When a young child is diagnosed

Cancer is no longer restricted to the middle age woman. The incidence of this disease now manifests itself over a lifetime; ranging from the very young to the elderly in both sexes.

Available statistics in South Africa, report that approximately 1700 children (birth to 16 years) are diagnosed annually with cancer. The most prevalent is Leukemia, followed by Retino blastoma and then brain tumours. With early detection, it is reported that 77% of these cancers can be cured.

During this difficult journey there is a range of aspects that should be taken into account to aid and help the patient. A support structure is one of the most important. Support for an adult is perhaps easier in comparison to a very young child. So how do we proceed when a little child is diagnosed with a malignant tumour?

The starting point for the parents is often an overwhelming multitude of questions and the disturbing absence of answers. Frequently asked questions may be:

• How will we be able to explain to him/her what is happening?

• Will we as parents be able to cope with this devastating event?

• How will it change our lives?

• How will it impact our other children?

A sick child is overwhelming to any parents, and each family will need support. Initially the focus will be on the sick child, and the confusion and urgency in the first few weeks could result in the collapse of a family life and routine.

Amidst the chaos following the diagnosis, the arrangements for treatment, and other organisational matters, the mother usually becomes the sole care taker of the patient while the father tries to tend to the rest of the houseshold.  This could result in unintentional polarisation within the household.   

It may also lead to the disintegration of the relationship between the parents. Under such uncertainty and confusion, accusations of non-involvement, neglect or self-interest often become the only communication tool used by parents to alleviate their own personal fears and anxiety.

An action plan

But what do you do under such circumstances? The impact of cancer on a family is huge and in each case the way we deal with it depends on a variety of factors. There is no golden rule but these pointers may be of assistance:

• Immediately after the diagnosis, the parents should share their grief, shock, distress and fear with each other before giving it out to others. The moment the rest of the family, friends and colleagues receive the news, the situation becomes more overwhelming. Although they are offering genuine hope and support, the parents at that moment are unable to comprehend their own situation and any additional grief exacerbates their circumstances.    

• Any misconceptions should be clarified and information to the patient and the other children should be direct, while explaining any planned interventions.

• The parents should involve the other children in the initial phase. Each child should be given a small responsibility (depending on their age) towards support of their sick sibling, so that they feel part of this journey. So often the other children are sidelined or ‘spared’ the circumstances by keeping them uninformed or sent away to stay with their grandparents. If need be, rather request the grandparents to come and assist the family at home.

• Household duties should be re-distributed and a plan of action should be put in place. It is important that the routine of the household is maintained as far as possible. It affords the necessary security and stability for the children to function in.

• Any assistance from friends, family and organisations should be considered.

• Schedule family meetings and use it as a center point for communication purposes, input, new ideas, strategies, complains and grievances from all.

A devastating intervention in the life of a family can become an opportunity to literally and figuratively take hands to create a protective and supportive net. Not just for the sick child but for the whole family which could have positive and constructive implications for a lifetime. Young children need a measure of stability which affords them the necessary security and sense of belonging they get at home.

Written by Dr Magda Rall