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
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
"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.
The National Hospice and Palliative Care Organization provides
more information on
palliative care for children.