Palliative Care Practices in Gynecological Cancers in Asian Countries-A Cross-Sectional Survey by the Federation of Asian Organizations for Radiation Oncology.

Abstract

Purpose: This survey was conducted to assess the current palliative care practices in advanced gynecological cancers among radiation oncologists across the Federation of Asian Organizations for Radiation Oncology (FARO) region. Materials and Methods: A web-based survey comprising of a 23-item questionnaire was sent to the members of the FARO research committee, FARO council officers, and members representing the national radiation oncology organizations (N = 36) that are a part of FARO. Results: All members (100%) responded to the questionnaire. While a majority (76%) of the respondents had both inpatient and outpatient services available for palliative care at their center, only 22% reported having access to specialist palliative care or an attached hospice facility. Among gynecological cancers, cervical cancer was the most common malignancy referred for palliative care (89%), followed by ovarian (64%) and uterine cancer (40%). A combination of palliative radiation and drug therapy (89%) was the most frequently employed treatment modality. Nearly 65% of the respondents reported prescribing strong opioids such as morphine, while 8.3% cited limited or no access to strong opioids. More than 60% of the respondents believed that palliative care was underutilized at their center, and oncologists' lack of time was cited as the most common barrier (47%) limiting its utilization. Formal training in palliative care for all radiation oncologists (75%), development of palliative care infrastructure (66.7%), and improved access to specialist palliative care (55.6%) were cited as the most important measures that need to be undertaken to facilitate palliative care in the region. Conclusions: This survey has identified notable gaps in palliative care practices for gynecological cancers in the FARO region. To effectively integrate comprehensive palliative care into the oncology workflows, efforts must focus on increased training, strengthening the existing infrastructure, and developing research models tailored to the region's needs.