• Ronaldo Corrêa Ferreira da Silva and Virginia Alonso Hortale.
• Coordenação de Prevenção e Vigilância, Instituto Nacional de Câncer, Rio de Janeiro, Brasil. rsilva@inca.gov.br
• Cad Saude Publica. 2006 Oct 1; 22 (10): 2055-66.

AbstractThe aim of this study was to present elements for debating guidelines on palliative care programs for cancer. A literature survey searched various databases (MEDLINE, LILACS, and Cochrane Library), homepages of palliative care organizations, publications by renowned authors in this area, reference textbooks on the subject, relevant articles cited by these books, and the thesis/dissertation database of CAPES (the Brazilian Coordinating Body for Training University Level Personnel). The data were grouped into four thematic categories: symptomatic palliation, organization of services, psychosocial characteristics, and spiritual characteristics. The article then proceeds to discuss cancer as a public health problem and its impact on individuals, the concept of palliative care and its context in health care, program models and their guidelines, death and dying, and care and caregivers. The study concludes by discussing the challenges for the Brazilian National Health System in structuring end-of-life programs as a consequence of the population's aging and increasing cancer incidence.

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