A study of people with cancer who have young children reveals that the parents are not certain how their children are doing. Although the parents observed signs that their children were experiencing physical, mental and social distress, they often avoided talking about it. The researchers recommend incorporating family support services for the entire family as a standard procedure when a parent is diagnosed with cancer.
Families have great difficulty when a member develops cancer, and this can become even more complicated for a parent with young children. About one fifth of all people newly diagnosed with cancer in Denmark have children younger than 18 years. All the parents participating in the qualitative study said that assessing their children’s well-being was difficult, since many of them acted quite normally in various everyday situations. However, some warning signs emerged, such as sleeping problems, separation anxiety and symptoms of obsessive-compulsive disorder, and some children even feared that they too had cancer.
“The parents could not determine whether their children’s problems were caused by the parent’s cancer or because of the children’s friends, their age or something else. Many parents seemed to hit a wall when trying to discuss it with their children. If the parents do not know how their children feel, they have even more difficulty in ensuring that the children get the help they need,” explains Anette Hauskov Graungaard, general practitioner and Associate Professor, Department of Public Health, University of Copenhagen.
Even though most people with cancer survive or end up living with it as a chronic disease, Anette Hauskov Graungaard has met many young people with anxiety and other mental health disorders as a general practitioner. She noticed that the challenges the children faced largely resulted from a parent being critically ill or dying.
“This shows the importance of asking children how they are doing when a parent has cancer so they can get the help they need as quickly as possible,” says Anette Hauskov Graungaard.
Many of the parents described feeling ambivalent – both hopeful and yet worried about the future. They were very concerned that their children’s fear of losing a parent would scar the children for life. However, when they saw their children behaving normally, they felt encouraged that their illness would not seriously affect their children’s lives negatively in the long term.
Further, most of the parents said that they tried to appear and act as normally as possible in their daily lives and to live a normal family life.
“Most of the children avoided talking about the illness with their parents, and many of the parents tried to keep their everyday lives as normal as possible. We also noticed that the parents tended to convince themselves that their children were acting ‘normally’, even if they were not,” explains Anette Hauskov Graungaard, who adds:
Most parents had difficulty discussing their feelings with their children because they feared making them feel even more sad or anxious. This is a very human response but can create even more difficulty for the children to express their concerns and get the help they need.
Support services for the entire family
All the parents were concerned about the poor communication with their children about their thoughts, experiences and concerns.
The researchers identified several obstacles to parents accepting various support services, such as the parents doubting whether their children needed support, the parents avoiding confronting difficult emotions and the possibility that the children would decline help. The researchers therefore recommend implementing family support services for the entire family as a standard procedure when a parent is diagnosed with cancer.
“Both children and parents would more easily accept this kind of support when there is no stigma attached to it,” concludes Anette Hauskov Graungaard.