This booklet has information to help patients with cancer who have children. It can be hard to talk to your child about your illness. Children are different and will react to cancer in their own way. Learning about:

• how to talk to your child about cancer
• how your child may react
• other helpful resources

can help you and your family cope during this difficult time.

You know your child better than anyone else. It’s up to you to decide when, how and what to tell your child. If you need more information or have any concerns about how your child is coping, your health care team is ready to help.

Talking to your child about cancer

Should I tell my child about my illness?

This is a very personal decision that each family has to make. Here are a few things to think about:

• Even very young children know when something is wrong. These are all signs to children that things are not normal:
  • changes to their regular daily schedule
  • more relatives and friends coming to visit
  • seeing people upset
  • whispered phone calls
• Children have very good imaginations. If they notice things are not normal, they can think of lots of scary reasons. These thoughts may worry them more than the truth.
• If your child finds out from someone else, you may damage the trust they have in you.
• Children can feel very alone if they aren’t told. They might feel they’re not important enough to be included in something that affects the whole family.
• Being honest and open with your child may help your family become closer.
• Adults often don’t realize how well children can deal with the truth. Even hearing very sad news is better than the worry they feel when they don’t know what’s happening.

We can’t stop them from feeling sad. But, if we share our feelings and give them information about what’s happening, we can support them in their sadness.

Who should tell my child?

• Even though it’s a very hard thing to do, it’s best for you to tell your child if you feel able to.
• If you don’t feel able to tell your child, your partner or a close relative such as a grandparent, can do it. It’s important that you know what they say to your child. It may be helpful for you to be there for the talk.

When should I tell my child?

• It’s usually best for your child to know about your illness as early as possible after your diagnosis.
• You don’t have to tell them everything at the same time. You can give a bit of information at a time.
• Be consistent in the way you explain things. Always check to see if your child understood what you said.
• Tell them information before things happen, but not too soon. For example, tell them when you have a scan or treatment coming up.
• After you finish treatment, tell them about your health and any changes. Make sure they know you will share all information with them.
• Talk to your child when they ask questions or seem worried about your health. But, keep your answers short and stay on topic.

Is it okay for me to be upset in front of my child?

It’s ok to get upset or cry. Seeing you cry lets your child know that it’s ok for them to cry and express their feelings too. Crying together is a way of sharing your feelings and supporting each other.

What should I tell them?

• You may want to practice what you will say. Think about and plan answers for the questions your child may ask. Use words that your child will understand.
• Ask them what they think cancer is. If they’re not sure, explain it as well as you can.
• It’s very helpful to use the word cancer. Nicknames like, “the big C” or saying things like, “I have a bad seed growing inside” can be confusing to your child.
• Don’t be afraid to say, “I don’t know” if you don’t know the answer to their question. Some questions don’t have answers. Other answers only become clear as time passes. But, try not to say, “I don’t know” all the time because your child might start to feel scared and unsure.
• Tell them that they didn’t cause your cancer, and nothing they do will make it worse or make it go away. Explain that you have doctors who have a plan to help you get better.
• Tell them your cancer can’t spread to other people. They or their healthy parent can’t catch it. It’s a different kind of illness than a cold or chicken pox.
• Let them know what will happen next. For example:
  • what will happen to you
  • how their daily schedules will change
  • who will take care of them if you are in the hospital

Talk about only the upcoming days or weeks. Talk about long-term issues only if your child has a specific concern.

• Ask your child if they are worried about anything in particular. Listen closely to their answer. What they say can become important in future talks with your child.
• Make sure your child knows that it’s ok to talk and ask questions, even if you both feel sad and upset. Set aside plenty of time to talk. Choose times when you won’t be interrupted.

Some examples of what to say to your child:

I have an illness. It’s called cancer. The doctor is giving me medicine to help me get well. Sometimes I will feel ill or tired, and sometimes I will feel fine. Dad/Mom will help me to take care of you until I feel better.

Being ill makes me feel sad. You are a help. But it’s all right for you to feel sad (or angry or worried). Our feelings change but Mommy/Daddy and I will always love you.

A lump was growing in my body that wasn’t supposed to be there. It’s called cancer. The doctors took it out in the operation I had. Now I will have treatment so that it doesn’t come back.

If you have any questions about cancer, you can ask me. Sometimes you hear scary things about cancer, but there are lots of different kinds of cancer. I will tell you what we know about my cancer.

The cancer is trying to grow again. That makes me angry and sad too. I have to take very strong medicine (or have another operation or radiotherapy) to try to get rid of it. Doctors know a lot about taking care of people when this happens. They think that this treatment will help me.

What if they ask if I will die?

Many children have heard of cancer and know that people can die from it. If they ask you if you will die:

• Tell them the truth about what you know about your cancer.
• If it’s very treatable, tell them people very rarely die from your kind of cancer.
• If you’re not sure about your health after your treatment, tell them sometimes people can die from cancer. But, it’s different for everyone and you hope to get better. Tell them your doctors are doing the best job they can to make you better.
• Promise them you will let them know about any other information or changes.

Let them know they may see changes in how you look (for example, you may lose weight or hair) as you go through treatment. It may seem to them that you are getting worse, but it’s part of you getting better. If you like, use children’s storybooks to help explain the side effects of your treatment.

If you have questions or concerns about how to best support your children, talk to your health care team.

How can I protect them from pain?

• You can’t take their pain away, but being honest, supportive and there when they need you can help your children cope.
• Pretending that nothing is wrong may cause your child to think their pain and fear isn’t real. Or, they may feel you don’t think they’re strong enough to cope.
• A big part of your job as a parent has been to protect your children from bad things. Unfortunately, pain is sometimes part of life. Now is the time to help your children build their inner strength and courage. The best way to help them cope is to let them know they are loved and cared for.

How do I know if they’re having problems coping?

It’s normal for your child’s feelings and behavior to change for a few weeks after they hear about your cancer. During this time, comfort them and accept them. Let them know it’s ok to experience many different feelings.

If the changes last longer than the first few weeks, they may be having problems coping. Some signs include:

• A normally quiet child starts to misbehave and argue all the time.
• A child who is normally selfish starts taking care of everyone in the family.
• A friendly child becomes moody and quiet.
• Your child starts acting younger than they are. This is normal when children are stressed, but if it lasts longer than a few weeks, they may be having trouble coping.
• Your child has trouble sleeping for a month or more.
• Your child is having more trouble than usual with schoolwork. Let them know they are still responsible for working hard at school.
• Your child no longer wants to do normal activities like sports or playing with friends. Let them know they can and should still try to enjoy their favourite activities.

Talk with your child’s caregivers (for example: daycare staff, teacher, babysitter or a play group supervisor). They may notice things that you don’t notice at home.

If the problems continue even after talking with your child, you may want to find extra help or advice.

Where can I get help?

• Talk to your family doctor, clergy, a school counselor or a hospital social worker for advice and/or a referral.
• You can find good information on the Internet and at your local library. Don’t forget to check the Princess Margaret Patient and Family Library and the Magic Castle Library for updated information.
• Some hospitals have Child Life Specialists. These are people who work with children who are dealing with serious medical conditions. Ask your doctor if there is a Child Life Specialist at your hospital.
• Talk to other cancer patients and ask them what worked for their families.
• Ask a close friend or family member for help, especially if you are feeling ill, overwhelmed or exhausted. Ask them to call up some of the resources listed in this guide or find out about resources in your community.
• Give your child the Kids Help Phone number if they don’t feel comfortable talking with you, family members or friends:
  1 800 668 6868.
• Find out whether you or your partner has an Employee Assistance Program at work. Ask your child/teen if they would like to use the counseling services.

Common ways infants and toddlers (up to 2 years old) react to a parent having cancer

What’s important to know about this age group?

• Children in this age group are focused on themselves.
• They can’t always understand what you explain to them, but they can feel comfort or discomfort.
• They don’t understand ideas like ‘yesterday’ or ‘tomorrow.’ They only understand what’s happening now.
• They know when something is gone, but they can’t understand the idea that it can come back. That’s why separating things or people from them is so upsetting.
• A loving relationship with their parents is the most important thing for them. They depend on you to keep them safe and feel loved.
• Even though they can’t say so, they know when something is wrong with their parents, and they feel the loss when a loved one isn’t around.
• It can take some time for them to feel comfortable if a parent looks different or is in an unfamiliar place, like the hospital.

What is most scary or upsetting?

• Being separated from their parent or parents (or main caregiver)
• Not feeling comforted or safe
• Sudden changes to their regular daily schedules
• Someone else’s needs being put ahead of
  their own

What can you do to help your child cope?

• Keep giving them lots of comfort (hugs, kisses, cuddles). If you are in the hospital, try to have your child come for short visits often, especially when they are ready for a bottle or quiet story. Remember to have someone bring some favourite toys.
• Try to keep regular routines (as much as possible).
• Try not to use too many different caregivers.
• If you have to take them somewhere new, bring familiar toys or other objects.
• If they have to come with you to appointments, bring food, toys and/or a comforting blanket or stuffed animal.
• Give them a t-shirt or scarf that has your scent on it. This can help provide them comfort when you are not around.

Common ways preschool children (ages 3 to 5) react to a parent having cancer

What’s important to know about this age group?

• Children in this age group are focused on their parents
  and themselves.
• They can only understand very simple words when you try to explain something.
• They are starting to understand things like ‘yesterday’ and ‘tomorrow,” but they can’t understand how long to wait until a certain date or event.
• They are starting to understand very simple ideas about how the body works, but ideas like illness are difficult.
• Even though they can’t always say so, they know when something is wrong with their parents. They feel loss when a loved one isn’t around.
• They can pay attention to what you are saying a little more, but after a short time, they want to go back and play.
• They use play as a way to make sense of the world and express their feelings.

What is most scary or upsetting?

• Believing they caused the cancer or they have the power to change it.
• How their own lives will change
• Thinking they can catch cancer, like a cold or chicken pox
• The physical changes they see in their parent (like losing hair or a body part)
• What other children will do or say about how different their parent looks
• New and different places like the hospital

What can you do to help your child cope?

• Be clear and talk simply to your child. Children this age don’t understand long words or many medical terms. It may help to draw a picture of what’s happening. Their questions can be unpredictable, so be prepared.
• Be available to answer any questions and to talk any time.
• Try to keep regular daily schedules (as much as possible). Tell them about any changes in their schedule for the day or in the near future.
• Give your child lots of hugs, cuddles, or kisses. They feel comfort when you are close.
• If you are in the hospital, try to have your child come for very short visits often. It’s a good idea to let them run around outdoors first, so they are more calm during the visit. Remember to bring some favourite toys.
• Provide them with toys like dolls, puppets, doctor’s kits, or a toy ambulance.
• If your child has to come with you to appointments, bring snacks, toys and drawing supplies.
• Reassure children that you are still the parent. Letting them know there are still rules is even more important during stressful times.
• Avoid saying things like, “Be very quiet so Mommy can get better.” Young children may think it means it’s their fault when their parent gets sick.
• Read books that relate to your situation or similar stories about animals, living things, hospitals, doctors and nurses.
• Pretend play can help them learn and understand what’s happening. It’s important to support this, so provide a corner with toys and items that children can use during pretend play.

Common ways school age children (ages 6 to 10) react to a parent having cancer 

What’s important to know about this age group?

• Children in this age group still depend on their parents
  and need attention.
• They want to fit in with their friends.
• They are starting to use reason and common sense in their thinking.
• They are concerned about rules and fairness.
• They are interested in how different parts of the body work.
• They use play and creative arts to make sense of the world and express their feelings.
• They are more aware of their feelings and why they have them.
• They learn quickly and use what they learn to find more information.

What is most scary or upsetting?

• Thinking their parent will die
• Thinking that their healthy parent will get sick too
• Thinking they did something to cause the cancer or they have the power to change it
• How their own lives will change and who will take care of them
• Not knowing what will happen next
• Mistaken ideas about cancer because of things they heard from friends or saw on TV
• What their friends will say or think about their parent’s cancer

What can you do to help your child cope?

• Try to keep regular routines (as much as possible).
• Be calm and provide them with lots of hugs and kisses. Children this age can feel lonely and worried. Being near and reassuring them can help.
• Let your child feel angry. It’s a natural part of adjusting to your illness.
• Reassure children that you are still the parent. Letting them know there are still rules is even more important during stressful times. Now is not the time to bend the rules.
• Let your child know what will happen soon. Children this age can’t think weeks or months ahead.
• Don’t take it personally if your child seems more interested in your IV or your surgery scar than how you feel. Children this age are very interested in how the body works.
• Explain your illness, treatment and any equipment you need. Make sure you give
  them the right information in case they have mistaken ideas.
• Provide lots of time for your children to talk or ask questions, but don’t be surprised if they don’t want to talk when you do.
• If the parent is in the hospital, try to plan things that the parent and child can do together like watching a video, reading a book, or playing a board game.
• Tell your child again and again that they didn’t cause your illness and can’t do anything to change it.
• Be patient and understanding.

Common ways preteens (ages 11 to 13) react to a parent having cancer

What’s important to know about this age group?

• Children in this age group start to build important
  relationships outside of their family.
• Their friends are very important to them.
• They need facts to help them understand information.
• They are beginning to think abstractly. This means they can use facts to create their own ideas or meanings of things.
• They want more freedom but still struggle to be responsible.
• They may use play or creative arts to make sense of the world and express their feelings.
• They are self-centred. Their ideas and thoughts are often about how things will affect them.
• Their frustration may cover-up their real feelings.

What is most scary or upsetting to them?

• Thinking their parent will die
• Thinking that their healthy parent will get sick too
• How their own lives will change
• How their parent’s cancer will affect their social life
• Not knowing what will happen next
• Mistaken ideas about cancer because of things they heard from friends or saw on TV

What can you do to help your child cope?

• Let your child know they should continue their regular activities.
• Talk to staff at your child’s school regularly to make sure everything is ok.
• Let your child feel angry. It’s a natural part of adjusting to your illness.
• Reassure your child that you are still the parent. Letting them know there are still rules that need to be followed is important. Keep their regular routines in place. Routine plays a very important part in their life.
• Let them know what will happen during the next few days or weeks, even if they don’t seem interested. They should learn the facts from you, not from other sources.
• Tell your child that the most important way to help is to keep working hard at school.
• Encourage your child to keep their relationships with friends and other important adults in their life.
• Keep up with family traditions but also talk about how the cancer may affect your family at holidays or events that are coming up.
• Provide lots of time for your children to talk or ask questions, but don’t be surprised if they don’t want to talk when you do.
• If you are in the hospital, try to plan things that you and your child can do together like watching a video, reading a book, or playing a board game.
• Tell your child again and again that they didn’t cause your illness and can’t do anything to change it.
• Regularly ask questions to check that your child has the right information about your illness. If they don’t, make sure you provide it.
• Use different resources to help you find the right words when talking about your cancer.
• Be patient and understanding. They need time to cope.

Common ways teenagers (ages 14 to 18) react to a parent having cancer

What’s important to know about this age group?

• They want to be independent, but they still need their parents.
• For teenagers, their friends are at least as important as their family.
• They can understand complicated information about illness.
• They struggle with abstract ideas like the meaning of life and death.
• They care about what their friends think. What their friends think can influence what they do.
• Their increased hormones are causing them to have mood swings.
• They can talk about their feelings in more detail.
• They are very self-conscious. They may feel as if the whole world is looking at them and judging them.
• Their behaviour is a bit like a roller coaster. Sometimes they may seem mature, and other times they behave as if they are much younger.

What is most scary or upsetting?

• Thinking their parent will die
• Not knowing what will happen in the future
• How their own lives will change
• Their friends will reject them
• Whether they are ready to be adults
• When their life feels like it is out of control
• Feeling alone and misunderstood
• Mistaken ideas about cancer because of things they heard from friends or saw on television

What can you do to help your child cope?

• Give your teen lots of information about your illness. Encourage them to ask questions and always tell them about any changes to your health.
• Let your child feel angry. It’s a natural part of adjusting to your illness.
• Reassure your teen that you are still the parent. Be consistent with rules and when responding to problem behaviours.
• Be specific about what they can do to help, but be realistic about how much time you expect them to be at home.
• Try not to take it personally if your teen seems more interested in their friends and social life. Friends are their support system.
• Don’t expect your teen to become an adult overnight. Allow them to be teenagers.
• Encourage your child to use a journal or sketchbook to privately express their feelings, especially if they have a hard time talking about it. Art classes and writing clubs can be very helpful at this time.
• Encourage your child to talk to another trusted adult. Sometimes it’s easier for them to talk to an aunt, uncle or favourite teacher than a parent.
• Teens may want to know how the cancer will affect them. Will it get in the way of their social life? Will they have to do more chores? This is normal. Be honest with them.
• Ask your teen if they want to come with you to your appointments. This can help them understand what you’re going through.

Resources

Support services for children

• Noogieland at Gilda’s Club Greater Toronto s magical room filled with goodies and activities for children living with or affected by cancer. Gilda’s Club also offers support groups for children and teens with cancer or who have a loved one with cancer. Call for more information and to register.
  Phone: 416 214 9898
  Website: Gilda's Club Toronto
  Address: 24 Cecil Street, Toronto ON M5T 1N2
  Cost: No fees
• Mothercraft Parent Infant Program is a service for families with children up to 6 years old. If you are worried about how your cancer is affecting your young child, a child therapist will visit you and your child at home (in Toronto only) or in the hospital. They can help you understand how well your child is coping with your illness and provide information and support to both of you.
  Phone: 416 364 7373
  Fax: 416 364 8008
  Website: Breaking The Cycle
  Address: 860 Richmond St. West, Suite 100, Toronto, ON M6J 1C9
  Cost: No fees
• The Magic Castle (Child Care) at Princess Margaret is a playroom for the children of patients and their families who are going to appointments and treatment at the hospital. A little different from a regular daycare, the Magic Castle provides sensitive care and support to children up to 12 years old in a fun and safe environment. Please reserve space in advance.
  Phone: 416 946 4501, extension 5157
  Address: 610 University Avenue, Toronto M4G 2M9
  Main floor, next to the Patient & Family Library
  Cost: No fees
• Wellspring (Child/Adolescent/Parent Groups) family program is for parents with cancer who are worried about their children’s needs. Children aged 6 to 12 and teens aged 13 to 18 meet in a safe setting. Parents of children aged 6 to 12 meet at the same time to talk about parenting issues. Call to register and for information. Interpreters available.
  Phone: 416 961 1928
  Website: Wellspring
  Address: Wellspring Downtown Toronto, 4 Charles St. E., 4th Floor, Toronto, ON M4Y 1T2
  Address: The Westerkirk House (Sunnybrook), 101 Wellness Way, Toronto, M4N 3M5
  Phone: 416 480 4440
  Cost: No fees
  

Support services for families

• Catholic Family Services of Toronto. Counselling is provided to individuals, couples, or families of all cultural, racial, and religious backgrounds who are experiencing a stressful situation. Call for more information about when counselling is offered.
  Languages: English, French, Italian
  Cost: Fees depend on your income
  Locations:
  
  • Catholic Pastoral Centre
    Phone: 416 921 1163
    Address: 1155 Yonge Street, Suite 200, Toronto M4T 1W2
  • North York Branch
    Phone: 416 222 0048
    Address: 5799 Yonge Street, Suite 300, Toronto
• Gilda’s Club Greater Toronto provides a place where men, women and children with cancer and their families and friends can gather for social and emotional support. The club provides comfortable spaces where adults, teens and children can relax.
  Phone: 416 214 9898
  Address: 24 Cecil Street, Toronto M5T 1N2
  Cost: No fees
• COSTI Family Counselling Centre provides employment, educational, settlement and social services to all immigrant communities, new Canadians and individuals or families in need of assistance. These services are offered Monday to Friday 8:30 am to 4:30 pm. Evening appointments are also available, but please call for more information.
  Phone: 416 658 8537
  Address: 1710 Dufferin Street, Toronto, M6E 3P2
  There are various locations throughout the GTA. Please visit the website for additional locations.
  Cost: Fees depend on your income
  Languages: Services are offered in a variety of languages. Please see website for more information.
• Family Services Toronto provides counselling to any individual, couple or family going through a stressful time. Services are offered Mondays to Fridays, 9:00 am to 5:00 pm. Evening appointments are available. Counselling is available in a variety of languages. Please call for more information.
  Phone: 416 595 9618
  Address: 202-128A Sterling Road, Toronto, M6R 2B7
  Cost: Fees depend on your income
• Jewish Family and Child Service of Metro Toronto.Counselling is offered for individuals, couples or families who are going through a stressful time. Services are offered Monday to Thursday 9:00 am to 5:00 pm, Friday 9:00 am to 4:00 pm.
  Phone: 416 638 7800
  Address: 4600 Bathurst Street, 1st floor, Toronto
  Cost: Fees depend on your income
  Languages: English, French, Hebrew, Hungarian, Russian and Yiddish
  Location:
  • Downtown Branch
    Phone: 416 961 9344
    Address: 35 Madison Avenue, Toronto, M5R 2S2
• Psychosocial Oncology Clinic at Princess Margaret offers emotional, psychological and social services by social workers, music and art therapists, psychologists and psychiatrists to help patients help their children cope with the cancer. You can ask for interpreter services.
  Phone: 416 946 4525
  Address: Princess Margaret Cancer Centre, 610 University Avenue, Toronto M5G 2M9
  Cost: No fees
  
• Wellspring offers different educational and support programs to help you and your family.
  Cost: No fees
  Locations: There are various locations across the Greater Toronto Area. Please check the website for more information.
  • Wellspring Downtown Toronto
    Phone: 416 961 1928
    Address: 4 Charles St. E., 4th Floor, Toronto, M4Y 1T2
  • The Westerkirk House (Sunnybrook)
    Phone: 416 480 4440
    Address: 101 Wellness Way, Toronto, M4N 3M5

Information services

• Resource Library, Canadian Breast Cancer Foundation (CBCF). CBCF offers support to anyone affected by breast cancer. They provide support and information around risk management, diagnosis, treatment, and survivorship as well as emotional and practical issues. They also offer peer support groups across the country.
  Phone: 416 596 6773
  Address: 55 St. Clair Avenue West, Suite 300, Toronto
  Cost: No fees
  
• Canadian Cancer Society has free pamphlets available about issues that children of parents who have cancer can relate to. Information and copies of the pamphlets are available to patients and families at the unit office closest to you.
  Phone: 416 961 7223
  Address: 55 St. Clair Avenue West, Suite 300 M4V 2Y7
• Cancer Information Service offers information over the phone about all types of cancer, related issues and general community resources. Written information can also be mailed free of charge.
  Cost: No fees
  Languages: English and French
  Phone:
  • Cancer Assistance Program: 905 383 9797
  • Juravinsky Cancer Centre: 905 387 9495
  • Homefront Cancer Service: 905 643 0404
  • Cancer Information Service: 905 574 5784
• Patient and Family Library at Princess Margaret has a wide range of information for patients with cancer and their families to see and borrow, including books, e-books, videos, DVDs, audiobooks or CDs. Located on the main floor and open for in-person services Monday to Friday, from 9:00 am to 4:00 pm. The Library space is open 24 hours a day, 7 days a week. During this time, you have access to all UHN health brochures.
  Phone: 416 946 4501 extension 5383
  Email: PatientEducation@uhn.ca
  Address: Princess Margaret Cancer Centre, 610 University Avenue, Toronto M5G 2M9
  Cost: No fees

Child care services

• Family, friends and neighbours
  Family, friends and neighbours are often willing to provide childcare support. It can be a way for them to provide you with help and support as you cope with having cancer. It’s important that you and your child feel comfortable with the caregiving skills of the person you choose.
• Visiting Homemakers Association Home Healthcare offers services including homemaking, personal care and temporary home childcare.
  Phone: 416 489 2500 or 1 888 314 6622
  Address: 30 Soudan Avenue, Suite 600, Toronto
• City of Toronto child care centres. Call or use the website to for information about child care centres in Toronto, fees or getting help with fees (day care subsidy).
  Phone: 416 392 5437
  For information about child care centres in other areas, contact:
  • Halton Region
    Phone: 1 888 703 5437
  • Peel Region
    Phone: 905 890 9432
  • Durham Region
    Phone: 905 666 6238
• Nanny Angel Network has a team of volunteer professional childcare providers that can help mothers with cancer while in treatment. They are experienced and skilled. They are trained in First Aid and CPR and provide free childcare at a most needed time.
  Phone: 416 730 0025
  Email: info@NannyAngelNetwork.com

Questions to ask the manager or director when choosing a child care centre:

• May I see license for the daycare? Is it up to date? (It should be posted somewhere in the daycare).
• Does this day care follow the rules for local and provincial health, fire, zoning and space requirements?
• What is the weekly cost? Do you have a contract with the city to take children receiving a fee subsidy?
• What are the hours the centre is open?
• Do you charge us if my child is absent because of holidays or if they are sick?
• Can you get to the daycare by public transit?
• What is the training and experience of the staff?
• Can we visit and meet with the director and staff?
• What plans do you have in place when children show signs of poor behaviour?
• Can you tell me about your regular daily schedule?
• What happens if my child becomes sick during the day?
• Can I see an example of a week’s menu (if meals or snacks are provided). What if my child can’t eat certain foods or has allergies?
• How can the staff help my child during this difficult time?
• How does your program support children’s development? What are some specific activities that do this?

Licensed private home child care

You can find licensed childcare in private homes. Here are some questions you should ask the director (or main child care provider) when you are choosing a private home child care service:

• How many children are in the home and what are their ages?
• Are there other people in the home, like teenagers or relatives? If so, can I meet them? (see if your child is comfortable with them)
• Are there any pets?
• Which areas of the home are used for childcare?
• Where do you take the children for outdoor play?
• What happens if you are sick or take a vacation?

Emergency Day Care

Contact the following centres if you need emergency out-of-home childcare services. Both provide services with fees on a sliding scale:

• Cavell Parent Child Centre
  Phone: 416 463 5399
  Address: 1117 Gerrard Street East (Leslie and Gerrard)
• Scadding Court Community Centre provides relief, emergency and occasional childcare. Giving notice is preferred, but they will provide emergency spacing if it’s available. They can take children from newborn to 5 years old. The centre is open Monday to Friday, 8:30 am to 4:00 pm.
  Phone: 416 392 0335
  Address: 707 Dundas St. West, Toronto M5T 2W6
  Cost: Fees depend on your income

Search online or go to Yellow Pages for places that can provide emergency in-home childcare services.

Other contacts

City of Toronto

• Toronto Children’s Services is a good source for any information about licensed childcare and early learning opportunities.
  Phone: 416 392 5437
• Toronto Parks, Forestry and Recreation. You can find information about recreation programs including after-school recreation and care (ARC).
  Phone: 416 338 4386
• Toronto Public Health/Toronto Health Connection. You can find information about programs and services that promote healthy child development.
  Phone: 416 338 7600

The Government of Ontario

Use these 2 resources to find information about the Government of Ontario’s programs and services for children.

• The Children’s Information Portal, Ministry of Children, Community and Social Services
• Ontario Government Information and Referral Service
  Phone: 1 800 267 8097

Books and pamphlets

This is only a sample list of books and pamphlets. Some are available in the Princess Margaret Patient and Family Library, in the Magic Castle, at your local Canadian Cancer Society office, or from your social worker. Please call or go to your local library or bookstore to get a more complete list.

Toddlers and preschool children

• Goodbye Mousie. Harris, Robie H.; illustrated by Jan Ormerod
  This book, with details and pictures, helps young children understand that someone very loved, can die. By talking about his feelings and asking questions, a young boy finally begins to accept Mousie’s death.
• Momma Croc Gets Sick. Huntley, Gretchen; Toronto, Ontario, 2012
  This book can help children understand the changes that may happen in their lives when a loved one is diagnosed with cancer.

Preschool and school aged children

• Butterfly Kisses and Wishes on Wings. McVicker, Ellen; USA: Butterfly Kisses, 2010
  A helpful book for children when someone they love has cancer. Suitable for ages 3 to 7.
• A Dragon in Your Heart. LeBlanc, Sophie; London, U.K.: Jessica Kingsley Publishers, 1999
  This book was written by a mother with breast cancer for her 5 year old daughter. She provides details about cancer and how chemotherapy works.
• The Goodbye Cancer Garden. Matthies, Jenna; Park Ridge, Illinois: Albert Whitman & Company, 2011
  After the first breaking news that Mom has cancer, every page shows grateful smiles and loving companionship. An upbeat, hopeful, and beautifully illustrated story. Suitable for ages 5 to 8.
• In Mommy’s Garden. Ammary, Neval J.; Lehighton, PA: Canyon Beach Visual, Communications, 2004
  This book helps explain cancer to young children. Available in the Princess Margaret Patient and Family Library.
• Kids Tell Kids What It’s Like. (Pamphlet in the Magic Castle)
  When a family member has cancer, kids share their stories about what is like to have a brother or a sister, mom or dad with cancer.
• Mom Has Cancer. Mallinos, Jennifer; Hauppauge, New York: Barron’s Educational Series, 2008
  This book focuses on just what needs to be said to make a tough situation manageable. Bright watercolours and cheerful cartoon illustrations keep the tone upbeat. Suitable for ages 4 to 7.
• Mom and the Polka-dot BooBoo. Sutherland, Eileen; Toronto, Ontario: McGraw-Hill, 2007
  This is a story that helps families talk about breast cancer. Written by a mother of 2 and illustrated by her young daughter, it gently prepares children for the weeks and months following their mother’s diagnosis.
• Mrs. B Has Cancer. Belec, Glynis; Ontario, Canada: Angel Hope Publishing, 2013
  A story about a boy and his friends whose teacher has cancer. Suitable for ages 8 to 12.
• Our Dad is Getting Better. American Cancer Society, 2007.
  A book for children who have a loved one with cancer. Suitable for ages 4 to 8.
• Our Mom Has Cancer. Ackerman, Abigail and Adrienne; Atlanta, GA: American Cancer Society, 2001
  Written and illustrated by 11 year old and 9 year old sisters, this book tells of their experiences and feelings when their mother had breast cancer. This book has funny moments that help families keep a positive attitude.
• The Rainbow Feelings About Cancer. Martin, Carrie and Martin, Chia; Prescott, Arizona: Hohm Press, 2001
  A book for children who have a loved one with cancer.
• When Someone You Love Has Cancer. Lewis, Alaric; USA: Abbey Press, 2005.
  This book will help kids cope with cancer in their lives. It includes 14 full-colour, full-page illustrations and 40 helpful tips written especially for children.

Teenagers

• Afraid to Ask. Toronto, Ontario: Kids Can Press, 1984
  This was specifically written for teens and gives answers to questions about cancer. This book is available in the Princess Margaret Patient and Family Library.
• Brushing Mom’s Hair. Cheng, Andrea; Honesdale, PA: Front Street, Incorporated, 2009.
  This story is about how a young girl deals with her mother’s breast cancer. It’s written in a series of poems, and each poem describes what is happening at that time with her mother.
• Medikidz Explain Cancer. American Cancer Society, 2010.
  Medikidz comic books take the reader on a superhero adventure though the human body to discover about different types of cancer that affect them and their families.
• My Parent Has Cancer and It Really Sucks. Silver, Maya and Silver, Martin; Naperville, IL: Sourcebooks Fire, 2013.
  This book helps to guide teens through the experience of having a parent with cancer. It offers ‟survival tips” from other teens who have experienced the ordeal firsthand. Suitable for ages 12 to 16.
• When Your Parent Has Cancer: A Guide For Teens. (Pamphlet) United States: National Institute of Health
  This guidebook can help prepare teens for some of the things they might face when living with a parent or relative who has cancer. This American guidebook is included in this list for information on helping teens cope. Any information about American medical practice may not be the same as in Canada.
• The Year My Mother Was Bald. Speitz, Ann; Washington, D.C.: Magination Press 2003
  Clare’s journal about the year her mother has treatment for cancer. This book has a lot of information about the illness, its diagnosis and treatment. Good for ages 8 to 13.

All ages and family

• Where’s Mom’s Hair?: A family journey through cancer. Watters, Debbie with Hayden and Emmett Waters; Toronto, Ontario: Second Story Press, 2005
  When Hayden and Emmett find out that their mother is going to lose her hair because of chemotherapy, they try to cheer her up by throwing a big hair-cutting party.

Parents

• Can I Still Kiss You? Russell, Neil; Deerfield Beach, Florida: Health Communications Inc, 2001
  This book provides help with answering your children’s questions about cancer.
• Cancer in The Family: Helping Children With a Parent’s Illness. Heiney, Sue; Atlanta, GA: American Cancer Society, 2001.
  This book includes steps to take to help children understand what happens when a parent has been diagnosed with cancer, how to talk to children about it, and how to answer difficult question about cancer.
• Helping Your Children Cope with Your Cancer. Van Dernoot, Peter; Long Island City, N.Y: Hatherleigh Press, 2002.
  This is a guide for parents and families.
• Raising an Emotionally Healthy Child When a Parent is Sick. Paula Rauch, Paula M.D. and Anna Muriel, M.D; New York, N.Y.: McGraw-Hill, 2005
  This book helps parents understand their child’s development, emotions and reactions at a difficult time. It supports parents as they encourage and help their child to cope.
• When a Parent Has Cancer: A Guide to Caring for Your Children. Schessel Harpham, Wendy M.D; New York, N.Y.: Harper-Collins, 2004
  A mother, doctor, and cancer survivor, Dr. Wendy Harpham offers clear, direct and sympathetic advice for parents trying to raise normal healthy children while they struggle with cancer. Also included is Becky and the Worry Cup, an illustrated children’s book that tells the story of a 7-year-old girl’s experience with her mother’s cancer.
• When a Parent is Sick: Helping Parents Explain Serious Illness to Children. Hamilton, Joan R.N.; Lawrencetown Beach, Nova Scotia, Canada: Pottersfield Press, 2007.
  This book provides parents and other caregivers with suggestions on how to provide children the information that their parent is seriously ill. There are lots of examples of how and what to say to children and teens.

Videos

• Hear How I Feel. Department of Psychosocial Resources, Northeastern Ontario Regional Cancer Centre, Sudbury
  This video focuses on the concerns of teens who are faced with their parent’s cancer. It’s available at the Patient and Family Library, Princess Margaret Cancer Centre.
• Kids Talking to Kids about Cancer: Discovery Rethink Breast Cancer.
  This is a series of 5 videos that provides information for children on what is cancer, treatment, recovery and when the cancer comes back.

Websites

These websites are included in this list for their information on children’s coping only. The American websites may have information that is not part of Canadian medical practice. Children can also look at these websites if you think the content is ok for them to see.

• Wisdo Health
• KIDSCOPE
• CANCERVIVE
• Bereaved Families of Ontario
• 211 Toronto. 211 Toronto can connect you to community, social, health and government services.
• Cancer in My Family. This is an interactive website for children ages 6 to 10. There are a number of games and tips that can help children to express their experiences and feelings related to cancer in their families.
•  Gilda's Club Toronto. Gilda’s Club Greater Toronto has a number on on-line resources. Please check the members’ forum. It is an on-line support room for families while they deal with cancer.
• RipRap. This website can help tweens and teens cope when a family member has cancer. Read stories from young people who have experienced having a parent with cancer. Information and tips to help with understanding are also included.
• National Cancer Institute
• The on-line version of the brochure When Someone in Your Family has Cancer allows children to find the answers to their questions quickly. They can also read comforting words of other children in similar situations.