Access to palliative care in patients with advanced cancer of the uterine cervix in the low- and middle-income countries: a systematic review

Abstract

Background Women with advanced uterine cervical cancer suffer from a combination of moderate to severe physical, psychological, social, and spiritual distress due to their disease and are in need of palliative care to improve their quality of life. Approximately 85% of the women live in the low- and middle-income countries. Whether these women and their families access palliative care is not known. Objectives To understand the geographic accessibility, availability, financial accessibility, and acceptability of palliative care by patients with advanced cervical cancer and their families. Methods We conducted a Systematic review following PRISMA guidelines in CINAHL, Cochrane Central Register of Controlled Trials, MEDLINE, PsychINFO, PubMed and Scopus for the core concepts: palliative care, access, advanced uterine cervical cancer. Eligible articles were published in English, contained original data on experiences of patients and/or caregivers including symptoms management, and discussed available resources, communication, satisfaction, and healthcare utilization. Results Overall there was limited access to palliative care with the few available facilities located in cities, far from the rural areas where most women lived. Pervasive poverty was common with poor affordability of healthcare, travelling, accommodation, and subsistence expenses. Misconceptions and poor knowledge of the disease, cultural beliefs and attitudes, and other health system insufficiencies also presented challenges for access. Conclusion Concerted effort should be made to improve availability of palliative care facilities. Health education to address misconceptions and other cognitive barriers that limit access among cervical cancer patients and their families should be urgently undertaken in the LMICs.

Ensuring access to palliative care for cervical cancer patients

“…The recently published article by Ooko et al [1] brings to attention limited access to palliative care (PC) in a vulnerable group of women diagnosed with advanced uterine cervical cancer (CC) and their families in low-and middle-income countries (LMICs). CC patients are prone to significant physical, psychosocial and spiritual suffering arising from the effects of their disease throughout the illness trajectory, especially among those living in poorer developing countries and the underserved minority populations in higherincome countries.…”

Best practices for managing malodorous and infected wounds in advanced cervical cancer

“…Providing efficacious wound care is critical not solely to alleviate symptoms, but also to enhance the general welfare and dignity of the patient. [4][5] The prevalence of malodorous and infected wounds among patients with advanced cervical cancer is in complex manner. These injuries and lesions frequently result from tumour's infiltration into adjacent tissues, which subsequently induces infection and necrosis.…”

“…Providing efficacious wound care is critical not solely to alleviate symptoms, but also to enhance the general welfare and dignity of the patient. 4 , 5 …”