If you are about to spend time with a child who has cancer, you might be wondering what to say to them. Or what not to say. Or whether to mention the cancer at all.

This is a kind question. Most kids in pediatric cancer treatment can sense when an adult is nervous around them. The adults who do best are the ones who treat the child the way they would treat any kid, with a few small adjustments.

The single most important thing

Treat the child like a child, not like a patient. They are still themselves. They still have a favorite color, a favorite snack, a favorite book, an opinion about which superhero is best. Lead with curiosity about them as a person.

What to say

Start with the regular stuff

"Hi, [name]. What are you reading right now?" "How was your weekend?" "I love your shirt." "Tell me about that toy."

The regular conversation a child would have with any adult is what they need most. Cancer kids are often hungry for the part of life that has nothing to do with their diagnosis.

Acknowledge the cancer briefly, if the moment is right

You do not have to bring up the cancer to spend time with them. If they bring it up, listen. If you have not seen them in a while, a soft acknowledgment can be appropriate.

Sample: "I have been thinking about you and your family. I am so glad to see you."

Then move on to regular conversation. The acknowledgment is a touch, not a topic.

Match their energy

If they are bouncy and playful, be bouncy and playful with them. If they are tired and quiet, sit with them quietly. If they want to talk about their hospital day, listen. If they want to talk about Mario Kart, talk about Mario Kart.

The child is in charge of the conversation. You are following their lead.

Ask about specific things in their life

"What is your favorite thing you have done this summer?"
"I heard you have a new pet. Tell me about them."
"What is the best book you have read recently?"
"What are you most excited about for [upcoming holiday/birthday/event]?"

Tell them about you

Children love when adults bring something real about themselves to a conversation. Tell them about your dog. Tell them about something funny that happened to you this week. Tell them about a movie you saw. Bring something to share.

What not to say

"You are so brave."

This is not a terrible thing to say. It is also one of the most over-used phrases cancer kids hear. Many of them are tired of it.

If you want to acknowledge their experience, try, "It is good to see you," or "I am thinking about you," instead.

"How are you feeling?"

If they are a small child, they may not have words for this. If they are older, they have answered this question hundreds of times. Either way, the answer is usually a polite "fine."

Try, "What have you been up to today?" or "What did you do this morning?" instead.

"You will be all better soon."

Well-meaning. Sometimes inaccurate. Cancer kids and their families are often deeply aware of the medical uncertainty in their situation. Avoid promising outcomes you cannot guarantee.

Anything about their appearance, especially their hair

If they have lost their hair, gained weight from steroids, lost weight from chemo, or look different from how they used to look, do not comment. Treat them the same as you always have.

If they bring it up, follow their lead. They may want to talk about it. They may not.

Anything about another person's cancer experience

"My uncle had cancer." "My friend's daughter had cancer." These references are well-meaning. They often make the child feel like a comparison case rather than a person.

Save those references for adult-only conversations.

"What kind of cancer do you have?"

Do not ask the child medical questions. They are not the medical team. Their parents will share what they want to share.

Small things that go a long way

Get down to their eye level

Crouch, kneel, or sit. Eye contact at their level changes the dynamic entirely.

Bring a small thing

A book. A small toy. A sticker. A snack. A drawing they can color in. Cancer kids are often handed gifts they cannot fully engage with. A small thoughtful something they can enjoy in the moment lands.

Ask them to teach you something

"Can you teach me how to play this game?" "How does this toy work?" "Can you read me your favorite page?" Kids love being the expert.

Send a text or letter after

A small follow-up after your visit is gold. A drawing. A text from your kid. A small note in the mail. It tells them they were memorable.

What if they bring up something hard

If the child brings up something hard, listen. Do not try to fix it. Do not change the subject too quickly.

Sample responses:

"That sounds really hard."
"Thank you for telling me."
"I am glad you said that out loud."
"Is there anything that makes that better?"
"I am thinking about you when you are at the hospital."

If the topic is too big for you, you can also say, "That is a really important thing to talk about. I think your mom or dad would be a great person to talk to about it too."

A note for the visitor reading this

Children with cancer want regular adults in their life. Aunts, uncles, grandparents, neighbors, family friends, teachers, coaches. The adults who show up and treat them like the same kid they have always been are some of the most important people in their world.

You do not have to be perfect. You have to be present.

Dina
Mom of Max | Founder, Maxwell’s Toy Shoppe
Childhood Cancer Advocate 💛

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