When a cure is not possible
There is no right or wrong way to react to the heartbreaking news that treatment is no longer able to cure your child’s cancer. No parent is ready to hear this, but you can be sure that your child’s palliative care team will work along with the treatment team to provide the best care for you and your child.
Your child’s healthcare teams aren’t giving up, but the focus of your child’s care is changing. The new goal is to make your child as comfortable as possible by focusing on their quality of life and supporting them and your family through this difficult experience.
Everyone in the family reacts differently. You may feel the same feelings you felt when your child was first diagnosed. Children react according to their age and maturity. It’s almost impossible to protect them from the situation. Even without being told, your child will sense that something is wrong.
Making decisions for quality of life @(Model.HeadingTag)>
Quality of life is what your child thinks is important about living. Whenever you are considering a treatment option, you and your child may have concerns. With each decision you make, think about how it can affect your child’s quality of life.
Depending on the age of your child, you may be able to make these decisions together. The palliative care team can help if you don’t know where to start or how to answer some of your child’s questions.
Older children may be able to express their own needs and desires. Ask your healthcare team for resources such as “My Wishes” and “Voicing My Choices.” These are easy to fill out forms that will help your child express how they wish to be cared for. Your child may have strong wishes about how they wish to be supported and cared for, what types of treatment they would like and how they would like to spend time with family and friends.
Some questions to ask about quality of life are:
- What is most important for my child’s quality of life?
- How will this treatment affect my child’s quality of life?
- Will it affect my child’s prognosis?
- What will it be like for my child and my family if my child goes through this treatment?
- Will this treatment make my child feel better or worse? If yes, for how long?
- What will happen without this treatment?
- Are there any other options to consider?
Length of time left @(Model.HeadingTag)>
When cancer can’t be cured, families often want to know how long their child has to live. Your doctor may be able to estimate this based on what they know about your child and their cancer, but it really is just an estimate. Some children can live longer than expected. Others may not live as long as predicted.
It’s normal to disagree @(Model.HeadingTag)>
Everyone in the family will react differently. Sometimes parents, family members and healthcare providers may disagree about whether cure continues to be possible. We all look at life differently. It’s normal to feel angry, hurt or frustrated when your opinions are different from that of others. Your healthcare team, social workers, psychologists and spiritual care workers can help you to work out your feelings and accept your differences.
Expert review and references
CureSearch. What if it seems that my child wants everything done. Bethesda, MD: National Childhood Cancer Foundation & Children's Oncology Group;
CureSearch. Palliative care. Bethesda, MD: National Childhood Cancer Foundation & Children's Oncology Group;
CureSearch. Making decisions about end of life care. Bethesda, MD: National Childhood Cancer Foundation & Children's Oncology Group;
CureSearch. End of life. Bethesda, MD: National Childhood Cancer Foundation & Children's Oncology Group;
Care of the Dying Child and the Family. Tomlinson, D. & Kline, N. E. (Eds.). Pediatric Oncology Nursing: Advanced Clinical Handbook. Germany: Springer; 2005: 30: pp. 431-442.
Walker, C.L., Wells, L.M., et al . Family-centered psychosocial care. Baggott, C. R., Kelly, K. P., Fochtman, D. et al. Nursing Care of Children and Adolescents with Cancer. 3rd ed. Philadelphia, PA: W. B. Saunders Company; 2002: 15: 365-390.
Wolfe, J. and Sourkes, B . Palliative care for the child with advanced cancer. Pizzo, P. A. & Poplack, D. G. (Eds.). Principles and Practice of Pediatric Oncology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2006: 51: 1531-1555.