Leah Rosengarten is an Assistant Professor of Children’s Nursing at Northumbria and formerly a Children and Young People’s Cancer Nurse. She is also a Trustee of Children’s Cancer North, a charity focused on improving lives for Children and Young People with Cancer.
September is Childhood Cancer Awareness Month, an internationally recognised month focusing on raising awareness of Childhood Cancer.
About Childhood Cancer
Each year around 400,000 Children and Young People aged 0-19 years develop cancer worldwide (WHO, 2021). In the UK, there are around 1600 Children and Young People diagnosed each year (CCLG, 2023). We are fortunate that in the UK, survival rates of childhood cancer are over 80%, but the goal is to improve international figures (30% in some countries) and increase survival rates for all.
Leukemias’, brain cancers and lymphomas are the most common cancers in childhood. Childhood cancers often occur in different parts of the body to adult cancers and respond differently to treatment. Unlike in adults, very few childhood cancers are caused by environmental, or lifestyle factors, and it is thought that around 10% of children have a predisposition to cancer due to genetic factors (WHO, 2021).
Cancer occurs when a single cell undergoes a genetic change, causing it to function incorrectly. This cell then rapidly multiplies to form a tumour or multiple tumours, avoids the bodies attempts to kill it, or prevent its growth, and invades surrounding cells and tissues which prevents them from being able to function correctly. Treatment of cancer in childhood depends on the type of cancer but may include one or a combination of the following: chemotherapy to prevent the tumour growing, eventually causing tumour death, surgery to remove a tumour, radiotherapy to destroy cancer cells, and immunotherapy to use the bodies own immune system to attack the cancer.
Family Nursing in Childhood Cancer
The diagnosis of cancer in childhood has a devastating impact on not just the child themselves, but the whole family. Though treatments in childhood cancer are improving all the time, they are very intense with some cancers requiring 3 years or more treatment.
Siblings of children with cancer often experience a disintegration in family life following diagnosis, which can affect their self-esteem and family relationships (Yang et al, 2016). Understandingly parental attention is often focused on the child with cancer, and siblings report numerous negative impacts, such as lack of parental attention, a reduction in social activities, reduced school achievements and feelings of isolation or exclusion (Carlsen et al, 2019).
Parents of children or young adults with cancer often report stress, anxiety and depression (Van Schoors et al. 2019). Parents also experience financial impacts due the cost of travel for treatment, loss of work and strained family relationships. It is important to note though, that not all impacts are negative as some families report improved relationships and post-traumatic growth as a result of their experiences (Van Schoors et al, 2019).
Nurses caring for children or young adults with cancer and their families need to pay close attention to the full family unit, considering how best to involve families in care. It is important to understand the benefits of family nursing for both the child and their family, whilst also considering the impact that caring for a loved one can have on an individual.
Carlsen, L.T., Christensen, S.R. and Olesen, S.P. (2019) “Adaption strategies used by siblings to childhood cancer patients,” Psycho-oncology, 28(7), pp. 1438–1444.
Children’s Cancer and Leukaemia Group. (2023). https://www.cclg.org.uk/csoir/incidence-of-childhood-cancer-in-the-uk
Van Schoors, M., De Paepe, AL., Norga, K., Cosyns, V., Morren, H., Vercruysse, T., Goubert, L., Verhofstadt, LL. (2019). ‘Family Members Dealing With Childhood Cancer: A Study on the Role of Family Functioning and Cancer Appraisal’. Frontiers in Psychology. 10. DOI=10.3389/fpsyg.2019.01405
World Health Organization. (2021). https://www.who.int/news-room/fact-sheets/detail/cancer-in-children.
Yang, Hui-Chuan MSN, RN; Mu, Pei-Fan PhD, RN; Sheng, Ching-Ching MSN, RN; Chen, Yi-Wei MD; Hung, Giun-Yi MD. A Systematic Review of the Experiences of Siblings of Children With Cancer. Cancer Nursing 39(3):p E12-E21, May/June 2016. | DOI: 10.1097/NCC.0000000000000258