The director of the Department of Palliative Care, Rehabilitation, and Integrative Medicine at MD Anderson Cancer Center (University of Texas), Eduardo Bruera, has warned that, despite the progress of medicine in addressing diseases, the response to pain, fear, and exhaustion of patients continues to be insufficient.
"Palliative care has been trying for more than sixty years to integrate a person-centered approach into medicine, and the results are still partial. Today we know how to treat the disease better than ever, but we do not attend to pain, fear, or fatigue of those who suffer it as well," he indicated during a conference organized by the platform Para Ti, Paliativos.
The specialist insists that the planning of clinical, educational, and research programs must be built from the needs of each sick person, and not be limited to the pathology they suffer from.
Bruera is in favor of the model of early palliative care, present from the moment of diagnosis and in parallel with the specific treatment of the disease. His work supports this approach: specialized teams relieve symptoms such as pain, fatigue, or anxiety, elevate the quality of life of patients and families, and also reduce healthcare costs by avoiding ICU admissions, shortening hospital stays, and limiting unnecessary interventions in the final phase of life.
With this perspective, the expert conveys his proposal to the care and academic field: that every hospital with an intensive care unit also has a palliative care unit; that each outpatient service has a support care consultation, and that all medical schools incorporate a Department of Palliative Medicine.
His visit comes shortly after the approval of the Palliative Care Strategy 2026-2030 by the Ministry of Health, a plan that aims to advance these cares and expand them beyond the final stage of life. However, specialists warn that the real challenge now is to equip it with professionals, resources, and specific training so that it materializes into effective changes.
From awareness to concrete measures
Bruera considers that one of the great challenges is to raise awareness among political and economic leaders so that health systems respond better to the vulnerability of patients and their families. While that shift does not occur, he maintains that professionals can already introduce improvements in their daily practice.
His team at MD Anderson has found that strengthening communication, taking time to listen, and involving the patient in decisions about their treatment increases their confidence and expectation of improvement.
"We need professionals, spaces, and resources, but there are also practical solutions that we can apply right now and that patients and families have the right to demand," he emphasizes.
The day concluded with a discussion between Bruera and Elia Martínez, president of the Spanish Society of Palliative Care (SECPAL), in which they analyzed what Spain needs to move towards more person-centered care.
SECPAL's data highlights the pending path: only 40 percent of patients who require specialized palliative care receive it. "We still struggle to understand that palliative care does not replace treatment, but accompanies it from the beginning. That is why it continues to be perceived as a failure of medicine. Spain needs a state law that guarantees training, interdisciplinary teams, and funding to respond to a need that keeps growing," Martínez states.
For You, Palliative groups almost a hundred entities
The conference took place within the framework of the annual meeting of affiliates of For You, Palliative, a social awareness platform that seeks to increase knowledge and public understanding of palliative care.
Created in November 2024 with the initial support of 13 organizations, it currently integrates 96 entities: patient associations, scientific societies, professional colleges, and foundations that collaborate to ensure that palliative care reaches all the people who need it.
"That almost 100 entities share this cause today demonstrates that palliative care is no longer just a matter for professionals, but for all of society. The visit of Dr. Bruera reminds us of where we need to move forward: care that looks after the person from the very first moment. Our commitment is that this right reaches everyone, no matter where they live," concluded the president of the Pía Aguirreche Foundation and spokesperson for Para Ti, Paliativos, José Galíndez.