want to talk.”

9. Talking to teenagers

Kum points out that teenagers may want more details about cancer and your treatment, although they may prefer to find out on their own. If so, guide them towards reliable sources of information, such as Breast Cancer Now’s health information booklets or Macmillan’s cancer information pages.

“They may feel torn between wanting to be there for you and dealing with their own lives or problems,” adds Kum.

10. Tell teachers and other parents

It may be helpful to talk to your children’s teachers, so they’re aware of the situation. Kum adds: “Your children may prefer to talk things over with their friends rather than with you, especially if they’re older. So, it can be helpful to talk with friends’ parents first.”

Breast Cancer Now helpline: 0808 800 6000Macmillan Cancer Support line: 0808 808 0000