There are 2 non governmental organisations (NGOs) providing palliative care services in the Greek Cypriot south: The Cyprus Association of Cancer Patients and Friends (PASYKAF), and the Cyprus Anti-Cancer Society (CACS).

Supportive care is also provided in 3 hospital oncology units, 2 are government funded one is joint government/commercially funded. A total of 8 palliative or supportive care services are provided across the Greek Cypriot south (Table 1). There are no palliative care services for Turkish Cypriots in the north, but there is some voluntary support for cancer patients. Palliative care services in Cyprus currently only provide for adult patients with cancer.

Table 1: Palliative care provision in Cyprus, 2005

The Cyprus Anti-Cancer Society runs 4 services. The 18 bed in-patient unit at the Arodaphnousa Hospice in Nicosia; a home care service based at the hospice that covers all districts; and day care centres open twice a week in 4 districts: Nicosia, Limassol, Paphos and Famagusta (see Table 2). Patients, or their families, can self-refer to the Society. Gradually since the mid-1990s as links have improved with the oncology centres more patients are referred by oncologists.

Table 2: Patient attendances in the different services run by the Cyprus Anti-Cancer Society – activity from 1999-2004

The Arodaphnousa Hospice has increased the number of patients treated each year in the in-patient unit by reducing unnecessary and lengthy in-patient stays. Once symptoms are controlled patients are able to return home, only returning for in-patient treatment if needed. With improvements to the home care service the numbers of patients treated at home increased from 280 in 1999 to 660 in 2004.³ A total of 1400 patients in 2004 attended one or more home care, inpatient or day care services, all of which provide medical and nursing care, psychosocial support, and physiotherapy.⁴ The 4 day care centres also offer a range of other services which can include music and art therapy, aromatherapy, reflexology, massage, hairdressing and manicure. Free transportation is provided for patients to access services, which in 2004 transported around 400 patients.⁵

The Cyprus Association of Cancer Patients and Friends (PA.SY.KAF) This organisation offers 3 services, including home care, day care and psychosocial support (see Table 3). Within these services the Association runs a lymphoedema clinic, and a psycho-social support team.

Table 3: Patient numbers in the two key services run by the Cyprus Association of Cancer Patients and Friends– activity from 1998-2003

They offer social support and activities, a free prosthesis service, a ‘stop smoking’ clinic, and free transport to oncology units and day care centres. The Association offers financial help in situations where patients and their family are suffering hardship as a result of the illness.

Hospital oncology and specialist units: There are now 2 oncology units in government funded hospitals which offer supportive care and some palliation⁶ at the end of life to cancer patients: Nicosia General Hospital Oncology Center,⁷ and the oncology ward in Limassol Hospital. There is also the joint government-commercially funded Bank of Cyprus Oncology Center, in Nicosia, which opened in 1998.^8,9 There is a 6 bed specialist AIDS ward in Larnaca Hospital.

Cancer patients, and their families, may opt for the patient to stay in one of these oncology units, where they can now receive specialist pain and symptom relief, or they may wish to self-refer or be referred to one of the two organisations providing the full range of palliative care cancer services.¹⁰ There are no private palliative care services available.

There are no specialist palliative care services for children or for patients with other life threatening illnesses such as AIDS, but there is some interest in offering supportive care for these groups of patients as Jane Kakas of The Cyprus Association of Cancer Patients and Friends describes:

‘There is an AIDS department in Larnaca Hospital, but I don’t think they see themselves under the umbrella of palliative care. We invite them [to seminars], and we send them anything interesting that comes through. If there was something that was relevant I would keep them informed, same as I do with the paediatric oncologist. I always send him copies of anything that comes through, especially related to opioids or pain in children. They do use morphine with children. But children don’t really die at home, they tend to be admitted to the ward and given IV fluids with morphine. At least they are using morphine now for the children, which is a move forward. There are no government in Cyprus so families don’t feel secure to have the children at home. They would love to have community services, of course, but it’s a long way off.’¹¹

Since 2003, Turkish Cypriots can access the in-patient and day care hospice services in the Greek Cypriot south. Although, no palliative care at home is available in the north there are 2 NGO organisations whose aim is to offer for support cancer patients.

The Help Those with Cancer Association is run by volunteers (many are cancer survivors), and with the help of a small number of nurses can offer some limited home nursing care and support, as well as social and financial support to cancer patients during and following treatment, including those at the end of life. Volunteers will also support families, if needed, after a patient has died.¹²

The Kemal Saracoglu Anticancer and Anti-leukaemia Association , but as of June 2005, this Association remains at the planning stage in developing a home care service.¹³