FEBRUARY 3 — Cancer is the current healthcare scourge of our community. Daily, the media reports on the latest victims of this disease — celebrities and other individuals who have succumbed to it.

To some, the word may seem synonymous with death.

Malaysia, as with most countries, has tried to “battle” this disease through various means. Typically this takes the form of preventive health screenings such as early detection and improving treatment. But this approach centres on those who are “currently well.”

Those who are suffering from the impact of their diseases are rarely the focus of the major push for healthcare. Perhaps a thought should be spared for the many thousands who are currently dealing with cancer. What about their needs?

The last published national data on the incidence of cancer in Malaysia (2007 National Cancer Registry) suggests that over 18,000 people are diagnosed yearly in Peninsular Malaysia. The fear of suffering from cancer has led to several countries adopting screening tests to reduce the incidence.

Yet a recent article in the British Medical Journal has questioned its effectiveness and that it may actually cause increased harm to some. For those newly diagnosed, the newer drugs and treatment could increase survival or delay disease progression but at increasingly high financial costs.

Medicine should be a profession that cares for the individual. However, in this post-modern era, the emphasis has shifted to pharmaceutical and technological advancements, sometimes to the detriment of the concept of care.

Much of the complaint in healthcare is that patients do not feel cared for either by their doctor, nurse or the hospital. Discussions always seem to revolve around prevention and early detection and rarely address the needs of those currently suffering from the disease.

This is especially true for those with advanced cancer. The debilitating impact of cancer such as severe pain, lethargy, depression or even a loss of meaning of life are rarely responded to appropriately by many healthcare professionals.

While oncologists are experts in knowing what treatments can reduce the cancer burden, in many countries, their training still does not cover treatment of pain and other distressing symptoms in the way that palliative care physicians are taught to address.

Yet there is ample evidence that we are able to both relieve the suffering and improve the quality of life of most cancer patients through palliative care. Recognised as a medical specialty in 1987 in the United Kingdom, palliative care has been available in Malaysia since 1991 through both the Ministry of Health services as well as in the non-government and private sector. At the heart of palliative care is the concept of addressing suffering and how it affects the patients and their family.

Scientific evidence verifies that palliative care is able to relieve the suffering and improve the quality of life of most cancer patients and others suffering from life-limiting illnesses such as AIDS/HIV, organ failure or degenerative neurological disorders.

Normally, this addresses "quality of life," which at times is a greater priority than “quantity of life.” Palliative care addresses current issues and the goals of care are determined by the patient and their family rather than the doctor. It deals with the present with a proposition of improving and defining hope for patients and their families.

The difference between palliative care and many other aspects of general medicine is that it truly addresses the impact of cancer and determines the goals of care from the perspective of the patient and their loved ones.

Often our physicians focus only on the disease, rather than the suffering — physical and otherwise — that it causes. Hence the World Health Organisation has recommended that both palliative care and disease modifying treatment is done together.

In September 2015, world leaders committed to identifying 17 sustainable development goals. Palliative care is in an excellent place to assist the world in meeting some of the targets identified. Another initiative is the inclusion of palliative care as part of the Universal Health Coverage.

In the Quality of Death Index 2015, which is a measure of quality of palliative care, many of the countries that do best have developed palliative care within its health system. Malaysia ranks 44th out of 80 countries.

What is the future of Malaysians facing the threat of cancer? Changes in lifestyle could reduce the burden of cancer but are we motivated enough to change some of our unhealthy habits? If we were to be diagnosed with cancer, what are our options? If caught early, a cure may still be achievable.

Unfortunately in many cases, it is diagnosed at a late stage. In almost all cases, palliative care could make a huge difference especially in dealing with the morbidity of the disease. And to make a real difference, the nation’s healthcare planning should include all stakeholders.

* Dr Ednin Hamzah is the CEO/Medical Director of Hospis Malaysia

** This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail Online.