Communicating Prognosis at Diagnosis and Relapse or Progression

  • Brittani K. Seynnaeve
  • Scott H. MaurerEmail author
  • Robert M. Arnold


Communication is the most common procedure in medicine and is a vital component of care in pediatric oncology. A significant body of evidence exists that can guide the conversations between pediatric oncology clinicians and patients and their families. Unique to the field of pediatrics in general is the triangular relationship that exists between the physician, the patient, and the patient’s parents, which requires special consideration when discussing communication. It must be recognized that although substantial data underpin the beneficial impact of clear, compassionate, and honest communication to both parents and in an age-appropriate manner, to children, these conversations are not easy. We cannot diminish the emotions that permeate conversations surrounding poor prognosis or relapse of disease; but this chapter serves to guide discussions with a goal to improve care of patients and their families. While the majority of evidence for honest communication comes from studies in adults, here we will review relevant data as it relates to pediatric oncology followed by how to apply this in pediatric oncology practice.


Communicating prognosis Honest communication Breaking bad news Prognostic information Children Advanced cancer Decision making End-of-life care 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Brittani K. Seynnaeve
    • 1
    • 2
  • Scott H. Maurer
    • 2
    • 3
    Email author
  • Robert M. Arnold
    • 2
    • 4
  1. 1.Pediatric Melanoma Program, Division of Pediatric Hematology/Oncology, UPMC Children’s Hospital of PittsburghPittsburghUSA
  2. 2.University of Pittsburgh School of MedicinePittsburghUSA
  3. 3.Division of Palliative Medicine and Supportive Care, Division of Pediatric Hematology/OncologyUPMC Children’s Hospital of PittsburghPittsburghUSA
  4. 4.Section of Palliative Care and Medical Ethics, Division of General Internal MedicinePittsburghUSA

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