Psychological Support for Pediatric Cancer Patients

Categories: Medical Center News
Siddika Mulchan, Psy.D. And Neuropsychologist Lauren Ayr Volta, Ph.D.

When facing a cancer diagnosis, patients need both excellent medical and psychological care. Connecticut Children’s now has full-time psychologists in its Center for Cancer & Blood Disorders. Siddika Mulchan, Psy.D., and neuropsychologist Lauren Ayr-Volta, Ph.D., are specialists with both medical and psychological training. And they have a special emphasis in hematology and oncology.

Dr. Mulchan and Dr. Ayr-Volta work closely with the clinical staff throughout the course of each child’s cancer treatment. And Dr. Ayr-Volta, as a neuropsychologist, brings additional expertise in brain development and how various medical treatments affect it. In particular, chemotherapy can have profound effects on young brains. Such awareness helps the cancer treatment team prepare parents for what might happen at school or home. The team also equips parents with the knowledge they need to request additional services their child might require.

Pediatric Cancer’s Mind-Body Connection

Behavioral Oncology“As pediatric psychologists,” says Dr. Ayr-Volta, “we understand the medical side of things; we know a lot about your child’s treatment and what they’re going through.”

Drs. Ayr-Volta and Mulchan also understand emotional adjustment. “We know what to watch out for in terms of symptom presentation. We know what is typical to expect and to help families normalize,” says Dr. Ayr-Volta. “We can tell a parent, ‘Of course your teenager is going to be sad with this kind of diagnosis. And this is normal sad versus clinical depression that we need to care for.’”

Prior to the pair’s arrival, patients who needed intensive psychological treatment received a referral to an outside specialist. That doctor might be a specialist in attention deficit/hyperactivity disorder (ADHD), or depression. But it was highly unlikely to find a psychologist with training and experience in hematology and oncology. They would start from a blank slate with each patient. The new caregiver had no familiarity with the child’s cancer diagnosis and treatment plan.

Family-Centered Cancer Care

Adding full-time psychologists in the Hematology/Oncology Division helps Connecticut Children’s provide family-centered care to patients with cancer.  With expertise in the unique challenges of advanced cancer, pediatric psychologists provide insight into the care of each child. They work closely with oncologists, so they know a patient’s current medical situation and changing prognosis. The oncologists relay information about behavioral changes that they observe in patients during the course of treatment.

Their skills can apply to the parents as well as the child. “We had a case when I first started working here,” says Dr. Ayr-Volta, “and we knew the prognosis was very poor. My role was to help Mom, who was getting very anxious and was not taking good care of herself.  That affected her ability to make her son’s end of life as full as possible. My job was to help her be part of this journey, so she didn’t miss it and have more difficulty with grief on the other side.”

Sometimes, the best thing a psychologist can do with an advanced cancer patient is nothing at all. “I have an 8-year-old patient,” Dr. Mulchan says, “and his prognosis is not good. Every time I meet with him, I have this reaction to cherish that moment…because I don’t know when things will go south with him.

“But I also try to put that to one side because I want to give that child an opportunity to just be a kid. I want to interact with him in a real way, not out of pity because he’s going to have a really hard and short life. Giving them those moments helps them live their lives for the time they’ve got.”

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