Doctor-patient relationships in primary care Doctor, help! My child has cancer

The following pair of articles started with a personal view from the mother of a child who had died of neuroblastoma. In it she argued that her general practitioner, although generally supportive, should have taken more of the initiative in offering help during her child's illness. We invited her general practitioner to respond.

The parent

A call for help may be an obvious one, from parents trying to come to terms with their child having cancer, or a hidden plea from parents outwardly coping with the demands thrust on them but who are inwardly desperately struggling. Are both these calls for help recognised and responded to by the family doctor?

My family's personal experience over the past 18 months has led me to ask many questions about the role of a general practitioner when a child patient develops cancer. In seeking answers, I have had discussions with several general practitioners, hospital doctors, and support staff and with other families affected by neuroblastoma or other life threatening childhood diseases. Each situation is unique, each family has individual needs, and each general practitioner has his or her own approach. However, there seem to be certain general patterns and problems. Before discussing these, I present our case history, which illustrates why I feel so strongly about the issue and believe that there is much to be learnt and changed.