In the recent past, when no effective therapy could be offered to children with cancer, pediatricians were naturally depressed by their helplessness and tended to reject these children and to put aside their distraught parents with the assertion, "There is nothing anyone can do." Now that children with cancer often can be treated successfully or even cured, we have a brand new perspective. Along with an upsurge of scientific interest and research in cancer, therapeutic optimism has grown.
Because of the great scientific progress recently made in the treatment of cancer, the pediatrician can no longer withdraw from active, even aggressive, treatment and compassionate management of children with cancer. There is now a real contribution he or she can make. As treatment of various kinds of childhood cancer becomes more clearly understood and better established, pediatricians will be able to - and will be expected to - take an ever increasing role in the care and treatment of these children.
But the treatment of childhood cancer is still a complex process involving several medical disciplines and specialties. Successful treatment often depends on close cooperation between pediatrician, hematologist, radiotherapist, and surgeon, but the role of the pediatrician in this cooperative effort is becoming ever more primary and central. Not only may the pediatrician be called upon to administer the various aspects of the child's chemotherapy and to recognize possible side effects resulting from it, but he or she must also be able to communicate with the family by discussing the child's condition, expected needs for future care, and prognosis. In addition, the pediatrician must provide the personal support that is important to any family with a seriously ill child. A fairly comprehensive knowledge of current techniques of diagnosis and therapy and an understanding of the prognosis of various types of cancer are needed for the pediatrician to effectively play his or her central role in the care of children with cancer.
The material on cancer contained in this issue and in the June issue has been selected on the basis of its clinical usefulness and relevance to practicing pediatricians. Emphasis is on what the pediatrician can do. The articles are clinically oriented and are not intended to be comprehensive reviews of the topics discussed.
Even children who cannot be cured of their cancer often can be greatly helped by being given conscientious and thorough pediatric care. When these children are avoided or neglected because of the pediatrician's personal bias that the condition is "hopeless," what hope these children have for prolonged survival or cure is lost. An important side effect or fringe benefit of the recent explosion of interest in and improvement in therapy of childhood cancer has been a new optimism, enabling children with cancer to receive a full measure of the same conscientious, compassionate, and thorough pediatric care their physicians routinely give to any other sick children.
The articles in this issue and in the one to follow give us many specific and sound reasons for the new optimism that has been growing among those most active in the treatment of children with cancer. This will increasingly enable the pediatrician to affirm his or her central and vital role in the treatment of children with cancer, just as he or she customarily does with children with any other serious illness.