Dateline DFCI
Clinicians offer tips to help ease parents' fears
Writing from their own experience and that of their colleagues, two DFCI pediatric oncologists have produced a guide for doctors when informing parents that their child has cancer.
In a recent paper published in the Journal of Clinical Oncology (www.jco.org), Jennifer Mack, MD, and Holcombe Grier, MD, of Dana-Farber and Children's Hospital Boston offer advice for what can be one of the most difficult conversations a physician will face. Their message: If handled properly, the discussion can be a crucial first step in reducing parents' anxiety.
"We know from published research, as well as our own practice, that the way bad news is first communicated can affect, for better or worse, people's adjustment to a diagnosis," says Mack. "And parents' understanding of their child's condition influences their choices for therapy."
Mack and Grier write that the "Day One Talk" — when physicians and parents first meet about a diagnosis — provides an opportunity to calm parents by replacing their fears and questions with solid information, the start of a treatment plan, and assurances that their concerns will be addressed throughout the child's care.
Because parents are apt to be overwhelmed by the amount of information they've received, and emotionally exhausted by the uncertainties leading up to the diagnosis, caregivers should acknowledge the enormity of this event in a family's life, Mack and Grier counsel.
"We tell parents they are part of a team," they write. "Our role is to help inform them about their child's disease and to plan and supervise the treatment. Their role is to teach us about their child and themselves, which will help us provide better care.
