Parents need to be helped to know how to talk about cancer with their children

October 03, 2015

Cancer is relatively common among women of childbearing age. Although the importance of communication with patients and their families has been recognised, relatively little has been published about communication with children when their parent is newly diagnosed as having cancer.

To explore how children are affected by breast cancer in the family, researchers in Oxford interviewed 37 mothers with early breast cancer and 31 of their children aged between 6 and 18 years.

They found that, even before their mother's diagnosis, children were much more aware of cancer as a life threatening illness than their parents and other adults realised.

The main sources of their information were television soap operas, health campaigns, and celebrities, as well as direct experience of relatives or friends' parents with cancer.

Parents sometimes misunderstood their children's reactions and underestimated the emotional impact or did not recognise the children's need for more preparation and information about the illness and its treatment.

Parents are often unaware how much their children know and, often reeling from the diagnosis themselves, may not be in the best position to decide what and how to tell their children, say the authors.

As part of their care, parents newly diagnosed with a life threatening illness need to be supported to think about how they will talk to their children, say the authors. General practitioners, hospital specialists, and nurses are well placed to help with these concerns, and if necessary to be involved in discussions with the children, they add.

Further work is also needed to develop and evaluate information for children of parents with cancer about cancer and its treatments, they conclude.

bmj

The researchers now show that mice lacking FSH or its receptor become resistant to bone loss despite severe loss of ovarian function. In mice with normal ovaries and approximately half the normal concentration of FSH, bone mass increased due to a decline in bone resorption by cells known as osteoclasts, which break down bone. Indeed, they report, FSH stimulates receptors found on the surface of bone-degrading osteoclasts and their precursors, leading to the bone cells' formation and function.

The study suggests that FSH plays a role in the normal process by which bone is mobilized by osteoclasts before it can be replaced, Zaidi said.

"As you run or walk throughout life, microcracks develop in bone," he explained. "Therefore, bone remodeling and replacement with new bone is required to maintain skeletal integrity. Osteoclasts essentially dig around those cracks to clear the way for repairs."

In combination with the research group's earlier finding that thyroid-stimulating hormone directly regulates the skeleton, the findings revise the understanding of how pituitary-derived hormones function, Zaidi added. Scientist had thought pituitary hormones acted primarily through their effects on other endocrine glands.

"This should change the textbook picture of pituitary hormone physiology," he said.

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