Movies could replace anaesthetic for child radiotherapy

Children with cancer could be spared dozens of doses of general anaesthesia by projecting a video directly on to the inside of a radiotherapy machine during treatment | OnMedica

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The new research was presented this week at the ESTRO 36 conference (European Society for Radiotherapy & Oncology), taking place in Vienna, Austria.

Catia Aguas, a radiation therapist and dosimetrist at the Cliniques Universitaires Saint Luc, Brussels, Belgium, told the conference that using video instead of general anaesthesia is less traumatic for children and their families, as well as making each treatment quicker and more cost effective.

The study included 12 children aged between one and a half and six years old who were treated with radiotherapy using a Tomotherapy® treatment unit at the university hospital. Six were treated before a video projector was installed in 2014 and six were treated after.

Before the video was available, general anaesthesia was needed for 83% of children’s treatments. Once the projector was installed, anaesthesia was only needed in 33% of treatments.

Read the full commentary here

Cancer as a stressful life event: Perceptions of children with cancer and their peers

Howard Sharp, K.M. Cancer. Published online: 4 May 2017

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Background: The medical traumatic stress model is commonly applied to childhood cancer, assuming that the diagnosis of cancer is a traumatic event. However, to the authors’ knowledge, little is known regarding what specifically children perceive as stressful about cancer or how it compares with other stressful events more often experienced by children.

 

Conclusions: Children do not necessarily view their cancer experience as their most stressful life event. The findings of the current study suggest that the diagnosis of cancer might be better viewed as a manageable stressor rather than a major trauma, and are consistent with the change in the fifth edition of the DSM to eliminate the diagnosis of a life-threatening illness as a qualifying trauma for PTSD.

Read the full abstract here

Psychosexual development and satisfaction in long-term survivors of childhood cancer

Lehmann, V. et al. Cancer. Published online: 6 February 2017

Background: Risk factors for impairment in psychosexual development and satisfaction among adult survivors of childhood cancer are poorly understood. The authors compared psychosexual outcomes between survivors and healthy controls, and tested whether at-risk survivors can be identified by 1) treatment neurotoxicity or 2) diagnosis.

Conclusions: The intensity of neurotoxic treatment may be a valuable indicator of risk for psychosexual impairment relative to diagnosis alone. Health care providers should assess romantic/sexual problems among survivors at risk and make referrals if needed.

Read the full abstract here

Respiratory Viral Infections and Coinfections in Children With Cancer, Fever and Neutropenia

Torres, J.P. et al. (2016). Pediatric Infectious Disease Journal. 35(9). pp. 949–954

colorized-transmission-electron-micrograph-of-avian-influenza-a-h5n1-viruses-seen-in-gold-grown-in-mdck-cells-660x544Background: Respiratory viral infections in episodes of fever and neutropenia (FN) in children with cancer are not well characterized. We compared the clinical outcome of infections caused by different respiratory viruses (RVs) and by RV coinfection in this population.

Methods: Children with cancer and FN at 3 hospitals in Chile were prospectively evaluated by clinical examination, blood cultures and detection of 17 RVs using multiplex polymerase chain reaction (nasopharyngeal samples). Clinical characterization and outcome variables were determined and compared by the type of RV detected.

Results: A total of 1044 episodes of FN in 525 children were included. At least 1 RV was detected in 46%. In 350 of 1044 (34%) episodes, we detected only RVs, of which 284 (81%) were classified as a single-RV infection and 66 (19%) as a viral coinfection. Respiratory symptoms were present at admission in 65% of the episodes with any detected RV. Median age was 6 years (interquartile range, 3–10), and 51% were women. The most common RVs detected were rhinovirus, respiratory syncytial virus, parainfluenza, influenza, adenovirus and human metapneumovirus. Episodes caused by different types of RVs had no differences in the clinical outcome (days of hospitalization, days of fever, O2 requirement, admission to the intensive care unit and death) and when comparing single and viral coinfection.

Conclusions: To our knowledge, this is the largest report comparing clinical outcome in FN episodes caused by different RVs in children with cancer. A positive polymerase chain reaction for RV at admission was significantly associated with the presence of respiratory symptoms. Our data showed a favorable outcome in all episodes with RV detection, including single and viral coinfections.

Read the abstract here

‘We urgently need kinder treatments for children’ – Noemi and Zofeya’s story

Cancer Research UK. Published online: 25 July 2016

When she was 4 years old, Zofeya was diagnosed with medulloblastoma, a type of brain tumour. Now 7, Zofeya lives with her parents Noemi and Matthew, and brother Malacai, in Bedfordshire.

Here, Noemi shares her daughter’s story – one of several that feature in the CRUK Annual Review, which highlights the progress we’ve made this year.

Read the full blog post here

How Variable Is Our Delivery of Information? Approaches to Patient Education About Oral Chemotherapy in the Pediatric Oncology Clinic

Khan, J.M. et al. Journal of Pediatric Health Care. Published online: July 23 2016

bubble-602146_960_720In pediatric patients with acute lymphoblastic leukemia, adherence to oral chemotherapy relies largely on a parent’s comprehension of the drug’s indication and administration guidelines. We assessed how pediatric oncology providers educate families about oral chemotherapy.

We conducted a cross-sectional survey of 68 physicians and nurses from 9 institutions in the Dana-Farber Cancer Institute Acute Lymphoblastic Leukemia Consortium.

The inter-individual approach to patient education is variable and may consist of handouts, treatment calendars, and discussions. The extent of teaching often varies depending on a provider’s subjective assessment of a family’s needs. Twenty-five percent of providers suggested standardizing patient teaching.

When developing educational models, care teams should consider approaches that (a) objectively identify families in need of extensive teaching, (b) designate allotted teaching time by nursing staff during clinic visits, and (c) maintain the variation and dynamism that informs a successful provider-patient relationship.

Read the abstract here

A child’s right to fertility preservation when undergoing sterilizing chemotherapy

ScienceDaily. Published online: 10th June 2016.

Image shows light microscopy of primary follicle of the ovary.

Ovarian tissue cryopreservation (OTC), harvesting and freezing ovarian tissue, is the most promising complication-free strategy to preserve potential fertility in pre-pubescent girls undergoing sterilising chemotherapy, according to a 13 year study by Fanny Chambon et al. in the journal, Human Fertility.

Almost 80% of children and adolescents currently treated for cancer or leukemia will be long term survivors. Paediatric oncologists are concerned that side effects such as low fertility, infertility and early menopause can reduce the quality of life for survivors. Indeed, in females, cancer treatments can result in premature ovarian insufficiency (POI). Therefore, preserving fertility in young girls is becoming a key issue for improving quality of life. However, only a few teams performing OTC in children have reported on their practice.

The paper reports on 13 years’ experience of ovarian tissue cryopreservation before sterilising treatment. The aim of the study on OTC in 36 girls at risk of early menopause, aged between 2 and 19 years old, at the Clermont-Ferrand City Paediatric Oncology Department is to assess how effective, feasible and risky this treatment is.

Laparoscopy was used to collect a third of each ovary that was frozen by a slow cooling protocol. Histological analysis of one random sample of each harvested ovarian tissue fragment was routinely performed before freezing.

The study uncovers unresolved issues in the practice of OTC. The minimum age to offer OTC remains undetermined, there is no current consensus on the quantity of ovarian cortex to be harvested for cryopreservation or whether best practice is to remove an entire ovary or to remove part of each ovary. Detecting ovarian damage is difficult too as it is not standardised, and re-introducing cancer cells via an ovarian graft because of malignant cells in frozen thawed ovarian tissue remains a concern.

Read the original research abstract here

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