Deena Levine, MD, FAAP, FAAHPM

Palliative care provides specialized support for those with serious illnesses. Children with cancer and catastrophic diseases most assuredly benefit from palliative care as it not only mitigates symptom burden but also enhances quality of life by providing social, emotional and spiritual support.

Palliative care improves patient quality of life 

Regardless of prognosis or outcome, pediatric cancers significantly impact the quality of life of patients and their families. We have found that early integration of palliative care is necessary to provide high-quality, goal-directed care for patients throughout their cancer trajectory.

We use mixed methods to identify the needs of patients and their families. Data collected from patient surveys serve as the foundation for the development of interventional studies that allow us to mitigate symptom burden, improve communication and provide resiliency building opportunities for families before, during and after treatment.

Our work has identified themes to better understand patient wants, needs, goals and values so that we can then implement clinical interventions to address these issues. Most recently, we showed that integrating palliative care into the treatment plans of children undergoing bone marrow transplants left them better suited to navigate their upcoming transplants. Our data showed that patients needed better symptom management during this process, and we were able to adjust our treatment strategy to identify and treat symptom burden in a more comprehensive manner.

The results of our studies lead to individualized, goal-directed care that prioritizes quality of life while honoring the preferences of the patient and their family.

Pediatric oncology produces a high level of distress in health care professionals. This is due to the challenges we face working with sick children and also because this is an ethically charged field. I use qualitative and quantitative measures to identify areas of distress and implement interventions that improve morale, clarify ethical boundaries and better support our treatment teams. 

In addition to providing interdisciplinary education to patients and their families, I am also invested in educating medical providers in the current standards of palliative care. I provide palliative care training for local regional hospice nurses, medical trainees and through the End-of-Life Nursing Education Consortium (ELNEC). My goal is to impart others with the knowledge and skills necessary to provide care that improves patient quality of life. 

Dr. Levine is a pediatric oncologist and palliative care physician who received her MD from Drexel University College of Medicine in Pennsylvania. She then completed a pediatric residency at the University of Medicine and Dentistry of New Jersey followed by a pediatric hematology and oncology fellowship at Johns Hopkins University, a bioethics fellowship at the National Institute of Health and a fellowship in hospice and palliative medicine at St. Jude Children’s Research Hospital in conjunction with Le bonheur Children’s Hospital and the University of Tennessee.

Dr. Levine is board certified in general pediatrics, pediatric hematology/oncology and hospice and palliative medicine. She is the Director of the Division of Quality of Life and Palliative Care in the Department of Oncology. She also serves as the Medical Director for the Quality of Life Service. Dr. Levine’s clinical research focus is improving patient- and family-centered palliative care for children with cancer.

Affiliations

• St. Jude Pediatric Oncology Education (POE) Program
• St. Jude Global Academy
• End-of-Life Nursing Education Consortium (ELNEC)