When parents of children with cancer differ on communication, families want a plan

Talking with children who have cancer and their families about serious illness can be difficult, especially when prognosis is poor or disease is advanced. For clinicians, those conversations can become even more complex when parents or patients disagree about how information should be shared. As part of the Revealing Information Genuinely and Honestly Across Time (RIGHTime) study, Erica Kaye, MD, MPH, Quality of Life and Palliative Care Division research director and Department of Oncology associate member, and her colleagues interviewed patients, family members and clinicians to better understand best practices for navigating differing communication preferences. The researchers found that families overwhelmingly wanted clinicians to ask about their communication preferences early, well before difficult conversations were necessary. Families also wanted care teams to proactively create a plan that reflected those preferences. The major recurring themes were that clinicians should have individual conversations with parents if their preferences diverged, while also respecting parents’ primary role in sharing difficult news with their children. The findings were published in JAMA Network Open.

“Disclosing information about prognosis is always difficult, and it becomes even more challenging when family members want to receive information in different ways,” Kaye said. “Fortunately, patients and parents have provided us with an actionable roadmap to help clinicians honor their communication needs and better support families during this impossibly difficult time in their lives.”

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