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RESEARCH: Gillian Forrest, Caroline Plumb, Sue Ziebland, and Alan Stein Breast cancer in the family--children's perceptions of their mother's cancer and its initial treatment: qualitative study BMJ 2006; 0: bmj.38793.567801.AEv1 [Abstract]

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Bereavement and Palliative Care of Children with Mothers diagnosed with Cancer.

Noor-ul-Ain Mughal   (25 April 2006)

Experiences of having a parent with cancer

Vida L Kennedy, Professor Mari Lloyd Williams, Dr. Mark B. Gabbay   (5 May 2006)

Website support for teenagers when a parent has cancer

Hilde H Ahmedzai, Sam H Ahmedzai   (11 May 2006)

Bereavement and Palliative Care of Children with Mothers diagnosed with Cancer. 25 April 2006
Noor-ul-Ain Mughal, Doctor(Summariser) Parkside Medical Centre,Bletchley,MiltonKeynes. MK3 6EN Send response to journal: Re: Bereavement and Palliative Care of Children with Mothers diagnosed with Cancer.	Previous traumatic incidents,like loss of a parent from cancer,watching the intense treatments like chemotherapy&radiotherapy,suffering from immense pain of their parents all place a child at increased risk of mental health problems.The risk is however much reduced if the child's family is understanding and supportive and offer full co-operation in caring for the child. Time and again,psychologists have proved that reliable love and commitment are the most important factors in enabling a child to come to terms with loss, and that each of us can help children face their difficulties - it is not a task for the expert.We just have to recognise the way that children communicate their distress,which varies from individual to individual alike adults. Giving children the chance to express their feelings on a range of topics from sinister ailments like cancer,or loss of life enables them to see in a positive way and helps children not only to cope but to grow through their experiences.Thence it calls on adults not to underestimate the bereaved child's struggle to come to terms with the pain of a loved one or even their loss. At times as devastating as these,children need extra love,tenderness and understanding,because regardless of how we see them,they have a perception and intuition much stronger than our wildest imaginations. References 1.Gillian Forrest et al.Breast Cancer in the family --children's perceptions of their mother's cancer and its initial treatment: qualitative study.BMJ 2006; 0: bmj.38793.567801.AEv1 2.Teifion Davies et al.ABC of Mental Health.BMJ books 1998;51-55. Competing interests: None declared
Experiences of having a parent with cancer 5 May 2006
Vida L Kennedy, Research Associate Academic Palliative and Supportive Care Studies Group, Primary Care Dept, Liverpool L69 3GB, Professor Mari Lloyd Williams, Dr. Mark B. Gabbay Send response to journal: Re: Experiences of having a parent with cancer	We were very interested to read the paper by Forrest et al (1) as this is a much needed research area. We are currently undergoing research into the experiences of family members (ill parent, carer, and children) when a parent has advanced cancer - many of the findings described are supported by our own work particularly the suggestion that parents “would benefit from preparation to tell their children and consider the ways children of different developmental stages might react”. Additionally our data suggests that the internet is an important source of information and that recommended websites would be helpful. Children particularly welcomed this as an area where they could access information in private. The authors however have not discussed that a child’s experience may differ according to the gender of the ill parent (2,3) and also the child’s own gender. Additionally in our study we are looking at family experiences when either a mother or father is affected with late stage disease. It is so important that children are included in the information giving process during any illness and it is of vital important in a disease such as cancer when the future is so uncertain. Whilst this paper adds much useful knowledge as to the perceptions of children when a parent is diagnosed with early stage disease, the needs of both children and parents change at different stages. It is vital that professionals recognised this in order to deliver truly holistic care to the patient and their family. 1. Forrest G, Plumb C, Ziebland S, and Stein A. Breast cancer in the family-children’s perceptions of their mother’s cancer and its initial treatment: qualitative study. BMJ, doi:10.1136/bmj.38793.567801.AE (published 13 April 2006). 2. Grant KE, and Compass BE. Stress and anxious-depressed symptoms among adolecents: searching for mechanisms of risk. Journal of Consulting & Clinical Psychology 1995;63:1015-1021. 3. Compas BE, Worsham NL, Epping-Jordan JE, Grant KE, Mireault G, Howell DC, et al. When Mom or Dad has cancer: markers of psychological distress in cancer patients, spouses, and children. Health Psychol 1994;13:507-515. Competing interests: None declared
Website support for teenagers when a parent has cancer 11 May 2006
Hilde H Ahmedzai, Information Researcher University of Sheffield, Academic Unit of Supportive Care, TPCC, Sheffield, S11 9NE, Sam H Ahmedzai Send response to journal: Re: Website support for teenagers when a parent has cancer	The excellent paper by Forrest et al pointed out the need for appropriate information for children of parents with cancer about cancer and its treatment. It also found that most of the teenagers in the study would have liked some recommended websites to explore, and the authors listed a couple of these. As the creator of one of those websites mentioned, we wish to share some experiences of supporting teenagers who have a parent with cancer. We launched www.riprap.org.uk – when a parent has cancer, in May 2003, having recognised the gap in information and support for this group of children. The site provides information about cancer and its treatments, but maybe more importantly it offers an online platform for supporting these children emotionally. Forrest et al found that alongside the need for information about cancer and treatments, older children in their study wanted to find out how others coped with a similar situation. Recognising the need for peer support, we have designed the main focus when entering the riprap website to be on stories from teenagers who are going through the experience of having a parent with cancer. So far, 66 stories from teenagers have been submitted to the site – offering an important resource for fellow teenagers in finding out how others are dealing with their situation. Secondly, in order to provide an additional level of peer support, the website has a forum where teenagers can share experiences by posting messages to each other. The stories and the forum are monitored to secure anonymity and a safe environment for teenagers using the site. Thirdly, although we regard the peer support features of the site to be crucial, we are also offering the option for teenagers to ask questions or ask advice from health care professionals. The riprap website is still the only dedicated website in the UK providing this service exclusively to this group of teenagers and we are very pleased to witness that the site is increasingly used by the intended target group. We appreciate the important role that staff in hospitals, primary care and hospices have in making this resource known to potential users and we can supply posters and postcard size contact cards that can be handed out to parents or directly to teenagers who may benefit from using the website. As well as serving as a resource for teenagers, the stories, forum messages and email queries offer us a new insight into the thoughts, concerns and coping strategies of teenagers who have a parent with cancer. We are in the process of collecting data from these resources which we will submit for publication at a later date. Competing interests: None declared