Perspectives on Care at the Close of Life: CODA
March 16, 2005

Caring for the Child With Cancer at the Close of Life

JAMA. 2005;293(11):1382. doi:10.1001/jama.293.11.1382

On November 3, 2004, Drs Hurwitz, Duncan, Wolfe,1 introduced Frank, a 13-year-old with acute lymphoblastic leukemia (ALL), his mother, and Dr L, his oncologist. Frank had been diagnosed about 4 years prior to his interview in August 2003. Although approximately 25% of children with cancer ultimately die of their disease, the authors note that in the early course of a patient’s illness, it is often impossible to determine whether the disease will be cured by cancer-directed treatment. If it becomes apparent that there are no longer any options for potentially curative therapy, the patient, family, and oncology team face enormous medical, psychological, and spiritual challenges. Optimal palliative care for children requires that the physician and caregiving team engage the patient and family in discussions of their hopes and fears and provide solace and support for emotional and physical pain.

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