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An estimated 1.58 million people in the United States living after a cancer diagnosis have a child under 18 at home, about 2.85 million children, and roughly 562,000 of them live with a parent in early treatment. The systematic review found no general excess of serious difficulty against reference groups, a slightly raised risk of internalising problems, and adolescent daughters most affected.
The population first, because it is larger than most people assume. A study of 13,385 adults with a history of cancer who took part in the United States National Health Interview Survey between 2000 and 2007 found that 18.3 per cent of those diagnosed within the previous two years, and 14.0 per cent of the whole sample, were living with a child under 18. Most of those parents were female (78.9 per cent), married (69.8 per cent) and under 50 (85.8 per cent). Of the 3,193 identified children, 30.5 per cent were under six when their parent was diagnosed and 33.4 per cent were born after the diagnosis. Weighted to the population, that gives an estimated 1.58 million survivors living with minor children, representing 2.85 million children, and an estimated 562,000 children living with a parent in the early phases of treatment and recovery.
How they do. The systematic review of the psychosocial impact of parental cancer found ten studies addressing whether early-stage parental cancer raises the risk of psychosocial difficulty and thirteen addressing what explains the variation. Its conclusion, with its own caveats, was that "children and adolescents do not generally experience elevated levels of serious psychosocial difficulties compared to reference groups, but they are at a slightly increased risk for internalising type problems", and that "Adolescent daughters appear to be the most negatively affected group." Internalising problems means anxiety, low mood and withdrawal rather than behaviour that disrupts a classroom, which is why they are easy to miss.
The review is unusually candid about the limits of its own method: "The prevalent use of measures of child psychopathology may be masking more context-specific problems and lower levels of distress." In other words, the instruments were built to detect disorder, and most of what these children experience is not disorder.
What predicts how a child does. The review found that family variables, "especially family communication/expressiveness", were consistently associated with child and adolescent psychosocial functioning, with suggestive evidence for the role of maternal depression and adjustment and of parenting, and that "There is little evidence that medical/treatment variables are important predictors of child outcomes." That last sentence is the useful one for a parent. How advanced the cancer is, which drugs are being given and how long treatment lasts did not predict how the children fared. How the family talked about it did.
What is available. A review evaluated 15 psychosocial interventions for children aged 0 to 18 of a parent with cancer against six needs identified in earlier consumer research: age-appropriate information about the parent's cancer, support for family communication, normalising and reducing isolation through peer support, a space to share feelings, individually tailored support, and specialised bereavement support where appropriate. "No intervention clearly met all six needs, but each partially addressed at least two needs, and three clearly met at least four needs." The need most often addressed was supporting family communication; the one least often addressed was bereavement support.
So the evidence supports a short, specific set of things: tell children something true and age-appropriate rather than nothing, keep the channel open rather than delivering one conversation, watch for the quiet kind of distress rather than the loud kind, treat an adolescent daughter as the person most likely to be carrying it silently, and get the parent's own depression treated, because it is one of the few predictors that is both measurable and modifiable. What is not reliably available is help after a parent dies, which is the need the intervention review found least often met.
Children's adjustment to a parent's illness tracks the family's communication rather than the illness itself. A child who is told nothing fills the gap with inference, usually worse than the truth and usually self-referential; a child who is told something true, repeatedly and at their own level, has a stable account to work from. That is why family variables predict outcomes in the review and medical variables do not.
Query for this technology: (TITLE:"Children of a parent treated for cancer" OR ABSTRACT:"Children of a parent treated for cancer") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Children of a parent treated for cancer, not a curated reading list.
Shares Carers: what you can do and UK carer support (breast cancer), Partners and relationships after cancer: what the divorce data actually show, Depression during and after cancer: the interview-based prevalence, and the care model that works, The carer's own recovery: what is known about the person who is not the patient and the tags rejuvenation, survivorship, psychosocial.
Shares Depression during and after cancer: the interview-based prevalence, and the care model that works, Psycho-oncology and distress screening, Quality of life, Survivorship and late effects are neglected and the tags rejuvenation, survivorship, psychosocial.
Shares Depression during and after cancer: the interview-based prevalence, and the care model that works, Psycho-oncology and distress screening, Quality of life, Survivorship and late effects are neglected and the tags rejuvenation, survivorship, psychosocial.
Shares Partners and relationships after cancer: what the divorce data actually show, Psycho-oncology and distress screening, Quality of life, Survivorship and late effects are neglected and the tags rejuvenation, survivorship, psychosocial.
Shares Psycho-oncology and distress screening, Quality of life, Survivorship and late effects are neglected, Melanoma and the tags rejuvenation, survivorship, psychosocial.
Shares Psycho-oncology and distress screening, Quality of life, Survivorship and late effects are neglected, Melanoma and the tags rejuvenation, survivorship, psychosocial.
Shares The carer's own recovery: what is known about the person who is not the patient, Psycho-oncology and distress screening, Quality of life, Survivorship and late effects are neglected and the tags rejuvenation, survivorship, psychosocial.
Shares Psycho-oncology and distress screening, Quality of life, Survivorship and late effects are neglected, Melanoma and the tags rejuvenation, survivorship, psychosocial.