Natasha Datoo, MD – BC Children’s Hospital and Canuck Place Children’s Hospice, BC, Canada
I am a pediatric oncologist and palliative care physician who works in both fields in Vancouver, Canada. My clinical and research interest includes enhanced communication, and the impact communication has on clinicians and patients/families.
Featured Articles
Khan A, Gupta A, Liu A, Ahmad AH. Advance Care Planning Conversations in Pediatric Patients with Refractory Oncologic Disease. Children. 2025; 12(4):479.
Ayala, A. A., Farner, H., Mehler, S., Christianson, C., Brinkman, T. M., Baker, J. N., Hinds, P. S., Mack, J. W., & Kaye, E. C. (2025). “We Were Still Left in the Back Field, Not Knowing”: Pediatric Cancer Patients and Parents Describe Obstacles to Prognostic Communication. Cancer Med, 14(7), e70810.
Christianson, C., Reeves, C., Farner, H., Mehler, S., Brinkman, T. M., Baker, J. N., Hinds, P., Mack, J. W., & Kaye, E. C. (2025). Preferences for Communication About Prognosis Among Children With Cancer, Parents, and Oncologists. JAMA Network Open, 8(4), e255431–e255431.
Kim, M. A., Sang, J., & Min, J. (2025). Continuing bonds, complicated grief, and posttraumatic growth among bereaved parents after the loss of a child to cancer. European Journal of Oncology Nursing.
Commentary
Reflection on Tributes: An important form of Communication for Clinicians
In pediatric palliative care, enhanced communication is a core competency and a skill we use daily when having difficult conversations with patients and families. This month’s list exemplifies how communication is one of the most important and widely discussed themes in pediatric oncology and palliative care, with a growing body of literature exploring how clinicians navigate conversations about delivering bad news1, prognostication2,3, and end of life4. However, the way we communicate the death of a patient is a form of communication which is often overlooked in the literature yet can be especially meaningful to the clinician and team who care for the patient. My experiences as a pediatric oncologist and palliative care clinician have led me to reflect more broadly on communication surrounding death itself, and how it continues even after a child has died.
Working across both oncology and pediatric palliative care has shown me how differently the death of a child is communicated within each setting. At Canuck Place Children’s Hospice, the moment a child dies, an email is sent to the entire team, clinical and non-clinical alike. It is a ritual that has existed for years, a way of acknowledging the significance of the loss and ensuring that no one learns of it by accident or delay. When I first arrived as a fellow, coming from oncology, I was already familiar with many of the children who died at the hospice. I found myself wanting to share more than the basic demographic details traditionally included in these notifications. I wanted the team to remember the child as I had known them, their uniqueness, their passions, the small joys that defined them far more than their illness. Over time, these emails evolved from simple announcements into tributes. It also became unexpectedly therapeutic for me, a way for me to process the intimate and intense journey that I had just been a part of.
The communication process after a child’s death in oncology is different. An email is sent to the clinical team, sometimes days after the child has died, primarily for record keeping. It contains the essential facts about the diagnosis but not a lot about who the child was as a person. In discussions with my oncology colleagues, especially the bedside nurses who have such close relationships with these patients, to learn of the child’s death with such impersonal communication can feel wrong. Not knowing the circumstances of the child’s last days or hours, who was present and how the child died can feel unsettling to those who knew them well. These conversations with my colleagues made me think about how important it is for teams who invest deeply in their patients to have timely, meaningful acknowledgment of a loss.
Reflecting on these differences has led me to ask: what is a tribute, and why does it matter. To me, a tribute is a form of communication that is more than just a summary. It is a gesture of compassion and remembrance. It captures who the child was as a human being, not just their diagnosis. It allows us to talk about their favourite songs, the way they lit up when their sibling entered the room, the stuffed animal they insisted on bringing to every appointment. Writing these tributes has also been beneficial and healing for me as a clinician. Reflecting on these experiences has allowed me to think about what went well, what I would do differently next time and has allowed me to heal and find closure. Writing can provide us with an outlet that is often under recognized but necessary to build resilience in this field. For me, it has become a practice of ritual, reflection, and gratitude. In a field where emotional boundaries can blur and cumulative loss is real, this ritual has helped me carry the work in a healthier way. It is a reminder that grief is not something to be avoided but something to be acknowledged and integrated into our work. For me, writing tributes has become a form of communication that bridges the clinical and the emotional.
My appreciation for writing deepened further and on a personal note when I recently experienced the loss of a mentor. Helping to write a tribute for him brought me back to the same principles I use when writing about my patients. It was a way of honouring his impact, of capturing the essence of who he was, and of processing my own grief. It reaffirmed for me that tributes matter because they allow us to continue the relationship in a different form, allow us to keep the person’s spirit alive in our memories and honouring the impact they had and will continue to have on us.
Ultimately, communicating difficult news does not end with the moment we tell a family that their child has cancer or is dying. It continues in how we honour that child’s life, how we support one another as a team, and how we make space for our own grief. Writing tributes has become one of the most meaningful ways I participate in this ongoing communication. It is a practice that honours the deceased, supports the living, and sustains me in the work I feel privileged to do, solidifying how important communication is for us as clinicians and as human beings.
References
- Khan A, Gupta A, Liu A, Ahmad AH. Advance Care Planning Conversations in Pediatric Patients with Refractory Oncologic Disease. Children. 2025; 12(4):479.
- Ayala, A. A., Farner, H., Mehler, S., Christianson, C., Brinkman, T. M., Baker, J. N., Hinds, P. S., Mack, J. W., & Kaye, E. C. (2025). “We Were Still Left in the Back Field, Not Knowing”: Pediatric Cancer Patients and Parents Describe Obstacles to Prognostic Communication. Cancer Med, 14(7), e70810.
- Christianson, C., Reeves, C., Farner, H., Mehler, S., Brinkman, T. M., Baker, J. N., Hinds, P., Mack, J. W., & Kaye, E. C. (2025). Preferences for Communication About Prognosis Among Children With Cancer, Parents, and Oncologists. JAMA Network Open, 8(4), e255431–e255431.
- Kim, M. A., Sang, J., & Min, J. (2025). Continuing bonds, complicated grief, and posttraumatic growth among bereaved parents after the loss of a child to cancer. European Journal of Oncology Nursing.
TRENDS 2025; Special Edition 3: Oncology
Click the links below to view this months full list in desired format.
Adelmann, M., Davidoff, K., Kiser, S., & Ritchie, C. (2025). Blended Pediatric/Adult Palliative Care for Young Adult With Autism and Pancreatic Cancer. Journal of Pain & Symptom Management, 69(5), e517–e518.
Aedo, M. M., Rodriguez, Z. N., Palma, T. C., & Yohannessen, V. K. (2024). Palliative sedation in pediatric patients with advanced cancer in palliative care. Andes Pediatrica, 95(6), 730EP – 736.
Alexander, A. K., Martinez, I., Tefera, R., Beauchemin, M. P., Lawhon, V. M., Nichols, A., Rosenberg, A. R., Bhatia, S., & Johnston, E. E. (2025). Bereaved Parents’ Perspectives on Financial Toxicity at End of Life for Children with Cancer: A Qualitative Study. The Journal of Pediatrics, 276, 114269.
Alshakhshir, N. S., Hendricks-Ferguson, V. L., Ward, E., Ersig, A. L., & Montgomery, K. E. (2025). Awakening the Spiritual Identity in Adolescents With Cancer: A Phenomenological Study. Cancer Nursing, 10.1097/NCC.0000000000001470.
Andriastuti, M., Halim, P. G., Mulyati, T., Bangun, M., & Widodo, D. P. (2024). Palliative Home Visit Intervention and Emergency Admission in Pediatric Cancer Children: A Randomized Controlled Trial. Current Pediatric Reviews, 20(2), 194–199.
Ayala, A. A., Farner, H., Mehler, S., Christianson, C., Brinkman, T. M., Baker, J. N., Hinds, P. S., Mack, J. W., & Kaye, E. C. (2025). “We Were Still Left in the Back Field, Not Knowing”: Pediatric Cancer Patients and Parents Describe Obstacles to Prognostic Communication. Cancer Med, 14(7), e70810.
Ayoub, M., Lövgren, M., Kreicbergs, U., & Udo, C. (2025). Voices of Children with Cancer and Their Siblings in the Family Talk Intervention. Children, 12(3).
Bingol, H. D., Aydin, A., Kebudi, R., Ertunc Soycan, M., Yildirim, U. M., Senol, B. K., & Zulfikar, O. B. (2025). Keeping Hope for Dying Children and Their Families: The Experiences of Physicians and Nurses in Pediatric Oncology. Pediatric Blood and Cancer, 72(8), e31827.
Cai, W., Tao, L., Zhang, Y., He, Y., & Huang, S. (2025). Research progress on hospice care preferences of parents of children with cancer. Chinese Journal of General Practitioners, 24(8), 1028EP – 1033.
Cardoso, A. L., Del Nero, L. G., Martins-Branco, D., Lacerda, A., Gomes, B., & Lopes, S. (2024). Aggressiveness of Care at the End of Life of Children Dying with Cancer in Public Hospitals-A Nationwide Retrospective Cohort Study. Journal of Palliative Medicine.
Chelazzi, C., Marelli, D., Mantovani, P., Franchi, F., & Vezzoli, C. (2025). Needs, status and future directions in palliative care for children with cancer: An insight into the Italian situation. Frontiers in Oncology, 15, 1582341.
Christianson, C., Mehler, S., Reeves, C., Farner, H., Brinkman, T. M., Baker, J. N., Hinds, P. S., Mack, J. W., & Kaye, E. C. (2025). “We’re going to get through this together”: Patient, parent, and oncologist recommendations for providing emotional support in advanced childhood cancer. Journal of Psychosocial Oncology, 1–18.
Christianson, C., Reeves, C., Farner, H., Mehler, S., Brinkman, T. M., Baker, J. N., Hinds, P., Mack, J. W., & Kaye, E. C. (2025). Preferences for Communication About Prognosis Among Children With Cancer, Parents, and Oncologists. JAMA Network Open, 8(4), e255431–e255431.
Cuviello, A., Figueroa Guzman, A. F., Zeng, E., Mothi, S. S., Baker, J. N., & Krasin, M. J. (2024). Utilization of Palliative Radiation in Pediatric Oncology Patients During the End-of-Life (EOL). Journal of Pain and Symptom Management, 68(6), 603-612.e2.
Deb, T. R., & Jahan, A. (2025). A Comprehensive Study on Symptoms and Suffering at the End of Life in Children with Leukemia Cancer. Scientia. Technology, Science and Society, 2(4), 28–38.
Dittmer, K., Vitinius, F., Hamm, I., Dabritz, T., Hanse, S., Hoemberg, M., Lorenz, A., Misgeld, R., Paul, N. W., Stamm, W., & Krieger, T. (2025). Designing and maturing the OKRA-Compass for breaking bad news in the German pediatric oncology setting: A participatory action research study. Patient Education and Counseling, 134, 108694.
Downing, J., Daniels, A., McNeil, M. J., Ndagire, M., Palat, G., Rassam, R. S., & Baker, J. N. (2024). Paediatric palliative care in cancer. Ecancermedicalscience, 18, 1823.
Eche-Ugwu, I. J., Mazzola, E., Stevens, S. E., Wolfe, J., & Feraco, A. M. (2025). Illness Uncertainty in Parents of Children With Cancer—An Exploratory Analysis to Inform Intervention Development. Pediatric Blood & Cancer, n/a(n/a), e31726.
El-Atoum, B., Gradick, K., Parker, K., Moore, D., Fluchel, M., & Sanchez-Birkhead, A. C. (2025). Palliative and End-of-Life Disparities for Pediatric Hispanic, Spanish-Preferring Patients With Cancer. Journal of Pediatric Hematology/Oncology.
El-Fatah, W. O. A., Mohamed, T., Abdallah, N., Ahmed, H. M., & Ayaad, S. R. A. E. F. (2025). Analyzing the nexus between burnout and psychological distress in pediatric oncology nurses: A descriptive correlational investigation. BMC Nursing, 24(1), 1–10.
Farchi, M. U., & Gidron, Y. (2025). Styles of Delivering News About a Child’s Cancer and Parents’ PTSD Symptoms. Psycho-Oncology, 34(1), e70071.
Foster, K., Sadler, B., Conrad, A. L., & Grafft, A. (2025). Development of an Evaluation Tool for Monitoring the Delivery of Psychosocial Care in Pediatric Oncology Settings. Cancers, 17(9), 1550.
Friebert, S., Trujillo Rivera, E. A., Baker, J. N., Thompkins, J. D., Grossoehme, D., Needle, J., & Lyon, M. E. (2025). Pediatric Advance Care Planning and Adolescent Preparedness and Quality of Life: An RCT. Pediatrics, 155(2), e2024068699.
Hamm, I., Dittmer, K., Vitinius, F., Reinert, D., Hoemberg, M., Kamm-Thonwart, R., Misgeld, R., & Krieger, T. (2025). Developing multi-perspective practice-based evidence theses for breaking bad news in the German pediatric oncology: A participatory group Delphi study. PEC Innovation, 7, 100413.
Hasan, F., Widger, K., Punnett, A., Rapoport, A., Morgenstern, D., Cohen-Gogo, S., Revon-Riviere, G., Abbott, L., Guilcher, G. M. T., Fernandez, C., Truong, T. H., Deyell, R. J., & Sung, L. (2025). Early phase study enrollment in Canadian children with cancer near end of life: A retrospective cohort study from Cancer in Young People in Canada. Cancer, 131(12), e35942.
Holly, S.-P., Heidelberg, R. E., Wright, R. P., Ly, A. G., Meyer, M., Vukadinovich, C., Baker, J. N., & Levine, D. R. (2025). Pediatric Hematology–Oncology Provider Attitudes and Beliefs About the Use of Integrative Modalities for Their Patients: A Cross-Sectional Survey. Journal of Integrative and Complementary Medicine.
Jibb, L. A., Liu, W., Stinson, J. N., Nathan, P. C., Chartrand, J., Alberts, N. M., Hashemi, E., Masama, T., Pease, H. G., Torres, L. B., Cortes, H. G., Kuczynski, S., Liu, S., La, H., & Fortier, M. A. (2024). Supporting parent capacity to manage pain in young children with cancer at home: Co-design and usability testing of the PainCaRe app. Paediatric and Neonatal Pain, 6(3), 80EP – 88.
Johnson, A., & Widger, K. (2025). Harnessing Social Media to Develop Conceptual Domains of Quality of Life for Adolescents With Advanced Cancer. Psycho-Oncology, 34(5), e70155.
Khan, A., Gupta, A., Liu, A., & Ahmad, A. H. (2025). Advance Care Planning Conversations in Pediatric Patients with Refractory Oncologic Disease. Children, 12(4), 479.
Kim, M. A., Sang, J., & Min, J. (2025). Continuing bonds, complicated grief, and posttraumatic growth among bereaved parents after the loss of a child to cancer. European Journal of Oncology Nursing.
Kirakosyan, V., & Bacque, M. F. (2025). Interpretative Phenomenological Analysis of Mothers’ Experience of Caring for Their Child Dying of Cancer at Home. Comprehensive Child and Adolescent Nursing, 1EP – 19.
Kleinlugtenbelt, L. B., Gorter, J. W., van Dalen, E. C., Ketelaar, M., & Tissing, W. J. E. (2025). Integrated care networks in multidisciplinary rehabilitation therapy services for childhood oncology close to home: Lessons learned from an international environmental scan. Supportive Care in Cancer, 33(5), 406.
Le, H. D., Braungart, S., Shalkow-Klincovstein, J., & Piche, N. (2025). Roles of pediatric surgeons in palliative pediatric oncology. Pediatric Blood & Cancer, 72 Suppl 2, e31354.
Mack, M. C., Claxton, R. N., Arnold, R. M., & Maurer, S. H. (2025). Peds OncoTalk: A Curriculum to Teach Communication Skills to Pediatric Hematology/Oncology Fellows. Pediatric Blood and Cancer.
Madni, A., Levine, D. R., Sawyer, K. E., Azzi, Y., Mandrell, B. N., Li, Y., Ashcraft, E., Boggs, J., Acharya, R., Caples, M., Gattuso, J. S., Shoulders, L. A., & Johnson, L. M. (2025). Impacts of Ethical Dilemmas and Moral Distress in Pediatric Hematology Oncology Nurses. Pediatric Blood and Cancer.
Malinowski, P. K., Pozo‐Kaderman, C., Muriel, A. C., Hanania, J., Pirl, W. F., Dorste, A., Rotman, C., Jankauskaite, G., Joyce, E. K., & Morris, S. E. (2025). Interventions for Children of Parents With Cancer From the Time of Cancer Diagnosis Through Bereavement: Two Systematic Reviews. Psycho-Oncology, 34(3), 1–26.
Martinez Garcia, E., Lopez de San Roman Fernandez, C., Nishishinya Aquino, M. B., Perez-Jaume, S., Fernandez-Jane, C., Cruz Martinez, O., & Morales La Madrid, A. (2025). Patient Acceptability of the First Integrative Pediatric Oncology Unit in Spain-The Pediatric Cancer Center Barcelona Experience: A Retrospective Study. Cancers, 17(2), 222.
Molinaro, M. L., Polzer, J., Laliberte Rudman, D., & Savundranayagam, M. (2025). Pediatric oncology caregiving as narrative repair: Restor(y)ing disrupted. Health: An Interdisciplinary Journal for the Social Study of Health.
Moreira, D. C., Hashmi, S. K., Andujar, A., Berg, F., Conger, K., Fox Irwin, L., Mikkelsen, M., Antillon-Klussmann, F., Bazzeh, F., Cypriano, M., Gao, Y. J., Gonzalez-Ramella, O., Rivas, S., Lopes, L. F., Mack, R., Morosini, F., Noun, D., Garcia, X., Homsi, M. R., … Rodriguez-Galindo, C. (2025). The St. Jude Global Academy: A Multifaceted Education Program to Expand Pediatric Oncology Workforce Capacity. Pediatric Blood and Cancer, 72(3), e31499.
Nair, M. (2025). Palliative care in pediatric Leukemia: The value added to care. Pediatric Hematology Oncology Journal, 10(3), 100479.
Ng, Y. H., & Fu, F. (2024). Coping with Anticipatory Grief: A Qualitative Study of Parents of Children with Advanced Cancer. Cancer Nursing.
Park, H. S., Brock, K. E., Lee, K., Korsah, K., & Radbill, L. M. (2025). Psychological Domains of Care of Pediatric Palliative Care Within Pediatric Oncology. Psycho-Oncology, 34(8), e70264.
Park, H. S., DeGroote, N., Lewis, R. W., Lee, K., Lange, A., Johnson, K., Kavalieratos, D., & Brock, K. E. (2025). The Scope of Clinical Practice of Inpatient and Outpatient Pediatric Palliative Care Within Pediatric Oncology. Pediatr. Blood Cancer.
Rakic, M., Sandri, A., Gysin, O., & Rost, M. (2025). Migrant Families’ Experiences in Pediatric Oncology: A Scoping Review. European Journal of Oncology Nursing.
Sahraian, L., Fakhar, N., Tarrahi, M. J., & Haghshenas, M. (2025). Family Functioning and the Quality of Life of Children with Cancer: A Descriptive Cross-Sectional Study. Journal of Comprehensive Pediatrics, 16(2), e157267.
Scarperi, P., & MacKenzie Greenle, M. (2025). Caring Beyond Cure: Perspectives of Pediatric Oncology Nurses on End-of-Life Care. Journal of Hospice & Palliative Nursing, 142–148.
Siefring, E., Olsavsky, A. L., Schaefer, M., Sutherland-Foggio, M., Himelhoch, A. C., Hill, K. N., Kenney, A. E., Humphrey, L., Olshefski, R., & Gerhardt, C. A. (2024). Benefit-finding in children with advanced cancer and their parents. Palliative & Supportive Care, 1EP – 7.
Silva-Rodrigues, F. M., Hinds, P. S., Scrideli, C. A., Brandalise, S. R., Salgado, M. A. S., & Nascimento, L. C. (2025). Pain as an Adverse Event During Chemotherapy in Children with Acute Lymphoblastic Leukemia: A Cross-Sectional Nationwide Study. Cancer Control, 32, 10732748251341522.
Snaman, J. M., Herold, B., Umaretiya, P. J., & Johnston, E. E. (2025). Parental Financial Support Needs After the Death of a Child From Cancer. Pediatric Blood and Cancer.
Superdock, A. K., Cravo, E., Christianson, C., Farner, H., Mehler, S., & Kaye, E. C. (2025). Communication About Prognosis Across Advancing Childhood Cancer: Preferences and Recommendations from Bereaved Parents. Journal of Palliative Medicine.
Superdock, A. K., Porter, A. S., Spears, W., Baker, J. N., Mack, J. W., & Kaye, E. C. (2025). Spiritual Communication Between Pediatric Oncologists, Caregivers, and Patients With Brain Tumors. Pediatric Blood and Cancer, 72(7), e31721.
Turner, E., Sirrine, E. H., Crabtree, V. M., Elliott, D. A., Carr, A., Elsener, P., & Parris, K. R. (2025). An Interprofessional Approach to Developing Family Psychosocial Support Programs in a Pediatric Oncology Healthcare Setting. Cancers, 17(8), 1342.
Uber, A., Adams, R. H., Marcus, S., Otto, M., Shaw, T., & Cuviello, A. (2025). A Unique Approach to Interdisciplinary Programmatic Palliative Care Development: Extending Into the Realm of Pediatric Palliative Oncology. Pediatric Blood and Cancer.
Udemgba, C. S., Palama, B. K., Darlington, W., & Hoehn, K. S. (2025). Differences in Inpatient Palliative Care Consultation During the Terminal Admission for Pediatric Neuro-Oncology Patients. The American Journal of Hospice & Palliative Care, 10499091251316570.
van Driessche, A., Beernaert, K., Deliens, L., Kars, M. C., Wallaert, S., Willems, L., Morren, H., Vercruysse, G., Van den Bossche, A., De Vleminck, A., & Cohen, J. (2025). Influence of pediatric advance care planning on the secondary outcomes of the BOOST pACP trial: Determinants of communication between parents and adolescents with cancer. European Journal of Pediatrics, 184(6), 338.
Vokinger, A. K., Pedraza, E. C., Tinner, E. M., von Bueren, A. O., Scheinemann, K., Bergstraesser, E., Michel, G., & De Clercq, E. (2024). Support Experiences and Wishes of Bereaved Parents After the Loss of Their Child to Cancer. Pediatric Blood and Cancer.
Walia, P., Martimianakis, M. A., Lucchetta, S., Punnett, A., & Hasan, F. (2025). Health practitioners’ perceptions of psychosocial support for siblings of children with poor prognosis cancers: A qualitative study. Supportive Care in Cancer, 33(5), 436.
Ye, J., Yang, L., Axelin, A., Likitalo, S., Wen, C., & Li, X. (2025). The implementation and strategy of triadic communication in pediatric oncology: A scoping review. Pediatric Research, 97(6), 1803EP – 1822.
Zahreddine, A., Ghobreel, N., & Doumit, M. A. A. (2025). Recommendations for Improving Equitability of Care for Pediatric Oncology. Seminars in Oncology Nursing, 41, 41.