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Monday, 5 March, 2001, 01:30 GMT
'Parents can help diagnose cancer'
Chemotherapy
Childhood cancers can be difficult to spot
Health professionals should listen carefully to parents when diagnosing childhood cancers, say researchers.

A study by a team from the University of Leicester found that some GPs tended to ignore what parents said - even though they had valuable insights that could have speeded up diagnosis.

The researchers conducted interviews with 20 parents of children with cancer.

The first signs of cancer in children are often vague and non-specific. They can include tiredness, irritability and stomach ache.

However, the researchers found that parents often assumed that these symptoms were the result of a minor illness and initially tried to manage them at home.

Many only sought medical help when the symptoms failed to clear up, or when new and more alarming symptoms developed.

Persuading doctors

But some parents reported difficulty in persuading doctors that there was something wrong with their child.

They also said they experienced long delays in getting appointments with specialists.

GPs often tended to assume that children's symptoms were due to minor illnesses at first consultation - drawing the same initial conclusion as the parents themselves.

The researchers point out that it is not unreasonable to put these symptoms down to a minor illness, as many of the very early symptoms of cancer are virtually indistinguishable from other common childhood illnesses.

They also stress that GPs were able to detect cancers such as leukaemia relatively quickly.

However, the study found that children who had cancers that were more difficult to diagnose had greater problems in being taken seriously by doctors.

Two children in the survey were never referred to specialists. Another five reported long delays in getting hospital appointments, and said that the children deteriorated while they waited.

Some parents began to resort to visits to A&E or to private doctors to try to get the attention they felt their child needed.

Some children were only diagnosed when a medical crisis, such as kidney failure, developed.

Partnership

In a statement, researchers Dr Mary Dixon-Woods and Dr David Heney said: "Many of the very early symptoms of childhood cancer mimic those of common minor illnesses, and there is no easy way of telling them apart at the early stages.

"What our work does is to show the importance of partnership between doctors and parents in working towards a diagnosis when a child keeps returning with symptoms that seem to be getting worse.

"Most of the time there will be nothing seriously wrong with the child, but very occasionally it will turn out that the child has cancer.

"We need to have ways of dealing with these rare and difficult to diagnose health problems, and our study shows how doctors can learn from patients."

Professor Christine Eiser, Cancer Research Campaign Professor of Health Psychology at the University of Sheffield, said: "We have been collecting similar data from parents for many years, and sadly it is true that some families do feel resentful about how long it can take to get a diagnosis, and this can be put down to doctors dismissing parental concerns."

However, Professor Eiser warned that sometimes parents did not always have a clear memory of the diagnostic process - and sometimes gave false significance to inconsequential events.

But she added: "It is important that doctors are trained to communicate with parents and understand about normal child development."

The research is published in The Lancet medical journal.

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