Medical students' concepts of childhood cancer and its management

Medical student's attitudes toward cancer and patients with cancer were studied prior to and following a required pediatric clerkship which included contact with children on an oncology service. Emphasis in the study was placed on the students' reactions to the child with cancer, and these were compared with the same students' attitudes in the context of the adult with cancer or general oncology. Early diagnosis is regarded as of more significance, and an aggressive therapeutic response following diagnosis of more urgency when the patient is a child. These attitudes, recognizing the importance of early diagnosis and expressing strong approval of aggressive therapy for the pediatric patient, increased during the clerkship. The students strongly supported a program aimed at return of the child to his normal activities with the least delay; recognized the special significance of long-range surveillance for secondary effects in the pediatric patient; and recommended the "center" as opposed to the community hospital as the site for care of the child with cancer. In other areas of cancer management, including (a) the importance of psychosocial support, (b) the problems of emotional involvement of the physician with the patient, and (c) care of the dying patient, attitudes toward patients in the two age groups was not significantly different.