“We’re going to get through this together”: emotional support in advanced childhood cancer

Families in the study emphasized something simple: when the situation feels overwhelming, clarity itself becomes a form of emotional support. Parents emphasized the need for clinicians to be honest and straightforward, even when the truth is painful.

As one parent put it: “Be direct, be truthful…give the parents all the facts to make the best decisions.” (Parent, cohort 2)

Clinicians also recognized the importance of maintaining consistent availability for follow‑up communication. Some families mentioned that being able to contact the clinician afterward, via email or phone, gave them practical and emotional reassurance as they processed new information.





2. Time, space, presence



One of the most universal requests from families was simple: don’t rush us.
Parents described how devastating it felt when bad news was delivered and the clinician quickly exited the room. One said :

• “Don’t give me bad news and run out…sit with me until we can get things together.” (Parent, cohort 3)

Patients wanted private, quiet spaces to process what they just heard, no hallway conversations and no interruptions. Some teenagers wanted clinicians to briefly step out so they could gather themselves before continuing.
Oncologists agreed, acknowledging their own need to block time for a moment:

• “When I sit down, I expect to have a significant amount of time uninterrupted.” (Oncologist 5)  

3. Emotional validation




Nearly every participant identified emotional validation as essential.
Parents noted that even small expressions of shared emotion can be incredibly meaningful.
One parent described how much it mattered to see their oncologist visibly moved:

• “It gave us comfort, knowing he felt what we felt.” (Parent, cohort 3)

It’s important to note that responses varied regarding physical expressions of empathy: some individuals welcomed gestures such as a hand on the shoulder, while others preferred no physical contact.  

This really shows how sensitive these moments are and why it’s essential to tailor the approach to each family’s preferences and needs.


4. Preserving realist hope



Patients and parents value the preservation of hope, even when prognosis is poor. Hope was not synonymous with cure for these families but may reflect achievable goals, such as symptom control, going to school, be with their friends, etc. A parent captured this beautifully:

• “If it’s a 1% chance, my daughter is the 1%, and you better treat her like the 1%.” (Parent, cohort 4)

At the same time, oncologists expressed caution around avoiding false hope, but families emphasized that honest hope, focused on achievable goals, was not misleading but life‑affirming.

This underscores the importance of balancing realism with empathy when supporting families between visits.



What this means for our practice



This study shows that emotional support isn’t an add‑on, especially when the prognosis is poor. Families expect presence, clarity, honesty, empathy and a bit more time than the system usually allows.

And for clinicians, offering this doesn’t require new tools or treatments: sometimes, it simply means saying, sincerely: “We’re going to get through this together.”


            Read next: Pediatric leukemia: what if everything happens at the cell surface?




About the Author – Carolina Lima

Anaesthesiology specialist Carolina is a specialist in Anaesthesiology with a deep passion for learning and sharing medical knowledge. Dedicated to advancing the field, Dr. Lima strives to bring fresh, evidence-based insights to the medical community. Viewing medicine not merely as a profession but as a lifelong journey of continuous learning, Dr. Lima is committed to making complex information clear, practical, and useful for healthcare professionals around the world.