Cancer Pain Relief

Authors: James Cleary, Hellen Gelband, Judith Wagner


This chapter considers the pain caused by cancer, recognizing that palliative care has been mostly confined to high-income countries (HICs), while low- and middle-income countries’ (LMICs) governments limit access to opioids and create barriers to securing pain relief drugs. The concern over illegal narcotics has tipped the scale against the legitimate medical needs of patients. The Global Opioid Policy Initiative (GOPI) has published a country-specific analysis of availability and regulation of the most common analgesic formulations. A useful first step in assessing the cost of palliative care to a health system looks at the cost of the most basic oral opioid medicine—oral morphine; in certain countries fentanyl patches offer the most inexpensive palliative method. To get the most appropriate medicine to patients may involve additional clinic or home visits with trained personnel. Building palliative care capacity in LMICs has required a coalition of private faith and philanthropic sectors to work with government to reform national and regional policies.



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