Children with BT experience unique and distressing symptoms that are distinct from other
pediatric malignancies. Progressive cognitive impairment and declining overall function are
signifi cant quality of life issues impacting on communication, decision-making, and safety.
Children with BT are at high risk of suffering in a cure-focused culture without a palliative care
approach initiated early in the trajectory.
In pediatric neuro-oncology, palliative care has always been a part of care delivery and pediatric oncologists have historically been intimately involved in EOL care. Pediatric palliative care is rapidly shifting from a focus of care from dying and death to an emphasis on quality of life and
living throughout the course of the child’s cancer trajectory regardless of the outcome. Integrating
palliative care principles early after diagnosis is particularly relevant to children with brain tumors
who may lead a productive and functional life for weeks to months after diagnosis.