Parenting concerns create challenges for mothers with advanced cancer and dependent children

A new study indicates that parenting concerns are associated with poor health-related quality of life among women with metastatic cancer who are parents of dependent children. Published early online in Cancer, a peer-reviewed journal of the American Cancer Society, the findings highlight the stresses women may face in dealing with family challenges and cancer.

In the United States, cancer is the leading disease-specific cause of early parental death. Women with advanced or incurable cancer who have dependent children are known to experience high rates of depression and anxiety as well as unique parenting challenges. Few studies have examined the parenting factors linked with health-related quality of life in these women, however.

To investigate, Eliza Park, MD of the University of North Carolina, Chapel Hill and her colleagues conducted a web-based survey of psychosocial concerns of 224 women with stage IV solid tumor malignancies who had at least one child under the age of 18 years.

The researchers found that, on average, patients had low health-related quality of life scores. Also, parenting concerns about the impact of their illness on their minor children had a strong negative association with their health-related quality of life.

"There are tens of thousands of parents in the United States living with advanced cancer, and improving their health-related quality of life is critical to patient-centered care for these individuals," said Dr. Park. "Across demographic groups, the overwhelming majority of parents of minor children identify their parental status as central to their identity. Our findings demonstrate that the parenting role is powerfully intertwined with the patient experience."

Dr. Park noted that the study's findings point to the need for interventions to reduce the psychological concerns of parents living with advanced cancer. "To improve the health outcomes for these patients, we need to address the ways in which cancer and parenting mutually intersect. Researchers studying health outcomes of patients can specifically include assessment of parenting concerns among adults with minor or dependent children, and clinicians and families can help parents adjust to the changes in parenting roles that occur because of an advanced cancer diagnosis and treatment."

Shirley Mertz, president of the Metastatic Breast Cancer Network agrees. "The study deserves the attention of healthcare teams across the U.S. as they interact with patients with dependent children. The whole person needs to be treated, not just the disease, and when you are treating a mother, thoughts of children impact that mother's quality of life."

"A mother first worries how she will tell her children about her disease and her impending death. How will her children thrive without her love and care," said Ms. Mertz. "In truth, oncology healthcare teams need to question mothers regularly about their parental stress and offer support and resources—not only to her, but also to her children."

Dr. Park extended thanks to the mothers living with metastatic breast cancer who completed the survey and to the Metastatic Breast Cancer Network, a national patient-led organization that seeks to inform, educate, and empower patients, which distributed the survey.