Dear Doctor: Ever since my father was diagnosed with cancer last summer, our 10-year-old son keeps asking my wife and me to explain exactly what cancer is. Our answers don't seem to satisfy him, so we wonder: What would you say to a 10-year-old to explain this disease?

Dear Reader: It's quite possible that you and your wife are doing a good job with the "what is it" portion of your answer. Your son's continued return to the question may indicate that he has additional questions that he can't quite formulate, or which he may find too difficult or scary to ask.

When kids ask about cancer, their questions often exist on multiple levels. There are the nuts and bolts of what cancer is and how it develops. There's the curiosity and anxiety regarding treatment -- what it entails, whether it works, and how much pain or discomfort are involved. And there's the dawning awareness that there are factors in life that may be beyond our control.

Listen for clues in the way that he repeats his questions. Is the subtext about pain? Is it about whether he or someone else in the family will get cancer? Is it about dying? Then restate the question with the added context and see if the conversation moved forward from there. It can take multiple tries over a period of time to get to the heart of it.

As for the basic biological explanation, cancer occurs when cells in the body go haywire and suddenly begin to multiply in an uncontrolled way. Unlike normal cells, which grow in specific places and at certain speeds, cancer cells ignore all the rules. They divide so quickly that they take over the environment and begin to damage the normal cells. It's as if a gang of unruly kids were to come into a school classroom and start to run wild. They would be so loud and disruptive that the students and the teaching environment would become overwhelmed.

That disruption is the reason cancers can become deadly. Our bodies are made up of many finely tuned systems, each dependent on certain conditions to function properly. When one system, such as the lungs, the kidneys, the stomach or the brain, becomes overwhelmed by the chaos and disorder caused by cancer, the entire body begins to suffer.

Clusters of cancer cells, called tumors, can cut off airways in the lungs, block passageways into and out of organs, generate blood vessels that hijack oxygen and nutrients from normal tissues, damage nerves and upset the critical balance of a host of biological processes. To restore order, medicines and treatments that will kill the rogue cells while sparing normal cells must be administered. Surgery is another way to remove cancerous cells from the body.

At 10 years old, children have begun to grasp concepts that verge on the complex. To explain the big picture, it helps to use analogies drawn from their own realm of experience. When getting into specifics, books and illustrations are valuable teaching aids. The American Cancer Society's website (cancer.org) is an excellent source of information on all aspects of cancer. The group's publications include books on talking to kids about cancer, which many parents and guardians have found to be helpful.

Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. 

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