Palliative Care

Abstract

Cancer is a leading cause of death in adolescents and young adults (AYAs) Wiener et al. (Pediatr Blood Cancer 60(5):715–718, 2013). Though most AYAs will survive, cancer will become incurable in 10–40 % Schrijvers and Meijnder (Cancer Treat Rev 33(7):616–621, 2007). Although the general philosophies of palliative care apply to AYAs, developmental considerations are unique to this group (Ferrari et al. J Clin Oncol Off J Am Soc Clin Oncol 28(32):4850–4857, 2010); Wein et al. J Clin Oncol Off J Am Soc Clin Oncol 28(32):4819–4824, 2010). The interaction of psychosocial, emotional, physical, and existential issues is essential to consider (Wein et al. J Clin Oncol Off J Am Soc Clin Oncol 28(32):4819–4824, 2010). The gaps in care experienced on both sides of the healthcare system between pediatric and adult medicine can be particularly impactful when delivering palliative care. The benefit of a multidisciplinary palliative care approach is widely appreciated as is the need to begin the process early in order to develop a trusting relationship (Wiener et al. Pediatr Blood Cancer 60(5):715–718, 2013; Baker et al. Pediatr Clin N Am 55(1):223–250, 2008; Ferris et al. J Clin Oncol Off J Am Soc Clin Oncol 27(18):3052–3058). Honest communication which supports autonomy is essential in discussions of their goals, worries, risks versus benefits of treatment, and advanced care planning (Clark and Fasciano Am J Hosp Palliat Care 32(1):101–111, 2015; Christenson et al. J Pediatr Health Care Off Publ Natl Assoc Pediatr Nurse Assoc Pract 24(5):286–291, 2010; Linebarger et al. Pediatr Clin N Am 61(4):785–796, 2014).