Provision of Palliative Care in Low- and Middle-Income Countries: Overcoming Obstacles for Effective Treatment Delivery REVIEW ARTICLES

Despite being declared a basic human right, access to adult and pediatric palliative care for millions of individuals in need in low- and middle-income countries (LMICs) continues to be limited or absent. The requirement to make palliative care available to patients with cancer is increasingly urgent because global cancer case prevalence is anticipated to double over the next two decades. Fifty percent of these cancers are expected to occur in LMICs, where mortality figures are disproportionately greater as a result of late detection of disease and insufficient access to appropriate treatment options. Notable initiatives in many LMICs have greatly improved access to palliative care. These can serve as development models for service scale-up in these regions, based on rigorous evaluation in the context of specific health systems. However, a multipronged public health approach is needed to fulfill the humane and ethical obligation to make palliative care universally available. This includes health policy that supports the integration of palliative care and investment in systems of health care delivery; changes in legislation and regulation that inappropriately restrict access to opioid medications for individuals with life-limiting illnesses; education and training of health professionals; development of a methodologically rigorous data and research base specific to LMICs that encompasses health systems and clinical care; and shifts in societal and health professional attitudes...
Source: Journal of Clinical Oncology - Category: Cancer & Oncology Authors: Tags: Palliative Care REVIEW ARTICLES Source Type: research

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ConclusionIn Europe in recent years for the availability of the vascular device of small dimensions and materials increasingly compatible, the "PICC-PORT" is positioned in the veins of the arm with ultrasound-guidance without complications such as pneumothorax, arterial puncture, hematoma of the neck, Pinch-off syndrome, such as the clinical case presented with extensive scars on the chest and neck. Thoracic devices (chest port, tunnel venous catheter) are not indicated in thickened and inelastic skins, due to the high risk of dehiscence of the surgical wound.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
This article provides clinicians with treatment approaches to these burdensome symptoms.
Source: Medical Clinics of North America - Category: Primary Care Authors: Source Type: research
In this narrative medicine essay, a pediatric palliative oncologist meditates on the intersection of faith and medicine and of varying expressions of spirituality in the face of abject pain and suffering among her pediatric patients with cancer.
Source: JAMA - Category: General Medicine Source Type: research
Conclusion: Our study shows that MDT discussion of patients with esophageal or GEJ cancer resulted in more patients treated with initial palliative radiotherapy and chemotherapy compared with patients not discussed by the MDT. Moreover, MDT discussion may have a positive effect on survival, highlighting the importance of MDT meetings at all stages of treatment. PMID: 32067535 [PubMed - as supplied by publisher]
Source: Acta Oncologica - Category: Cancer & Oncology Authors: Tags: Acta Oncol Source Type: research
CONCLUSIONS: Patient and illness factors were not associated with needs among those who attended appointments with support providers. Study results suggest that a biopsychosocial approach from interdisciplinary providers is warranted to manage the needs of patients referred for additional supportive care. PMID: 32066250 [PubMed - as supplied by publisher]
Source: The American Journal of Hospice and Palliative Care - Category: Palliative Care Authors: Tags: Am J Hosp Palliat Care Source Type: research
Abstract BACKGROUND: The significance of palliative care consultation in psychiatry is unclear. ACTUAL CASE SERIES: Analysis of the introduction of palliative care consultation in a large psychiatric hospital. POSSIBLE COURSES OF ACTION: Continue without offering, survey the need for or offer palliative care consultation, and analyse its introduction. FORMULATION OF A PLAN: Palliative care consultation was established and details including patient age, department, diagnosis, main problem, solution and discharge were analysed during the first 2 years. OUTCOME: Two consultations in the fir...
Source: Palliative Medicine - Category: Palliative Care Authors: Tags: Palliat Med Source Type: research
Authors: Haber PK, Sia D Abstract Biliary tract cancers (BTC), which include cholangiocarcinoma (both intra- and extrahepatic) and gallbladder, represent a heterogeneous group of malignancies with relatively low-incidence and poor prognosis. Therapeutic options for BTC patients at advanced stage are severely limited and palliative chemotherapy remains the maintreatment option. In the past decade, genome profiling via next-generation sequencing of large international cohorts has paved the way for precision oncology in BTC, identifying unique molecular subtypes, recurrent mutations, and genomic rearrangements. Target...
Source: Discovery Medicine - Category: Research Tags: Discov Med Source Type: research
ConclusionRecurrent FGFR2 amplification was observed in roughly 4.0% of GC patients. High FGFR2 amplification was significantly associated with poor progression free survival and overall survival in GC patients. Clinical studies of FGFR2-directed therapies are warranted and should consider stratification by FGFR2 CNA.
Source: Pathology Research and Practice - Category: Pathology Source Type: research
Transcutaneous electrical nerve stimulation (TENS) is primarily used for pain, but might be useful for various other physical symptoms, including nausea, fatigue, dyspnea, and constipation. However, few studies have used TENS for treating the physical symptoms of patients with advanced cancer. In this crossover trial, we assess the effects of TENS on pain and other physical symptoms in 20 in-patients with advanced cancer receiving palliative care. For 5-day phases between wash out periods of 5 days, patients received TENS or non-TENS. TENS was delivered at four points: the center of the back for mainly nausea and dyspnea, ...
Source: International Journal of Rehabilitation Research - Category: Rehabilitation Tags: Original Articles Source Type: research
Malignant pleural mesothelioma (MPM) is a rare, aggressive tumor originating from mesothelial cells. It is associated with exposure to asbestos, mainly occupational, rarely environmental or domestic. Diagnosis is usually made at an advanced stage because symptoms are non-specific and late. The management of this tumor is challenging and outcome is poor. Therapeutic strategies are mainly based on surgery with curative intent or palliative cytotoxic chemotherapy. Few patients are candidates for surgery which must necessarily take into account numerous factors (i.e.
Source: Lung Cancer - Category: Cancer & Oncology Authors: Source Type: research
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