The Collaborating Center maintains a twenty year commitment to promoting optimum supportive care and symptom management for cancer patients in developing countries. The PRG has promoted pain management and symptom assessment across the globe. Cancer centers in countries such as Mexico, India, Thailand, the Philippines and Vietnam have benefited from on-site training and collaborative research. Today, the Collaborating Center focuses on two primary areas – (1) Asia and (2) Latin America and the Caribbean.
Asia
The PRG has been active in Asia for nearly two decades. Training and collaboration has occurred in Thailand, Vietnam, the Philippines and China. An extensive bilateral program for cancer pain management was launched in China in 1993.
In China, there are 1.6 million new cancer diagnoses each year. Cancer deaths total 1.3 million per year. The majority is incurable at the time of diagnoses. Few patients have access to good pain relief. In order to bring about the changes needed for cancer patients in China, the PRG partnered with China’s Ministry of Health’s Bureau of Drug Administration and Policy to provide five national training seminars and core team training or train-the-trainers programs on cancer pain management. In addition to training, the program outcome measures included dissemination of information on cancer pain management and the establishment of cancer pain research in China. Significant positive outcomes have been observed and documented. These include the following: 1) changes in drug regulation and policy, 2) the availability of new formulations of opioids, 3) the distribution of national guidelines on pain management, 4) the establishment of clinical trials of analgesics, 5) the development of a valid pain assessment tool in Chinese (link?), 6) the establishment of a pain clinic in major cancer hospitals, and 7) the increase of morphine consumption.
Current Projects
The Collaborating Center has worked with researchers and clinicians in several countries to produce pain and symptom assessment tools in several Asian languages. [Validated pain assessment tools] have been produced in Chinese, Japanese, Hindi, Filipino, Thai and Vietnamese. The Center is working with investigators in the development of studies of pain management practice as well as studies of the epidemiology of cancer symptoms. Clinical trials looking at potentially more effective ways of providing symptom control are also underway in several countries.
Management of Cancer Pain: Clinical Practice Guidelines. The Agency for Health Care Policy and Reform guidelines are available in Chinese. To order, email us at prg@mdanderson.org.
Pediatric Cancer Pain: A Research and Training Program for Chinese Pediatricians. Physicians in Beijing and Shanghai will complete a survey to help determine the level of knowledge and current practice for Chinese pediatricians who treat cancer pain. Two pediatricians will participate in a six-month palliative care training program at the cancer center.
Latin America and the Caribbean
There are 477 million cancer cases diagnosed each year. By the year 2020, that number will increase to 841 million. Cancer deaths in Latin America are rising dramatically. By the year 2020, cancer deaths will outnumber deaths by infectious disease 3 to 1. Of this number, less than 1% of patients receive adequate management of cancer pain. The Collaborating Center will work closely with the Pan American Health Organization to provide training and research in the area of supportive and palliative care in this region.
The Collaborating Center will seek to provide training opportunities for practitioners in the region, to improve patient access to supportive and palliative cancer care, and to increase availability of supportive care medications in the region.
Current Projects
AHCPR Guidelines for the Management of Cancer Pain. Spanish Translation. This publication has guided English-speaking clinicians since its release in 1994. The Collaborating Center financed the translation and printing of the Spanish version. 7,000 copies will be distributed at no cost to health care professionals throughout Latin America and the Caribbean. A complimentary copy is available for healthcare professionals. To obtain a copy, send your email order to prg@mdanderson.org.
Advanced Cancer Survey. A survey has been designed to determine existing services and treatment options for patients with advanced cancer. The set of surveys will be distributed to health care professionals in Latin America and the Caribbean who treat patients with advanced cancer. Latin American oncologists, pharmacists and nurses are invited to participate. Contact prg@mdanderson.org.
Palliative Care Demonstration Projects. The Pain Research Group at the MD Anderson Cancer Center will provide technical assistance and cooperation in the formulation, design, implementation and evaluation of three demonstration projects in the Region. The projects will analyze the social benefits and cost effectiveness of supportive care and cancer pain relief. For more information, contact the Pan American Health Organization.