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I work in a small pediatrics department where we rarely see kids with cancer. A few days ago, I overheard a child with a glioma tell her mom she was scared. The mom replied, "I know, sweetie, I'm scared too." I wasn't sure what to say but her response didn't seem helpful. What would you have said?-R.C., COLO.
I'm sure the mother was expressing her own truth by admitting that she also was frightened. But that doesn't provide much reassurance for the little girl who's undergoing terrifying treatments.
Children know when they're not going to get well. They deserve honest answers to all of their questions. When the truth's withheld, they're likely to conjure up what they believe the truth to be, which may be even worse than the reality.
Anytime I hear a child say, "I'm scared," I ask for specifics to get at what's bothering her. Then I can offer suggestions or solutions that may ease her distress.
For example, suppose she says, "I'm afraid to go in the MRI machine."
"What frightens you most about it?" I'd ask.
"The banging sound."
"If you want, we can play your favorite music so you can listen to that instead of the noise. What else is scary about it?"
"I'm afraid of feeling closed in."
"We can give you some medicine to help you relax. What else are you worried about, Emily?"
"Can my mom go with me?"
As a rule, you should give a child as much information as she asks for, but you must gear your response to her age and developmental level. Younger children typically fear separation from their parents, as Emily revealed to me. Avoid overly detailed or graphic explanations and be sensitive to cues that she's "had enough"-for example, when she suddenly changes the subject.
The American Society of Clinical Oncology offers helpful tips and links for parents and clinicians caring for pediatric patients with cancer. Visit the Web site at http://www.asco.org and click on "http://Cancer.Net Feature: Preparing Your Child for Medical Procedures."
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