What are the unique challenges associated with treating children with cancer?
Dr. Arceci: The first is to appreciate the immense, dynamic changes that occur at all ages, but that often are accentuated in children and, sometimes, in the elderly. The rapidly changing physiology, developmental characteristics, and psychosocial changes that occur in children – from infants to toddlers to school age to adolescents – are enormous. These rapidly changing individuals can metabolize chemotherapeutic agents in profoundly different ways. One must also consider the relationships and central place children play in the lives of their immediate and extended families. This creates major challenges in terms of communicating information – sometimes good and too often bad – to not just the patient but to the family as well. Learning how to discuss and explain complex issues, such as the need for often toxic treatments, to children of different ages is also a significant challenge. Integration of children and adolescents into their schools and dealing with future challenges of jobs
