World Cancer Day stands as an annual initiative by the Union for International Cancer Control, established on February 4, 2000. Its purpose is to foster unity within the global cancer community, aiming to alleviate the worldwide cancer burden and champion equitable access to vital cancer diagnosis, treatment, and care. The overarching theme for the 2022-2024 campaign is ‘Close the Care Gap.’ In 2024, the global call is for unity of voices and proactive engagement, emphasising the need for robust alliances and inventive collaborations to make strides in the fight against cancer.
Pain is an “unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage”. Acute pain is pain of recent onset and limited duration due to injuries, illness, or as a result of surgical interventions, e.g. post-operative pain, acute headaches, strain trauma and burns, fractures, activated arthrosis, and dental pain. However, acute pain which persists for longer than three months, is generally classified as chronic pain.
Pain is a common symptom in patients who survive cancer and in those who live with progressive advanced disease (incurable disease). Cancer related pain can be acute or chronic. Persistent cancer pain can, in some individuals, lead to the development of chronic widespread pain induced by plastic changes in the sensory nervous system.
Pain affects up to 40% of cancer survivors and affects at least 66% of patients with advanced progressive disease, many of whom experience poor pain control.
Cancer survivors continue to live with physical and psychological symptoms associated with pain (such as cardiopulmonary compromise, fatigue, pain, neuropathies, reduced physical function, depression, and anxiety) that interferes with functioning and negatively affects quality of life:
- 66% will survive for at least 5 years and 40% will be alive more than 10 years after diagnosis.
- Between 33% and 40% of cancer survivors suffer from chronic pain, often neuropathic in nature.
For patients who live with progressive advanced disease, pain is a very common symptom:
• 1.9 million European cancer patients die from their disease each year.
• 66% will experience pain before death and 55% will experience moderate‐to‐severe intensity pain.
In September 2020, SIP (Societal Impact of Pain) launched its Position Paper addressing Cancer-related Pain. SIP calls upon EU and national policymakers to:
- Establish and/or use pain as a quality indicator in the assessment of healthcare systems’ quality and thus contribute to assessing the societal impact of pain and build on existing initiatives and opportunities to fill the data gap on the societal impact of pain.
- Reference the inclusion of standards for the management of cancer-related pain across Europe to improve cancer pain management, promote quality of care and reduce variation and inequalities across Europe.
- Make resources for cancer care services and treatments available.
- Encourage Member States to provide an appropriate level of education and training in pain assessment and management and other principle of palliative care to all healthcare professionals involved in the care or patients with cancer related pain.
- Promote and allocate adequate funding to the development of pain research.
During this period, SIP aligned its efforts with the development and unveiling of the European Commission’s Beating Cancer Plan. SIP actively contributed insights to the Commission’s Roadmap and engaged in the public consultation process.
Europe’s Beating Cancer Plan has several Flagship initiatives and supporting actions that are of particular interest to SIP, such as:
- Flagship 1: Creation of the Knowledge Centre on Cancer.
- Flagship 5: Making an EU Network of National Comprehensive Cancer Centres and developing of an Inter-speciality Cancer Training Programme.
- Flagship 9: Setting up a Cancer Inequalities Registry.
- Creation of a Stakeholder Contact Group.
The momentum triggered the creation of the Special Committee on Beating Cancer of the European Parliament. The Committee was tasked with establishing a set of concrete recommendations for the member states and the EU institutions to strengthen our resilience against cancer.
In this context, SIP conducted external outreach on the subject and held discussions with over 20 influential EU policymakers from both the European Institutions and Member States to deliberate on recommendations for cancer pain policy.
SIP also organised a multi-stakeholder cancer pain policy event in early March 2021, drawing the participation of more than 75 attendees from various parts of Europe. The event was hosted and endorsed by several members of the European Parliament’s Special Committee on Beating Cancer (BECA).
Through these initiatives, SIP had the chance to contribute input to the ‘Report on reinforcing Europe in the battle against cancer – toward a comprehensive and coordinated strategy.’
SIP highlighted the need for the Beating Cancer Plan to address effective cancer pain management.
This could be contextualised within the fifth theme of the Plan, i.e., Ensuring Access to High Standards in Cancer Care, which aligns with SIP’s following calls to EU institutions and national governments:
- Establish and/or use pain as a quality indicator in the assessment of healthcare systems’ quality and thus contribute to assessing the societal impact of pain and build on existing initiatives and opportunities to fill the data gap on the societal impact of pain.
- Reference the inclusion of standards for the management of cancer-related pain across Europe to improve cancer pain management, promote quality of care and reduce variation and inequalities across Europe.
The BECA Draft Report on enhancing Europe’s fight against cancer incorporated key SIP priorities. These included advocating for equitable access to quality cancer care, addressing pain management within the cancer care pathway, and emphasising support for patients, survivors, and caregivers through pain relief, psychological services, and adapted physical activity. Additionally, the Draft Report recognised the importance of quality standards, called for improved education and training for health professionals, supported launching an inter-speciality cancer training program, and urged the development of multidisciplinary decision-making and practice in cancer services.
Here are some direct quotes from the BECA Report on strengthening Europe in the fight against cancer – towards a comprehensive and coordinated strategy. Numerous amendments proposed by us were accepted by MEPs and later included in the final report:
- ‘Calls on MS to improve the reintegration of cancer survivors into social activities and the labout market’
- ‘Recalls the recommendations and tools developed by CHRODIS+ Joint Action to foster patients’ retention at work, ability to return to work and their reintegration into the labour market and encourages the Commission to support the implementation of these recommendations and tools across MS’
- ‘Calls for implementing adequate referrals to specialised multidisciplinary expert centres at both national and European level’
In terms of next steps, the Commission published an Implementation Roadmap to complement the Beating Cancer Plan.
On a practical level, SIP/EFIC has engaged in a number of EU-level activities to help support the momentum for the implementation of the Beating Cancer Plan. For example:
- Becoming engaged in the call for an EU Inter-speciality Cancer Training Programme, as mentioned above.
- Outlining a special focus on capacity building and education for all (professionals, patients, policymakers, and other stakeholders within the health policy ecosystem).
- Participating as an active member within the European Cancer Organisation’s policy workstreams.
However, there are gaps that still need to be addressed. SIP will continue to work on this very important topic in 2024 and beyond, by continuously disseminating and updating their position papers, tracking the implementation of the policy, and monitoring future calls within the Horizon Europe and EU4Health programmes.
For further insights into SIP and its focus on cancer pain, consult the following resources:
- Find out more about our Cancer Pain Policy.
- Read SIP Position on the importance of addressing cancer related pain management in the Europe’s Beating Cancer Plan and beyond.
- SIP’s Input to the Commission’s Roadmap and Public Consultation Process.
- SIP contributed to the European Cancer Organisation’s publication entitled “Free from Cancer: Achieving Quality of Life for All Cancer Patients and Survivors”.