title: The global state of palliative care-progress and challenges in cancer care.
abstract: All persons have a right to palliative care during cancer treatment and at the end-of-life. The World Health Organization (WHO) defines palliative care as a medical specialty that addresses physical, psychological, social, legal, and spiritual domains of care by an interdisciplinary team of professional and lay health care providers. Widespread adoption of this universal definition will aid policy development and educational initiatives on a national level. The need for palliative care is expanding due to the aging of the world's population and the increase in the rate of cancer in both developed and developing countries. However, in one third of the world there is no access to palliative care for persons with serious or terminal illness. Palliative care improves symptoms, most frequently pain, and improves quality of life for patients and their families, especially in the terminal disease phase. Accessibility to palliative care services, adequately trained health care professionals, availability of essential medicines, and gaps in education vary greatly throughout the world. Pain management is an integral concept in the practice of palliative care; however, opioiphobia, insufficient supply of opioids, and regulatory restrictions contribute to undue suffering for millions. Ongoing advocacy efforts call for increased awareness, palliative care integration with cancer care, and public and professional education. Enacting necessary change will require the engagement of health ministries and the recognition of the unique needs and resources of each country. The aim of this review is to examine progress in palliative care development and explore some of the barriers influencing cancer care across the globe.
authors.affiliation: Palliative Care Program, Hospital of the University of Pennsylvania, 3400 Spruce Street, 1202 Penn Tower, Philadelphia, PA 19104, USA. breville@comcast.net.
authors.forename: Barbara
authors.initials: B
authors.lastname: Reville
authors.affiliation: Palliative Care Program, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
authors.forename: Anessa M
authors.initials: AM
authors.lastname: Foxwell
keywords: Cancer; global; human right; opioid; palliative care