Audrey Pottinger | Parental psychosocial concerns when a child has cancer
Despite scientific advances over the past 40 years that have improved the survival rate for some childhood cancers, receiving the diagnosis that your child has cancer is likely ranked as one of the worst nightmares for parents. It is only surpassed by news that the cancer has returned.
Some parents may not initially accept the diagnosis, believing that children do not get cancer, so there is some mistake. Some who disbelieve the diagnosis may also believe the illness is not biological and, therefore, will not respond to conventional medicine. Some accept the diagnosis but have negative associations with chemotherapy and fear its effect on their child.
Understanding psychosocial concerns of parents begins with understanding their beliefs about cancer and treatment and the reasons why some may refuse or delay appropriate treatment. During this emotionally challenging and frightening time, often, parents are also faced with concerns about the financial cost of treatment, which is exacerbated when the parent stops working in order to be with the child in hospital or at home.
Family support can also be challenging for some. Support can be experienced as inadequate when close family members live outside of Jamaica or the family unit is small. On the other hand, family support can be stressful when the extended family is overinvolved and each relative has an opinion on the diagnosis and treatment.
Guilt is often experienced when parents feel that their attention to their sick child has resulted in them neglecting other members of their family, including their other children. Self-blame and anger can result when parents ruminate and obsess that either they or the physician was not sufficiently vigilant in picking up the signs or had not responded quickly enough. Fear is a constant, with parents worrying about how to inform the child that the prognosis is not good, worrying that their child is dying, or fearing what the end-stage of the illness will be like.
What is needed is a team approach in which the caregiving team provides wrap-around support services addressing psychosocial concerns that will be beneficial to both the child and parent. In addition to the paediatrician, therefore, a comprehensive support team will consist of a psychologist, a social worker, a worker, a child coach/teacher, and a spiritual facilitator.
For more reading on this topic, please see https://www.contemporarypediatrics.com/view/when-cancer-strikes-family-p....
- Dr Audrey Pottinger is consultant clinical psychologist, Department of Child Health, University Hospital of the West Indies. Send feedback to firstname.lastname@example.org.