Russia: The State-of-the-Art of Palliative Care

Abstract

The Russian Federation is a country with a high cancer morbidity, which unfortunately has a tendency to increase annually. For example, St. Petersburg, the second largest city in Russia (population 5 million people) has the highest cancer morbidity in Russia, with more than 17,000 new patients per year. 1 In the Novosibirsk region, which covers a large territory of the Russian Federation, cancer morbidity is 333.5 per 100,000 citizens and has an annual increase of 5–6%. The majority of Russian patients with cancer are diagnosed with advanced disease. Palliative treatment for these patients is far from perfect. This can be explained by a number of factors. First, the lack of knowledge of the basic principles of palliation and a deficiency of skilled specialists pose obstacles to creating a structure for palliative care in Russia. Second, there are legislation limitations and problems of drug use regulation. Finally, evaluation of symptom severity and prevalence, its impact on quality of life, and adequacy of treatment, as well as studies of the barriers to effective palliative care and symptom management, are absolutely new in Russia. An extensive search of the current literature has found no citations describing the status of symptom control in cancer patients in Russia. Based on studies that have been done in countries with more health resources, we can expect symptom prevalence and severity to be greater among Russian cancer patients than in such countries as the United States and France. 2