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Even when a child with cancer's prognosis is unpromising, parent/physician communication can provide hope, study finds


 

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Jennifer Mack, MD

Physicians who inform parents of children with cancer about the likely course of the disease can provide hope, even when the child's prognosis is poor, according to a Dana-Farber Cancer Institute study presented at a press briefing at the American Society of Clinical Oncology annual meeting.

"Previous studies suggest that physicians are reluctant to give prognostic information, out of fear that it will destroy hope," said Jennifer Mack, MD, the study's lead author. "Strikingly, we found that honest communication of prognostic information can actually help parents to feel more hopeful, not less."

The researchers sought to determine whether there is any validity to the view that withholding prognostic information, in cases where the medical outlook for a child is poor, can help sustain parents' hopes. Few previous studies have explored the relationship between prognostic disclosure and hope in this setting.

The researchers surveyed 194 parents of children with cancer in their first year of treatment and the children's physicians. They assessed whether there was any connection between parents' recall of prognostic information conveyed by the physician and the extent to which they felt such communication "always" made them feel hopeful.

They found that parents who reported receiving extensive prognostic information were also more likely to report that physician communication made them feel hopeful, even when the prognosis was poor.

The lead author of the research is Jane Weeks, MD, of Dana-Farber. Co-authors include Joanne Wolfe, MD, and Holcombe Grier, MD, of Dana-Farber and Paul Cleary, PhD, and E. Francis Cook, ScD, of the Harvard School of Public Health.

Dana-Farber Cancer Institute (www.dana-farber.org) is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States. It is a founding member of the Dana-Farber/Harvard Cancer Center (DF/HCC), designated a comprehensive cancer center by the National Cancer Institute.

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