(12) Stronger Together: Integrating Neuro-Oncology and Pediatric Palliative Care at Diagnosis

Title: Stronger Together: Integrating Neuro-Oncology and Pediatric Palliative Care at Diagnosis

Abstract : Section 2 and 3: Brain tumors are the leading cause of cancer-related death in children and often result in significant symptom burden, affecting quality of life. However, early integration of palliative care in neuro-oncology remains challenging due to barriers such as limited access to specialists, insurance constraints, and misconceptions about palliative care. At Rady Children’s Hospital we embedded a Palliative Care clinic within the existing Neuro /Oncology clinic to provide early support for children diagnosed with high-grade brain tumors. We help guide families through their health care journey and ensure palliative care becomes a part of their treatment plan.

Section 4: As a quality improvement initiative, data was reviewed from all pediatric palliative care patients seen in our clinic over the past five years. Patients seen by our palliative physician from 2019-2024 had charts reviewed to determine how many passed away and whether they had an Allow Natural Death (AND) status. This study evaluates the impact of integrating palliative care into an outpatient neuro-oncology clinic, tracking 41 patients (out of 54 total seen by the Palliative Care MD) from diagnosis through end-of-life.

Section 5: Findings demonstrate that early palliative care involvement improves symptom management while facilitating goals of care discussions and end of life planning. Among the 41 patients who passed, 38 had AND status, reflecting acceptance of palliative care when introduced as a standard component of treatment.

The findings demonstrate that through multidisciplinary collaboration (including rounds, clinic coordination, and hospice referrals) we help bridge the gaps in care and provide essential support to families throughout the disease trajectory. Therefore, it is recommended that pediatric neuro-oncology clinics consider integrating palliative care in order to enhance patient outcomes and family support.