Nature reviews. Clinical oncology
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Over the past two decades, paediatric palliative care has emerged as both a primary approach and as its own medical subspecialty, the overall aim of which is to ease suffering for children with life-threatening illness and their families through a concurrent model of care. However, most discussions have been focused on the transition to palliative care when no realistic hope for cure exists. ⋯ This article will examine our current understanding of several areas of palliative care, with the ultimate message that palliative care is simply a novel term for the total care of a child and family, an approach that should be applied consistently and concurrently regardless of disease status. By improving familiarity with palliative care and building relationships with palliative care specialists, the paediatric oncology clinician will ensure that the best care possible for children and families is provided, regardless of outcome.
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Access to pain relief is a crucial concern for patients with cancer, and remains so at all stages of the illness trajectory. This Review covers the scope of the problem and considers the optimal palliative strategy, mainly through the use of opioids. It also discusses various barriers to effective pain management around the world, including regulatory and attitudinal barriers towards opioids, and the unwillingness of national governments to integrate palliative care effectively in cancer control efforts.