I was 15 when my grandfather was diagnosed with cancer. He and my grandmother lived just around the corner and were as much a part of my daily life as my own parents. The diagnosis came fast, and so did his passing, with just weeks between the two. I never saw a treatment journey. What I did see was my mother’s devastation, raw and all consuming. Her grief left little space for mine, and I did what most teenagers do. I retreated, closed off, and figured it out alone.
Late last July, I lost my father. The story was similar. His diagnosis came at the beginning of June, well after it had spread from his colon to several other locations. There was no treatment road to navigate, no options to weigh. But I was a mother of my own teenagers this time, not a child. And I was determined to do things differently for my own kids than had been done for me. I wanted to keep them informed, share how I was feeling, and make real space for them to do the same.
What I didn’t have, either time, was a real guide for how to do any of that. Which is part of why a new book by Dr. Sanjay Juneja felt so necessary the moment I heard about it.
Dr. Juneja — known to his 750,000+ social media followers as TheOncDoc — is a triple board-certified hematologist and medical oncologist, and also a father of young children. His book, We Need to Talk About Cancer: An Important Book for Patients, Family and Friends, is written for children ages 10 to 14 and takes a fact-based, compassionate approach to explaining diagnosis, treatment, and the emotional reality of loving someone with cancer. Filled with information that’s easy to digest and illustrations that feel more artful than medical, it’s the kind of book every parent and kid can lean on.
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What happens when we try to protect kids from the truth
Most parents’ first instinct is to shield their children. Don’t say too much. Don’t say the c-word. Wait until you know more. The problem is that kids are already watching.
“Kids are incredibly perceptive,” Dr. Juneja told me. “Even when adults avoid the word ‘cancer,’ children notice whispered conversations, changed routines, tears, fatigue, and tension in the home. What I’ve seen clinically — and what research supports — is that when children are left to fill in the blanks themselves, their imaginations are often scarier than reality.”
My 15-year-old self would have told you I was fine. I wasn’t fine. I was spinning stories in my own head, reading my mother’s face, trying to piece together what was real. Age-appropriate honesty, Dr. Juneja says, tends to reduce anxiety and help children feel emotionally included in something the entire family is already living through.
Having the first conversation about cancer
The opening conversation doesn’t need to be perfect. It needs to be honest, calm, and clear — and according to Dr. Juneja, there are a few non-negotiables.
“Say the word cancer,” he said. “Avoid vague euphemisms like ‘very sick’ because children can interpret that in frightening ways. Explain what will change and what won’t. And remind the child, repeatedly, that this is not their fault and they cannot catch it.”
He also makes the point that one big conversation is rarely enough. Cancer treatment can stretch over months or years. Children benefit most from smaller, ongoing check-ins that evolve as the situation does. Whenever possible, Dr. Juneja encourages parents to update kids before visible changes happen — before hair loss, before hospitalizations, before difficult scan results. Surprises, he says, tend to increase fear. Even something as simple as “here’s what’s happening this week” helps restore a sense of predictability in a season that can feel deeply unstable.
What to say at every age
How you talk about cancer has to shift depending on who you’re talking to. Obviously you know your child best, but the general framework Dr. Juneja lays out gives a solid age-based template.
Young children process through routines and visuals. Keep it concrete and anchored to what they’ll actually see: “Mom may lose her hair,” or “Dad will be tired after his medicine.”
School-aged kids want cause-and-effect explanations. They’ll have questions about schedules, routines, and treatment, and they deserve real answers to those questions.
Teenagers process through meaning and uncertainty. They often want honesty closer to what adults receive — including, sometimes, prognosis discussions. They still need emotional reassurance, even when they’d never ask for it.
That last one offers younger me a bit of perspective. At 15, I wasn’t shut out. I just didn’t want to add to the pile. My mother’s grief was so present, so consuming, that bringing her my own felt like one more weight she couldn’t carry. So I didn’t. What I know now is that kids will make that calculation quietly, on their own, every time. Which is exactly why adults have to be the ones to open the door.
The questions kids actually ask–and how to answer them
Kids ask direct questions. Sometimes brutally so. “Is Grandma going to die?” “Is it contagious?” “Why does Dad look like that?” Dr. Juneja’s advice for parents who freeze up in those moments is both simple and reassuring.
“Parents should know they don’t have to answer perfectly — they just have to answer honestly,” he said. “It’s okay to say, ‘I don’t know yet,’ as long as it’s followed by reassurance that the adults and doctors are doing everything they can.”
Some scripts he suggests: “Cancer is not contagious, so you can still hug Grandma.” “The medicine helping Dad fight the cancer is also what’s making his hair fall out.” Clear, factual, warm is the recipe.
Helping kids understand physical changes from treatment
The physical changes that come with treatment, from hair loss, and weight shifts to exhaustion, can be the hardest thing for kids to make sense of, because they’re watching someone they love look and feel different and don’t know why. Dr. Juneja draws a clear line between what the cancer is doing and what the treatment is doing.
“Cancer cells come from your body’s normal cells,” he explains. “This makes it challenging to treat cancer without having any effect on healthy cells. The key is that healthy cells will often regrow and recover — whereas, if the treatment worked, the cancer will not.”
That distinction makes a difference for kids. Hair grows back. The cancer, ideally, doesn’t.
Signs your child is struggling (and not saying so)
Children often show stress behaviorally before they express it verbally. Irritability, sleep changes, stomachaches, clinginess, withdrawal, falling grades, or suddenly acting much younger than their age are all signs Dr. Juneja says to keep an eye out for.
“I tell parents not to assume ‘they seem fine’ means they’ve processed everything well,” he said. “Often the best intervention is creating repeated openings for conversation without pressure.”
He also normalizes counseling, school support, and child-life specialists when needed. He rightfully notes that building that habit of open emotional check-ins is good practice for life, regardless of what you’re going through.
What might actually surprise you
I asked Dr. Juneja what he most wants parents to take away from his book — the thing they might not expect. His answer was about relief.
“The relief they would likely feel after the initial discomfort of having frank, honest conversations. A little more pain up front could likely save you a massive amount of accrued, unspoken pain over time,” he said. “And almost always, kids prefer it. They are remarkably adaptive compared to older adults, if not for brain elasticity alone.”
I think about that in the context of my own experience, both as the child I was, shut out and trying to hold myself together at 15, and as the mother I became, trying to get it right when my father was dying last summer. Neither situation gave me a clean road. There was no treatment timeline to prepare for, no chapter in a book about the rapid loss I’d face twice in my life.
What I know now is that the conversation itself, even when it’s hard, even when you don’t have all the answers, is an act of love. It tells a child, “you belong in this family’s story.” Your feelings are real. You are not alone in this.
That’s what We Need to Talk About Cancer is trying to give families — a starting point, a common language, and permission to let their kids in.
We Need to Talk About Cancer: An Important Book for Patients, Family and Friends by Dr. Sanjay Juneja is available now.
