Availability and accessibility of opioids for cancer pain in Europe is a fundamental aspect for palliative and supportive care. There is evidence that in many European countries, particularly among Eastern European countries, patient access to the medication needed to relieve strong cancer pain is profoundly restricted by inadequate formulary availability and over-regulation.

ESMO and the European Association for Palliative Care (EAPC) have conducted a survey using standards derived from the World Health Organization (WHO) and the International Narcotics Control Board (INCB), that exposed formulary deficiencies and excessive regulatory barriers which interfere with appropriate patient care in many European countries.
 
The results are published in the Annals of Oncology and describe the availability and cost of opioids for cancer pain in each surveyed country as well as different forms of regulatory restrictions.

The paper reports that urgent and intensive efforts are needed to expand partnership among advocacy initiatives by stakeholders and international organizations with authorities and regulators, particularly in the countries with the most severe restrictions for opioid availability and accessibility.

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The ESMO Oncologist/Patient communication survey was designed by the Palliative Care Working Group (PCWG) to evaluate the important issue of communication between oncologists and patients with advanced cancer in regards to: 

• Evaluation of communication practices between physicians and patients suffering from advanced cancer
• Evaluation of attitudes impacting communication dynamics and the decision-making process within the setting of life-threatening illness
• Identification of factors that impact communication styles and attitudes towards communication, taking into account the variables of geography, age, sexual experience and education

The survey aims to:

• Identify and understand the strengths, weaknesses, inequalities, and areas of necessary improvement in the field and practice of oncologist/patient communication
• Gain a better understanding of the critical communication issues so that it is possible to address such topics in a manner that is sensitive and appropriate to the cultural heterogeneity of the ESMO members and patients
• Establish further evidence of the need of reliable data on how oncologists handle delicate and crucial communication issues
• Understand key differences and appropriate use of communication styles such as paternalism vs. democratic collaboration, candor vs. non-candor (protective concealment) and patient focus vs. family focus

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