Karachi: Cancer patients in Sindh, including those in Karachi, are facing immense hardships as no public sector hospital in the province offers comprehensive treatment for all types of cancers under one roof, forcing patients to move from one hospital to another for surgery, chemotherapy and radiotherapy while many terminally ill patients are left without palliative care to ease their suffering.
Health officials and oncologists say the fragmented system of cancer care in Sindh means that patients are often referred from one institution to another, delaying treatment and increasing financial and emotional burden on families already struggling with the disease.
Pakistan records new cancer cases every year, with experts estimating that over 180,000 people develop cancer annually in the country. Sindh, particularly Karachi, accounts for a significant proportion of these cases due to its large population and better diagnostic facilities that detect cancers more frequently than other regions.
However, despite Karachi being Pakistan’s largest city and the healthcare hub of the province, no single government hospital provides complete cancer care including surgery, chemotherapy, radiotherapy and palliative care services.
Patients diagnosed with cancer often begin treatment at one hospital but are later referred elsewhere for other components of therapy.
A recent case involving a 55 year old man from Hyderabad diagnosed with stomach cancer illustrates the ordeal faced by many families seeking treatment in Sindh.
According to a senior official of the Sindh health department who recently retired, the patient was initially referred to the Sindh Institute of Urology and Transplantation (SIUT) in Karachi after being diagnosed in Hyderabad. However, after visiting both the Reagent Plaza facility and the main SIUT hospital near Civil Hospital Karachi, the patient was advised to seek treatment at Jinnah Postgraduate Medical Centre (JPMC).
At JPMC, doctors in the cancer ward examined the patient but referred him to the Karachi Institute of Radiotherapy and Nuclear Medicine (KIRAN), a specialised cancer treatment centre run by the Pakistan Atomic Energy Commission.
When the patient reached KIRAN hospital, the administration referred him back to JPMC after determining that the cancer had already spread to multiple organs and was in stage four, making curative treatment unlikely.
According to the health official, oncologists at JPMC then advised the patient’s relatives to seek palliative care at Aga Khan University Hospital because no public sector hospital in Sindh currently offers dedicated palliative care services for terminal cancer patients.
“After wandering between hospitals for several days, the patient returned to Hyderabad and is now waiting for death at home. Cancer causes immense pain and suffering, but in the largest city of Pakistan no one was able to provide him relief from his symptoms,” the official said.
The absence of palliative care services in public hospitals means that many patients with advanced or metastatic cancers spend their final days in severe pain without access to proper symptom management.
Another major challenge faced by cancer patients in the province is the limited availability of strong pain medications. Doctors say oral and injectable morphine, which is considered the standard treatment for severe cancer related pain, is rarely available in public hospitals. Similarly, fentanyl patches used to manage chronic cancer pain are difficult to obtain.
Due to strict regulatory controls and limited supply, many hospitals either do not stock these medicines or face bureaucratic hurdles in procuring them, leaving patients to suffer uncontrolled pain.
Health experts say the lack of palliative care and limited access to opioid based pain relief drugs represents a major gap in cancer care in the country.
Officials within the Sindh health department acknowledge that cancer treatment services are scattered across several institutions in Karachi.
At Jinnah Postgraduate Medical Centre, patients can undergo cancer surgery while chemotherapy is arranged through financial assistance programmes such as Pakistan Bait ul Maal for those who cannot afford the expensive medicines.
Hospital officials say JPMC also houses one of the country’s major radiotherapy facilities but concede that the hospital does not currently provide structured palliative care services.
Despite the increasing burden of cancer, Sindh has yet to establish a comprehensive public sector cancer hospital that provides diagnosis, surgery, chemotherapy, radiotherapy and palliative care under one roof.
This is despite the provincial government spending hundreds of millions of rupees to support specialised procedures such as bone marrow transplants at institutions like Dow University of Health Sciences (DUHS) and the National Institute of Blood Diseases (NIBD) in Karachi.
Critics say the government should invest in establishing a full fledged cancer treatment centre that can provide integrated services to patients rather than relying on fragmented care across multiple hospitals.
Repeated attempts were made to obtain the version of Sindh Health Minister Dr Azra Pechuho through her personal staff but she was not available for comment.
Dr Pechuho has, however, stated on several occasions that Sindh has some of the best healthcare facilities in the country and that the province’s achievements in the health sector are often not highlighted.
Patients and families continue to bear the brunt of an overburdened and fragmented cancer care system. Many are forced to sell property, borrow money or seek financial help from relatives and charities in order to continue treatment.
Health experts warn that without the establishment of integrated cancer treatment centres and the introduction of proper palliative care services in public hospitals, thousands of patients in Sindh will continue to struggle not only to receive treatment but also to find relief from the pain caused by advanced stages of the disease.
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