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Study reveals little opposition to early palliative care for symptom management in pediatric oncology

A recently published study shows that very few children with cancer and their families are opposed to receiving palliative care interventions to manage symptoms early on in the treatment of the disease.

Writing for Oncology Nurse Advisor Shannon Aymes, MD reports on a study published in JAMA Oncology1 that children with cancer report high levels of suffering early in the treatment period and most were not opposed to receiving palliative care interventions.

The study reveals that although early pallaitive care is considered an important part of optimal care for cancer patients, is it often perceived as unwanted and unneeded early on in paediatric oncology.

The authors were keen to better understand patients’ and parents’ perceptions of palliative care and symptom burden at the beginning stages of treatment for childhood cancers.

They report that respondents cited nausea, decreased appetite and pain as common symptoms at this stage of treatment as well as anxiety, constipation, depression, and diarrhea.

Many of the patients who reported suffering from symptoms indicated that a specific symptom caused a “great deal” of suffering.

Findings
Their findings suggest that children with cancer and their families are not opposed to the early intervention of palliative care, writing, “Pediatric oncology patients experience a high degree of symptom-related suffering early in cancer therapy, and very few patients or parents in this study expressed negative attitudes toward early palliative care”.

The article goes on to quote from an accompanying editorial2 written by Jennifer W. Mack, MD, MPH, of the Division of Pediatric Hematology/Oncology at Boston Children’s Hospital where she states, “These data suggest that pediatric oncologists such as myself do not sufficiently meet one of our fundamental obligations to these children – we are not adequately treating their suffering. We must think about how best to respond and remedy this gap.”

References
1. Levine DR, Mandrell BN, Sykes A, et al. Patients’ and parents’ needs, attitudes, and perceptions about early palliative care integration in pediatric oncology. JAMA Oncol. 2017 Mar 9. doi: 10.1001/jamaoncol.2017.0368 [Epub ahead of print]

2. Mack JW. Pediatric palliative care — a shared priority. JAMA Oncol. 2017 Mar 9. doi: 10.1001/jamaoncol.2017.0351 [Epub ahead of print]

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