Your child's first appointment after diagnosis

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Your child's first appointment after diagnosis

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Other than the first time you meet the family, the most important visit in the entire relationship between you and the family, and the child who has a cancer diagnosed, is that first meeting where you sit down and talk about what the diagnosis is. How it was made. Explain exactly what kind of cancer it is and what it really means. Because, this is a complex issue. And then start talking about the treatment. This is a lot of information they give a family in one sitting. And it's not at all unusual that the family is not able to absorb all that. You might say, "Why give them all that information when it's hard for them to do so?". Well, normally with children with cancer, we have to get on with treatment pretty promptly. We don't have a lot of time to wait. So, we often have to do that over the course of a 2, 3 even 4 hour meeting with them. To make sure that they understand what we need to do and give us permission. If we have more time, then I usually break it up into two meetings. One is usually talk about the diagnosis. And answer all the questions about that. And, then the second meeting is to sit down, maybe the next day, and talk about the treatment in detail. Again, if the child is old enough, then I include the child in these discussions, Because, again, they need to understand what's going to happen to them. And not be frightened by something that they have no idea what's going to come along. The other thing is that in the pediatric oncology we are pretty strong about giving the child, again if they are old enough, the name of what they have. So, we will tell them that they have cancer. We will tell them what kind it is. We will try to describe what that means in terms that they understand. A younger child, or 7 or 8, is going to understand less and need to be have it explained in a different way than a child who's 16 or 17. But, they need to know. You might say, "Why do they need to know?". Because, you do not want them to hear that name. That diagnosis. For someone at school, a child or friend, or some other parent who inadvertently says it or whatever. That is the wrong way for them to hear it. They need to hear it from us. Because, they need to trust us.

Watch Video: Your child's first appointment after diagnosis by Stuart E. Siegel, MD, ...

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Stuart E. Siegel, MD

Director, Children’s Center for Cancer & Blood Diseases, Children's Hospital Los Angeles

Before recently shifting his focus to international medicine, Stuart Siegel, MD, was Chief of the Division of Hematology/Oncology for 35 years and the founding director of the the Children’s Center for Cancer & Blood Diseases at Children’s Hospital Los Angeles, and Professor and Head of the Division of Hematology-Oncology Department of Pediatrics, Keck School of Medicine of University of Southern California. He remains a leader in supportive care and research in pediatric oncology, with a special focus on neuroblastoma, non-Hodgkin lymphoma, Ewing Sarcoma, acute lymphoblastic leukemia and brain tumors. From developing the first pediatric protective environment in 1971 for children undergoing intensive chemotherapy, to pioneering current efforts to develop academic and clinical care programs nationally and locally for adolescents and young adults with cancer, Dr. Siegel’s contributions have revolutionized the field of pediatric oncology. Dr. Siegel has been honored for his work by the American Cancer Society, Children Foundation, the Cancer Foundation, the Chase Foundation, Padres Contra El Cancer, the Israel Cancer Research Fund and Ronald McDonald House Charities, where he is a member of the National Board, and has consistently been listed among the nation’s top doctors in such publications asAmerica’s Top Doctors and Best Doctors in America. He is a father of one son, Joshua; grandfather of David and Elijah; and lives in Pacific Palisades with his wife of seven years.

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Transcription: 
Other than the first time you meet the family, the most important visit in the entire relationship between you and the family, and the child who has a cancer diagnosed, is that first meeting where you sit down and talk about what the diagnosis is. How it was made. Explain exactly what kind of cancer it is and what it really means. Because, this is a complex issue. And then start talking about the treatment. This is a lot of information they give a family in one sitting. And it's not at all unusual that the family is not able to absorb all that. You might say, "Why give them all that information when it's hard for them to do so?". Well, normally with children with cancer, we have to get on with treatment pretty promptly. We don't have a lot of time to wait. So, we often have to do that over the course of a 2, 3 even 4 hour meeting with them. To make sure that they understand what we need to do and give us permission. If we have more time, then I usually break it up into two meetings. One is usually talk about the diagnosis. And answer all the questions about that. And, then the second meeting is to sit down, maybe the next day, and talk about the treatment in detail. Again, if the child is old enough, then I include the child in these discussions, Because, again, they need to understand what's going to happen to them. And not be frightened by something that they have no idea what's going to come along. The other thing is that in the pediatric oncology we are pretty strong about giving the child, again if they are old enough, the name of what they have. So, we will tell them that they have cancer. We will tell them what kind it is. We will try to describe what that means in terms that they understand. A younger child, or 7 or 8, is going to understand less and need to be have it explained in a different way than a child who's 16 or 17. But, they need to know. You might say, "Why do they need to know?". Because, you do not want them to hear that name. That diagnosis. For someone at school, a child or friend, or some other parent who inadvertently says it or whatever. That is the wrong way for them to hear it. They need to hear it from us. Because, they need to trust us.