Children and adolescents with cancer: Experiences of their diagnostic itinerary

OBJECTIVE: To comprehend the experiences of children and adolescents with cancer, from the beginning of the signs and symptoms until the diagnosis is confirmed, through reports of their parents and to identify factors that hinder early diagnosis in healthcare services.
METHODOLOGICAL APPROACH: Participants were parents of children and adolescents diagnosed with cancer in 2007, under follow-up in a Brazilian school-hospital. Data collection was carried out using observation and interview, completed with data from secondary source (medical records). Data was subject to qualitative analysis, according to thematic content analysis.
RESULTS AND DISCUSSION: The diagnostic itinerary of children and adolescents with cancer began with the perception that something was wrong with their health. Signs and symptoms as fever, weight loss, nausea, tumor formation, paleness, tiredness, apathy, weakness and abdominal pain were reported. This symptomatology emerges insidiously and has limited response to therapeutics. The confirmation of diagnosis represents a moment of transition, that is, from healthy to sick. This moment brings up a crisis on the dynamics of the family, altering relationships, changing the daily duties, feelings of anguish, rage, frustration, besides intense suffering resulting from the possibility of death.
CONCLUSION: Late diagnosis, delay in searching for medical care and restrictions on access to specific technologies are factors that interfere in the estimates of survivorship of children and adolescents with cancer. In addition, early diagnosis of child-adolescent cancer is a challenge, as the signs and symptoms are unspecific and can be present in the so-called common diseases of childhood. The results of the study will contribute to increase the comprehension of the causes of the delay in diagnosis, establish actions targeting early detection and access to health services.