Parents, Doctors Often Differ on Chemo for Incurable Kids

Health professionals would usually opt for supportive care alone, study shows

URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_117679.html
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By Mary Elizabeth Dallas

Tuesday, October 18, 2011 HealthDay Logo

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TUESDAY, Oct. 18 (HealthDay News) -- Parents of children with incurable cancer tend to prefer to continue aggressive chemotherapy rather than pursue supportive end-of-life care, researchers have found.

The study findings revealed that if given the choice, the health care professionals treating these very sick children under the age of 18 would opt for supportive care alone to alleviate their patients' discomfort, according to the report published in the Oct. 17 issue of CMAJ, the Canadian Medical Association Journal.

"The choice between palliative chemotherapy and supportive care alone is one of the most important and difficult decisions for parents of children whose disease cannot be cured," Dr. Lillian Sung, of the division of hematology/oncology at the Hospital for Sick Children in Toronto, said in a journal news release.

In conducting the study, the researchers compared the treatment preferences of 77 parents whose children had little chance of surviving cancer to those of 128 health care professionals, including the doctors, residents, nurses and social workers, who care for children diagnosed with cancer.

The investigators found that 55 percent of parents preferred chemotherapy over supportive care. In contrast, only 16 percent of health care professionals would make the same choice.

Although parents placed a high value on their child's quality of life, the study also revealed that parents would choose chemotherapy for their child even if it reduced their quality of life and survival time.

The researchers pointed out that one reason for this discrepancy is the health care professionals viewed supportive care more positively than parents. The professionals' previous experiences with other children in similar circumstances may have something to do with that, the study authors suggested in the news release.

Meanwhile, parents may remain hopeful that their child has a chance for survival regardless of their poor prognosis, the researchers added.

"This study is important because it highlights the incongruity between the preferences of parents and health care workers," Sung's team explained. "However, it may be that this incongruity masks a greater concern: miscommunication or unrealistic expectations."

The study authors concluded that health care professionals should be aware of parents' views on aggressive chemotherapy and communicate information about the child's quality of life and survival when making treatment decisions. They noted, however, that parents can remain hopeful while still optimizing their child's
quality of life.

SOURCE: CMAJ, news release, Oct. 17, 2011

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