Massachusetts Comprehensive Cancer Control Coalition Plan 2006-2011:
Palliative Care

Palliative care is an approach that seeks to prevent and reduce suffering for people facing life-threatening illnesses. Palliative care involves early identification and assessment of problems. This includes relief of pain and other distressing physical symptoms as well as psychological and spiritual issues. The goal of palliative care is to help patients live active lives and to help families cope. Palliative care must begin at the time of diagnosis.

One of the most common palliative care issues for cancer patients is pain management. Pain is an experience that differs from person to person. Emotional, spiritual, and financial difficulties can influence a person’s experience of pain. It is important to provide cancer patients with an approach that incorporates the latest medical advances for pain relief with personal considerations. In Massachusetts, there is an effort to incorporate palliative care into all aspects of cancer care. Medical schools, hospitals, and cancer centers are training doctors and nurses in palliative care. They are creating new palliative care programs, or enhancing existing ones. Several palliative care organizations provide education and awareness, and promote palliative care principles. Coalition members working on this section of the plan have set priorities to improve education and training for providers, policy makers, health care professionals, and consumers. They have also included strategies for improved pain management policies.

Goal: Ensure that all Commonwealth residents have access to quality palliative care.

Target Measures:

• By 2011, increase the number of certified palliative care providers.
  Where we are: 52 MD, 6 RNP, 178 RN, 2 LPN/VN, 76 nursing assistants
  Our target: 15% increase in certified palliative care providers
• By 2011, increase the number of NCI Cancer Centers and Commission on Cancer- approved hospitals with palliative care programs. Where we are: 20% (telephone survey, 2005) Our target: 50% (no HP2010 objective)

• Encourage reimbursement for palliative care (case management & follow-up).
• Provide statewide education of policy makers, health professionals, patients & family (general public) on quality palliative care.
• Support efforts to educate the public about the prevalence of pain, the consequences of unrelieved pain, what appropriate pain management is and how to speak up in order to get effective pain relief.
• Encourage strong advocacy of pain management public policy interventions.
• Support efforts that ensure basic pain management competency for all health care providers.
• Support and encourage participation in CEU opportunities for providers on symptom management. Collaborate with the many agencies providing palliative care education.
• Ensure equity of access to excellence in pain management.
• Ensure that patients have access to complementary alternative medicine (CAM) and that these interventions are coordinated with the person’s overall treatment plan.