title: Exploring concerns of children with cancer.
abstract: BACKGROUND
  Aggressive treatment protocols in pediatric oncology have major effects on the lives of children with cancer. The effects of lifestyle changes such as hospitalization and home schooling on quality of life have not been investigated. This study explores lifestyle effects of cancer therapy on the quality of life of children with cancer. The goals of this study were to identify important quality-of-life issues from the perspectives of children with cancer and to identify how they think their experience with cancer treatment could be improved.
  
  
  METHODS
  Pediatric oncology patients age 5-21 were interviewed individually. Sample questions included, "Ever since you got sick, what has bothered you the most?" and "How has having this illness affected your life?" Responses were analyzed using standard qualitative techniques.
  
  
  RESULTS
  Thirty-one patients were interviewed in depth. Four major themes emerged including (1) loneliness and isolation: the loss of a normal childhood, (2) decreased pleasure from food, (3) physical discomfort and disability, and (4) emotional responses to cancer, specifically anger and fear. Their suggestions for improvement included better-tasting food, more comfortable hospital décor, and social activities with children their own age.
  
  
  CONCLUSIONS
  Children cited concerns regarding pleasures taken away as well as pain inflicted due to cancer treatment. In addition to traditionally mentioned side effects, children complained of difficulty enjoying food and restricted social activity. To improve the quality of life of children with cancer, healthcare providers should focus on potentially modifiable variables including food-related pleasure, hospital aesthetics, and social activity.
authors.affiliation: Department of Pediatrics, Section of Hematology/Oncology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY 10467, USA. Kmoody@Montefiore.org
authors.forename: Karen
authors.initials: K
authors.lastname: Moody
authors.forename: Marc
authors.initials: M
authors.lastname: Meyer
authors.forename: Carol A
authors.initials: CA
authors.lastname: Mancuso
authors.forename: Mary
authors.initials: M
authors.lastname: Charlson
authors.forename: Laura
authors.initials: L
authors.lastname: Robbins
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004644:Emotions; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D009369:Neoplasms; D009518:New York; D011788:Quality of Life; D012803:Sick Role; D012918:Social Alienation; D011795:Surveys and Questionnaires