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When it comes to talking about cancer with kids, there is no one that compares to Holly Senn (Certified Child Life Specialist at Inova L.J. Murphy Children’s Hospital). We’re going to share some tips for parents, teachers, and anyone else who works with children, so that you can approach this serious topic in a really open, kind, and educational way.  

In this episode, we talk about…

[1:16] Holly’s experience in the Child Life field

Holly has been at Inova Children’s Hospital for almost 17 years.  She was born and raised in Mississippi and went to school at University of Southern Mississippi, where they had a bachelor’s program in Child Life.  Holly then did her internship at Children’s Medical Center in Dallas and completed a Child Life fellowship at Texas Children’s Hospital in Houston.  The fellowship happened to be in the hematology-oncology (hem-onc) outpatient clinic, which was her first exposure to that particular field.  When her fellowship was over, Holly looked for jobs all over the United States.  She ended up in Virginia at Inova Children’s Hospital in their inpatient hem-onc unit.

[3:19] Working with hematology-oncology families

Holly enjoys being able to create relationships and see people through difficult times.  Working with the hem-onc population really gave her the opportunity to work with families on a more long-term basis and to not only help them through a procedure but also to help celebrate the positives that happen in their lives. It’s very family-oriented, and it is fulfilling for Holly to know that she is there to share in the highs and lows, while trying to make the lows a little less low.

[4:30] Engaging in an open and honest conversation about cancer with a child

These tips can apply to many different diagnoses and difficult issues such as the COVID-19 pandemic.  One of the biggest things Holly highlights is being open and honest.  That doesn’t mean you have to give all the little details; we want to make sure that our honest explanation is also age-appropriate.  Choosing words that make sense for the age group is vital.  

Holly also finds it useful to use analogies that kids might be familiar with.  For example, she might explain cancer to siblings that are 4-6 years old with a superhero analogy.  Holly says that cancer is in the body, and chemotherapy labels the cancer as villainous.  So, take Spiderman and Venom.  Maybe the cancer could be called Venom, and the chemo could be Spiderman who goes in to help get rid of the bad guy. Sometimes, good guys get in the way and get a little hurt, but we fix them back up.  That is a way to talk about blood counts changing as someone goes through treatment.  So without getting into too many details, Holly encourages being upfront and age-appropriate.

Starting with the basics is also advised.  We never know where kids are coming from, what background knowledge they are bringing to the conversation, and what their cultural beliefs may be.  Starting with minimal facts and allowing children to guide the conversation as far as what they want to know and how much they want to know is important.  It gives them some control, and keeps them from getting overwhelmed too quickly.

[7:58] Handling a child’s emotional reaction to the conversation about cancer

Children react to a conversation about cancer in all kinds of different ways. Holly has spoken with children that are very engaged and soaking up every single word, while other children will present more of a flat affect.  Others will ask several questions, while still others will cry.  

There is no set way that we should expect anybody to react to these types of conversations.  We need to support children where they’re at and help them cope with difficult information.  Affirming and validating their feelings can be helpful, and as adults and caregivers we need to be honest about our feelings as well. 

[9:20] Being open and honest about our emotions, as adults

 It’s ok to let children know that you don’t like the situation, and you aren’t happy about the information either.  If you are open about your emotions, that shows children that they can be open with you about theirs.  They will feel like communication is truly open, rather than feeling like they have to protect you as their caregivers.

[13:31] Wrapping up a difficult conversation 

It can be difficult to end this kind of conversation and have everyone get on with their days.  Holly recommends validating to the child that you gave them a lot of information, and remind them that they have adults who are available to answer their questions as they come up.  

This is an extremely stressful experience for an entire family.  Siblings have to cope with knowing their sibling is sick, and they also have to adjust as their world gets turned upside down.  Mom and Dad may be away more, and schedules have to change.  Letting children know you are there to support them is important, as is making special time just for them.

It’s not so much shutting the door on the conversation and checking it off your list as done.  It is the beginning of many ongoing conversations.

[15:40] Resources for dealing with childhood cancer

Resources:

• What About Me? When Brothers and Sisters Get Sick by Allen Peterkin
• The Puddle Jumper’s Guide to Kicking Cancer by Elizabeth Billups (guest on episode 38 of Child Life on Call)
• Leukemia & Lymphoma Society
• American Cancer Society
• American Childhood Cancer Organization
• The Child Life department at your closest children’s hospital!

Connect with Holly:

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