| Supportive care for children with cancer. | |
| | |
MedLine Citation:
|
PMID: 21600366 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
In developed countries the survival rate of children with cancer exceeds 75%. Optimal supportive care is necessary to deliver the burdensome treatment protocols. As the intensity of primary treatment has escalated, so have the side effects like myelosuppression and infection. Children who receive aggressive chemotherapy have an approximately 40% chance of experiencing a febrile episode during neutropenia. Patients should be treated with intravenous broad-spectrum antibiotics even if they have been assessed as low risk. There is no proof of the usefulness of special measures concerning food products during neutropenia. In contrast to adults, most children who receive chemotherapy will have a central venous catheter inserted (≥80-90%). The two most important complications are infections and thrombosis. The Multinational Association of Supportive Care in Cancer (MASCC) guideline in adult oncology is available to prevent and treat nausea and vomiting. In highly emetogenic chemotherapy, the combination of a serotonin receptor antagonist plus a corticosteroid should be used. Pain in children with cancer is mainly therapy- or procedure-related. As in adults, the stepladder of the World Health Organization (WHO) is used as a guideline for adequate treatment of pain. It is of utmost importance that children receive optimal pain management during the initial procedures. Sedation is performed in many different ways. Palliative care starts with information about the incurability of the disease for parents, the patient, and the professionals involved. Children in palliative care for progressive cancer should be at home as much as possible, even in the terminal phase. The organization of health care and the facilities differ at a national level, so the requirements and choices for optimal care vary by country. Palliative care has to be incorporated into the structural base in the training of pediatricians and pediatric nurses. The first goal of palliative care is to reduce distressing symptoms. During the whole period of palliative care stepwise withdrawal and withholding of treatment options are important issues. The multidisciplinary approach should also span the broad field of psychosocial issues covering both the child's and the caregiver's specific psychosocial needs. Continuity of care is also depicted by contacts afterwards during family bereavement. |
| | |
Authors:
|
Marianne D van de Wetering; Netteke Y N Schouten-van Meeteren |
Related Documents
:
|
11396086 - Acute care testing. blood gases and electrolytes at the point of care. 19913526 - Use of error grid analysis to evaluate acceptability of a point of care prothrombin tim... 17432636 - Interpreting laboratory values in the rehabilitation setting. 7628116 - Value-added laboratory medicine in an era of managed care. 14768156 - Catheter-associated urinary tract infections: primary care guidelines. 15164386 - Warfarin-induced limb gangrene in the setting of lung adenocarcinoma. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Seminars in oncology Volume: 38 ISSN: 1532-8708 ISO Abbreviation: Semin. Oncol. Publication Date: 2011 Jun |
Date Detail:
|
Created Date: 2011-05-23 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0420432 Medline TA: Semin Oncol Country: United States |
Other Details:
|
Languages: eng Pagination: 374-9 Citation Subset: IM |
Copyright Information:
|
Copyright © 2011 Elsevier Inc. All rights reserved. |
Affiliation:
|
Emma Children's Hospital, Amsterdam, The Netherlands. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Supportive care treatment guidelines: value, limitations, and opportunities.
Next Document: Thinking and talking about life expectancy in incurable cancer.