Understanding treatment recommendations at diagnosis of advanced cancer in pediatric oncology: The need to explore decision‐making challenges globally

Abstract

Pediatric oncologists strive to consider and prioritize all possible curative treatment options. Deciding not to recommend curative treatment can be difficult, particularly in the context of a new diagnosis of advanced cancer if the chance of survival is anticipated to be very low, yet patients, families, and medical teams still hope for cure. Presently, the factors that influence clinicians' upfront treatment decision-making for children diagnosed with advanced cancer with poor prognosis remain understudied. [1][2][3] Understanding these factors is particularly important in low-and middle-income countries (LMICs; inclusive of low-income, lower middle-income, and upper middle-income countries), where less than 40% of children diagnosed with cancer are estimated to survive. 4,5 When children in LMICs are diagnosed with advanced cancers that are typically treated with curative intent in higher resourced settings, recommending non-curative therapy may cause moral distress for some clinicians. 6 This burden Abbreviation: LMICs, low-and middle-income countries.