Cancer in children
Oncology / / August 12, 2017
in pediatric oncology as in any other areas of medicine, are the most dramatic situations that require the most careful, tactful and courageous attitude.Features ethics in pediatric oncology related to the features of tumors in children.Absolutely small number of malignant tumors in children leads to the fact that most parents are not aware of the possibility of neoplasms of childhood.The absence of even the minimum of information in an easy to print the parents of tumors in children creates a situation where a message that their child is suspected malignancy, take them by surprise.This is due to the fact that in most cases the cancer is detected in a child when seemingly (at least for the parents), he seems to be relatively healthy.And when parents finally report that their child has a malignant tumor, this message is perceived by the family as a catastrophe.
should always remember that from the first meeting with the parents of a child with cancer depends on how will develop the relationship between
Rules, which is recommended to be guided in their relations with a child with cancer, and his family, of course, can not be standardized.It is necessary to take into account the degree of education, culture, education of parents, type of nervous activity, their reactions during the first meeting with the doctor.But if the parents can be different forms of communication, different degrees of information (in this case from which the doctor has no right to hide the truth about the diagnosis), in respect of children, there is one firm rule - children should not know the truth about their disease.In their hands (and adults) should never fall medical records.Sick children, especially those of school age, know a lot.They know what a "cancer", "sarcoma", "swelling", and often the prognosis of this disease.With children, you have to be good, seasoned, optimistic.They are often asked about their disease.A child of any age can never be called a diagnosis, but the seriousness of the disease (in consultation with your doctor), in some cases we should speak.It has to do because the treatment for cancer for a long period and if the child (especially older ones) all the time saying that the disease had light, it will soon pass, you can make him not only a negative attitude to oneself, but also suspicionthat his cheating.After the baby is very observant, he compares the different facts from the surrounding hospital environment, attitude of parents and make certain conclusions, often not always correct.
Many cancers occur with periods of improvement (remission) and then may come a new deterioration of the child's condition.The child may be informed that the disease had long, during which sometimes may be worsening (if they were), but that his illness is curable and he will recover.Relationship to the child should be smooth and quiet, and in any case should not change with a change in the patient's condition and small, especially in the terminal stage, when the child's death comes.Unfortunately, pediatric oncology, such situations are not so rare and particularly hard, not only for parents but also for all the others.But even in such cases, a doctor and a nurse must be courageous and productive, because they must be able not only to alleviate the suffering of the dying, but also to help his family.
experience that has accumulated pediatric oncology, allows us to recommend the following.
1. From the first meeting with the parents of the child depends on the further - it has to be sustained in optimistic tones.The message of the diagnosis is possible only in cases when the doctor does not doubt it.Parents should be aware that the diagnosis of which they know will be confirmed or ruled out in the shortest deadlines, and at the same time to see that this is all done.
2. When the diagnosis is very clear, to re-doctor meeting with the parents, during which follows in general to talk about the disease and its treatment, without hiding the potential for adverse prognosis in a number of cases, but mostly pointing to the possibility of cure.
3. Explain to your child disease, it is necessary to take into account the awareness of parents about the medical issues, the level of education in general.Avoid primitivism, a simplified explanation of the disease, it is impossible to draw all rosy - the parents must gradually learn that in front of them waiting for the ordeal, they must preserve strength for this difficult and long struggle, and must be assured that their assistants will always be a doctor andnurse.
4. Already at the first meeting with the parents of a nurse is to convince them to ask a doctor (and only the doctor) about everything that interests them.This avoids omissions, largely prevents potential conflicts, dissatisfaction with the parents, and most importantly - the parents do not tend to seek information from those who sometimes are not related to the treatment and care of the child.It should stop talking hospital workers (lifters, nurses, barmaids, and others.) With parents.Sometimes poorly spoken word negates all the hard work of a psychotherapeutic physician.
5. In the process of the treatment of the child's parents informed the doctor about the course of the disease, the means and methods that are used for treatment.Parents should be aware that the use of all necessary means and methods of treatment, and they should never have a thought that their child is not done all that has modern medicine.Uncertainty in this leads to the fact that parents are looking for a variety of "foreign" products (which are often used for their child, but under other names), about which they have heard from their friends.
6. During treatment, the possibility of improving and deteriorating condition of the child, and parents should be warned about this in advance.Possible side effects of radiation and drug therapy, treatment of complications which parents also need to be warned.In all cases, it is not necessary to exaggerate the success and hope to take on failure.We need to convince parents to take every day that child as a victory, one can never take away the last "drop of hope" from their parents in the most severe cases of the disease.
7. In the terminal stage of the disease doctor and a nurse should not only be with a dying child, but also close to his family;She often need their help and support.This darkest hour of our life and work, but everything must be done to ease the grief of parents.Often, when they need medical attention (necessary in such cases to have a soothing agent and heart).
All deontological problems in pediatric oncology, can be successfully addressed only if the clinic for children with malignant tumors employs a team of like-minded people.In the children's clinic, where treats children with cancer should work selflessly loving children people capable as anyone else for empathy, optimistic by nature, and many in the fight for the life of the child depends on the work of nurses.