School as part of palliative care in pediatric oncology.

Background. - School intervention programs for children and adolescents with cancer have been developed in France during the last years. Their primary objective is to improve the psychosocial adaptation of these children to normal life through school integration. These programs are however inadequate for these children who will ultimately die from their disease and may require a specific school intervention. Material and methods. - School data from 30 children requiring palliative care were prospectively collected School interest its evolution and specific adaptations according to the child's status were analysed. Results. - Sixty per cent of the children showed a continuous desire for school education throughout their life's end Reading, mathematics and computer work were the most favorite topics. Physical disability and fatigue may change their request during the evolution of the disease. School refusal occurred in 40% of the children and is mainly due to other extra-academic topics, or related to uncontrolled pain. Conclusion. - Objectives of life's end school are different from educational programs proposed for children with cancer. They must be part of palliative care and have to be defined as a specific entity.