Cristina Olteanu1, Helen Dimaras2,3,4. 1. a Faculty of Arts & Science , Human Biology Program , and. 2. b Department of Ophthalmology and Vision Science , University of Toronto . 3. c The Division of Visual Science , Toronto Western Research Institute , and. 4. d The Department of Ophthalmology & Vision Sciences , The Hospital for Sick Children , Toronto , Ontario , Canada.
Abstract
BACKGROUND: Enucleation (eye removal) is often the only curative treatment for the childhood eye cancer retinoblastoma, yet parental refusal of enucleation commonly contributes to treatment delay and poor survival globally. METHODS: Physicians who treat retinoblastoma were surveyed to glean underlying reasons for treatment refusal. RESULTS: Refusal rates were higher when less time was spent with parents explaining retinoblastoma/enucleation, and where fewer support services were available. Reasons for refusal included parental belief in alternative treatments, culture, and social stigma. CONCLUSIONS: We suggest strategies to increase parental compliance with enucleation and save the lives of children with retinoblastoma.
BACKGROUND: Enucleation (eye removal) is often the only curative treatment for the childhood eye cancer retinoblastoma, yet parental refusal of enucleation commonly contributes to treatment delay and poor survival globally. METHODS: Physicians who treat retinoblastoma were surveyed to glean underlying reasons for treatment refusal. RESULTS: Refusal rates were higher when less time was spent with parents explaining retinoblastoma/enucleation, and where fewer support services were available. Reasons for refusal included parental belief in alternative treatments, culture, and social stigma. CONCLUSIONS: We suggest strategies to increase parental compliance with enucleation and save the lives of children with retinoblastoma.
Entities:
Keywords:
Enucleation refusal; global survival disparity; health inequalities; retinoblastoma; treatment compliance; treatment delay
Authors: Michala Burges; Ibrahim Qaddoumi; Rachel C Brennan; Lisa Krull; Natasha Sahr; Carlos Rodriguez-Galindo; Sima Jeha; Matthew W Wilson Journal: JCO Glob Oncol Date: 2020-10