title: End of life in children with cancer: experience at the pediatric oncology department of the istituto nazionale tumori in Milan.
abstract: 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).
authors.affiliation: Struttura Complessa di Oncologia Pediatrica, Istituto Nazionale Tumori, Milano, Italy. silberetta@gmail.com
authors.forename: Silvia
authors.initials: S
authors.lastname: Beretta
authors.forename: Daniela
authors.initials: D
authors.lastname: Polastri
authors.forename: Carlo Alfredo
authors.initials: CA
authors.lastname: Clerici
authors.forename: Michela
authors.initials: M
authors.lastname: Casanova
authors.forename: Graziella
authors.initials: G
authors.lastname: Cefalo
authors.forename: Andrea
authors.initials: A
authors.lastname: Ferrari
authors.forename: Roberto
authors.initials: R
authors.lastname: Luksch
authors.forename: Maura
authors.initials: M
authors.lastname: Massimino
authors.forename: Cristina
authors.initials: C
authors.lastname: Meazza
authors.forename: Marta Giorgia
authors.initials: MG
authors.lastname: Podda
authors.forename: Filippo
authors.initials: F
authors.lastname: Spreafico
authors.forename: Monica
authors.initials: M
authors.lastname: Terenziani
authors.forename: Franca Fossati
authors.initials: FF
authors.lastname: Bellani
mesh_terms: 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