The first week after a childhood cancer diagnosis — what happens

In the hours after a confirmed diagnosis, the oncology team typically meets with the family to explain the diagnosis in plain language and outline the next steps. The first priority is completing any remaining tests needed to stage the cancer — this may mean a few more blood samples, scans, or a lumbar puncture. You will be given a point of contact, usually a paediatric oncology nurse or coordinator, who you can call with questions. Treatment rarely starts within the first 24 hours — the team takes time to gather all information before recommending a treatment plan. If there is a specific reason for urgency (for example a very high white cell count in leukaemia) the team will tell you clearly and explain why they need to act quickly.

Whether your child is admitted to hospital immediately depends on the type of cancer and how well they are feeling. Children with leukaemia and a very abnormal blood count are usually admitted for monitoring and to begin stabilising treatment quickly. Children with solid tumours who are reasonably well may complete their investigations as outpatients and be admitted when treatment begins. If your child is admitted, most paediatric oncology units allow a parent to stay overnight and some allow both parents. Ask the ward team about their policy — in most units a cot or fold-out bed is provided for a parent. Bring comfortable clothes, phone chargers, and any comfort items for your child.

How much you tell your child depends on their age and maturity. Paediatric psycho-oncologists generally advise being honest in age-appropriate language: young children need to know they are going to the hospital for medicine to make them better, while older children and teenagers often want to understand more about their illness. Avoid saying things like 'you will be fine' as a definitive promise. What children need most is reassurance that they are not alone and that the adults around them are doing everything possible. Most paediatric oncology teams have a child psychologist or counsellor who can guide you through these conversations — ask for a referral if one is not offered automatically.

The speed at which treatment begins depends on the type of cancer. In leukaemia with a very high white cell count, a stabilising step called leucoreduction may begin within one to two days. For most solid tumours — Wilms' tumour, neuroblastoma, brain tumours — the treatment planning process takes one to two weeks: completing staging scans, reviewing biopsy results at a tumour board, and agreeing on a personalised plan. This waiting period feels very long for parents, but it is not wasted time — the decisions made in this phase shape the entire treatment journey. CION Cancer Clinics holds a tumour board review for every child so no single doctor's opinion drives the plan.

The first week is a mixture of medical appointments and unexpected practical demands. Key things to organise: arrange for someone to look after other children at home; notify your employer as early as you are comfortable — many parents need extended leave; contact your health insurance provider to understand what is covered; ask the hospital social worker about financial support schemes available in your state, including government assistance programmes. Keep a notebook or phone app to record every appointment, test result, and question that occurs to you. You do not need to manage all of this alone — the CION team can connect you with a care coordinator who helps families navigate the practicalities.

Getting a second opinion is entirely reasonable and most oncologists welcome it. The diagnosis rests on pathology reports and molecular test results — documents your treating team can share with another centre. A second opinion is especially worth considering if the cancer type is rare, if the diagnosis feels unclear, or if you simply want to feel more confident before committing to a treatment plan. CION Cancer Clinics provides a free written second opinion service — you can bring your child's existing reports and scans to a specialist who will review them and discuss whether the proposed plan is consistent with international guidelines.