Child/Adolescent Health

Parents of children with cancer are overly optimistic about a cure, but not about other outcomes of cancer therapy

Children who survive cancer sometimes have significant late effects of cancer and its treatment. Parents of children with cancer tend to be overly optimistic about the chances of a cure, but not about future problems related to cancer or cancer therapy, according to a new study. Physicians often do not communicate prognosis information clearly and explicitly; however, they do tend to detail the adverse effects related to treatment. To provide parents with more realistic expectations about their child's prognosis, doctors need to be specific about the probability of cure as well as the possibility of long-term cancer- and treatment-related limitations, suggests Jennifer W. Mack, M.D., M.P.H., of the Dana-Farber Cancer Institute.

Dr. Mack and fellow investigators surveyed 194 parents of children with cancer treated at 1 hospital, along with the children's physicians. They compared parent and physician expectations for the likelihood of a cure and functional outcomes. The majority of parents (61 percent) were more optimistic than physicians about the chances that their child would be cured. Parental ratings of the likelihood of a cure matched physician ratings in only 29 percent of cases, and only 10 percent of parents were more pessimistic than the doctors about the chances of cure.

Most parents (70 percent) believed that their opinions about the likelihood of a cure were the same as those of their child's oncologist. Parents' beliefs about quality-of-life impairment due to cancer treatment were similar to physicians, but parents were more pessimistic than physicians about the impact of cancer treatment on physical and intellectual functioning.

The study was supported in part by the Agency for Healthcare Research and Quality (T32 HS00063).

See "Understanding of prognosis among parents of children with cancer: Parental optimism and the parent-physician interaction," by Dr. Mack, E. Francis Cook, Joanne Wolfe, and others, in the April 10, 2007, Journal of Clinical Oncology 25(11), pp. 1357-1362.

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