Disclosing a diagnosis in African pediatric oncology units

Disclosing the diagnosis to families is an extremely difficult moment not just forthe families involved, but also for the doctors who have to communicate this diagnosis. Despitethis, disclosing a cancer diagnosis should be considered as a strategic moment, which can clearlyaffect the course of treatment. This statement is even truer for African pediatric oncology units,where socioeconomic and cultural specificities mean that one out of four families will drop outand abandon the ongoing treatment. It is therefore important to note that the parent thatdoctors have the opportunity to meet and inform of the cancer diagnosis is equally likely towithdraw with his sick child without gaining access to medical care. Beyond economic reasons,these withdrawals are linked to a lack of knowledge of the disease and the treatment or tothe influence of local beliefs. In a part of the world where access to education is limited andwith a high level of illiteracy, the majority of parents only have one cultural interpretationof the disease. These parents are convinced that cancer is linked to a spell cast on the child,and they therefore prefer to take the child to a traditional doctor. It appeared to us thatbetter information on the disease and treatment needed, will allow these families to make aninformed choice regarding the type of medicine they wish for their children. For this reason,we wanted to look at the way in which are carried out the said "disclosing of diagnosis", inorder to evaluate them. Field work and a multicentred investigation conducted with parentsand African caregivers, made it possible for us to achieve this objective and to offer prospectsfor improvement by the creation of an "African guide to disclosing the diagnosis of pediatriccancer".