Oncology

Parental refusal of treatment for leukaemia – When courts decide

Olivia is a 14-year-old girl from rural NSW who was diagnosed with Pre B Acute Lymphoblastic Leukemia (ALL).  The treatment is long and arduous, but if treated immediately has a 90 percent survival rate. Without treatment she will die within four weeks. Olivia has other conditions including epileptic encephalopathy (DEE), a severe intellectual disability, global developmental delay, communication difficulties, drug-resistant seizures and behavioural difficulties. The cancer therapy would require Olivia to have over 50 general anaesthetics as she won’t accept treatment without being restrained.  

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Caring for Children with Cancer Wherever They May Live: ARIA and the Global Initiative for Childhood Cancer

Is it possible, and is it ethical to resource-adapt cancer treatment developed in high income countries for the benefit of children with cancer living in low- and middle-income settings?

This is the dilemma, and the challenge, faced by health care professionals in such countries who care for 80% of the world’s children who have cancer, and where the chance of cure often remains poor. Adapting cancer treatment is a key pillar of the WHO Global Initiative for Childhood Cancer to improve the cure rates for children with cancer to 60% by 2030.

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The past, present, and future of paediatric neuro-oncology – using medulloblastoma as an example

Medulloblastoma is the most common malignant brain tumour of childhood. Despite multidisciplinary therapies offered by neurosurgery, radiation oncology and paediatric oncology through cooperative group clinical trials, there are significant late effects of therapy, including but not limited to neuroendocrine deficits, neurocognitive impairment and second malignant neoplasms

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CAR T Cell Therapy for acute leukaemia: The RCH experience as the national paediatric referral centre

Chimeric Antigen Receptor (CAR) T cells have revolutionised treatment for patients with acute lymphoblastic leukaemia (ALL) where standard therapies have failed.  We reflect on our first 12 months as the first national paediatric referral centre providing CAR T cell treatment to children with relapsed or refractory ALL from Australia and New Zealand, and highlight the collective efforts and lessons for the hospital-wide CAR T cell team. 

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Endeavoring to preserve fertility for children undergoing cancer treatment – current evidence, current debate 

Today, 80% of children treated for cancer will survive. However, a significant proportion of survivors are at risk of infertility, due to toxicity of their treatment. The Royal Children’s Hospital is a leader worldwide in promoting discussion of fertility issues at the time of treatment, and offering options that might be able to preserve fertility for the future.

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Neuro-Oncology: The past, the present and the future

Neuro-Oncology had stagnated for several decades with little to no improvement in patient outcomes despite marked improvements in other areas of paediatric oncology. With the advent of advanced genomics and epigenomics and an explosion in our understanding of disease, we are finally seeing improvements. Dr Hansford will discuss the advances in modern Paediatric Neuro-Oncology and highlight the opportunities, problems and challenges as we push for better cure rates and quality of survivorship into the future for children with brain tumours.

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Multidisciplinary teams: Are we ready?

Addressing the increasing complexity of care is a new challenge in tertiary hospitals. We also all agree that a holistic approach is the standard of care. Multidisciplinary teams have the potential to offer a greater level of expertise with a more diverse approach to work on common goals of care.

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