Survey reveals ‘global pandemic’ of untreated cancer pain

Findings from an international survey presented in the Special Session on Saturday morning at ESMO 2012 concluded that hundreds of millions of cancer patients around the world are suffering needlessly due to government failures to ensure adequate access to pain-relieving drugs.

The ‘International Collaborative Project to Evaluate the Availability and Accessibility of Opioids for the Management of Cancer Pain’ was conducted by ESMO and the Developing Countries Task Force (DCTF), together with the European Association for Palliative Care (EAPC), the Pain and Policies Study Group (PPSG) at the University of Wisconsin Carbone Cancer Centre, the Union for International Cancer Control (UICC) and the World Health Organization (WHO).

Lead author of the report, Professor Nathan Cherny, from Shaare Zedek Medical Center, Jerusalem, Israel, said, “Unrelieved cancer pain is a cause of major worldwide suffering, not because we don’t have the tools necessary to relieve pain, but because most patients don’t have access to the essential pain-relieving medications.”

Between December 2010 and July 2012, the survey gathered information submitted by experts from 76 countries and 19 Indian states. The results, which collectively represent 58% of all countries, revealed that:

• Very few countries provide all 7 of the opioid medications considered essential for pain relief by the International Association for Hospice and Palliative care
• In many countries, fewer than 3 of the 7 medications are available
• In many countries, the medications that are available are either unsubsidized or weakly subsidized by government, with availability often limited
• Many countries have highly restrictive regulations limiting the entitlement of cancer patients to receive prescriptions, including restrictive limits on the duration of prescriptions, restrictions on dispensing, and bureaucratic burdens in the prescribing and dispensing processes
• The issues were found to be particularly severe in Africa, Asia, the Middle East and Latin and Central America

Findings from this survey highlight the urgent need to examine drug control policies and repeal the excessive restrictions which are impeding a fundamental aspect of cancer care. “The study has provided an unprecedented wealth of knowledge that will be an essential tool in lobbying to reformulate national plans for the treatment of cancer pain,” said Professor Cherny.