SIOP Working Committees on Standards of Care and Training, and Psychosocial Issues in Pediatric Oncology (1993)
One of the aims of all childhood cancer parent organisations is to improve the treatment and care of children with cancer. It is obvious that only treatment in a highly specialised paediatric cancer unit (PCU) guarantees the best possible medical and psychosocial care. But what exactly is a PCU? What should is provide? And what are its facilities?
The SIOP (International Society of Paediatric Oncology) has adopted recommendations worked out by the SIOP Committee on Standards of Care and Training and the SIOP Committee on Psychosocial Issues. The texts of the Recommendations for the Organisation of a Paediatric Cancer Unit (PCU) and of the Aims and Recommendations for Psychosocial Care are printed below. If you also would like to receive a copy of the recommendations for Training of a Paediatric Haematologist/Oncologist, please contact the Secretariat. Knowing these recommendations might be helpful to achieve better care for the children in your country.
Recommendations for the Organisation of a Paediatric Cancer Unit (PCU)
- All children with cancer should be offered child-orientated diagnoses, treatment, after-care and follow-up. Special attention is also required for adolescents and young adults to the age of 20.
- A PCU functions on a multidisciplinary team work principle. It can be a special unit integrated in a paediatric department or be located in a large general oncology centre. In the latter case there should be close links with paediatric services and separate facilities for hospitalised children including psychosocial, social and educational services.
- A PCU is part of, or linked to a national and/or international multidisciplinary organisation for paediatric oncology, in order to facilitate communication and co-ordination of new treatment methods and research. Sufficient data management staff and equipment should be available to participate in clinical trials and to supply data to cancer registries.
- A PCU provides centralised primary treatment to enough patients (50 or more new patients/year) to warrant specific structures for paediatric oncology in surgery, radio-oncology, pathology, intensive care, supportive care and rehabilitation. All of these facilities should be on site or close-by. It may be necessary to centralise further the primary treatment of brain tumours or other malignancies requiring highly specialised treatment.
- A PCU is operated by appropriately trained specialists (paediatric oncologist/haematologist, paediatric surgeon with special interest in oncology, paediatric oncology nurses, paediatric psychologists, social workers, teachers etc.) to:
- ensure a round-the-clock service
- recruit new PCU personnel and
- provide adequate training in paediatric oncology.
A PCU comprises the following facilities:
a) a ward for in-patients sufficiently staffed and equipped (including proper isolation facilities) to
– execute complex medical orders;
– establish central lines;
– monitor long-term infusions;
– care and support critically ill, myelo-/immunosuppressed or dying children and their parents;
– handle and prepare the administration of cytostatic drugs and
– keep adequate records.
– Accomodation on the ward or close-by should be provided for parents. Religious/ministerial support should be also available;
b) a day-clinic for short-term investigations, short-term infusions or short-term surveillance of patients;
c) an out-patient clinic closely linked to imaging and laboratory facilities, providing rapid service for ambulatory treatment and control;
d) an administration for organising and co-ordinating the long-term follow-up and evaluation of former cancer patients.