Journal of cancer & allied specialties最新文献

{"title":"Outcome of Classic Hodgkin Lymphoma Treated with ABVD Regimen- A Single Center Experience.","authors":"Nouman Nawaz Ali, Madiha Noor, Natasha Ali, Mohammad Usman Shaikh, Salman Naseem Adil","doi":"10.2478/jcas-2026-0008","DOIUrl":"10.2478/jcas-2026-0008","url":null,"abstract":"<p><strong>Introduction: </strong>Classic Hodgkin lymphoma (cHL) treatment has evolved over recent years, driven by advances in novel agents. In low-income countries with resource constraints, ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapy is the cheapest and most curative option. Here we highlight the outcome of the ABVD regimen in adults with classic Hodgkin lymphoma (cHL) and associated factors.</p><p><strong>Materials and methods: </strong>A retrospective cohort study conducted at Aga Khan University Hospital, Karachi, Pakistan, from 1st January 2013 to 31st December 2023, included 246 patients (aged 18 years or older at cHL diagnosis) who received ABVD as their first chemotherapy regimen. Median OS and PFS were estimated using the Kaplan-Meier method, and the association between variables was assessed using the log-rank test. Univariate and multivariate analyses were used to identify significant factors using Cox regression.</p><p><strong>Results: </strong>The median age of our cohort was 35 years, with a male predominance (1.6 male-to-female ratio). Out of 246 patients, 78 (31.7%) had early-stage disease, while 168 (68.3%) had advanced-stage disease. The median overall survival and progression-free survival (PFS) were not reached. Median follow-up duration was 35 months. Two hundred and five (83.3%) patients remained alive at the end of the study. OS and PFS at 2 years were 85.6% and 74.7%, respectively. Factors that significantly affected OS were age, stage, bulky disease, and ECOG.</p><p><strong>Conclusion: </strong>Our findings show that ABVD is still an effective and economical regimen in developing parts of the world and signifies the importance of age, bulky disease, ECOG, stage, and the risk stratification approach.</p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"12 1","pages":"50-58"},"PeriodicalIF":0.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated Palliative care in Metastatic gastrointestinal Cancer: A Retrospective Experience from a Lead Cancer Centre in Pakistan.","authors":"Amer Farooqi, Jamshed Ali, Kashif Sajjad, Sajjad Ullah","doi":"10.2478/jcas-2026-0009","DOIUrl":"10.2478/jcas-2026-0009","url":null,"abstract":"<p><strong>Background: </strong>The goal of palliative care is to alleviate the suffering of patients with advanced cancer, such as through pain management. Multiple randomized controlled trials have supported the early integration of palliative care. Despite the undeniable advantages of early palliative care, most data have come from developed countries. This study offers real-life insights into the integration of palliative care services for patients with advanced gastrointestinal cancer and their impact on quality of life in a developing country.</p><p><strong>Materials and methods: </strong>We retrospectively evaluated patients with metastatic gastrointestinal cancer treated at our center from January 2018 to December 2022. The subjects included patients with metastatic gastrointestinal (GI) cancer who received palliative care either within 90 days of diagnosis (early group) or after 90 days (late group). The impact of early versus late integration of palliative care was assessed.</p><p><strong>Results: </strong>A total of 216 patients were included in the analysis - 123 in the early group and 93 in the late group. While the majority of patients were referred electively to palliative care, emergency referrals were more frequent in the early group (62 total; 40 [64%] in the early group, 22 [36%] in the late group, p = 0.15). The number of patients receiving chemotherapy in the last 30 days of life was 39 (early group: 17; late group: 22; p = 0.06). On the Edmonton Symptom Assessment Scale (ESAS), symptoms such as pain, nausea, and wellbeing were better controlled in the early group, although the differences were not statistically significant. The disease burden was significantly higher in the early group (p = 0.01).</p><p><strong>Conclusion: </strong>Despite a higher disease burden in the early group, symptom control was comparable between the groups. The greater number of emergency referrals in the early group highlights the role of palliative care during crises and underscores the need for better integration of palliative care services.</p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"12 1","pages":"59-64"},"PeriodicalIF":0.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Preoperative Tapentadol in Reduction of Peri-operative Analgesics Requirements After Breast Conservative Surgery in Cancer Patients: A Randomized Controlled Trial.","authors":"Yusra Saleem, Allah Ditta Ashfaq, Syed Raza Mehdi, Asad Aleem","doi":"10.2478/jcas-2026-0012","DOIUrl":"10.2478/jcas-2026-0012","url":null,"abstract":"<p><strong>Introduction: </strong>Tapentadol, a centrally acting μ-opioid receptor agonist and noradrenaline reuptake inhibitor, has shown promise in providing potent analgesia with fewer opioid-related side effects. This study evaluated its role as a pre-emptive analgesic in cancer patients undergoing breast conservation surgery.</p><p><strong>Materials and methods: </strong>A prospective, double-blinded, randomized controlled trial was conducted on 70 American Society of Anesthesiologists class II adult females, scheduled for conservative breast surgery, randomized into two groups after informed consent. Group A received 75 mg oral tapentadol, and Group B an oral placebo, one hour before induction. Intraoperatively, more than 20% increase in mean arterial pressure from baseline, and postoperatively, pain score (at 1, 2, 3, and 4 hours) greater than 3 was treated with intravenous morphine (up to 0.1 mg/kg). Data regarding total morphine used (dose and number of patients) intra-operatively and postoperatively, time to first rescue dose, and pain scores postoperatively, and side effects were documented.</p><p><strong>Results: </strong>Mean intraoperative morphine requirement was significantly lower in the tapentadol group (1.11 ± 1.53 mg) compared with the placebo group (3.36 ± 1.60 mg; <i>p</i> < 0.001). Only 13 (37.1%) patients in the tapentadol group required intraoperative morphine compared to 31 (88.6%) in the placebo group (<i>p</i> < 0.001). Postoperative pain scores were lower in the tapentadol group at 1 hour (1.89 ± 0.83 vs 2.46 ± 1.15, p = 0.020) and 3 hours (1.06 ± 0.24 vs 1.23 ± 0.43, <i>p</i> = 0.042). Rescue morphine use post op was lower in the tapentadol group [5 (14.3%) vs.10 (28.6%), <i>p</i> = 0.145] with a longer time to first rescue dose (58.0 ± 21.7 vs. 43.5 ± 27.3 minutes, <i>p</i> = 0.290).</p><p><strong>Conclusion: </strong>Pre-emptive tapentadol administration significantly reduced perioperative morphine use and improved postoperative pain scores at certain time points. However, the increase in time to first rescue analgesia was not statistically significant.</p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"12 1","pages":"78-84"},"PeriodicalIF":0.0,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Medulloblastoma Treated with Volumetric Modulated Arc Therapy Craniospinal Irradiation: A Retrospective Study.","authors":"Muhammad Anas Tahseen Asar, Tabinda Sadaf, Asma Rashid, Aqueel Shahid, Fajar Rafi Ranjha, Raheel Mukhtar, Haniya Rizwan, Ahmad Rashid","doi":"10.2478/jcas-2026-0006","DOIUrl":"10.2478/jcas-2026-0006","url":null,"abstract":"<p><strong>Introduction: </strong>Cranio-spinal irradiation (CSI) is essential in treating central nervous system malignancies such as medulloblastoma, but conventional 3D-conformal radiotherapy poses challenges in dose uniformity and toxicity. Advanced techniques like Volumetric Modulated Arc Therapy (VMAT) offer improved target coverage and organ sparing, yet data on its use in resource-limited settings remain scarce. This study aimed to evaluate the clinical feasibility, dosimetric performance, toxicity profile, and early outcomes of CSI delivered via VMAT in medulloblastoma patients treated at a tertiary care center in Pakistan.</p><p><strong>Materials and methods: </strong>This retrospective study included 113 patients (median age 12 years, range 4-37) diagnosed with medulloblastoma and treated between 2018 and 2024. Patients underwent surgical resection followed by VMAT-based CSI, with doses ranging from 23.4 to 36 Gy and tumor boosts of 54-55.4 Gy. Dosimetric parameters including planning target volume (PTV) coverage, conformity index (CI), homogeneity index (HI), and organ-at-risk (OAR) doses were analyzed. Acute toxicities were graded, and disease-free survival (DFS) was assessed over a median follow-up of 15 months.</p><p><strong>Results: </strong>Gross total or near-total resection was achieved in 38.1% of patients. Mean PTV coverage was 94%, with median CI and HI values of 1.02 and 0.10, respectively, indicating excellent dose conformity and homogeneity. The majority of patients required multiple isocenters for complete cranio-spinal coverage. Acute toxicities were predominantly mild to moderate, with esophagitis (11%), bone marrow suppression (12%), and nausea/vomiting (10%) most commonly observed. Organ doses remained within acceptable limits. The two-year DFS rate was 76%.</p><p><strong>Conclusion: </strong>VMAT-based CSI is a feasible and effective treatment modality for medulloblastoma in a resource-constrained setting, providing superior dosimetric outcomes with manageable toxicity. These findings support the broader adoption of advanced radio-therapy techniques like VMAT in similar clinical environments.</p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"12 1","pages":"40-45"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brown Tumor in Primary Hyperparathyroidism and Hungry Bone Syndrome Post-Parathyroidectomy: Two Rare Entities.","authors":"Tanveer Fatima, Maryam Arshad, Zainab Ajmal, Ahmed Imran Siddiqi, Waqas Shafiq","doi":"10.2478/jcas-2026-0007","DOIUrl":"10.2478/jcas-2026-0007","url":null,"abstract":"","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"12 1","pages":"46-49"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presentation of Metastatic Colorectal Carcinoma at a Tertiary Care Center in Pakistan.","authors":"Sehar Salim Virani, Muhammad Taha Nasim, Fiza Adnan, Muhammad Ibrahim, Munira Shabbir Moosajee, Muhammad Rizwan Khan, Kulsoom Ghias, Muhammad Murtaza, Sadaf Khan, Syed Nabeel Zafar","doi":"10.2478/jcas-2026-0001","DOIUrl":"10.2478/jcas-2026-0001","url":null,"abstract":"<p><strong>Introduction: </strong>Metastatic colorectal cancer (mCRC) poses significant challenges in low- and middle-income countries (LMICs) due to limited access to comprehensive care. This study aims to analyze the clinical characteristics, treatment patterns, and outcomes of patients with metastatic colorectal cancer (mCRC) at a single tertiary care center in Pakistan.</p><p><strong>Materials and methods: </strong>A retrospective cross-sectional study was conducted on 141 patients diagnosed with mCRC at the Aga Khan University Hospital (AKUH) between January 2020 and December 2022. Data on demographics, tumor characteristics, metastasis patterns, treatment modalities, and outcomes were extracted from electronic medical records. Descriptive statistics and survival analysis were performed.</p><p><strong>Results: </strong>The mean age of the cohort was 51 years (SD ± 17.43), with 56.7% male patients. The study included patients from all over Pakistan, with the majority residing in Sindh (71.1%). Additionally, 8.5% of patients were from outside Pakistan. Rectum (27.5%) and sigmoid colon (20.4%) were the predominant tumor locations. Adenocarcinoma was the most common histological type (90.1%). Liver-only metastases were observed in 27.5% of patients, with 48.2% presenting multisite metastases. Chemotherapy was administered to 74.6% of patients, with FOLFOX being the most common regimen (38.3%). Primary tumor resection was performed in 43.7% of cases, and metastatic lesion resection in 7.7%. Fragmented care was observed, with 21.4% of patients receiving diagnostic or therapeutic interventions outside AKUH as well. The median time from diagnosis of metastasis to death was 4.9 months (IQR: 1.1-9.3).</p><p><strong>Conclusion: </strong>mCRC patients in Pakistan present with a younger age, higher prevalence of multisite metastases, and limited access to advanced multimodal treatments compared to HICs. These findings underscore the need for tailored public health initiatives, including age-specific screening programs, improved diagnostic and treatment infrastructure, and enhanced access to advanced therapies to improve outcomes in LMICs.</p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"12 1","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy of Esophageal Stenting in Managing Esophageal Tumor Perforation: A Retrospective Study.","authors":"Zainab Shakeel, Muhammad Kashan Sajid, Amer Rehman Farooqi, Samar Minallah, Zubair Shabbir Khanzada, Farhan Ali","doi":"10.2478/jcas-2026-0003","DOIUrl":"10.2478/jcas-2026-0003","url":null,"abstract":"<p><strong>Introduction: </strong>Esophageal tumor perforation is a serious complication, seen in patients undergoing chemo-radiotherapy for advanced-stage cancer, and can lead to life-threatening conditions like sepsis and empyema. Esophageal stenting with self-expandable metal stents offers a safer, less invasive alternative to surgery, helping restore oral intake and improve patient comfort. This study aims to determine the effectiveness of esophageal stenting in managing esophageal tumor perforation at different disease stages and to assess long-term outcomes.</p><p><strong>Material and method: </strong>This retrospective cohort study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Center in Peshawar by reviewing 600 patient records presenting with esophageal tumor perforation from January 2016 to December 2021, and retracted between October and December 2024. Eighty patients who underwent esophageal stenting were enrolled in the study. Data on demographics, tumor characteristics, treatment history, and survival status were collected from the hospital's electronic system. SPSS-25 was used for analysis purposes. The chi-square test was employed to determine statistical significance (p ≤ 0.05).</p><p><strong>Results: </strong>The mean age of patients was 46.98±11.62 years, and most patients were male (45, 56.3%). Squamous cell carcinoma was the most prevalent histological type, accounting for 74(92.5%) of cases. Advanced-stage disease was observed in the majority of cases, with T3 at 48 (60.5%) and T4 at 15 (18.8%). Additionally, 34(42.5%) exhibited nodal involvement (N1 and N2 each) and 23(28.7%) had metastatic. The median stent insertion during the study period was 83 days, with a range from 1 day to 7 years. Survival status was suboptimal, with 76(95%) deceased, 4(5%) surviving. Kaplan-Meier analysis demonstrates a median survival of 200 days.</p><p><strong>Conclusion: </strong>Esophageal stenting is an effective palliative intervention for managing tumor-induced esophageal perforation, particularly in patients with advanced disease, and prolongs survival.</p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"12 1","pages":"18-23"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Pediatric and Adolescent Girls with Malignant Ovarian Germ Cell Tumors after Chemotherapy and Surgery: A Single Institutional Experience.","authors":"Niaz Ali, Rabia Muhammad Wali, Aqeela Rashid, Naila Inayat, Misbah Zainab, Sajid Ali, Syeda Tehreem Zahra Gillani, Najma Shaheen","doi":"10.2478/jcas-2026-0005","DOIUrl":"10.2478/jcas-2026-0005","url":null,"abstract":"<p><strong>Introduction: </strong>Malignant ovarian germ cell tumors are rare and vital cancers in the pediatric age group of females, affecting 1-2% of all ovarian malignancies. Advances in surgical management, chemotherapy, and patient care have significantly improved survival.</p><p><strong>Materials and methods: </strong>This retrospective study investigates the treatment outcomes of 116 pediatric patients diagnosed with Malignant ovarian germ cell tumors at a tertiary care center in Pakistan between 1999 and 2022. The study focuses on patterns of care, survival rates, recurrence, and complications associated with therapy.</p><p><strong>Results: </strong>The median age was 13.5 years, with dysgerminomas predominating (38.7%). Most patients had upfront surgery (87.9%), followed by adjuvant chemotherapy, including JEB (Carboplatin, etoposide, bleomycin) (64.7%), BEP (bleomycin, etoposide, cisplatin) (25.0%), and PEB (cisplatin, Etoposide, Bleomycin) (4.3%). The five-year event-free survival (EFS) and overall survival (OS) were 87.1% and 90.5%, respectively. Histology, chemotherapy regimen, and risk group classification were key factors influencing survival, with dysgerminoma showing the best prognosis. In patients whose tumor markers normalized rapidly, event-free survival (EFS) was better. Relapsed disease was observed in 2.6% of patients, and disease progression occurred in 7.8%.</p><p><strong>Conclusion: </strong>Our study shows good outcomes for girls with ovarian tumors. This study highlights the effectiveness of multimodal treatment strategies, including both surgery and chemotherapy, in improving survival outcomes for pediatric patients with malignant ovarian germ cell tumors in low-resource settings.</p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"12 1","pages":"30-39"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Technical Feasibility and Surgical Outcomes of Laparoscopic Excision of Abdominopelvic Solid Tumors in Children: A Retrospective Review.","authors":"Sajid Ali, Muhammad Bilal Qayyum, Muniba Jalil, Tariq Latif, Aamir Ali Syed, Muhammad Ali Sheikh","doi":"10.2478/jcas-2026-0002","DOIUrl":"10.2478/jcas-2026-0002","url":null,"abstract":"<p><strong>Introduction: </strong>Minimal invasive surgery for abdominopelvic solid organ tumors in paediatric patients is a growing field. Technical challenges persist despite potential benefits, such as reduced postoperative pain and shorter recovery times.</p><p><strong>Materials and methods: </strong>This was a retrospective review of all paediatric patients who underwent laparoscopic excision for abdominopelvic tumors. Parameters such as demographics, tumor histology, tumor location and size, blood loss, operation duration, and early outcomes were analyzed.</p><p><strong>Results: </strong>Thirty-five patients underwent laparoscopy. The median age was 13 years. Females constituted the majority (29). Tumor sites included the pelvis (n=29), right kidney (n=2), retroperitoneal (n=3), and colon (n=1). The average tumor size was 11 cm. Successful laparoscopic excision was achieved in 32 cases, without postoperative complications, with a mean hospital stay of two days.</p><p><strong>Conclusions: </strong>Laparoscopic excision is technically feasible for paediatric abdominopelvic solid organ tumors, offering minimal complications. However, further studies are needed to define long-term outcomes.</p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"12 1","pages":"12-17"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to Palliative Care for Terminally Ill Children in a Developing Country Cancer Hospital: A Qualitative Study.","authors":"Saba Khurshid, Atif Saleem, Zubair S Khanzada","doi":"10.2478/jcas-2026-0004","DOIUrl":"10.2478/jcas-2026-0004","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric palliative care (PPC) aims to improve the quality of life for children with life-limiting illnesses and support their families by addressing physical, psychological, social, and spiritual needs. Globally, significant barriers to PPC delivery include limited integration into health systems, inadequate provider training, restricted access to pain medications, and communication challenges. These issues are particularly pronounced in low- and middle-income countries, where cultural, infrastructural, and resource constraints further complicate care. Despite growing recognition of PPC's importance, there is limited understanding of the experiences of children, families, and healthcare providers in these contexts. This study explores barriers to PPC provision in a developing-country cancer hospital, highlighting context-specific challenges and opportunities for improvement.</p><p><strong>Materials and methods: </strong>A retrospective qualitative content analysis of clinical documentation was conducted for 150 pediatric patients (≤18 years) referred to the palliative medicine team at a tertiary care cancer hospital between 1st January 2019 and 27th August 2024, at which point thematic saturation was achieved. Clinical notes were analyzed using Braun and Clarke's thematic analysis framework and coded in NVivo 15. Key themes and subthemes emerged. Ethical approval was obtained from the Institutional Review Board.</p><p><strong>Results: </strong>Five themes were identified as challenges in palliative care provision to children. These were barriers to effective care, psychological and family-related challenges, impact on quality of life, financial constraints and resource limitations, medical adherence, and treatment non-compliance.</p><p><strong>Conclusion: </strong>These findings underscore the urgent need to address multifaceted medical, psychosocial, and socioeconomic challenges to pediatric palliative care in developing countries. Prioritizing a multidisciplinary approach, raising awareness, expanding access to pain management, and reinforcing psychosocial support are imperative steps. Through concerted efforts, the quality of life for children with life-limiting illnesses and their families can be meaningfully improved.</p>","PeriodicalId":73631,"journal":{"name":"Journal of cancer & allied specialties","volume":"12 1","pages":"24-29"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}