WHO regards palliative care as an essential part of cancer treatment and has affirmed its role early in the disease process. Palliative care aims to relieve pain and suffering and to promote an increased quality of life for patients and their families. Although palliative care does not aim to hasten death, it accepts dying as a normal process and serves to help patients and their families cope with illness and through the bereavement process. Palliative care may be initiated at the time of diagnosis, rather than in the late stages of the disease. The palliative care process begins with establishing the goals of the patient, which may be used to established advanced directives regarding the types of care the patient will receive. Palliative care can help to achieve these goals via pain management and symptom control and by providing spiritual, psychosocial, and bereavement support to patients and their families.
Barriers to effective pain management in cancer patients include inadequate assessment, whether from a failure of patients to report their pain or from physician inaccuracy; inadequate treatment; poor access to care; lack of financial resources; and minority bias.
Inadequate pain assessment has been stated by health professionals to be the number one potential barrier to optimal pain care. Inaccurate or inadequate assessment may be caused by patient underreporting of pain, which may stem from fear of being labeled as seeking drugs, by cultural stoicism, or by misconceptions about the normalcy of their pain levels. All cancer patients should be screened for the presence of pain using standardized diagnostic techniques at regular intervals. Patients should also be educated on the importance of reporting pain to their providers. Even in the presence of patient reporting of pain and the benefit of standardized assessment tools, physicians have been shown to underassess pain...