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Palliative care for cancer patients: Concept and challenges

Article: Dr. Amna Al-Harsi – Palliative Care Consultant

Palliative care is a medical science that carries the philosophy of treating symptoms, relieving suffering, and focusing on quality of life when a patient faces life-threatening diseases such as malignant diseases, fatal chronic diseases, or diseases related to aging.

The World Health Organization (WHO) defines palliative care as “an approach that improves the quality of life of patients and their families facing problems associated with life-threatening diseases, through prevention and alleviation of suffering through early diagnose, flawless assessment and treatment of pain, and other physical, psychological, social and spiritual problems.” It is a multidisciplinary approach to medical care by drawing on input from physicians, nurses, occupational therapists, Physiotherapist, psychologists, social workers, dietitians and other health professionals to develop a plan of care to alleviate suffering in all areas of a patient’s life.

WHO is currently focusing on palliative care to be available to the millions of people who need it around the world, and while some see the provision of palliative care as a sign of well-being in the health system, WHO considers it essential, raises the slogan “letting no one behind” and aims to provide palliative care in all countries of the world by 2030. WHO estimates that about 40 million people annually need palliative care; 78% of these live in low- and middle-income countries. Globally, only 14% of people who need palliative care are currently receiving it. It is expressly recognized under the human right to health and should be provided within the framework of comprehensive, people-centered health services.

On its official website, WHO has put forward key facts regarding palliative care and a package of recommendations to the world. These recommendations include recommendations related to the provision and development of palliative care services, and recommendations for integrating palliative care within primary care programs and pediatric services, besides emergency and exceptional circumstances. You can learn more through the following link: https://www.who.int/ar/news-room/fact-sheets/detail/palliative-care

Palliative care for cancer patients:

Palliative care for cancer patients, aims to take care of the symptoms caused by the disease from the first day of the patient’s diagnosis, such as pain, wasting, loss of appetite, etc., and then accompany the patient to relieve him/her in the treatment journey by dealing with the side effects resulting from chemotherapy, radiation and surgical interventions. Palliative care is also concerned with providing care to patients in the late stages of malignant diseases, who unfortunately the treatments have not been able to control their diseases. Palliative care is most effective when delivered early, as it not only improves patients’ quality of life but also reduces the number of unnecessary hospital admissions and use of health services.

End-of-life palliative care aims to provide care, symptomatic treatment, and psycho-social and spiritual support to the patient and his\ her family, and to provide the patient with better days free from suffering or controlled symptoms.

The world today is adopting a policy of providing end-of-life palliative care to patients in their homes or nursing homes instead of hospitals for therapeutic purposes. This approach aims to provide care to the patient in the “places dearest to his\ her heart” away from crowded hospital halls.

Pain and difficulty breathing are the most common and serious symptoms in patients who require palliative care, and it is estimated that 80% of patients with cancer will experience moderate to severe pain at the end of their lives. Opioids are essential for pain management and can also relieve other common bothersome physical symptoms, including shortness of breath. Controlling these symptoms at an early stage is a moral imperative to alleviate suffering and respect human dignity.

The challenges of providing palliative care:

There are many challenges to palliative care including that national health policies and systems often do not include palliative care at all, training of health professionals in palliative care is often limited or non-existent, population’s difficulty in obtaining access to opioids for pain relief due to laws that limit access, and misconceptions that improving access to opioid analgesics will lead to increased substance abuse.

There is also a misunderstanding among policy-makers, health professionals, and the public about palliative care and the benefits it can bring to patients and health systems. There are cultural and social barriers such as beliefs about death and dying, as well as misconceptions about palliative care such as the belief that it is only offered to cancer patients, or in the last weeks of a patient’s life.

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