08:51pm Monday 11 December 2017

Discussing child’s cancer prognosis more likely to produce peace of mind and decrease anxiety in parents

Dana-Farber Cancer Institute

The research should ease physicians’ concerns that discussing an unfavorable prognosis with young patients’ parents will cause the parents to become despondent or emotionally distraught, the authors said.

“Most agree that patients and families should know as much about their diagnosis, treatment, and prognosis that physicians can give them,” said Jonathan Marron, MD, of Dana-Farber/Boston Children’s, who led the study. “At the same time, data have suggested that some oncologists are reluctant to discuss the details of prognosis with patients and their families out of concern that it might cause unnecessary anxiety and lead to depression. Our study suggests that such concerns are largely unwarranted.”

In the study, Marron and his colleagues surveyed 353 parents of children newly diagnosed with cancer at Dana-Farber/Boston Children’s and Children’s Hospital of Philadelphia, asking about their discussions of prognosis with the child’s oncologist, and whether those conversations had a positive or negative effect.

The investigators found that among parents whose children had less favorable prognoses, those who reported receiving high-quality information from the medical team gained peace of mind and had greater trust in the child’s oncologist. Parents who received more prognostic information were not significantly more anxious, depressed, or less hopeful than those who received less of such information.

“Providing families with a full explanation of the likely course of a disease is critical to helping them plan and have reasonable expectations about the outcome of treatment,” Marron remarked. “More research is needed to determine if the information being provided by oncologists is fully received and understood by families.”

The senior author of the paper is Jennifer Mack, MD, MPH, of Dana-Farber/Children’s. Co-authors are Tammy Kang, MD, MSCE, of Children’s Hospital of Philadelphia, and Angel Cronin of Dana-Farber.

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