Prognostic disclosures over time: Parental preferences and physician practices

Abstract

The majority of parents wanted detailed, longitudinal prognostic conversations; nearly none of the parents preferred less prognostic information. A return to these conversations over time can help rather than hurt parents. Future studies should assess the ideal contents of these longitudinal discussions, and the communication preferences of pediatric patients. Cancer 2017;123:4031-8. © 2017 American Cancer Society.

Ethical issues in the care of adolescent and young adult oncology patients

“…However, prognostic communication challenges both clinicians and families. Before the 1970s, nondisclosure of a cancer diagnosis was the predominant approach to communication in pediatric and adult oncology . Improvements in treatment options and larger societal shifts led to more transparent communication, initially transitioning from “never tell” to “always tell.” The current literature supports a more nuanced approach that seeks cues from the child or adolescent and meets their individual communication needs.…”

Development of the “Day 100 Talk”: Addressing existing communication gaps during the early cancer treatment period in childhood cancer

“…6–8 Notably, parents of children with cancer report wanting to revisit prognostic discussions during the year after diagnosis. 9 Additionally, parents hold less active decision-making roles than they desire. 10 In advanced childhood cancer, approximately one-third of parents report limited abilities to express hopes and worries during discussions of their child’s medical condition.…”

Don't let perfect be the enemy of good: How to improve prognostic communication in pediatric oncology

“…10, 11 First, Sisk and colleagues confirmed what we previously knew: in a survey of 156 parents of children with cancer, the vast majority wanted to hear about prognosis in as much detail as possible, and 85% considered a numeric estimate to be extremely or very important. 11 What was new was the finding that this desire for detailed information did not change over time. At the time of diagnosis, 4 months, and 12 months later, at least 84% of parents wanted detailed information and fewer than 5% said they would have wanted less.…”