Dr Philippa Kaye: Like Kate Middleton, my three young children witnessed my gruelling cancer treatment… this is what I said when they asked if Mum was going to die

Like many of you, I watched the video released by Kensington Palace yesterday. I was happy that Kate Middleton’s chemotherapy was over.

And at the end I had tears in my eyes.

It was particularly poignant for me because five years ago I was in much the same situation as our Princess of Wales.

I was 39 years old when I was diagnosed with bowel cancer in 2019. Like Kate, 42, I also have three children, who were 11, 7 and 4 at the time – around the same age as George, Charlotte and Louis.

Like Kate, I was overwhelmed with relief and triumph when, after chemotherapy and multiple surgeries, I was declared cancer-free in late 2020.

In the clip we saw a very happy family with three children who looked like most young children: carefree and content.

But I know the truth is that the young royals have likely experienced situations over the past year that we hope no child ever has to deal with.

For parents with cancer, dealing with their children’s expectations, questions, and comments is one of the greatest challenges of this devastating disease.

And five years later, after several more interventions, I know that the challenge doesn’t end when the first treatment is completed.

As a GP, a patient and a parent I am often asked for advice on how to deal with this situation. The truth is that there is no ‘right’ way to treat cancer. There is only the best way for you, whether you are Kate and William or another family.

But I did learn a few lessons.

First, it is generally true that honesty is the best policy.

Of course, the young royals haven’t had much choice but to be open with their children, given the intense media attention. But I think it’s for the best.

My husband and I made a commitment from the beginning to be as honest as possible. When I was first diagnosed, my mother was with me in the hospital.

I called my husband to tell him and asked him not to tell the kids yet. I wanted to tell them together.

I called my best friend, a child psychotherapist, from the hospital locker room to ask what she should do.

I begged her not to react as a friend at that moment, but only to give me professional advice.

She advised me to tell the truth.

The reality is that children do know that something is wrong. They are very intuitive and can pick up things very well at home.

The two oldest wanted to know if I was going to die. Even then I told the truth; that the doctors and I would do everything we could to prevent that.

But I also made sure that I would never answer with a categorical ‘no’.

You can tailor the exact questions you ask to the age of your child. After all, a four-year-old asks very different questions than an eleven-year-old.

For example, I explained to the two youngest children that the cancer was a clump of bad cells in my abdomen that was causing me pain and that the doctors would cut out the cancer.

I told them that because of the surgery and chemotherapy I have to save all my energy for my recovery, which can make my brain and body slower than normal.

I always gave them hope. I told them that the doctors would destroy my cancer and that they would give me powerful medicines to deal with my disease.

There is a tendency to think that for those around you, the end of surgery and chemotherapy, or even being declared cancer-free, is accompanied by fear and panic.

The journey doesn’t end there, it’s just the beginning of a new part of the story.

For me, it meant – and still means – that every time I had a check-up I had to turn off the ‘scanxiety’, which rekindled the trauma of my initial diagnosis.

I was grateful to be here and relieved that I didn’t have to go through treatment, but it also felt like there was a sword of Damocles hanging over my head.

As for my children, I have seen illuminating changes in their behavior. Perhaps it was just kindness, but I worry that many of their new actions were driven by a sense of underlying fear.

For example, they often ask if I have a special key that I can use to open public toilets, because they know that I cannot wait due to the impact of my operation.

They ask me to bring my calorie supplement powders or snacks when we go out to eat, but my bowels aren’t cooperating.

Yet they recognize when I am tired and try to let me rest even when I don’t want to. I try to see all of these amazingly empathetic qualities as positive things that my cancer has brought them.

And then there are the promises you do and don’t make.

After my diagnosis, the children asked me to promise that I would not die, or that I would come home from the hospital after the surgery.

I chose my words carefully and assured them that I was doing my best to get and stay healthy.

But I’ve stopped making promises. I don’t promise anymore I will be at the school pick up, or at the assembly, because there was a time when I had to go to the hospital for a fever, or some other medical situation. Instead, I tell them I will do my best.

My children often ask me if I’m afraid.

I have always been open about my fears. Telling the truth meant that they felt able to be honest about their own worries; they could also tell me if they were afraid.

I couldn’t fix it, as much as I wanted to, but I could just be there. And that felt like a powerful thing to do.

The same goes for anger. They were angry, I was sick and, honestly, so was I.

I had my 11-year-old daughter utter every possible curse word about the cancer, which made her laugh out loud.

They wrote their feelings about cancer on a stack of cheap boards and we smashed them to pieces.

Feelings are not good or bad, they are just feelings and we need to express them and talk about them.

I hope I gave them what they needed.

Today, five years after my diagnosis, I can happily say that I am doing well and am currently cancer free.

As the princess said, I am also often grateful for the ‘simple but important things in life’ these days.

‘On simply loving and being loved’.

I am not the person I was before I got cancer. And my family is not the same either.

They may worry more about me. But they, and I, are also stronger and recognize the joy in the time we spend together (in between the expected sibling squabbles).

We are all different than we were — and always will be. And now I realize that’s okay.