Journal of pediatric hematology/oncology
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Palliative care in cancer has always been an important issue in low and middle income countries. In many occasions most resources have been devoted to expensive treatments although palliative and supportive care approaches are very important. ⋯ The Cancer Control Department of Ministry of Health has started the National Cancer Control Program in 2008 and also prepared a Palliative Care Action Plan. Dokuz Eylul University in Turkey has also organised a multidisciplinary palliative care team to create the necessary future plans and will open the first academic program under the Department of Clinical Oncology.
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J. Pediatr. Hematol. Oncol. · Apr 2011
Opioids for cancer pain in the Middle Eastern countries: a physician point of view.
Cancer is an increasing problem in the Middle Eastern (ME) countries. It is the fourth leading cause of death in this region. At present, resources for cancer control in the ME countries as a whole are not only inadequate but directed almost exclusively to treatment. ⋯ An estimated 60% (27 million) of these people in developing countries would benefit from palliative care, and this number is growing as chronic diseases such as cancer rise rapidly. From the situation analysis of palliative care in the ME countries, suggesting that pain relief is insufficient, improvements in palliative care delivery are a high priority. We reviewed the situation of pain management and pain control in Lebanon and the ME countries, the barriers that are present, and we propose the priorities and a reform for an integrated approach to address the problem of under-treated pain at all levels:
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J. Pediatr. Hematol. Oncol. · Apr 2011
Opioids for cancer pain: availability, accessibility, and regulatory barriers in Turkey and Pallia-Turk Project.
Palliative care is an emerging topic in Turkey within recent years. Currently, there are only few number of palliative care services across the country and majority of the centers are pain control units. ⋯ One of the main headings of Turkish Cancer Control Programme 2009-2015 is palliative care and a serial palliative care unit implementation with continuous training programmes is planned to be finalized until 2015. This article reviews the current palliative care situation in Turkey, opioid availability in Turkey and also briefly summarizes Pallia-Turk Project which is unique with respect to many different aspects for implementation, and can be a good model for many other countries that still did not have such an implemented palliative care program.
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J. Pediatr. Hematol. Oncol. · Apr 2011
Palliative care: concepts, needs, and challenges: perspectives on the experience at the Children's Cancer Hospital in Egypt.
Palliative care is uprising in developing countries. The Children's Cancer Hospital Egypt 57357 palliative care service put the main concepts in pediatric palliation in consideration while facing the challenges and needs for these children and their families. The palliative care program developed will be connected to other centers in Egypt as well as further branches of the hospital in other Egyptian cities.
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Children with cancer experience repeated invasive and painful medical procedures. Pain and distress does not decrease with repeated procedures and may worsen if pain is not adequately managed. ⋯ Guiding principles described in the recommendations continue to hold true today: maximize comfort and minimize pain, use nonpharmacologic and pharmacologic interventions, prepare the child and family, consider the developmental age of the child, support family and child involvement, assure provider competency in performing procedures and sedation, and use appropriate monitoring to assure safety. This article reviews these key components for managing painful procedures in children and reviews the latest pharmacological and nonpharmacological interventions most effective in minimizing pain and discomfort.