Understanding of Prognosis Among Parents of Children Who Died of Cancer

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Abstract
Cancer remains the leading cause of nonaccidental death in childhood.1 We previously reported that, according to their parents, children who die of cancer experience significant suffering and inadequate palliation in the last month of life.2 One potential obstacle to more effective integration of palliative care into the treatment of children with advanced cancer is that unrealistic physician and/or parental prognostic expectations may be leading to inappropriate treatment goals. Yet little is known about the understanding of prognosis and treatment preferences of parents of children who die of cancer. Studies in adults with terminal cancer have demonstrated that communication between physicians and patients about treatment preferences is suboptimal.3-9 A number of studies have shown that adults with cancer tend to overestimate their survival probabilities, and these unrealistic expectations are, in turn, related to preferences for more aggressive therapies.3,7,9 It is not known if the experiences among dying children are similar.