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Palliative care consultation in pediatric oncology

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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.

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References

  1. 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

    Google Scholar 

  2. Himelstein BP (2005) Palliative care in pediatrics. Anesthesiol Clin North America 23:837–856

    Article  PubMed  CAS  Google Scholar 

  3. Thompson LA, Knapp C, Madden V, Shenkman E (2002) Pediatricians’ perceptions of and preferred timing for pediatric palliative care. Pediatrics 123:e777–782

    Article  Google Scholar 

  4. 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

    Article  PubMed  Google Scholar 

  5. 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

    Article  PubMed  Google Scholar 

  6. 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

    Article  PubMed  Google Scholar 

  7. Committee B, Society CP (2008) Advance care planning for paediatric patients. Pediatr Child Health 13:791–96

    Google Scholar 

  8. American Academy of Pediatrics, Committee on Bioethics and Committee on Hospital Care (2000) Palliative care for children. Pediatrics 106:351–357

    Article  Google Scholar 

  9. Himelstein BP, Hilden JM, Boldt AM, Weissman D (2004) Pediatric palliative care. N Engl J Med 350:1752–1762

    Article  PubMed  CAS  Google Scholar 

  10. 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

    Article  PubMed  CAS  Google Scholar 

  11. 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

    Article  PubMed  Google Scholar 

  12. 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

    Article  Google Scholar 

  13. 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

    Article  Google Scholar 

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Conflicts of interest

The authors have no conflicts of interest to declare.

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Correspondence to Donna L. Johnston.

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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

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  • DOI: https://doi.org/10.1007/s00520-011-1152-6

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