For Kids Facing Cancer, Treatment Goals May Help with Coping

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Devon Davis has developed a notable sense of style with an array of baseball cap and sneaker combinations in red, white, black, orange and grey. He has more than a dozen colorful matching sets.

Add to that mix a new pair of gleaming white Nikes, which the 15-year-old purchased with a gift card from his family on July 25, the day he underwent a stem cell transplantation to combat acute myeloid leukemia (AML). On that day, clinicians at MD Anderson Cancer Center in Houston brought in bone marrow—donated by Devon’s twin brother. To mark the occasion, a hospital chaplain administered a blessing and then everyone joined in to sing a round of “Happy Birthday.”

“They say it’s a rebirth—the day that you’re reborn,” Devon says, describing the scene from his hospital room a month later.

The ceremony and hoopla surrounding a stem cell transplantation is one of the more high-profile ways to commemorate a treatment milestone. But for children and teens with cancer, it’s also important to mark more incremental goals, whether it’s completing a chemotherapy session or a scary lab test, mental health clinicians say. To a young child especially, a year can seem more like infinity. “Children definitely respond favorably to short-term incentives and prizes,” says Yvette Drake McLin, an assistant clinical professor of psychiatry at City of Hope in Los Angeles.

At the same time, parents should stay clued in to their own child’s personality and coping style, says Regina Melchor-Beaupre, a licensed clinical psychologist practicing in Miami. Whether a child wants to be feted, or even to acknowledge their cancer, might shift significantly as the months and years pass. “We have this assumption that cancer is a static diagnosis, and it is not,” says Melchor-Beaupre, who completed a psycho-oncology clinical fellowship at Memorial Sloan-Kettering Cancer Center.

“With children, it’s even more complicated because the children themselves are moving targets,” she says. “They continue to develop cognitively, psychologically, physically, spiritually, morally.”

As children navigate a life-threatening diagnosis, the objects they bring along or the gifts they receive can become emotional touchstones, accruing value or power over time. A cozy “blankie,” a calming force for any child, can transform into a protective shield during unsettling experiences, such as an MRI test, Melchor-Beaupre says.

The child psychologist recalls one young girl, about six years old, who had always dreamed of a dollhouse. It became a family project, something they all embraced and looked forward to creating after chemotherapy ended. The girl’s father built some furniture. The mother sewed little blankets and pillows. The girl helped with painting.

“It’s the whole idea that it’s our cancer, and it’s not just your cancer,” Melchor-Beaupre says. “So the person doesn’t feel alone in this endeavor. This is a dollhouse that she will always have. And it will be that meaning-making transitional object.”

I look at them. I count them. You can see the struggle through the beads. You can see the good through it, too.

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