Delivering Cancer Care in Palestine: A Structured Situational Analysis from the Perspective of Oncology Nursing

Cancer care in Palestine operates within a health system constrained by occupation, movement restrictions, resource scarcity, and chronic instability. These conditions fragment service delivery and create major inequities.

This study foregrounds the roles, challenges, and ethical responsibilities of oncology and palliative care nurses across the cancer care continuum, and examines how political instability, blockade, and health system fragmentation shape access to care and nurses' capacity to sustain services under profound constraint.

A hybrid methodology combined a comprehensive review of peer-reviewed and grey literature with situational and experiential insights from Palestinian and international nurses working across oncology and palliative care. This triangulated approach enabled an in-depth understanding of systemic barriers and facilitators across the continuum of care.

Substantial inequities were identified at every stage of the cancer pathway. Prevention and early detection are constrained by stigma, limited health promotion, and minimal screening. Fragmented referral systems disrupt continuity of care. Diagnostic and treatment capacity is undermined by shortages of medicines, equipment, and specialized staff. Urban-centered services with movement restrictions, especially for patients in Gaza, make care extremely challenging. Nurses emerged as pivotal in sustaining patient education, psychosocial support, and care coordination despite resource scarcity and significant moral distress.

Cancer care in Palestine is severely limited by structural, political, and resource-related factors. Nevertheless, nurses' adaptability and commitment remain central to sustaining oncology services.

Strengthening cancer care requires embedding nursing leadership within national cancer strategies, expanding training, and integrating supportive care into routine pathways.