Depending on the child's age, they need to know what the process is and often times the nurse or physician-oncologist can be very helpful in providing the parent with some ideas and the right words. Probably the most important point is not to keep secrets from a child since most children can read emotions in other people's faces about such serious illnesses. An open discussion with a child over time and obviously at their developmental level is probably the best approach and many of us think is a very therapeutic way to handle serious illnesses. My teenage daughter has sickle cell anemia. She misses school often when she is in crisis and is having difficulty fitting in with the kids at her high school.
Sickle cell is a very troubling disease for young adolescents.
Many of their peers do not seem to understand the pain and discomfort that is often quite variable. Here, many times, information for her friends with her full knowledge, that is, about the disease can be quite helpful. Again, information that she can share and then secondly, we have often found that an individual buddy, or peer, who can be supportive and assist in social situations, can be a helpful friend. Again, this has to be orchestrated with the full knowledge of the young adolescent. The question on chemotherapy is, for many of us in pediatric medicine, one of the most difficult times in working with families.