Cancer: Official: FG To Examine Hospice and Palliative Care Policy

In order to guarantee that cancer patients have a reasonably good quality of life, the federal government will review the National Policy and Strategic Plan for Hospice and Palliative Care 2021.

The National Coordinator of the National Cancer Control Program, Dr. Uchechukwu Nwokwu, revealed this on Sunday in Abuja in an interview with Newsmen.

Nwokwu said that the policy, inaugurated in 2021 was meant to institutionalise hospice and palliative care services in Nigeria.

According to the International Association for Hospice and Palliative Care (IAHPC), Hospice and Palliative Care (HPC) is the active holistic care of individuals across all ages with serious health-related suffering due to severe illness and especially of those near the end of life.

The association also says HPC focuses on a continuum of care from diagnosis till patient’s death and bereavement.

It also addresses all domains that may cause suffering, including end-of-life care, loss, grief, and bereavement.

Nwokwu said that though the policy was already being implemented, it was not up to the expected scale.

“We are very certain that by 2024, we will review the document and then review our level of implementation as a country and see what we can do to improve on it.

“We have a new government and we are hoping that the renewed hope agenda will also translate into addressing palliative care needs of cancer patients and other patients that need palliative care services,” he said.

According to Nwokwu, cancer which does not respect any race, religion or social status, has the capacity to impoverish the richest of all people, because of the cost of care which is very expensive.

“So palliative care deals with terminal illnesses and not just cancer.

“For any illness that has the capacity or potential to last for too long, it is important to institutionalise palliative care as part of the care the person needs to receive,” he said.

Explaining how the policy came about, Nwokwu said that sometimes, someone might have a pain that could not be removed but could only be ameliorated by giving some pain medication that could just palliate it.

“So while we cannot take away the pain, we need to palliate it so that somebody who has that kind of illness will not die in pain but also live a fairly good quality of life as much as possible.

“The policy document spells out that palliative care should even start from a point of diagnosis and that means that you need to integrate the psychosocial needs of the person and even the person’s faith based system.

“If he’s a Christian you involve the pastor or the priests, if he’s a Muslim you involve the Imam or whoever can give that person some psychological or moral support.

“This is because they need to first of all accept diagnosis and the way they accept the diagnosis goes a long way in determining how far the person can accept the treatment that they’re going to be provided.

“It will also determine how much the person can also collaborate or participate in that care.

“So this palliative care is meant to start from the point of diagnosis, to end of life and even at the end of life, it also involves bereavement, even the person who has lost that loved one needs to be integrated to be able to accept the loss,” he said.

Nwokwu said that many cancer patients who were diagnosed late did not actually present late as they complained to someone or some facility when they felt pain or noticed some abnormality.

He, however, said due to lack of awareness or ability to diagnose at the facility, they did not get the needed care early enough.

“If these health workers they present to at the facilities, are able to carry out certain levels of tests or screening, they pick up these diseases early, then treatment can begin early enough and survival rate will also be higher.

“So what we want to do with the palliative care policy is to integrate these services since we have said it’s going to start from the point of diagnosis.

“We want to integrate it in the primary levels of care so that people will understand what is to be done at that level and then cascade it or refer when it goes beyond what they can do,” he said.

Nwokwu said the palliative care policy was looking at integrating HPC services at the primary, secondary and tertiary levels of care so that at these levels, everybody knew what to do at any point in time.

He said also, that in-patients, or those who had terminal illnesses could have the opportunity of receiving a fairly good quality of life before they die.

This, he said, was because, when curative measures were no longer possible, all the patients might require was palliative care.

“At that time, it will be a waste of resources to keep that patient in a hospital bed because the bed fees and the cost of care is quite exorbitant and that adds to what we call financial toxicity.

“Those patients ought to be referred probably to a health centre or to a hospice centre where since all they require is palliation, they can stay there and be taken care of while they receive those palliative care services and be managed symptomatically.

“However, it is imperative that those working in primary healthcare facilities or in hospice homes receive the appropriate training.

“Thereafter, oncologists or other specialized physicians can pay them frequent visits to handle their other medical requirements,” the speaker stated.