NCCP

Dr Uchechukwu Nwokwu, National Coordinator, National Cancer Control Plan (NCCP), Federal Ministry of Health and Social Welfare, said this in an interview with newsmen on Friday in Abuja.

Nwokwu said the inability of a health facility to provide further curative treatment should not automatically result in a patient being discharged without arrangements for continued care elsewhere.

He said where a facility lacked the required capacity, such a patient should be referred to another facility where appropriate care could be provided.

“Even when there is no bed space, you should refer that person to where that care can be continued,” he said.

According to him, the only circumstance in which a cancer patient should appropriately be discharged home is when the person is clinically stable, able to take necessary treatment orally and unlikely to require immediate hospital intervention.

“No matter how bad the situation looks, being bad is all the reason you should be in the hospital,” Nwokwu said.

He explained that cancer treatment could involve different modalities, including surgery, chemotherapy, radiotherapy and targeted therapy, depending on the type and stage of the disease.

Nwokwu said there could, however, be a point in advanced cancer where treatment aimed at achieving a cure was no longer feasible, particularly when the disease had spread to other parts of the body.

He stressed that reaching such a point did not mean that medical care should stop, as the patient would still require appropriate care, including management of pain and other symptoms.

“The patient is entitled to peaceful death. A pain-free death.

“Even if you can no longer provide treatment that is aimed at cure, the patient should not die in pain,” he said.

The coordinator said this was where palliative care became particularly important, noting that it should not be viewed as care reserved only for patients who were dying or had exhausted all treatment options.

He said the National Palliative Care Policy had prescribed the institutionalisation of palliative care from the point of diagnosis through the course of the illness and until the end of life.

“We are not trying to say start palliative care when it is now hopeless, no, palliative care should be instituted within six weeks of diagnosis,” he said.

Nwokwu explained that early palliative care was intended to address not only physical symptoms but also the psychological, social, financial and spiritual challenges associated with cancer.

He said a cancer diagnosis could affect a patient’s employment, family livelihood and ability to meet treatment costs, adding that fear of losing a job could even discourage some people from disclosing their condition.

According to him, these challenges could make it difficult for patients to commence treatment, remain on it or complete the required treatment.

Nwokwu said palliative care should therefore be integrated into cancer management from an early stage to help patients cope with the disease while receiving treatment.

He said spiritual care could also form part of the support provided, depending on the patient’s beliefs, while stressing that it should complement, rather than replace, medical treatment.

“The person need to be part of the patient’s care pattern, so that they can be counselled and to understand that whatever he or she believes in can also be part of the healing process.

“In other words, while you receive treatment, medical care, you can also get that psychological and spiritual care,” he said.

The coordinator added that families should also be involved in the care process because cancer could affect the wider family system.

He said pain management remained an important component of palliative care, adding that some forms of radiotherapy could also be used for palliative purposes to relieve symptoms and pain rather than to achieve a cure.

Nwokwu said failure to introduce palliative care early could make it more difficult for patients to cope with the disease and could affect their ability to initiate, remain on and complete treatment.

He therefore stressed the need for a continuum of care in which cancer patients remained within the healthcare system and received appropriate support according to the stage and progression of their disease.

He said even when curative treatment was no longer possible, patients should continue to receive care that preserves their comfort, dignity and quality of life until the end of life.(NAN)