By Interviewed by Midweek Staff
Wednesday – December 31, 2008
Dr. Diane Thompson
Queen’s Medical Center Women’s Center medical director and Cancer Center director
Where did you receive your schooling and training?
I did my medical school training in Ohio at Wright State University and I completed my psychiatry residency at the University of Pittsburgh, where I did special training in women’s health and psychiatric oncology. After my residency, my husband and I moved here to Hawaii.
How long have you been practicing?
What exactly is a psychiatric oncologist?
I’m a psychiatrist who specializes in dealing with cancer patients. It’s a unique specialty that is getting more recognition as we begin to focus on the overall quality of life of cancer patients. Psychiatric oncology is very different from general psychiatry. For the most part, these are patients who have never had any kind of psychiatric illness before. These are patients who are specifically dealing with changes in mood associated with their cancer diagnosis and the treatment.
What is a typical work week like for you?
My typical work week is divided between the Women’s Center and the Cancer Center. My job with cancer patients is to make sure that there are programs to support the cancer patients. One closest to my heart is the CLIMB program. This is a program for children whose parents have cancer. We also offer many other support groups and community education programs through the cancer center.
Can you talk in detail about what the CLIMB program offers?
It’s a national program (founded by The Children’s Treehouse Foundation), and CLIMB® stands for Children’s Lives Include Moments of Bravery. It is a four- to six-week support program where children meet for one evening each week. They come in with their parents. The children and their parents have a light dinner together, and after that the children leave the parents and begin the program. We give them a tour of different parts of the hospital so they can see what the chemotherapy and radiation oncology departments look like. It takes a lot of the scariness out of the equation, because their imagination of where Mom and Dad are going is often different from the reality. Then on different nights we do different types of art therapy and discuss emotions that they are experiencing. At the end of the evening, the parent and the child are able to talk about what the child did. Hopefully that will really open up the communication and they’ll just begin talking more – that’s the real goal of the program.
Are the art activities designed for each specific age group, or do all the children do the same activity?
The program is open to children ages 5-18, and the general activities are applicable to the full age range. But certainly the discussion varies. For example, the younger children might draw a Mardi Gras mask with an expression on it, which is the expression or emotion they felt when their parent was first diagnosed. It’s amazing the different emotions that children have. Teenagers might also draw something, but their picture of how they felt may be very different or more abstract. Just seeing that there are others their age going through this can be very therapeutic for them.
What are the biggest differences in working with children versus working with adults?
When we work with children, we really do work with the whole family, because when parents are faced with cancer, children are affected. It’s important that the children and the parents are on the same page, and that’s often not the case. One of the most-common questions I’ve been asked over the years is, ‘How do I talk to my children about my diagnosis?’ Or, ‘Do I tell my child that my husband has stage 4 colon cancer?’People often need help just figuring out how to process the diagnosis themselves. When children are involved, there are additional questions like, ‘How do I put it in words that my child can understand?
Is there ever a clear-cut answer to those questions, or does it vary depending on the case and the age of the child?
Children are perceptive, they know something is wrong, so hiding it can often make things worse because children tend to imagine the worst scenario.Their ideas of what happens when Mom or Dad gets chemotherapy or radiation may be very different from the reality.
What are the most-common questions you are asked by children whose parents have been diagnosed with cancer?
It can be just about any question from, ‘What is going to happen to my mom?’to ‘Is my mom’s hair ever going to grow back?’And you may wonder, why didn’t that child just ask Mom? Again, children are perceptive and they may sense that Mom may get upset or cry, and children try to avoid that. That is why the CLIMB program is so helpful, it promotes communication.
What advice do you give to parents who have infants, where they aren’t able to tell them what’s going on, especially in a terminal cancer case?
Regardless of the child’s age, this is a highly emotional issue. With the support of our multi-disciplinary team, including the social worker and psychiatrist in the cancer center, we can help patients as they face these challenges. We might ask them about information they would like to share with their child in the future, or suggest taking some time to write some stories and things that the child can look at in different times in their lives. One very special patient came to me at a point where his cancer had progressed to an end stage. He had been a really active, responsible man, and he felt awful because all of a sudden everyone had to take care of him. He felt like he was not contributing. He said, ‘I feel totally helpless, all I do is sit all day in this wheelchair.’I asked him if he has breakfast with his girls. And he said yes. Then I asked him, ‘Do you ever tell them they look pretty as they leave for school or tell them you are proud when they show you their schoolwork?’ And again he said yes. Then I told him, ‘That’s what they’re going to remember for the rest of their lives. That self-esteem that you’re giving to them now is an incredible gift, so you really are an important part of the family right now. No matter what age that the kids are, there are things we can do to help the parents and the children.
Is there a particular age that the kids take it the hardest?
It’s hard at all ages. Generally at around age 5 children really start to become aware of their parents and the fact that they can get sick. As children mature, the emotions can become more complex.