Guidance for public health planners on people living with advanced cancer

Oct 8 2007

The World Health Organisation (WHO) has released its first guide on planning palliative care services for people living with advanced stages of cancer.

The guide, which is based on consultations with more than 70 leading cancer experts in the world, has identified highly effective low-cost public health models to care for terminally ill cancer patients, especially in developing countries.

The guide Palliative care: cancer control knowledge into action, WHO guide for effective programmes was launched on the occasion of World Hospice and Palliative Care Day (6 October).

Palliative care improves the quality of life of patients and their families facing life-threatening illness by providing pain relief and management of other distressing and debilitating symptoms. Palliative care services are appropriate from the time of diagnosis of a life-threatening illness and throughout the course of the illness. Preliminary estimates show that each year, 4.8 million people who suffer from moderate to severe pain caused by cancer do not receive treatment.

"Everyone has a right to be treated, and die, with dignity. The relief of pain - physical, emotional, spiritual and social - is a human right," said Dr Catherine Le Galès-Camus, WHO Assistant Director-General for Noncommunicable Diseases and Mental Health. "Palliative care is an urgent need worldwide for people living with advanced stages of cancer, particularly in developing countries, where a high proportion of people with cancer are diagnosed when treatment is no longer effective."

Guidance for public health planners

The new guide is aimed primarily at public health planners. It provides guidance on how to conduct a national situation analysis and response review, mapping the burden of cancers in advanced stages against palliative care services available, and recommending plans for low-cost public health models to close any gaps.

"Simple and low-cost public health models of palliative care can be implemented to reach the majority of the target population, particularly in developing countries where the majority of cases are diagnosed in late stages," said Dr Benedetto Saraceno, Acting Director for Chronic Diseases and Health Promotion. "These models consider the integration of palliative care services in the existing health system, with a special emphasis on community- and home-based care."

In 2005, out of 58 million deaths worldwide 7.6 million were due to cancer. More than 70% of all cancer deaths occur in developing countries, where resources available for prevention, diagnosis and treatment of cancer are limited or nonexistent. Based on WHO projections, cancer deaths will continue to rise with an estimated 9 million people dying from cancer in 2015, and 11.4 million dying in 2030.

Yet many of these deaths can be avoided. More than 40% of all cancers can be prevented. Others can be detected early, treated and cured. Even with late-stage cancer, the suffering of patients can be relieved with good palliative care.