New research presented at the 2014 European Society for Medical Oncology (ESMO) Congress (held 26–30 September, Madrid, Spain) reveals that many terminally ill cancer patients are not offered palliative care as part of end-of-life treatment.
The studies, conducted across six institutes in both Romania and Switzerland, assessed advanced cancer patients over a period of six months. Only 10% of patients were found to have an end-of-life care plan in place, unveiling a substantial gap between the perceived need for palliative care and the actual implementations of care in incurable cancer patients.
The statistics further revealed that 17% of patients received no palliative care interventions, while 26% of patients did not have their symptoms addressed. In addition to this, 20% of patients wanted to discuss end-of-life care with a healthcare professional, but it occurred in just 15% of these cases.
Alexandru Grigorescu (Institute of Oncology Bucharest, Romania), member of the ESMO Palliative Care Working Group, commented: “…we conducted a study to assess palliative care needs and delivery in patients with advanced, incurable cancer. Our study shows that there are significant gaps in the delivery of palliative care for patients with advanced, incurable cancer. Our findings argue for healthcare decision-makers to increase the budget for palliative care. We hope the study will make a point about the importance of treating patients during this period. In Romania we do not have an independent specialty of palliative care, so it should be the responsibility of medical oncologists.”
Over the last decade the integration of palliative care has proven to be challenging, predominantly in resource-restricted countries. Where healthcare budgets are restricted, the availability of palliative care specialists and healthcare specialist training is limited. A lack of funding in hospitals has been shown to also reduce the availability of anticancer drugs or pain-reliving medication to cancer patients.
Since 2003, ESMO has awarded ‘ESMO Designated Centre of Integrated Oncology and Palliative Care’ accolades to 175 centers that have been recognized as centers achieving a high standard of palliative care. This year, 15 new oncology centers in Europe, Canada, South America and Africa have been awarded the title in the hope of providing more incentives and structured programs that teach the essential skills required for providing palliative care to cancer patients.
ESMO has also focused its efforts to remove barriers in the availability of pain-relieving medication for cancer patients globally.
Nathan Cherny, an oncologist and palliative medicine specialist at Shaare Zedek Medical Centre (Jerusalem, Israel) commented: ‘We are working with our partners to promote legislative reforms to guarantee that all patients have access to affordable, effective pain medication to relieve the tragedy of needless suffering caused by undertreated cancer pain.’
Future ESMO plans are set to integrate palliative care with specific anticancer treatment to optimize the end-of-life care available to cancer patients. Alongside newly awarded centers this month, ESMO has also published three sets of guidelines for patients, families and oncologists to improve the implementation and effectiveness of palliative care. These new directions in end-of-life treatments are set to provide widely available and high-quality palliative care, and commit to overcome the challenges that future incurable cancer patients face.
Sources: Achimas-Chadariu P, Curca R, Grigorescu A et al. Key Interventions of Palliative Cancer Care (KI-PCC) – patient perceived need and remembered delivery by health-care professionals (HCP): A prospective, longitudinal, multicenter study. Annals of Oncology doi: 10.1093/annonc/mdu350.11 (2014); European Society for Medical Oncology press release