Provision of palliative care for oncological patients in Pakistan: A review of challenges and current practices

Palliative medicine in Pakistan is a fairly new discipline with only a handful of institutions providing specialized services to oncological patients in need. With the majority of cancer patients presenting at advanced stages of the disease when cure and even control of the disease appears unlikely, there is tremendous burden on patients who need aggressive symptom management and care. Unfortunately, due to a lack of specialized and trained palliative care providers in the nation, it is estimated that less than 1% of the total population of Pakistan has access to palliative care services. The remaining burden of palliation must be shared by oncologists, internists, pediatric oncologists, and family physicians who have little or no training in palliative medicine. This results in enormous unmet needs for those suffering with serious and life-limiting illnesses. Realizing this need, major tertiary care health care networks in the nation have developed and begun providing specialized palliative care services to patients with advanced stages of cancers. Many philanthropic and charitable networks have laid down the foundations for community-based hospices to provide end-of-life care for terminal cancer patients.