A significant number of children of cancer patients may be at risk for emotional and behavioral problems after learning of a parent’s cancer diagnosis. In a new analysis, researchers suggest that family dysfunction before diagnosis may increase a child’s risk of experiencing such problems.

Approximately 21% of all cancer patients with a new cancer diagnosis are age 25 to 54 years, and many may have dependent children living with them at home. Although most children and adolescents cope well with a parent’s illness, some can become highly distressed or develop psychosocial issues. Therefore, knowing which factors may affect a child’s adjustment to a parent’s cancer diagnosis and to develop specific screening tools and health care programs for those children who experience problems is important.

In a recent study led by Birgit Möller, PhD, of the University Medical Center Hamburg-Eppendorf and the University Medical Center Münster in Germany, 235 families—including 402 parents and 324 children age 11 to 21 years—completed questionnaires that assessed emotional and behavioral health. At least one parent in each family had received a cancer diagnosis. The study was published in Cancer (2014; doi: 10.1002/cncr.28644).

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The researchers found that average levels of emotional and behavioral symptoms were increased in children of patients with cancer, compared with norms. From both the parents’ and the children’s perspectives, the best predictor of emotional and behavioral problems was general family dysfunction.

Screening for child mental health problems, family dysfunction, and parental depression can be easily adopted into cancer care so that families in need of support can be identified. “Additional training of oncologists, interdisciplinary approaches, and family-based mental health liaison services are recommended to meet the needs of minor children and their families and to minimize negative long-term effects in children,” she said. Möller and her team developed the Children of Somatically Ill Parents (COSIP) program, a preventive counseling program. The program focuses on family communication, affective involvement of family members, flexible problem solving, mutual support, and parenting issues.