Explaining a chronic cancer like an MPN to a child can feel overwhelming — especially when the symptoms aren’t always visible. In this new article, pediatric psychologist Dr. Joanna Patten shares expert advice on what to say and how to say it. Learn why late is better than never and how honest, age-appropriate conversations help children feel more connected.
Silence in chronic cancer
Telling a child that someone they love has cancer is never easy. But when the cancer is slow-moving, invisible to the eye, and classified as “chronic” — like the blood cancers known as myeloproliferative neoplasms (MPNs) — the conversation gets even more complicated.
Do you say the word “cancer” at all? Do you wait until there are visible signs of illness? Are they too young to understand?
These are questions many patients in the MPN community struggle with — often for months or years after their diagnosis. But pediatric psychologist Dr. Joanna Patten, who has spent over a decade supporting families at Seattle Children’s Hospital, encourages loved ones to consider another question first: What might happen if I don’t explain it?
As it turns out, being open and developmentally honest with a child about a diagnosis isn’t just helpful — it’s protective.
When words fail us
“Surgery will come by to see you in an hour.” = “You’ll have surgery in an hour.”
“You’ll spend the night on the pediatric floor.” = “You’ll be sleeping on the [literal] floor.”
Medical jargon that took an episode or two of ER to grasp hits the ears of children differently. New research shows that children and teenagers often misunderstand basic medical phrases — and adults frequently underestimate how confusing those conversations can be (Maravelas et al., 2025).
Medicalized English refers to everyday words that take on a completely different meaning in a medical context. For example, a doctor might say a scan was “impressive” or that a patient has “positive nodes.” In regular conversation, impressive and positive are good things. But in medicine, they can signal serious concerns.
This disconnect can be especially confusing for children and teens, who tend to interpret language literally.
In a 2025 peer-reviewed study by Dr. Aarabhi Rajagopal and colleagues at the University of Minnesota, teenagers were asked to interpret common phrases doctors use with patients. While 97% correctly understood that a “negative cancer screening” was good news, far fewer understood that “the tumor is progressing” was not.
In a separate study focused on children ages 4 to 12, the misunderstandings were even more striking. One child thought a CAT scan involved actual cats. Another believed being “put to sleep” for surgery meant the same thing that happened to their pet — that they would never wake up.
Children who aren’t given clear explanations often fill in the blanks themselves — and those guesses can be more frightening than reality. A child who doesn’t understand a parent’s fatigue or pain might interpret it as rejection.
These misinterpretations often go unnoticed, because unlike adults, children rarely ask for clarification. They internalize what they think is happening, which can lead to unnecessary fear or lasting distress.
Expert perspective: Dr. Joanna Patten on how kids learn about illness
“I’m a talking doctor,” Dr. Patten explains to patients at Seattle Children’s Hospital. She manages the mental well-being of children experiencing cancer.
When she first meets with a child, she listens before she teaches. “Asking what they know helps me understand if there are any misunderstandings… and gives me a sense of how uncomfortable it is for them to talk about it.”
This same approach can help MPN patients open up to the children in their lives — especially when the disease is quiet but real.
Tips for talking to a child about MPN
Dr. Patten stresses that you don’t need to have all the answers — but you do need to start the conversation. Here’s how Patten suggests doing that:
- Start by asking them if they’re open to talk. Try: “Can I check in with you about something?” or “I’d like to talk to you about something important. Is that ok?”
- Ask them to explain what they know. This can help you identify misunderstandings. “What have you heard about MPNs?”
- Be direct. Don’t avoid or euphemize the word “cancer” or “myeloproliferative neoplasm.”
- Use age-appropriate, real words, and expect growth. Starting from their level of understanding, provide new information and check in often. Children are constantly expanding their world view. You’ll need to revisit important conversations as they grow and develop.
- Set expectations. Let them know your energy, mobility, or habits might shift. “We’re getting on this train together — and we might have to shift how we spend time and how I show up for you.”
If you’ve waited to tell them — it’s not too late
Maybe you’ve delayed the conversation out of fear, worry, or uncertainty. That’s okay. Patten says it’s never too late to tell a child the truth in a way they can understand. Transparency is how you teach them about people and the world:
“I wasn’t sure how to talk about this before. I was worried it might make you sad. But I want you to understand what’s going on.”
Make room for them to come back to the conversation, as they form new questions:
“I’ll check in with you again. You might have new questions later, and we can talk about them.”
This creates safety, not just for the moment, but for the future.
Why this matters for their health too
This isn’t just a conversation about cancer — it’s a moment to shape how a child engages with future challenges, both emotional and practical.
When adults explain their diagnosis in a way that’s truthful and age-appropriate, it creates clarity. When they invite follow-up questions and return to the topic over time, it builds trust. These are communication patterns that support long-term coping — not only with your MPN, but with any future uncertainty the child may face.
When kids understand why someone they love may not play, cook, or talk the way they used to, they’re less likely to take it personally — and more likely to adapt with compassion.
Talking about your MPN creates a family framework where health, uncertainty, and change can be discussed without fear. “Kids will continue to have experiences where they don’t know all the answers,” Patten points out. “If they already have a framework for ‘this is how we talk about it in our family’… they can ask questions and look for comfort.”
You don’t have to be perfect — just present
By choosing to speak with honesty and language a child can understand you open the door to connection and resilience.
“We don’t have to protect each other from sad feelings,” Patten reminds us. “Sad feelings aren’t dangerous. We do better with our sad feelings when we have comfort and support.”
That’s the power of showing up. And that’s the kind of legacy every parent, grandparent, and loved one can offer.
Written by: Amielle Moreno, PhD, Science Content Manager
Sources:
Maravelas, R., Linneman, Z., Marmet, J., Hendrickson, M. A., Lunos, S., Hause, E., Quade, A., Allen, K., Kelly, M. M., Marmet, S., Norling, B., Rajagopal, A. S., Suk, M., & Pitt, M. (2024). Children’s Understanding of Commonly Used Medical Terminology. Pediatrics, 155(1), e2024067871. https://doi.org/10.1542/peds.2024-067871
Rajagopal, A. S., Hendrickson, M. A., Pitt, M. B., Kelly, M. M., Lunos, S., Marmet, S., Norling, B., Suk, M., Allen, K. A., Hause, E., Linneman, Z. M., Maravelas, R., Quade, A., & Marmet, J. (2025). Lost in Translation: Teenagers’ Understanding of Common Medical Jargon. Hospital Pediatrics, 15(3), 204–209. https://doi.org/10.1542/hpeds.2024-008076
