Reader at­tempts to ex­plain can­cer to cu­ri­ous 10-year -old

The Hazleton Standard-Speaker - - WEATHER / HEALTH - EL­IZ­A­BETH KO, M.D. Ask the Doc­tors EVE GLAZIER, M.D. EVE GLAZIER, M.D., MBA, is an in­ternist and as­sis­tant pro­fes­sor of medicine at UCLA Health. EL­IZ­A­BETH KO, M.D., is an in­ternist and pri­mary care physi­cian at UCLA Health. Send your ques­tions to ask­thedo

DEAR DOC­TORS: Ever since my fa­ther was di­ag­nosed with can­cer last sum­mer, our 10- year-old son keeps ask­ing my wife and me to ex­plain ex­actly what can­cer is. Our an­swers don’t seem to sat­isfy him, so we won­der: What would you say to a 10-year-old to ex­plain this dis­ease?

DEAR READER: It’ s quite pos­si­ble that you and your wife are do­ing a good job with the “what is it” por­tion of your an­swer. Your son’s con­tin­ued re­turn to the ques­tion may in­di­cate that he has ad­di­tional ques­tions that he can’t quite for­mu­late, or which he may find too dif­fi­cult or scary to ask.

When kids ask about can­cer, their ques­tions of­ten ex­ist on mul­ti­ple levels. There are the nuts and bolts of what can­cer is and how it de­vel­ops. There’s the cu­rios­ity and anx­i­ety re g ard­ing treat­ment — what it en­tails, whether it works, and how much pain or dis­com­fort are in­volved. And there’s the dawn­ing aware­ness that there are fac­tors in life that may be be­yond our con­trol.

Lis­ten for clues in the way that he re­peats his ques­tions. Is the sub­text about pain? Is it about whether he or some­one else in the fam­ily will get can­cer? Is it about dy­ing? Then re­state the ques­tion with the added con­text and see if the con­ver­sa­tion moved for­ward from there. It can take mul­ti­ple tries over a pe­riod of time to get to the heart of it.

As for the ba­sic bi­o­log­i­cal ex­pla­na­tion, can­cer oc­curs when cells in the body go hay­wire and sud­denly be­gin to mul­ti­ply in a nun con­trolled way.

Un­like nor­mal cells, which grow in spe­cific places and at cer­tain speeds, can­cer cells ig­nore all the rules. They di­vide so quickly that they take over the en­vi­ron­ment and be­gin to dam­age the nor­mal cells. It’s as if a gang of un­ruly kids were to come into a school class­room and start to run wild. They would be so loud and dis­rup­tive that the stu­dents and the teach­ing en­vi­ron­ment would be­come over­whelmed.

That dis­rup­tion is the rea­son can­cers can be­come deadly. Our bod­ies are made up of many finely tuned sys­tems, each de­pen­dent on cer­tain con­di­tions to func­tion prop­erly.

When one sys­tem, such as the lungs, the kid­neys, the stom­ach or the brain, be­comes over­whelmed by the chaos and dis­or­der caused by can­cer, the en­tire body be­gins to suf­fer.

Clus­ters of can­cer cells, called tu­mors, can cut off air­ways in the lungs, block pas­sage­ways into and out of or­gans, gen­er­ate blood ves­sels that hi­jack oxy­gen and nu­tri­ents from nor­mal tis­sues, dam­age nerve sand up­set the crit­i­cal bal­ance of a host of bi­o­log­i­cal pro­cesses. To re­store or­der, medicines and treat­ments that will kill the rogue cells while spar­ing nor­mal cells must be ad­min­is­tered. Surgery is another way to re­move can­cer­ous cells from the body.

At 10 years old, chil­dren have be­gun to grasp con­cepts that verge on the com­plex. To ex­plain the big pic­ture, it helps to use analo­gies drawn from their own realm of ex­pe­ri­ence. When get­ting into specifics, books and il­lus­tra­tions are valu­able teach­ing aids. The Amer­i­can Can­cer So­ci­ety’ s web­site (can­cer.org) is an ex­cel­lent source of in­for­ma­tion on all as­pects of can­cer. The group’s pub­li­ca­tions in­clude books on talk­ing to kids about can­cer, which many par­ents and guardians have found to be help­ful.

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