Cancer correlates with negative family relationships for pediatric patients with cancer, according to new research presented on Monday, December 5, at the 58th American Society of Hematology Annual Meeting and Exposition in San Diego, CA. The finding is based on data from a newly developed patient-reported outcome tool, recently created as part of the National Institute of Health’s Patient-Reported Outcome Measurement Information System (PROMIS) to evaluate children’s perspectives on family relationships. 

“Family relationships are the subjective experience of feeling involved, important, and accepted in one’s family,” said Craig Erker, MD, at the Medical College of Wisconsin in Milwaukee. “Previous research has demonstrated the impact of cancer on the family from the parent’s perspective. This project sought to determine the impact of cancer and cancer therapy on family relationships in children with cancer and their siblings, both on and off therapy.”

Erker and colleagues hypothesized that siblings of patients with cancer would have worse family relationships than the brother or sister with cancer and that pediatric patients currently undergoing cancer therapy would also have poorer family relationships than childhood cancer survivors. They also projected that the negative relationships would foster difficulties with depression, anxiety, and social relationships. 

Researchers studied pediatric patients with cancer and their siblings, divided into four groups: (a) on-therapy patients, (b) siblings of on-therapy patients, (c) off-therapy patients, and (d) siblings of off-therapy patients. One-hundred and ninety children, aged 8–17 years old, completed the assessment in the cross-sectional study. Forty-eight were on-therapy patients, and 62 were off-therapy patients. Paired data included 25 pairs of on-therapy patients and siblings and 31 pairs of off-therapy patients and siblings. Most of the participants were male, and 65% of patients had leukemia or lymphoma.

Participants used the PROMIS tool, focusing on the family relationships, depression, anxiety, and social relationships domains. The children were prompted to self-report on questions such as: “my family and I have fun together” and “my parents listen to me.” 

The study authors found that the siblings of off-therapy patients had lower family relationship scores than the off-therapy patients, and that off-therapy patients had better family relationship scores than patients currently undergoing treatment. However, no noteworthy variance was found in on-therapy patients’ family relationship scores when compared with their siblings or between the two groups of siblings. Moreover, off-therapy patients communicated better family relationships than their siblings and on-therapy patients.

“This study provides important information for pediatric oncology staff to help identify at-risk families in need of support,” Erker said.