Pediatric tumors of the central nervous system: palliative approach for an excellent care

Background: Tumors of the central nervous system (TCNS) cause death and sequels in childhood. But at the same time, living with a TCNS provides a unique opportunity to care for life itself, to the parents and families and to the health system. This is a description of a personal professional experience as a pediatric oncologist and palliative care pediatrician. Methods: This is a transversal description of the series of patients who died between Jul’ 2013 and Jul’ 2018 with the primary diagnosis of TCNS, who receive chemotherapy or radiotherapy or both and who later were subject of palliative care in Panamá Children’s Hospital Dr José Renan Esquivel. The mean time of each case in oncologic treatment and the mean time on palliative care were compared. The frequency of symptoms such as pain, dyspnea, gastrointestinal, anxiety during the last week were described as well as main socioemotional problem and the reception of attention by social worker and psychotherapy and spiritual guidance to the parents. Results: 9 cases accomplished the inclusion criteria. 22% of the series since the moment of diagnosis are considered incurable, 66% were subject of partial resection and chemo/radio or both were offered. 12% recurred after finishing treatment. Anxiety was the most difficult symptom to treat according to the parents, and pain, according to the physicians. 88% of parents who had passed the bereavement stage considered that our psychological and spiritual approach helped them. Conclusion: TCNS should be known by the personnel who give the psychoemotional- social attention beside their clinicians. Only an interdisciplinary approach will provide an excellent neurooncologist care.

Biography :

María Ah Chu de Spengler has completed his PhD from Panama University and Postdoctoral studies from Universidad Javeriana de Bogota. She is the first Palliative Care Paediatrician of Panama Children´s Hospital, and a Member of the National Palliative Care Program of the Ministry of Health in Panamá. She is a Professor in the School of Nursing at Panama University.

E-mail: compahumani@hotmail.com

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