End of life in children with cancer: experience at the pediatric oncology department of the istituto nazionale tumori in Milan.
BACKGROUND
Coping with end-stage pediatric cancer patients and the related bereavement is a challenge for all the caregivers involved.


METHODS
Forty-seven cancer patients who died in 2006 were assessed as concerns the main place of care in the end stage of their disease, their symptoms, the palliative treatments received, and the site of death.


RESULTS
The end stage was managed at the Istituto Nazionale Tumori Pediatric Oncology Department in 61% of cases, at home in 26%, and in hospices or other hospital facilities in 11%. Pain was the most common symptom, followed by asthenia, anorexia, dyspnea, and nausea/vomiting. About half the patients died at home, 8.5% at our institute, 43% at other hospitals, and 8.5% in hospices.


CONCLUSIONS
The care of pediatric cancer patients during the end stage of their disease is the responsibility of the caregivers who have followed them up since their diagnosis. However, it would be useful to establish an exchange of information and expertise between pediatric oncologists and the other facilities involved (hospices, other hospitals) or people assisting patients at home (family, family pediatrician/general practitioner GP).
Beretta
Silvia
S
Struttura Complessa di Oncologia Pediatrica, Istituto Nazionale Tumori, Milano, Italy. silberetta@gmail.com
Polastri
Daniela
D
Clerici
Carlo Alfredo
CA
Casanova
Michela
M
Cefalo
Graziella
G
Ferrari
Andrea
A
Luksch
Roberto
R
Massimino
Maura
M
Meazza
Cristina
C
Podda
Marta Giorgia
MG
Spreafico
Filippo
F
Terenziani
Monica
M
Bellani
Franca Fossati
FF
D000293:Adolescent; D000328:Adult; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010166:Palliative Care; D011788:Quality of Life / Q000523:psychology; D012189:Retrospective Studies; D013727:Terminal Care / Q000523:psychology*; D055815:Young Adult