S496 Cancer Pain

961 Slide PRACTICAL PALLIATIVE CARE IN RURAL INDIA L.T. u: Professor of Anesthesia, Gujarat Cancer Institute, B.J. Medical College Campus, Ahmedabad 380 016, India

Fri 2:00

ACC Hall 0

Throughout the world, over half the cancer patients are in developing countries and the majority of these patients are incurable at time of diagnosis. In India, 80% of patients dying from cancer are from rural areas. A module to provide effective palliative care and analgesic drugs (particularly narcotics such as oral morphine) to these needy patients through the Government primary health care system has been devised at Ahmedabad. Three main problems, unique to rural cancer patients in developing countries like India, are being managed as follows:

1. Assessment of cancer pain in these illiterate or less-educated rural patients is undertaken by visual charts and coin scales.

2. Delivery of oral morphine and similar palliative care drugs in their own villages is undertaken through rural physicians and village health workers. This ensures regular follow-up of patients.

3. Training of medical personnel involved in palliative care is undertaken by trained teachers in rural training centers.

This module can easily be adopted by other centers in developing countries having large rural population and Government narcotic laws for providing effective palliative care and pain relief, even in remote villages.

i’#l-N OF TFRPIINAL CANCER PATIENTS IN XINJIANG, CHINA: A FUR- THER STUDY OF SOCIAL AND ETHICAL INFLUENCE ON PAIN. Y .H. Hu, H.Y. Hu, J. Huang and B.Z. Xue, Research Institute of Redicopsycholegy, Shiheti medical College, Xinjiang,China

AIPl OF INVESTIGATION: In order to confirm our previous conclusion for that the incidences or prevalences of some pain syndromes (including terminal cancer pain) in Chinese people were louer than that of Occidentals, we collected more terminal cancer patients in Rour hoapitals in Xinjiang, China to make a further inwastigation.

mETHOQS8The medical histories of deceased cancer patients from four hospi- tals in Xinjiang, China, during the last ten years were revieued. patients were selected according to the following criteria. (1) The diaqnosis of ma- lignant carcinoma is confirmed; (2) In no cases did mental symptoma or dis- turbance of consciousness accur more thanone month before death. (3) There wss no surgery or radiotherapy being given during the last hospital time before death. (4) We use the intake of narcotic analgesics as the criterion to measure the degree of pain. RESULTS: Of the 352 terminal cancer patients, there were 99 cases who had

pain synptons and wanted ta use narcotic analgesics (28%). 91 cases in 245 Hans (37%) and 8 cases in 107 Uighur-Karaks (7.519) had pain symptoms. There uas a statistically significant difference between the tuo nationalities. In the 99 cases, who experienced pain, only S3 had clinically intractable pain in moderate and severe degree. 'IThey Were 53.5% in the 99 and 15% in the to- tal 352 patients. CONCLUSION: These figures are concordant with our past conclusion. The

incidence of terminal cancer pain in Chinese people is lower than that of Occidentals. The social and ethical influences might be impartant causes for this difference.