Cancer disclosure to children by parenting patients: A retrospective observational study in Akita Prefecture, Japan

Objective This study investigated how parents with cancer disclose their diagnosis to their children using initial telephone consultation data. Materials and Methods This retrospective observational study was conducted using data from consultations received between January 2017 and February 2024 through the Akita CLIMB🄬 Program, which supports patients with cancer who have children. The consultation data included information on participants’ demographics (e.g., age, sex, and cancer type) and whether the parent disclosed the cancer to the child, the child’s reactions, and related concerns. Basic attributes were analyzed descriptively, and consultation content was qualitatively categorized. Results Data from 388 parents were analyzed. Breast cancer was the most common type of cancer (270 patients, 69.6%). Of the parents, 35.8% had one child and 64.2% had two, and the children’s mean age was 8.5 ± 2.6 years. Only 137 (35.3 %) parents disclosed their diagnosis. Parents who informed their children about their cancer regarded them as integral members of the family and prioritized maintaining a peaceful daily life while discussing the illness. Children exhibited proactive responses, such as encouraging their parents and suggesting ways to support the family. On the other hand, many parents who did not inform their children about their cancer cited fear of their children's reactions and their own inability to cope as the reason. Children who were not informed about the cancer exhibited anxiety and confusion, often questioning their parents' behavior. Conclusion Communicating about cancer fosters trust and stability within the family, but parents often face psychological burdens that can become a barrier. Children’s responses indicated a desire to help, whereas non-disclosure could exacerbate anxiety and confusion. It is essential to provide communication strategies and information tailored to the child's developmental stage to help parents appropriately convey their cancer diagnosis.