Responses to Parental Cancer: A Clinical Perspective
Parental cancer constitutes a unique stressor, and newly diagnosed patients often express deep concerns about how their children will adapt to the illness and treatments. Although data on this underserved group of “second-order patients” is growing, the literature has yielded limited practical information for the clinician working with cancer patients who have children at home. The present study examines long-term adjustment in two samples of grown daughters of cancer patients. Subjects reported having experienced significant emotional upheaval and substantial family disruption during the acute phase of their parents' diagnosis and treatments. Many of the family problems were related to difficulties with the healthy parent. Subjects also recalled numerous positive changes during this acute phase of adjustment to the stressor. Over the long term, subjects did not differ from comparison women on several measures of psychological adjustment, suggesting that children of cancer patients are not necessarily at elevated risk for long-term psychological maladjustment. Nevertheless, many subjects continued to experience a lasting subjective impact of their cancer experiences that appeared to be too subtle or existential to be measured by general psychological instruments. Most of these changes were positive, and deriving a sense of benefit from the experience was a near-universal phenomenon. Subjects discussed what helped and hindered their coping efforts, and made a number of recommendations to others facing this family stressor. Inadequate communication about the cancer was identified by many subjects as an impediment to their eventual adjustment.