Palliative care improves the quality of life of patients and their families who are facing problems associated with life-threatening illness. Palliative care uses a team approach to prevent and relieve suffering through the early identification, correct assessment and treatment of pain and other problems, whether physical, psychosocial or spiritual.
Palliative care is an urgent humanitarian need worldwide for people with cancer and other chronic fatal diseases. Only 14% of people in the world needing palliative care currently receive it. Palliative care is explicitly recognized under the human right to health and is particularly needed in places where a high proportion of cancer patients present in advanced stages and have little chance of being cured.
Ideally palliative care services should be provided from the time of diagnosis, adapting to the increasing needs of cancer patients and their families as the disease progresses. Palliative care is applicable early in the course of illness, in conjunction with other therapies such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications. Palliative care intends neither to hasten nor postpone death but to enhance quality of life; however, it may sometimes positively influence the course of illness and survival. Early palliative care also reduces unnecessary hospitalizations and the use of health care services.
Palliative care services should offer a support system to help the family cope during the patient’s illness and after the patient’s death, including bereavement counselling if indicated.
Palliative care can be provided relatively simply and inexpensively, but in many countries major barriers remain which include:
- lack of training and awareness of palliative care among health professionals;
- lack of awareness of palliative care among decision-makers and the general public about the benefits it can offer to patients and health systems;
- overly restrictive regulations for morphine and other controlled palliative medicines;
- cultural and social barriers, such as beliefs about death and dying; and
- misconceptions about palliative care, such as that it is only for the last weeks of life or that improving access to opioids will lead to increased substance abuse.
These barriers need to be addressed, and palliative care should be made accessible to all, irrespective of the patient’s income, disease type or age.