Cancer is a leading cause of death globally. The World Health Organization reports there are more than 18 million new cases every year and 9.6 million deaths, most in low-or middle-income countries.
Great advances have been made in the treatment of cancer, but measures to relieve the horrific pain experienced by patients lag woefully behind. WHO hopes to remedy this with its new guidance on pain management.
speaks about proposed reforms to Medicare Part B drug pricing policies at the Brookings Institute in Washington.
Director of WHO’s Department for the Management of Noncommunicable Diseases, Etienne Krug, says controlling pain should be an essential part of cancer treatment. Yet, he says pain is very often neglected as part of that treatment, a situation he considers unacceptable.
“Nobody, cancer patients or not cancer patients should live or die in pain in the 21st century. We have the knowledge of how to treat pain," said Krug. "We have the medicines of how to address it. It is a question of making sure everybody has that knowledge and everybody has access to the necessary treatment.”
Krug says the situation is most acute in the poorer countries because pain management systems tend not to be in place. But he notes even in the rich countries people are still living and dying in pain.
WHO says opioid painkillers like oral morphine are an essential treatment for moderate to severe cancer pain. But WHO Noncommunicable Coordinator, Cheriana Varghese says some governments have enacted regulatory and legal barriers against their use in reaction to the global scare of opioid and morphine addiction.
“When a government of a country wants to introduce opioids, there is always this looming danger that this is going to get out of hand," Varghese said. "And, so the governments are more conservative because of this.”
Varghese says there are sufficient safeguards against the abuse of opioids and morphine. He says these painkillers should be given only by trained health care providers, doctors and nurses. He adds oral preparation should be given whenever possible to prevent addiction.