Don’t send cancer patients home when they need care – FG warns hospitals

The Federal Government has urged healthcare facilities not to send cancer patients home when they still require hospital-based care, stressing that treatment and support should continue even when a cure is no longer possible.

The National Coordinator of the National Cancer Control Plan at the Federal Ministry of Health and Social Welfare, Dr Uchechukwu Nwokwu, made the call in an interview on Friday, August 28. Nwokwu said a hospital’s inability to provide further curative treatment should not automatically lead to a patient being discharged without arrangements for continued care.

He said where a facility lacked the capacity to provide the required treatment, the patient should be promptly referred to another appropriate facility to ensure that care continued without interruption. “Even when there is no bed space, you should refer that person to where that care can be continued,” he said, stressing the importance of uninterrupted cancer care.

According to Nwokwu, a cancer patient should only be discharged when clinically stable, able to take treatment orally and unlikely to require further medical intervention or monitoring. “No matter how bad the situation looks, being bad is all the reason you should be in the hospital,” he said, urging healthcare facilities to prioritise patients’ continuing care needs.

He explained that cancer treatment could involve surgery, chemotherapy, radiotherapy and targeted therapy, depending on the type and stage of the disease, as well as the individual patient’s clinical needs. Nwokwu acknowledged that there could be a stage in advanced cancer when treatment aimed at achieving a cure was no longer feasible, particularly after the disease had spread to other parts of the body.

However, he stressed that the end of curative treatment should not mean the end of medical care. Patients would still require appropriate support, including effective management of pain and other distressing symptoms. “The patient is entitled to peaceful death. A pain-free death. Even if you can no longer provide treatment that is aimed at cure, the patient should not die in pain,” he said.

Nwokwu said palliative care was particularly important in such circumstances and should not be regarded as care reserved only for patients who were dying or had exhausted all treatment options. He said the National Palliative Care Policy provides for palliative care to be integrated from the point of diagnosis throughout the course of illness and until the end of life.

“We are not trying to say start palliative care when it is now hopeless, no, palliative care should be instituted within six weeks of diagnosis,” he said. According to him, palliative care addresses more than physical symptoms, also providing support for the psychological, social, financial and spiritual challenges associated with cancer and its treatment.

He noted that a cancer diagnosis could affect employment, family income and the ability to meet treatment costs. These pressures, he said, could discourage some patients from disclosing their condition or make it difficult for them to begin, continue or complete treatment. Nwokwu therefore advocated the early integration of palliative care into cancer management to help patients cope with the disease while receiving appropriate treatment and support.

He added that spiritual care could form part of the support offered to patients, depending on their beliefs, but stressed that it should complement rather than replace medical treatment and should reflect the patient’s preferences. He also encouraged the involvement of families in cancer care, noting that the disease could affect the wider family through financial pressures, emotional distress and treatment-related decisions.

Nwokwu said pain management remained a key component of palliative care and explained that radiotherapy could sometimes be used to relieve symptoms and pain rather than to achieve a cure, depending on the goals of treatment. He warned that delaying palliative care could make it more difficult for patients to cope with the disease and could affect their ability to start, continue and complete treatment.

He therefore emphasised the need for a continuum of care in which cancer patients remain within the healthcare system and receive appropriate treatment and support according to their condition, disease progression and individual care needs. Even when curative treatment is no longer possible, he said, patients should continue receiving care that preserves their comfort, dignity and quality of life until the end of life.