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Supportive care of the paediatric cancer patient
1Bristol Royal Hospital for Sick Children, United Kingdom.
Insights
Aggressive supportive care significantly reduces mortality in children with cancer. This includes managing infections, nutrition, and blood products, alongside surgical interventions for improved survival.
Area of Science:
- Pediatric Oncology
- Surgical Oncology
- Critical Care Medicine
Background:
- Cytotoxic therapy for pediatric cancers leads to high mortality and morbidity.
- Survival rates are improving despite more toxic treatments.
- Aggressive supportive care has dramatically reduced mortality over 30 years.
Purpose of the Study:
- To detail essential supportive care aspects for pediatric patients undergoing cancer therapy and surgery.
- To highlight the role of the multidisciplinary team in pediatric cancer management.
- To emphasize the importance of surgical planning and patient management during treatment.
Main Methods:
- Review of current supportive care practices in pediatric oncology.
- Integration of surgical intervention within the multidisciplinary cancer care team.
- Focus on infection management, nutritional support, and blood product utilization.
Main Results:
- Supportive care modalities, including infection control, nutrition, and blood product management, are crucial.
- Paediatric surgeons are integral to multidisciplinary teams, ensuring safe surgical interventions.
- Improved survival is linked to aggressive supportive care strategies.
Conclusions:
- Aggressive supportive care is paramount in improving survival for pediatric cancer patients.
- Multidisciplinary collaboration, including surgical expertise, is essential for optimal outcomes.
- Effective management of complications and patient stress during therapy and surgery is key.
Abstract:
Cytotoxic therapy for paediatric malignancy continues to be associated with significant mortality and morbidity. However, survival figures continue to improve despite increasingly toxic treatment protocols. Aggressive supportive care, more than any other modality, has produced a dramatic reduction in mortality during the past 30 years, and includes the appropriate management of infection, provision of adequate nutrition, and proper use of blood and blood products. The paediatric surgeon plays an integral role in the multidisciplinary team of cancer management and together with other team specialists is responsible for the planning of surgical intervention and also ensuring the safe passage of immunologically impaired patients through the additional stress of surgery. This paper details essential aspects of supportive care as commonly practiced in paediatric patients undergoing therapy and surgery.