INCTR Supportive Care Handbook

At the time of the August 2007 thematic workshop held in Tanzania, the Supportive Care Working Group created an outline for a supportive care handbook.

In the interim period between the August 2007 workshop and the follow-up workshop, it was considered essential to refine the purpose of the handbook and to identify the intended users of the handbook so that content would be relevant for the users. Although it was originally thought possible to create a handbook relevant to both adults and children with cancer, since there are differences in approaches to providing supportive care to these patient populations it was decided to develop separate handbooks for each. It was agreed that the handbook for pediatric supportive care would be developed first.

The purpose of the Pediatric Supportive Care Handbook is: to improve the outcome and survival of children with cancer by providing guidelines for the management of tumor and treatment-related complications to provide basic guidelines for pediatric pain management and palliative care to provide guidelines for blood and blood component therapy to address psychosocial issues facing children and their families during and after treatment

The major topics covered include: Structure of the Pediatric Cancer Care Unit Pediatric Oncological Emergencies Co-morbidities Common to Low- and Middle-Income Countries Management of Treatment-Related Complications Febrile Neutropenia Prevention and Management of Infections During Treatment Common Side Effects of Chemotherapy Pain Management Acute and Late Effects of Radiation Therapy Blood Component Therapy Psychosocial Support Basics of Pediatric Palliative Care

The handbook will be useful to health care professionals involved in the care of children with cancer such as pediatric oncologists, pediatricians, hematologists, fellows, residents, medical students, both pediatric and pediatric oncology nurses and social workers. It is intended to provide information of particular value to the care of children undergoing cancer treatment in resource-limited settings, but is likely to be of value to a much broader readership.

A general outline of major topics has been created and the structure and content for preparing information related to each topic has been defined.

In November 2008, pediatric oncologists from low- and middle-income countries including Brazil, Mexico, Morocco, Algeria, Tunisia, Nigeria, Tanzania, Jordan, Turkey, India and Pakistan attended a two-day workshop to work with INCTR staff and pediatric oncologists from major U.S. university hospitals in discussing and preparing content for the handbook. It was considered essential to obtain the input of investigators facing a range of resource limitations to ensure that the handbook contains information relevant to situations ranging from those where only basic care is possible, to centers where optimal care (or close to optimal care) is feasible.

By early December 2008, first drafts of many of the planned sections were completed. Further work on the Handbook was undertaken in the Thematic Workshop in January 2008 in Tanzania (see report in this edition of NETWORK). All of this material is available online for viewing and discussion (http://inctr.wikidot.com). All site members can make comments on the relevant pages by clicking on "discussion" at the bottom of the page, or by contributing to a specific discussion thread (theme). Such comments will be taken into account in the preparation of the final handbook.

Melissa Adde, INCTR,

Brussels, Belgium