This case study aims to facilitate the development of competencies that reflect the role of the Specialist Cancer Nurse (SCN) in managing disease and treatment related care for the child and family affected by ALL across the cancer journey.
Childhood cancer is highly curative, with 81% five-year relative survival among children aged zero-14 in the period 2004-2010. Despite this, cancer causes significant morbidity and mortality for children, and was a leading cause of death for those aged one–14 in 2008–2010.3
Acute lymphoblastic leukaemias are the most common cancer affecting children3, with a peak incidence in children aged zero to four.4
Children have unique developmental needs across all domains of health requiring responses of specialised health care professionals and services.
There are many points along the cancer journey when SCNs can improve outcomes for people at risk of, or affected by, childhood leukaemia. These include:
Section 1: Find the condition early
- Early diagnosis and treatment is important to achieve good survival outcomes and deliver treatment with the least intensity possible.5
- Increasing the awareness of clues to early diagnosis of cancer in the context of normal childhood development within the health care community may lead to earlier referrals to specialist cancer services.
- Specialist paediatric cancer services and multidisciplinary teams (MDTs) are considered to be more suited to providing evidence based, age-appropriate care and ensuring access to international clinical collaboration.
Section 2: Have the best treatment and support during active treatment
- The child and their family require the specialist support of an expert multidisciplinary paediatric cancer service involving paediatric oncologists, surgeons, radiotherapists, diagnostic services, allied health professionals and nurses with paediatric expertise throughout the cancer journey.
- The improved survival outcomes associated with childhood cancer can be attributed to advances in treatments, and delivery of individualised treatments based on the person's disease, presenting symptoms and risk factors.
- Families require information and support to make treatment decisions, which may involve enrolment in a clinical trial.
- Children require age appropriate supportive care to manage the effects of their disease and its treatment and procedural distress.
Section 3: Have the best treatment and support between and after active treatment
- Treatments used to cure childhood cancer can have long-term effects.
- 'Late effects' may impact all domains of health, and may persist or develop many years from the diagnosis of cancer.5
- People affected by childhood cancer need information and support about appropriate monitoring and health care following completion of treatment.
- The prognosis for children whose cancer relapses depends on a range of factors, requiring additional specialised treatment and supportive care interventions.