Paediatric palliative care in cancer.

Abstract

More than 21 million children globally need access to palliative care (PC) - including children with cancer. Providing Paediatric Palliative Care (PPC) for children with cancer is an ethical imperative with pain relief being recognised as a human right and an important public health consideration, with PPC being essential for reducing suffering in children and families. PPC addresses children's symptoms and aims to provide comfort even if a cure is not possible. PC for children with cancer is about ensuring that the child and family have the best possible quality of life starting at diagnosis and throughout the disease trajectory regardless of cancer treatment outcomes. Many principles of PPC for children with cancer are similar to those for children with other serious health conditions. These include the following: promotion of quality of life; provision of PC care across the continuum of care (from diagnosis through to bereavement); pain and symptom management; emotional support; social care; spiritual care; good communication with children and family; advance care planning; end-of-life care; and bereavement care. PPC should be provided across the range of care settings, wherever the child and their family need care, by an inter-disciplinary team providing support to the child, their families (including siblings) and other significant others, and consider the financial impact of having a child with cancer. It should not be a last resort, but an essential component of care. In this paper, we provide a brief overview of the integration of PPC into paediatric cancer care through the review of challenges in providing PPC in paediatric oncology, global examples of clinical provision of PPC in paediatric cancer care, a review of global research priorities in this area and examples of global education programmes aimed at improving PPC in paediatric cancer care.