MDNews - Cleveland-Akron-Canton

++++++++++++++++++++++++++++++++ + +++ + SPECiAL SECTioN: CANCER +++ ++++++++++++++++++++++++++++++++ Increased Palliative Care Needed for Pediatric Oncology Patients by Sarah Friebert, mD A a child is more than just diagnosing an illness. It may be the scariest news the child's parents have ever received. It means the child may be pulled out of school and away from friends for a long period of time. And it means there will be a lot of difficult decisions to make down the road. A diagnosis is the first step in a cancer care journey — which can be overwhelming to the strongest of patients and families. But what is often missed at this stage is palliative care. While the patient's oncology team focuses on treatment, a palliative care team needs to be brought in to care for other important aspects of the patient's life. Support may include managing troublesome symptoms such as fatigue and pain, making home visits, explaining financial implications, providing support for siblings, helping families transition from one level of care to another and offering spiritual guidance. If treatment is not successful, additional expertise includes managing end of life at home. The primary goal of palliative care is to work alongside oncologists and their treatment teams to provide patients and their families with the additional support they need during and after cancer-directed therapy — no matter the severity of the disease. 36 CANCEr dIAGNoSIS For | Cleveland/Akron/Canton MD News The interdisciplina r y tea m may include physicians, nurses and nurse practitioners, social workers, psychologists, child life staff, bereavement coordinators, expressive therapists, pharmacists, volunteers, spiritual care coordinators, dietitians, rehab therapists and massotherapists. A recent New England Journal of Medicine study examined the effects of introducing palliative care early after diagnosis for patients with metastatic non-small-cell lung cancer. Investigators found that patients who received early palliative care had a better quality of life, fewer depressive symptoms, plus longer survival rates. There have also been several studies that have shown pediatric patients who receive more support cope better in general. Particularly with children, the need for additional support is invaluable. Kids don't have the experience of living a full, healthy life to put what they're going through in perspective. Depending on their age, they may feel isolated after being away from their friends, experience depression and anxiety, or they may not be verbally or emotionally able to process what's happening to them. Palliative care can be the extra mortar between the bricks to create an even more solid wall of support. Palliative care teams can also offer important support to ■ mdNEWS.Com ■ NovEmBEr /dECEmBEr oncology treatment teams as well. According to a 2011 public opinion research study commissioned by the Center to Advance Palliative Care, with support from the American Cancer Society and the American Cancer Society Cancer Action Network, there is not only misunderstanding about palliative care among consumers, but also among physicians. This is particularly true in how it's differentiated from hospice and end-of-life care. Palliative care in this study is defined as "… specialized medical care for people with serious illnesses. This type of care is focused on providing patients with relief from the symptoms, pain and stress of a serious illness — whatever the diagnosis." Palliative care should not be brought into the picture only at the end of life. As a recognized medical specialty, it should be standard of care any time a child is diagnosed with cancer or another serious illness. To not offer it at the beginning of a difficult journey is to deprive children and their families of valuable care and resources. Dr. Sarah Friebert is Director of Pediatric Palliative Care at Akron Children's Hospital and Professor of Pediatrics at Northeast Ohio Medical University. She is board-certified in Pediatrics and Pediatric Hematology/ Oncolog y, as well as Hospice and Palliative Medicine. ■

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