Breast cancer in the family—children's perceptions of their mother's cancer and its initial treatment: qualitative study
BMJ 2006; 332 doi: https://doi.org/10.1136/bmj.38793.567801.AE (Published 27 April 2006) Cite this as: BMJ 2006;332:998All rapid responses
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We were very interested to read the paper by Forrest et al (1) as
this is a much needed research area.
We are currently undergoing research into the experiences of family
members (ill parent, carer, and children) when a parent has advanced
cancer - many of the findings described are supported by our own work
particularly the suggestion that parents “would benefit from preparation
to tell their children and consider the ways children of different
developmental stages might react”. Additionally our data suggests that the
internet is an important source of information and that recommended
websites would be helpful. Children particularly welcomed this as an area
where they could access information in private.
The authors however have not discussed that a child’s experience may
differ according to the gender of the ill parent (2,3) and also the
child’s own gender. Additionally in our study we are looking at family
experiences when either a mother or father is affected with late stage
disease.
It is so important that children are included in the information
giving process during any illness and it is of vital important in a
disease such as cancer when the future is so uncertain. Whilst this paper
adds much useful knowledge as to the perceptions of children when a parent
is diagnosed with early stage disease, the needs of both children and
parents change at different stages. It is vital that professionals
recognised this in order to deliver truly holistic care to the patient and
their family.
1. Forrest G, Plumb C, Ziebland S, and Stein A. Breast cancer in the
family-children’s perceptions of their mother’s cancer and its initial
treatment: qualitative study. BMJ, doi:10.1136/bmj.38793.567801.AE
(published 13 April 2006).
2. Grant KE, and Compass BE. Stress and anxious-depressed symptoms among
adolecents: searching for mechanisms of risk. Journal of Consulting &
Clinical Psychology 1995;63:1015-1021.
3. Compas BE, Worsham NL, Epping-Jordan JE, Grant KE, Mireault G, Howell
DC, et al. When Mom or Dad has cancer: markers of psychological distress
in cancer patients, spouses, and children. Health Psychol 1994;13:507-515.
Competing interests:
None declared
Competing interests: No competing interests
Previous traumatic incidents,like loss of a parent from
cancer,watching the intense treatments like
chemotherapy&radiotherapy,suffering from immense pain of their parents all
place a child at increased risk of mental health problems.The risk is
however much reduced if the child's family is understanding and supportive
and offer full co-operation in caring for the child.
Time and again,psychologists have proved that reliable love and
commitment are the most important factors in enabling a child to come to
terms with loss, and that each of us can help children face their
difficulties - it is not a task for the expert.We just have to recognise
the way that children communicate their distress,which varies from
individual to individual alike adults.
Giving children the chance to express their feelings on a range of
topics from sinister ailments like cancer,or loss of life enables them to
see in a positive way and helps children not only to cope but to grow
through their experiences.Thence it calls on adults not to underestimate
the bereaved child's struggle to come to terms with the pain of a loved
one or even their loss.
At times as devastating as these,children need extra love,tenderness
and understanding,because regardless of how we see them,they
have a perception and intuition much stronger than our wildest
imaginations.
References
1.Gillian Forrest et al.Breast Cancer in the family --children's
perceptions of their mother's cancer and its initial treatment:
qualitative study.BMJ 2006; 0: bmj.38793.567801.AEv1
2.Teifion Davies et al.ABC of Mental Health.BMJ books 1998;51-55.
Competing interests:
None declared
Competing interests: No competing interests
Website support for teenagers when a parent has cancer
The excellent paper by Forrest et al pointed out the need for
appropriate information for children of parents with cancer about cancer
and its treatment. It also found that most of the teenagers in the study
would have liked some recommended websites to explore, and the authors
listed a couple of these.
As the creator of one of those websites mentioned, we wish to share
some experiences of supporting teenagers who have a parent with cancer.
We launched www.riprap.org.uk – when a parent has cancer, in May 2003,
having recognised the gap in information and support for this group of
children. The site provides information about cancer and its treatments,
but maybe more importantly it offers an online platform for supporting
these children emotionally.
Forrest et al found that alongside the need for information about
cancer and treatments, older children in their study wanted to find out
how others coped with a similar situation. Recognising the need for peer
support, we have designed the main focus when entering the riprap website
to be on stories from teenagers who are going through the experience of
having a parent with cancer. So far, 66 stories from teenagers have been
submitted to the site – offering an important resource for fellow
teenagers in finding out how others are dealing with their situation.
Secondly, in order to provide an additional level of peer support,
the website has a forum where teenagers can share experiences by posting
messages to each other. The stories and the forum are monitored to secure
anonymity and a safe environment for teenagers using the site.
Thirdly, although we regard the peer support features of the site to
be crucial, we are also offering the option for teenagers to ask questions
or ask advice from health care professionals.
The riprap website is still the only dedicated website in the UK
providing this service exclusively to this group of teenagers and we are
very pleased to witness that the site is increasingly used by the intended
target group. We appreciate the important role that staff in hospitals,
primary care and hospices have in making this resource known to potential
users and we can supply posters and postcard size contact cards that can
be handed out to parents or directly to teenagers who may benefit from
using the website.
As well as serving as a resource for teenagers, the stories, forum
messages and email queries offer us a new insight into the thoughts,
concerns and coping strategies of teenagers who have a parent with cancer.
We are in the process of collecting data from these resources which we
will submit for publication at a later date.
Competing interests:
None declared
Competing interests: No competing interests