When your child asks whether you are going to die

This page is for parents with cancer whose child has asked, "Are you going to die?" It draws on NCI guidance to help you answer honestly, at the right level for your child's age.

It can arrive at any time, such as in the car or at bath time. Many children are not asking for a statistic. They may be asking who will take care of them. This is a common view, not an NCI finding.

NCI's page for parents opens on honesty: telling the truth is better than letting children imagine the worst. That is the frame for everything else.

Then it gives you the specific correction most children need. Just because you have cancer does not mean you will die from it, and in fact many people live with cancer for a long time. For a child whose entire mental file on cancer comes from a film or a rumour at school, that sentence is genuinely new information.

NCI also lists other things children need to hear alongside it:

• Nothing they did caused the cancer.
• They will be cared for, whatever happens.
• It is okay to feel upset, angry or frightened.

You are not choosing between honesty and comfort. These messages are all true things you can say.

NCI's guidance says children should know they will be cared for, whatever the outcome.

This does not predict the future. It speaks to the fear under the question, which for many children is about who will look after them. Ask your team or a social worker to help you plan how to make it true.

Sometimes the honest answer is that nobody knows yet. NCI's page is built on telling the truth rather than letting children imagine the worst. Saying "I do not know yet, and we will keep telling you the truth" fits that approach. NCI's page does not give a script for this, so ask your team's social worker to help with the words.

Children may ask again. That is common, and answering honestly each time is consistent with NCI's approach. Do not read a repeat as proof your first answer failed.

NCI's page gives different advice by age:

• Young children: even toddlers sense that something is wrong, so honesty matters early.
• Teenagers: they need independence while they work through worry. Involve them in decisions and support talks with trusted adults.
• Adult children: NCI says you may ask them for help with medical decisions and care, and suggests discussing advance directives.

Children may regress emotionally, struggle at school or become clingy. NCI suggests keeping normal activities such as school and sports.

NCI encourages parents to give children access to outside support, such as teachers and spiritual leaders. A hospital social worker can help you rehearse the words before you need them, which is a lot easier than composing them while your child is looking at you.