A cancer diagnosis brings with it not only pain and treatments, but a complete lifestyle change – there are all the appointments, tests, medications, infusions, scans, special diets, and so on to deal with; time in and out of hospital; fatigue, lethargy, boredom and a change in eating habits…
For children things are worse, because they can often not go to school while under treatment due to their impaired immune systems and possibilities of infection; often they can also not even see their friends and need to keep themselves entertained for days, weeks and even months on end. I mean, adult company is OK, but when you are a child you need to play and need other children around…
The sudden move from health to illness and the unwelcome tests and procedures needed to get a diagnosis can be very frightening for a child, and hospital stays can be a scary and overwhelming experience.
It’s very scary for a child to be told their body is not working right, and that they have cancer and it is completely normal for a child or teen to be afraid of new and often painful experiences.
It’s hard to handle being stuck with needles and having biopsies, bone marrow aspirations, lumbar punctures, scans, or other tests. Some children can be afraid that they won’t be able to handle the treatment or what the treatment will do to their body. They may worry about how they will look and feel, and how their friends will react. The thought that they may die can be terrifying.
It is also upsetting for children to see their parents and relatives stressed out.
In between the whirlwind of doctors, clinics, hospitals and illness, children need to learn coping skills to deal with it all, including the depression that is often a side-effect.
There are various methods that YOU can help your child deal with his or her cancer emotions, including Play Therapy.
“Play Therapy is a way of being with the child that honours their unique developmental level and looks for ways of helping in the ‘language’ of the child—play.”
Play Therapy can include Music Therapy, Art Therapy, be used as a supportive therapy to help children work through a range of emotional issues, including fear, anger, confusion and grief that may be associated with their cancer diagnosis, treatment and solitude.
Though play is often regarded simply as a way for individuals, particularly children, to relax, scientific research has proven that play is a crucial factor in healthy child development.
You can find many FREE downloadable books on Play Therapy, such as:
Partners in Play: A Step-by-step Guide to Imaginative Play in Children
Fifteen Effective Play Therapy Techniques: 15 techniques that are
effective, enjoyable, inexpensive, and easy to implement.
Play Therapy: Play Therapy to aid the child in the release of energy and aggression and more
Puppet Therapy: A valuable tool in therapy with children, as it provides a nonthreatening and spontaneous means of communication
One size does not fit all, however, so here are some ideas for helping children with cancer cope – according to their age group.
Infants and Very Young Children (Birth to Age 3)
Infants and very young children (birth to age 3) will benefit from the following:
- Make their bedroom cheerful with good lighting, art, and bright colours and take some of their favourite blankies and toys to their hospital room to make them feel more at ease.
- Cuddle and hug your baby often.
- Distract your baby with toys and colourful things.
- Get ideas from a recreation therapist or child life worker on other ways to help.
- Limit the number of visitors, but let your child’s siblings visit them as often as feels comfortable for the situation (based on the health and the need of each child to socialise).
- Keep a favourite stuffed animal, blanket, or other special object near your child.
- Record lullabies, stories, or messages for when you can’t be with the baby or child.
- Set aside time for play.
- Soothe and comfort by being with your child, holding, touching, rocking, and singing or playing music.
- Stay with your baby or child during tests and procedures.
- Stick to your usual schedule as much as possible, including nap times and meals.
- Talk with other parents of very young children with cancer to see what works for them.
- Talk with the team social worker or nurse about your own emotions in dealing with your child’s distress.
- Try to establish the crib as a safe, treatment-free place. Take your baby out of the crib for any treatment, test, etc., that may cause discomfort or pain.
- Use a stuffed animal to let your baby know when a staff member or visitor entering the room isn’t going to do anything that causes pain. The stuffed animal can be a cue that this person is “safe,” to help the infant stay calm.
- Use video, phone, and other means so your child can see and hear parents in real time.
Toddlers or Pre-Schoolers (Ages 3 To 5)
The toddler or pre-school child with cancer will benefit from the following:
- Give very simple explanations of what’s happening and repeat them often.
- Comfort your child when he or she is upset or scared.
- Check on your child’s understanding of what’s happening.
- Do not try to persuade your child using reason or logic.
- Offer choices when possible.
- Do not tolerate biting, hitting, kicking, or other aggressive behaviour. Teach your child how to express feelings in healthy ways (things that don’t hurt the child or other people).
- Teach acceptable expressions of angry feelings such as talking, drawing, or pounding a pillow.
- Encourage doll play and other play to rehearse or repeat worrisome or painful experiences.
- Create opportunities for physical activities.
- Try to stick to a schedule for meals, naps, and play.
- Teach staff how to get your child’s cooperation.
- Talk with the child life expert or social worker about how to reward good behavior when your child cooperates with tests and procedures.
- Make use of experts on the cancer team to help you with your child or teach you useful strategies.
- Give simple explanations for a parent’s crying and sadness. For example, “I just feel a little sad and a little tired today. It makes me feel better to cry and get it all out of my system. Now I feel better.”
- Don’t forget to have fun; laugh together when possible.
School-Age Children (Ages 6 To 12)
School-age children are especially sensitive to parental feedback during an illness.
The school-age child with cancer will benefit from the following:
- Explain the diagnosis and treatment plan in words your child can understand.
- Include your child as much as possible in talks about diagnosis and treatment.
- Answer all questions honestly and in understandable language, including “Am I going to die?” (Discuss ways to answer these difficult questions with the cancer care team.)
- Listen for unasked questions, and pay attention when your child talks about fears and concerns.
- Offer repeated reassurance that the child did not cause the cancer.
- Encourage and help youngsters to identify and name feelings.
- Teach that sadness, anger, and guilt are normal feelings and that it’s OK to talk about them.
- Teach about feeling and managing anxiety.
- Relieve anxiety about missing school by sharing with your child’s teacher and classmates about what’s happening, and encourage your child to share as well.
- Console your child over missed sports events, parties, and other activities.
- Encourage expressing feelings, especially anger, and safe ways to do it.
- Use cancer team professionals to intervene or suggest strategies for parents to use.
- Allow your child to keep feelings private, if that’s preferred.
- Offer art activities (writing, drawing, painting, collage) that will encourage expression of personal thoughts and feelings Make sure there’s fun and pleasure in each day.
- Arrange for daily physical activity, if possible.
- Help your child stay in touch with siblings, friends, and classmates by using things like cards, phone calls, text messages, video games, social media, and e-mail.
- Make plans with team members and teachers to keep up with schoolwork, which can include classes on speakerphone or the computer, recordings of class discussion, and visits from classmates (if possible).
- Plan your child’s return to school when the cancer care team can estimate a date.
- Use humour to distract.
- Arrange for your child to meet other patients their age to see how they have dealt with cancer.
Teens (Ages 13 to 18)
The teenage years are challenging as teens are learning to separate from their parents and be more independent. Illness forces some of the task of separation to be put on hold.
Teens with cancer will benefit from the following:
- Offer comfort and empathy.
- Include your teen in all discussions about diagnosis and treatment planning.
- Encourage your teen to ask questions (parents should listen for unasked questions).
- Give information on normal emotional reactions to a cancer diagnosis.
- Repeat reassurances that they did not cause the cancer.
- Address spiritual concerns or questions such as “Why me?” (Or encourage others to address them.)
- Encourage your teen to share feelings with someone: parents, family, friends, the cancer team, or other staff.
- Be willing to tolerate some reluctance to share thoughts and feelings.
- Encourage your teen to keep a journal or log.
- Allow time for your teen to talk privately with team professionals.
- Offer assurance that all of you – the patient, parents, and other family members – will be able to manage this crisis and help each other through it.
- Address feelings of anger and frustration (even if they are unspoken).
- Use team professionals to teach new coping strategies.
- Encourage your teen to share news of their diagnosis with friends and classmates, and stay in touch with them.
- Arrange for visits of siblings and friends.
- Develop a plan with team members and teachers at school for keeping up with classes, as well as a plan to return to school and deal with any restrictions that might apply.
- Make sure there’s some fun and pleasure in each day.
- Use humour to deal with frustration.
- Help your child make contact with other teen patients, if desired.
- Take your child to a teen support group and stress the importance of learning from other teens (if available in your area).