The Role of the Surgeon in Palliative Care

Palliative surgery in pediatric cancer care is often defined as surgical interventions with the intent to improve a patient’s quality of life by relieving suffering secondary to symptoms of advanced oncologic disease. Pediatric oncology surgeons are usually consulted to perform procedures that can improve the quality of life for children facing serious illness but which also carry the potential for significant risks and postoperative complications. Decisions are usually difficult to take and a multidisciplinary approach is required. The surgical team, as a part of the interdisciplinary collaboration, should act in the best interest of the patient and to determine, in conjunction with the patient, the family, and other caregivers, what the best interests might be. As the technical innovation and the knowledge in cancer research advances, pediatric oncology patients will become increasingly complex. Pediatric surgeons will continue to play a critical role in the decision-making process. Surgical interventions in end-of-life care include the management of airway and breathing compromise, feeding needs, and pain-control issues among others. Less invasive image-guided procedures usually performed by interventional radiologists are occasionally preferred to invasive surgical procedures.