{"entity":{"id":"idea-moon-palliative-care-from-diagnosis-everywhere","kind":"idea","name":"Palliative care from diagnosis for every advanced cancer, including opioid access, worldwide","aka":[],"tldr":"Palliative care given early alongside cancer treatment improves quality of life and sometimes survival, and most of the world has no access to it or to morphine. Make both universal.","summary":"Early integrated palliative care improved quality of life, mood and in some trials survival in metastatic cancer (Temel 2010), and is guideline-recommended, yet is delivered late or not at all in most settings; the Lancet Commission on palliative care documented that most of the world's population lacks access to opioids for pain. The proposal is a global standard: automatic palliative care referral at diagnosis of advanced cancer, trained generalist palliative capacity in every cancer unit, and a financed programme guaranteeing affordable oral morphine and essential palliative medicines in every country.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Pain relief and palliative care are unavailable to most): WHO fact sheet, Palliative care","url":"https://www.who.int/news-room/fact-sheets/detail/palliative-care"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":["mgh"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-palliative","b-global-access"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Universal early palliative care and opioid access reduce severe uncontrolled pain at end of life by over half and improve quality of life scores in advanced cancer across participating countries.","rationale":"The evidence is settled and the interventions are inexpensive; the barriers are regulation of opioids, workforce and the misconception that palliative care means giving up.","test":"National implementation in three countries with a WHO-style essential package; measure opioid availability, referral timing and patient- and family-reported outcomes against matched countries.","maturity":"being-tested-at-scale","actor":"policy","cost":"large","horizonYears":5},"route":"/ideas/idea-moon-palliative-care-from-diagnosis-everywhere/","neighbours":{"institution":[{"id":"mgh","kind":"institution","name":"Massachusetts General Hospital Cancer Center","route":"/institutions/mgh/"}],"bottleneck":[{"id":"b-global-access","kind":"bottleneck","name":"Most of the world has almost no cancer care","route":"/bottlenecks/b-global-access/"},{"id":"b-palliative","kind":"bottleneck","name":"Pain relief and palliative care are unavailable to most","route":"/bottlenecks/b-palliative/"}],"paper":[{"id":"paper-temel-early-palliative-care-nejm-2010","kind":"paper","name":"Temel: early palliative care alongside chemotherapy improved quality of life, mood and survival in lung cancer","route":"/key-papers/paper-temel-early-palliative-care-nejm-2010/"}]}}