After struggling with prostate cancer since 1990, 75-year-old Xu Hanlin is now at home, bedridden.

The cancer has spread to his legs, leaving him immobile. Until recently, the old man was in agony, unable to sleep even five hours a day, with his temper and family life suffering as a result.

"We could do nothing when we heard my father moaning all day and all night," said Xu's daughter, who declined to be named.

Xu and his family know his cancer is terminal.

"All we hope is that he can spend his last days free from pain," said Xu's daughter.

Thanks to Xinhua Hospice, Xu is now able to enjoy a good night's sleep because of painkillers provided by the hospice. Doctor Shen Wei and nurse Sun Meilai from the hospice have also visited the family and given them medical advice -- all free of charge.

Painless, peaceful end

Since Shanghai Xinhua Hospice was set up on June 22, 2002, it has treated 849 patients like Xu. The hospice, the only one in the city to provide free medical care for terminally ill cancer patients, is jointly run by the Li Ka Shing Foundation and local Xinhua Hospital. By calling 021-35120101, cancer victims can reduce their suffering.

After witnessing the terrible last days of his father who died of lung cancer, Hong Kong tycoon Li Ka Shing set up a 100 million yuan (US$12 million) foundation to help dying cancer patients in need. The foundation gives 1 million yuan to 22 hospices across the Chinese mainland.

Hospices used to be places of shelter for travelers, especially those maintained by religious order or monks. Since the 1960s, however, they have developed into homes for the sick or destitute, especially the terminally ill. Hospices do not carry out euthanasia, which ends patients' lives through medical means. Instead they help them through their last days by easing their pain.

"In China, the term is still very new, for the concept that terminally ill patients need special care in their last days has not been widely accepted," said Chen Qiang, professor of Xinhua Hospice.

Many terminal cancer patients in China spend their last two or three months at home after all medical treatment has been exhausted or due to financial problems.

"Although we can't save their lives, we can improve their quality of life by easing their pain and also giving them care and love," said Chen.

Apart from Chen, the hospice has another six staff, including one social worker, who provide medical support to cancer patients in Shanghai and nearby cities such as Wuxi in Jiangsu Province.

"We give patients various medicines under a 'three-ladder painkilling treatment' and according to their specific situation," said Chen.

Doctor Shen said many patients needed more than medicine.

"They need someone to listen to them, talk to them and help them achieve their incomplete hopes so they can leave the world without regrets." said Shen.

After his younger sister was born, Miao Jie, a 19-year-old with cancer in his lymph nodes, felt he was being discarded by the world as his parents and grandparents had little time for him.

Few people talked to him and his temper soured. But volunteers of his own age from the hospice have freed him from his virtual prison by talking with him about football and music.

The social worker tried to get Miao a free ticket for an Andy Lau concert, but by then he was too weak to see his beloved star on stage.

The hospice staff decided to buy a brightly colored mini TV set for the young man, but the only one on display was not for sale. They contacted the Shanghai TV Set Factory, which searched through its stock at all its agencies and found a pink one for Miao.

Another cancer patient surnamed Yang had one last wish -- to see his daughter. He had lost contact with her after his wife left him with their daughter seven years ago. With the help of the local public security department and the community, volunteers finally found his daughter, who came to Yang's bedside seven days before he passed away.

Over 100 volunteers, including students and families who have benefited from the service, have joined with hospice to help patients.

Difficult future

"It's a good beginning that many people are aware of the lives of terminally ill cancer patients," said Chen. "But we need more support from society."

According to statistics from Shanghai Disease Control and Prevention Center, of the 80,000 cancer patients in Shanghai, 20,000 will never recover.

During past year, the Xinhua Hospice has cared for 500 patients. With only two rooms in the city's west Yangpu District, the hospice can only provide home services for patients.

"We need some wards so patients can be cared for in our hospice and they can leave the world in a more comfortable environment," said Chen.

(China Daily September 15, 2003)