Abstract
Purpose
Pediatric oncology patients benefit from the involvement of palliative care. This study examined the timing of palliative care consultation.
Methods
A retrospective chart review was performed on all children from the Children’s Hospital of Eastern Ontario with a diagnosis of malignancy.
Results
Since 2006, 50 children with cancer were referred to palliative care. The mean time of referral after diagnosis was 461 days, with 8(16%) referred within 30 days of diagnosis, 13(26%) before a relapse occurred, 20(40%) after the first relapse, and 9(18%) after ≥2 relapses. Of the 40 patients referred to palliative care who died, 28% died at home, 30% in hospital, and 43% in hospice. Of the 49 oncology patients who died during the study period, 88% received a palliative care consult prior to death.
Conclusions
The majority of children in this study who died from cancer were referred to palliative care. Oncologists should strive to refer patients early in their disease.
Similar content being viewed by others
References
Field MJ, Behrman R (2003) When children die: improving palliative and end-of-life care for children and their families. National Academies Press, Washington D.C., pp 19–71
Himelstein BP (2005) Palliative care in pediatrics. Anesthesiol Clin North America 23:837–856
Thompson LA, Knapp C, Madden V, Shenkman E (2002) Pediatricians’ perceptions of and preferred timing for pediatric palliative care. Pediatrics 123:e777–782
Zhukovsky DS, Herzog CE, Kaur G, Palmer JL, Bruera E (2009) The impact of palliative care consultation on symptom assessment, communication needs, and palliative interventions in pediatric patients with cancer. J Palliat Med 12:343–349
Wolfe J, Hammel JF, Edwards EK, Duncan J, Comeau M, Breyer J, Aldridge SA, Grier HE, Berde C, Dussel V, Weeks JC (2008) Easing of suffering in children with cancer at the end of life: is care changing? J Clin Oncol 26:1717–1723
Widger K, Davies D, Drouin DJ, Beaune L, Daoust L, Farran RP, Humbert N, Nalewajek F, Rattray M, Rugg M, Bishop M (2007) Pediatric patients receiving palliative care in Canada. Arch Pediatr Adolesc Med 161:597–602
Committee B, Society CP (2008) Advance care planning for paediatric patients. Pediatr Child Health 13:791–96
American Academy of Pediatrics, Committee on Bioethics and Committee on Hospital Care (2000) Palliative care for children. Pediatrics 106:351–357
Himelstein BP, Hilden JM, Boldt AM, Weissman D (2004) Pediatric palliative care. N Engl J Med 350:1752–1762
Vadeboncoeur CM, Splinter WM, Rattray M, Johnston DL, Coulombe L (2010) A paediatric palliative care programme in development: trends in referral and location of death. Arch Dis Child 95:686–689
Johnston DL, Nagel K, Friedman DL, Meza JL, Hurwitz CA, Friebert S (2008) Availability and utilization of palliative care and end-of-life services for pediatric oncology patients: A report from the Children’s Oncology Group Palliative Care Committee. J Clin Oncol 26:4646–4650
Pritchard M, Burghen E, Srivastava DK, Okuma J, Anderson L, Powell B, Furman WL, Hinds PS (2008) Cancer-related symptoms most concerning to parents during the last week and last day of their child’s life. Pediatrics 121:1301–1309
Wolfe J, Grier H, Klar N, Levin SB, Ellenbogen JM, Salem-Schatz S, Emanuel EJ, Weeks JC (2000) Symptoms and suffering at the end of life in children with cancer. N Engl J Med 343:326–333
Conflicts of interest
The authors have no conflicts of interest to declare.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Johnston, D.L., Vadeboncoeur, C. Palliative care consultation in pediatric oncology. Support Care Cancer 20, 799–803 (2012). https://doi.org/10.1007/s00520-011-1152-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00520-011-1152-6