Expert calls for end to gaps in palliative care

In collaboration with the Press Association

Cancer survivors do not always receive the appropriate long-term care to help them cope with ongoing symptoms, an expert has claimed.

Half of newly-diagnosed adult cancer patients can expect to live for at least five years or more, and this figure is increasing. But according to Marie Fallon, professor of palliative medicine at the University of Edinburgh, some continue to experience symptoms that need managing. These may include pain, sexual difficulties, depression and anxiety.

The expert is concerned that there are gaps in 'palliative' care - treatment aimed at alleviating symptoms - which has traditionally been aimed at patients who are nearing the end of their lives. This means that some patients are left with unmet needs.

"There is an enormous population of long-term survivors of cancer, many of whom are living with a range of symptoms," the professor pointed out. "Some of them will not know whether they are cured and whether the symptoms they are experiencing are treatment-related or whether they are related to recurrence of the disease that has not yet been diagnosed.

"These patients exist in a limbo," she continued. "They fall between two stools: they have finished being treated by oncologists, but are not receiving the care and support from palliative care teams that patients at the end of life receive. Yet the impact of cancer and cancer treatment on the long-term health of survivors is substantial and many of them remain very symptomatic, with poor quality of life. Clearly a proportion will unfortunately be diagnosed with recurrent cancer at some point."

Professor Fallon has co-edited a special issue of the European Journal of Cancer on Palliative Care to highlight the gap between oncology and palliative care.

In her joint paper with co-editor Professor John Smyth, professor of medical oncology at the University of Edinburgh, she wrote: "We need to develop a particular supportive care model for sick patients and traditional palliative care expertise should feed into this model. Life and illness are a continuum and our patients do not always fit into well-defined boxes. As specialists, our challenge is to accommodate this continuum rather than restrict it."

Professor Alexander Eggermont, president of the European Cancer Organisation, commented: "To be cured from cancer but living with symptoms that are related to often complex multidisciplinary treatments involving surgery, radiation therapy and chemotherapy is already difficult enough. To reintegrate into society, resuming work full or part-time, adds to the complexities and socio-psychological pressure that an ever-increasing number of 'former-patients' have to deal with.

"All this must be looked into and will need special initiatives to deal with these special and unmet needs of this population. We better start tackling these issues now as they will only increase in number and magnitude."