Hundreds of millions of cancer patients around the world suffer needlessly because they don’t have adequate access to pain-relieving drugs, according to a new international survey.
“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 medication,” said Nathan Cherny, MD, lead author of the study presented at the 2012 Congress of the European Society for Medical Oncology in Vienna, Austria.
“This pandemic affects literally billions of people. Not only are the patients suffering often terrible unrelieved pain, but their family members are often permanently scarred by the memories of witnessing such suffering in their loved ones,” said Cherny, an oncologist and palliative medicine specialist at Shaare Zedek Medical Center in Jerusalem, Israel.
Researchers gathered data from over 150 reports submitted by experts in 76 countries; mostly emerging nations in Africa, Asia, the Middle East, Latin America and the Caribbean.
They found that very few countries provided all seven of the opioid medications that are considered essential for the relief of cancer pain. Those medicines include codeine, morphine, oxycodone and fentanyl.
In many countries, the pain relievers are either not subsidized or weakly subsidized by the government, and supply of the drugs is limited. Many countries also have regulations or bureaucratic obstacles that limit the prescriptions cancer patients can obtain. The researchers said there was an urgent need to repeal excessive restrictions, particularly in Africa, Asia, the Middle East and Latin America.
“We now know which countries have suboptimal formularies of medication to relive pain, we know how much patients must pay out-of-pocket for the medications, and we know which countries have excessive regulatory barriers making it sometimes nearly impossible for a patient to get a prescription,” said Cherny.
“In many, if not most, of the counties and states we have looked at, patients are stymied by regulatory barriers at multiple steps along this process; the end result being that hundreds of millions patients don’t have access to essential pain-relieving medications,” he added
Studies have shown that pain affects about two-thirds of patients with metastatic, advanced or terminal cancer.
“Unrelieved pain continues to be a substantial worldwide public health concern in patients with solid cancers and hematological malignancies,” said Dr. Carla Ripamonti, head of the Supportive Care in Cancer Unit of the IRCCS Foundation National Cancer Institute of Milan, Italy.