ASCO: You’re listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the world’s leading professional organization for doctors who care for people with cancer. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Cancer research discussed in this podcast is ongoing, so the data described here may change as research progresses. Brielle Gregory Collins: Hi, everyone. I'm Brielle Gregory Collins, a member of the Cancer.Net content team, and I'll be your host for today's Cancer.Net podcast. Cancer.Net is the patient information website of ASCO, the American Society of Clinical Oncology. Today, we're going to be discussing how parents can talk with their children about a metastatic cancer diagnosis and their prognosis. The information discussed in this podcast is based on a study published in JCO Oncology Practice titled, “Talking with Children About Prognosis: The Decisions and Experiences of Mothers with Metastatic Cancer.” Our guests today are Dr. Eliza Park and Dr. Paula Rauch. Dr. Park served as the lead author on the study, and Dr. Rauch served as a co-author on the study. Dr. Park is the deputy director for the UNC Lineberger Comprehensive Cancer Support Program at the University of North Carolina at Chapel Hill in Chapel Hill, North Carolina. Thanks for joining us today, Dr. Park. Dr. Eliza Park: Thank you for having me. Brielle Gregory Collins: Dr. Rauch is the director of the Marjorie E. Korff Parenting At a Challenging Time, or PACT, program at Massachusetts General Hospital in Boston, Massachusetts. She is also a member of the Cancer.Net Psychosocial Oncology Advisory Panel. Thanks for joining us today, Dr. Rauch. Dr. Paula Rauch: My pleasure. Brielle Gregory Collins: Before we begin, we should mention that Dr. Rauch and Dr. Park do not have any relationships to disclose related to this podcast, but you can find their full disclosure statements on Cancer.Net. Now, to begin, Dr. Rauch, what are some of the challenges or fears parents with metastatic cancer have in talking with their children about their illness? Dr. Rauch: I think as parents themselves are adjusting to their own diagnosis, whether it's the parent who is living with the cancer or their co-parent, they are hoping to not burden their children, to not worry them too much, and at the same time, they want to be sure to include their children in this very important event that's happening in the life of the family, and that is a tough balance for any parent. Brielle Gregory Collins: And I recognize that these conversations might be different for parents who don't have metastatic cancer. So what ways are these discussions different when parents have non-metastatic cancer? Dr. Rauch: I think for me, the easiest way to talk about this is to think about how we encourage parents to talk with their children about cancer, and that varies depending on the age of the child. But 1 way that we often talk with parents that they may explain cancer to younger children is to talk about the fact that our bodies are made up of millions and millions and millions of teeny-weeny, little cells that are kind of like Legos, and that what cancer cells are, they're kind of like Legos that are mixed up and don't fit together right and can't do their jobs right. When someone has an early-stage cancer, the goal of treatment by their medical team is to be able to get rid of the cancer completely. The goal of treatment when someone has metastatic disease, when those mixed-up cells are in more than 1 place in someone's body and the treatment can't make them go away com