Parents and caregivers of children undergoing cancer treatment may overestimate the severity of the child’s symptoms and underestimate how well kids are able to manage despite their diagnosis, a US study suggests.

Researchers examined data on symptoms experienced by 482 newly diagnosed childhood cancer patients before treatment initiation and again afterwards, based on responses from children and their adult caregivers on the Patient-Reported Outcomes Measurement Information System for health-related quality of life.

When researchers looked at agreement between child self-reported symptoms and caregiver-reported symptoms, they found moderate agreement for mobility but poor agreement for symptoms like fatigue and psychological stress.

“These findings argue for inclusion of the child’s voice whenever possible, because they suggest that children are the best reporters on their own experiences,” said lead study author, paediatric oncologist Dr Jennifer Mack, of Harvard Medical School, Dana-Farber Cancer Institute and Boston Children’s Hospital, in Massachusetts.