When there is no curative treatment for pediatric cancer

Stuart E. Siegel, MD Director, Children's Hospital Los Angeles shares advice for parents with a child diagnosed with cancer on how to best support them when there is no curative treatment available
Pediatric Cancer Advice | When No Curative Treatment Is Available
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When there is no curative treatment for pediatric cancer

Handling the time when there is no real curative treatment available, often called the end of life period, is very difficult. And, I think, that there are some general principles we all follow. But, we are all human beings, and we have our own way of approaching this. I think, number one, you have to be honest with the family. And, if that really is the situation, then you have to tell that that's the situation. Now, you may have some experimental treatment that you may want to try, for which you don't know whether it's going to work. But, you are trying to find out and develop new treatments that we work. That's the only way you can find out. And you may present that to them. But, even if you do that I think it's important that you say to the family "There's no right way to go here. There isn't a treatment that we know it's going to work. Whatever you choose to do, you need to be comfortable with it." So, honesty with the family. And, the other thing, it's very important, is to let them know that you will continue to provide maximum support for their child. To make them as comfortable as possible. To be there to answer questions. To not withdraw from that child's care. I also make sure that they understand that they probably, at that point, are most important people in that child's life. To be there, to be with their child. To support their child. That's really important. Children of certain ages really are worried about separation. When they begin to think about death, they think of separation. It's very important that we as physicians and care givers, nurses and the parents are with that child. Do not withdraw from that child. That we are there for them. I certainly tell the child the same thing. Children who are old enough, we will sit down and talk about the fact that we don't have any treatment available. We are going to try to really make you maximally comfortable. We are going try to make it possible you do whatever you can do during that time. We'll be here. We're not going to disappear. Your parents are not going to disappear. The nurses are not going to disappear. We're going to be here to help you. And I've had teenagers directly ask me that question "Am I dying?". And, again, I'm very truthful with them. What is really interesting, and it's a general well known phenomena, the teenagers often will tell you then that their more worried about what this will do to their parents. What their death will do to their parents than they are worried about themselves. It's really rather remarkable dynamic. And you see it over and over again. So, you have to be prepared to support them during that. And, prepared to make sure they're comfortable, and try to reduce their physical uncomfortableness or physical pain. But, also by being there and listening to them sometime. Just listening or being there to support them. To try to reduce the anxiety and fear that they may feel.

Stuart E. Siegel, MD Director, Children's Hospital Los Angeles shares advice for parents with a child diagnosed with cancer on how to best support them when there is no curative treatment available


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Stuart E. Siegel, MD

Director, Children’s Center for Cancer & Blood Diseases, Children's Hospital Los Angeles

Before recently shifting his focus to international medicine, Stuart Siegel, MD, was Chief of the Division of Hematology/Oncology for 35 years and the founding director of the the Children’s Center for Cancer & Blood Diseases at Children’s Hospital Los Angeles, and Professor and Head of the Division of Hematology-Oncology Department of Pediatrics, Keck School of Medicine of University of Southern California. He remains a leader in supportive care and research in pediatric oncology, with a special focus on neuroblastoma, non-Hodgkin lymphoma, Ewing Sarcoma, acute lymphoblastic leukemia and brain tumors. From developing the first pediatric protective environment in 1971 for children undergoing intensive chemotherapy, to pioneering current efforts to develop academic and clinical care programs nationally and locally for adolescents and young adults with cancer, Dr. Siegel’s contributions have revolutionized the field of pediatric oncology. Dr. Siegel has been honored for his work by the American Cancer Society, Children Foundation, the Cancer Foundation, the Chase Foundation, Padres Contra El Cancer, the Israel Cancer Research Fund and Ronald McDonald House Charities, where he is a member of the National Board, and has consistently been listed among the nation’s top doctors in such publications asAmerica’s Top Doctors and Best Doctors in America. He is a father of one son, Joshua; grandfather of David and Elijah; and lives in Pacific Palisades with his wife of seven years.

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