Easing life at the end

The word "Palliative Care" may be new to many of us but the care existed in various labels for centuries within our society. Palliative care is defined as an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness. It helps prevent and relief of sufferings by early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.
Palliative care can help people with a variety of illnesses like cancer, dementia, HIV/AIDS, neurological disorders, end stage cardiac failure, kidney failure and other life-limiting illnesses.
In most countries including Bangladesh, cancer is the main area of intervention for palliative medicine. In Bangladesh, new cancer cases per year can be estimated as 200,000. Out of these, 150 thousand die in each year. National Institute of Cancer Research and other hospitals can provide treatment to only 2 percent of all cancer patients per year.
Relief of sufferings of these cancer patients and improving patient's quality of life is a primary objective in the effort against cancer. When cancer is not curable, important quality of life advantages still can be achieved through optimal (often palliative) anticancer treatment e.g. chemotherapy, radiotherapy and supportive care, including pain ,symptom and fatigue management and end of life palliation.
Patients should not suffer needlessly from cancer pain. Most pain from cancer can be adequately controlled with analgesics given by mouth. It is estimated that about 85 percent of patients could be free of significant pain with the techniques we have available today. Most cancer patients with terminal disease need expert pain management; between 60-80 percent of such patients have significant pain. Multi-centre studies indicate that about 40 percent of outpatients with cancer pain do not receive analgesics potent enough to manage their pain.
Almost 80 percent of all cancer patients in our country still present at late stage when palliative care is the only way for the patient and family; also often inadequate treatment due to financial and social issues brings them from curative to incurable stage. To solve this problem, we need to work with our policy makers to create awareness and develop guidelines to address non-communicable disease burden like cancer.
The writer is a Palliative Medicine Specialist and also the Chairperson, Bangladesh Palliative and Supportive Care Foundation. E-mail: [email protected]