The last journey, coming home before dying for migrant cancer patients: A case series

Abstract

Background: Global migration has led to an increasing number of migrant patients receiving cancer diagnoses in foreign countries. These individuals often experience worse outcomes due to advanced disease at diagnosis and limited access to specialized care. When palliative care becomes the primary option, many express a wish to return to their home country for End-of-Life care. However, no guidelines or care pathways currently address this sensitive issue.

Case presentation: This case series describes three migrant patients who wished to return to their home countries for End-of-Life care. The first case highlights the critical role of early communication, administrative challenges, and disparities in palliative care availability. The second case demonstrates that even highly disabled patients can undertake a final journey if clinically stable, provided appropriate accommodations and support are in place. Both cases followed a similar framework: identifying a palliative care provider in the home country and having a Mini-Team member accompany the patient. In contrast, the third case underscores the difficulty of fulfilling this wish when clinical deterioration progresses rapidly, preventing repatriationConclusion:Fulfilling the desire of migrant oncology patients to return to their home countries for End-of-Life care presents various challenges. These obstacles may arise from differences in national healthcare systems, administrative issues, and the patient's clinical condition. It is crucial for the Mini-Team to identify this wish as early as possible to secure appropriate arrangements in the patient's home country. Additionally, having a member of the Mini-Team accompany the patient during the journey can provide significant support.

Keywords: End-of-Life; cancer and migration; medical ethics in repatriation; migrant oncology patient; palliative and supportive care; patient repatriation.