“Your son has cancer.” Words no parent wants to hear and no physician wants to say. Unfortunately, whether it’s cancer or another chronic illness, these words are spoken each and every day. 


Trauma Informed Care with Chronically Ill Patients


Depending on their life circumstances, for some children and families, this may not be the first they've heard these words. Maybe mom, granddad, or an aunt passed away from cancer. Or maybe this is Johnny’s second or third cancer recurrence.


From current diagnosis to past experiences, these factors can have a cumulative effect on the child and family’s anxiety and their ability to cope. As Pan Pantziarka shares in his article “On paranoid parents”, published in Pediatric Blood & Cancer:


In our case, our previous family tragedy was considered a distraction, convenient support for the idea that our alarm was unwarranted. The situation at the time of relapse, when our fears were dismissed as those of ‘paranoid parents’, is perhaps more common. The physician who uttered that phrase did so in a kind and sympathetic way.


Pantziarka continues, explaining to physicians that validating the anxiety is one of the keys to helping a patient or parent cope:


For a parent the feeling that our concerns are not being taken seriously, when we are clearly so worried, is one of the hardest to deal with. Clinicians can address this simply by listening to our concerns, even if they prove to be unfounded. In time parents learn (ideally partnering with their oncologists) and become more adept at differentiating between valid and invalid concerns – but not when they feel their concerns have been summarily dismissed.


Using trauma informed care framework, physicians and nurses providing care to chronically ill children and families should keep the following in mind, especially at diagnosis and during treatment planning:


- Acknowledge common emotional reactions to trauma and traumatic stress.

- Ask about fears and worries.

- Connect parents to family support resources in the hospital. 

- Provide simple explanations about medical procedures and treatment to the child and family to reduce fears and worries.

- Provide the child with as much age-appropriate involvement as possible in treatment planning. 


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