Successful treatment of leukaemia depends upon the effectiveness of the health-care system. Key areas include:16
- early detection,
- access to appropriate treatment services,
- collaboration between health-care professionals, and
- ongoing medical research and clinical trials.
When a diagnosis of cancer is suspected or confirmed, referral to a paediatric cancer centre is required.5 Guidelines for such centres have recently been published in the USA and UK.5, 14 These specialist paediatric cancer services should have resources to:5
- enable accurate diagnosis and delivery of the most appropriate therapies, the provision of best supportive care and long-term follow up
- enable access to international cooperative group studies and international experts - this is important due to the small numbers of children with cancer and the need to pool expertise and access adequate numbers to ensure the validity of clinical trials
- provide access to an MDT including paediatric oncologists, specialist nursing and allied health staff and other paediatric sub-specialists, such as radiation oncologists, surgeons, and neurologists which are essential for ensuring the child's physical and psychosocial wellbeing.
A multidisciplinary approach to the management of childhood cancer has been recommended to provide the complex range of services required.14 Anticipated benefits from such an approach include:14
- each person is considered from a range of viewpoints and expertise
- an MDT promotes shared learning between professionals
- a greater probability of timely, appropriate treatment and better continuity of care
- regular discussion in the context of an MDT is more likely to lead to improved clinical policies, more effective delivery of care and multidisciplinary participation in audit and research
- regular person-centred meetings, joint assessments and shared recording
- systems that enable teams to provide more comprehensive services.
Referral to specialist centres may involve relocation of the family from a rural or remote area, further increasing the burden.17
Describe the characteristics of an MDT approach to working with a child and family affected by cancer. (access page 90 Improving outcomes in children and young people with cancer14 )
Identify the tertiary paediatric care services available in your local region, and outline the referral pathway to this service.