**2. A Multidisciplinary effort: Type of strategy in all the phases of the disease**

From the earliest years, the effort to care for the child with cancer has been multidisciplinary, multi-institutional, and international, involving a highly cooperative and collaborative effort of physicians, nurses, psychologists, social workers, and allied health care professionals all working together across national borders. When, thirty years ago, physicians treating the children found themselves struggling with the psychological and social repercussions of the cancer on their young dying patients and their families issues that ranged far beyond their medical expertise and training, psychosocial practitioners helped in dealing with these broader human concerns. The pediatric oncologists and hematologists from countries throughout the world began working cooperatively with psychiatrists, social workers, nursing care specialists, and psychologists. To the credit of all involved, this cooperative multidisciplinary, multi-institutional and international effort has been from the very earliest years and continues to be the hallmark of the treatment of childhood cancer. It is important that all members of the health care team engage in psychosocial support, and not just the psychosocial personnel.

What works in one cultural setting may not work as well in others. How might a center apply programs from one country or setting to another? Not all hospitals can afford a

Not all cultures appreciate intervention by a psychologist or psychiatrist. What can pediatric hematologists do to modify their approach to the children and their families with maximal success, in a manner most appropriate to and respectful of the needs of the families within their own cultural setting? And above all, how can a center best monitor its intervention programs, to ensure that the needs of the children and their families are being met appropriately, in their best interests, and with greatest effectiveness and use of resources?

How do we help a family whose child has been diagnosed with a life-threatening illness? How do we help the children and their families cope with the illness and its treatment? As the medical treatment of childhood cancer has moved from an inevitable death sentence to an approximately 80% cure rate, the importance of including the psychosocial in the treatment of the children has now been so integrated that the majority of the pediatric cancer centers throughout the world now view treatment as a biopsychosocial process.

From the very beginning, with the shock of the diagnosis itself, the children and their families undergo a critical change in their lives. The illness has a high social and economic cost, even if the treatment itself is done free of charge to the families. Whether the child is treated in countries with limited resources or in the wealthier countries, personal, family, and cultural circumstances can block access to a full cure, a cure that treats the child at all levels: medical, psychological and social. As the families face the task of adjustment to this new reality, with the support of the hospital health care team the families can find a source of renewed energy and the inner strength to cope with the disease and the treatment

Each phase of treatment has its own characteristic that contribute to the reaction of parents and children. The phases are the following: acute phase, during treatment, after treatment,

**2. A Multidisciplinary effort: Type of strategy in all the phases of the disease**  From the earliest years, the effort to care for the child with cancer has been multidisciplinary, multi-institutional, and international, involving a highly cooperative and collaborative effort of physicians, nurses, psychologists, social workers, and allied health care professionals all working together across national borders. When, thirty years ago, physicians treating the children found themselves struggling with the psychological and social repercussions of the cancer on their young dying patients and their families issues that ranged far beyond their medical expertise and training, psychosocial practitioners helped in dealing with these broader human concerns. The pediatric oncologists and hematologists from countries throughout the world began working cooperatively with psychiatrists, social workers, nursing care specialists, and psychologists. To the credit of all involved, this cooperative multidisciplinary, multi-institutional and international effort has been from the very earliest years and continues to be the hallmark of the treatment of childhood cancer. It is important that all members of the health care team engage in

psychosocial support, and not just the psychosocial personnel.

psychosocial team.

process.

long-term follow-up, end-of-life.
