Palliative Care is a major focus area for Psyence.

Dr Amza Ali, neurologist and global medical director at Psyence shares some more light on this subject explaining what palliative care is, why it needs more attention and what Psyence’s vision and mission are when it comes to improving the access to and the effectiveness of palliative care globally.

1. What is Palliative Care?

 Palliative Care is a holistic approach to the care of individuals across all age groups who have serious health related suffering due to major illnesses, the sort that can indeed be life ending. It is important to note that palliative care is not just confined to people near the end of life; it is also for people far earlier in their trajectory of illness.

Palliative Care aims to improve the quality of life of patients, and of their families and caregivers. It is a holistic approach because it involves assessing and managing physical illness, but also pays attention to the spiritual and psychological distress that accompanies the diagnosis of something really severe or life ending; it also pays attention to social needs. Palliative Care helps families and the patient themselves understand what is going on and enables them to determine their own goals of care.

Palliative Care positively influences the course of illness. It doesn’t necessarily prolong life, but it certainly improves the quality of life and is therefore an indispensable component of care when it comes to dealing with serious illnesses.

Each year, an estimated 40 million people are in need of palliative care; 78% of them people live in low- and middle-income countries. WHO, August 2020

2. Why should palliative care be an important part of healthcare systems and is there a growing need for palliative care globally?

It is obvious that people get sick everywhere in the world, suffer everywhere in the world and die everywhere in the world.

In under resourced parts of the world, the sad reality is that even the basics needs of pain amelioration for people with cancer and end-of-life considerations are not being met. As you can imagine, the psychological suffering that accompanies the physical suffering is even more accentuated in such settings.

It is necessary for all of us throughout the world to think about how we can address the mental and physical suffering associated with serious illnesses. Including Palliative Care as part of our healthcare systems, it is essential, as it helps to keep people out of hospital, reduces ER visits and improves quality of life, not just for the patient, but also for their families.

3. Why then psychedelics and why in particular, psilocybin in Palliative Care?

Much of the distress that people have to live with when they face an end-of-life diagnosis is mental anguish, fear, anxiety, depression and all its consequences, which impacts on appetite and on relationships.

If we could find a way to positively impact the mental state of patients in need of Palliative Care, such that they are able to be more at peace knowing that their life is ending sooner than they ever would have anticipated, then think about how this could improve their quality of life. Nothing can be worse than existential distress.

Integrating psychedelic therapies into the overall holistic approach to people who are undergoing Palliative Care is certainly a rational approach given that there are many anecdotes of its benefit.

What needs now to be done is to prove that psychedelics actually can help improve mental health in a very objective way. This is one of the reasons why Psyence is committed to an approach that is objective and which finds evidence to support the role of psilocybin, and psychedelics in general, for ameliorating mental health disorders in particular in the context of Palliative Care.

We already see research indicating that “a one-time, single-dose of psilocybin, combined with psychotherapy, appears to be associated with significant improvements in emotional and existential distress in cancer patients. These effects persisted nearly five years after the drug was administered.”
NYU Grossman School of Medicine, 2020

Worldwide, only about 14% of people who need palliative care currently receive it. WHO, August 2020

4. Tell us about your intention to move into clinical trials for the use of psilocybin in Palliative Care and where you are at in this process?

We are a scientific company, and you will recognise it in our name, Psyence. As such, we have to evaluate psilocybin as a potential medicine and that means clinical trials. A clinical trial will help to demonstrate efficacy.

Off course as responsible people and as a responsible company, we must first and foremost make sure that the drug we make available to patients and the public is safe. To this end we have a drug development process that has a nutraceutical pathway and a longer term pharmaceutical pathway. Ultimately they converge around doing observational clinical trials which help to inform more formal, randomized clinical trials, which will provide the evidence that we need to support its need for one indication or another.

To do this we have formed collaborative relationships around the world. We have strong relationships with major institutions in Jamaica, in the UK and in Canada.

Through these, we will be studying the role of psilocybin in treating a variety of mental health disorders in the context of Palliative Care. While all our studies are rigorous quantitative studies, we are also committed to obtaining qualitative data because we recognise that we have to include personal aspects of the suffering that takes place in the context of Palliative Care. We want to show, if possible, how our therapeutic agents can change that.

5. You talk about providing a more holistic approach to palliative care. Tell us about your 360 degree Palliative Care approach and how you intend to put this ethos into action at Psyence?

We are a holistic company and we have conceptualised the term a 360 degree palliative care approach in which we see our role as not only providing a medicine. We recognise that our medical treatment is only part of a larger consideration in which we recognise the need to treat the psychological, the physical and the social needs of the person so affected.

Our approach to this complex problem requires us to therefore have a multidimensional approach and a multidisciplinary approach to the problem. The need for contributing to Palliative Care recognises that we must therefore think at a community level and beyond just the need of the individual. Indeed all of this is underscored by the crisis of the global pandemic, which has taken resources away from cancer care, and away from the patient or the community of individuals who are receiving palliative care, because most healthcare systems have been stressed and indeed broken by the sudden acute and severe demands of the Covid 19 pandemic.

It is our privilege to be able to participate in providing another option for improving the quality of life and the care in general of individuals undergoing palliative care.