The relationship between oncologists and parents of children with cancer can be complex and unique, with each family having differing needs. Dr Ren Manias, Consultant Paediatric Oncologist at Southampton General Hospital and Contact’s medical adviser, tells us how open and honest communication between doctors and parents is key to developing trust and understanding, and why this is important.
When faced with a cancer diagnosis, parents must entrust the health of their children to oncologists they’ve only just met. The relationships that subsequently develop can be very special as we work together to support the child through their long treatment journey.
As a paediatric oncology consultant, I meet children and their parents at one of the most vulnerable and challenging times in their lives. It’s remarkable that so many parents are able to trust a nearstranger with the lives of their children, and often quickly develop a relationship of mutual respect and understanding.
A good parent-doctor relationship results in a better experience for children, families and their doctors. Parents want and deserve to be treated with sensitivity and care, be involved in decisions about treatment to an extent that feels right to them, and have relationships based on shared trust and respect.
Every child and family are different and have their own unique needs. It’s hugely important for doctors to take the time to get to know patients on a human level to build organic and solid relationships. There really is no substitute to spending time connecting with families, finding out what’s important to them, understanding their values, interests, fears and aspirations, and listening properly to what they have to say.
Open and honest communication is key to developing trust and understanding. I try to be direct and clear with families and children and encourage them to be direct with me. The conversations we have are often difficult and emotionally challenging, especially when they involve delivering complicated and upsetting information. Parents (including individual parents of the same child) differ widely in terms of how much information they want to receive and how much input they want to have into decisions about their child’s care. Attitudes towards this can change as the cancer pathway progresses and doctors need to be mindful of this fluidity. I find it helps to ask directly, while watching closely for verbal and non-verbal cues, and encourage parents to express their needs and concerns.
As doctors, we’re also human. Relationships are complex and we can’t get it right every time, especially in the highly emotive and high-stakes area of children’s cancer care. I want parents to feel comfortable voicing their concerns and to tell me if they’re not happy with any aspect of their child’s care. If something has upset a family, I want to know so I can try to put it right – even if that something is me.
Not every parent-doctor relationship goes smoothly. Nearly a quarter of parents of children with cancer experience challenges in their relationship with doctors, most of which come down to issues with communication. Research has shown that doctors don’t always realise when a family is finding the therapeutic relationship challenging, but that they’d do their best to fix issues if they were made aware of them.
If you feel that there are problems with your relationship with your child’s doctor, please let them know. If you don’t feel comfortable speaking to them directly, you could talk to another member of the healthcare team and ask them to advocate on your behalf.
Working with children with cancer and their parents to build supportive and long-lasting relationships is one of the most rewarding and important parts of my role as a paediatric oncologist. The opportunity to be part of these remarkable families’ lives is an immense privilege and responsibility which I will always value.
From Contact magazine issue 104 | Autumn 2024
