Don’t send cancer patients home without care – FG

The Federal Government has said cancer patients should not be sent home when they still require hospital-based care, emphasising that treatment should continue even when cure is no longer possible.

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 at another appropriate facility.

He said where a facility lacked the required capacity, such a patient should be referred promptly to another facility where appropriate care and necessary medical support could be provided without interruption.

“Even when there is no bed space, you should refer that person to where that care can be continued,” he said, stressing the need for uninterrupted cancer treatment.

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

“No matter how bad the situation looks, being bad is all the reason you should be in the hospital,” Nwokwu said, urging facilities to prioritise patients’ continuing needs.

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

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.

He stressed that reaching such a point did not mean medical care should stop, as the patient would still require appropriate care, including effective management of pain and other distressing 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 for patients who were dying or had exhausted treatment options.

He said the National Palliative Care Policy prescribed institutionalisation of palliative care from diagnosis through the course of illness and until the end of life, ensuring continuous support for patients throughout.

“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 palliative care was intended to address not only physical symptoms but also psychological, social, financial and spiritual challenges associated with cancer and its treatment, especially for vulnerable patients.

He said a cancer diagnosis could affect employment, family livelihood and ability to meet treatment costs, adding that fear of losing a job could 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, thereby worsening outcomes and quality of life during 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 appropriate treatment and support during treatment properly.

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 and reflect preferences.

“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, including finances, emotional wellbeing and treatment decisions and support related.

He said pain management remained an important component of palliative care, adding that forms of radiotherapy could also be used to relieve symptoms and pain rather than achieve cure, depending on treatment goals.

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

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

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

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