Too many Canadians with terminal cancer do not have a say in where their lives will end, simply because palliative-care services and support for their caregivers varies so widely across the country.

That's the conclusion of a special report about end-of-life care in Canadian Cancer Statistics 2010, released today by the Canadian Cancer Society.

The report found that while most terminally-ill people would prefer to die at home, more than 55 per cent of deaths occur in hospitals.

Part of the reason for that is because community-based services are simply not available for dying people in some jurisdictions, the report concludes.

The report found that Canada has a "patchwork approach" to end-of-life care, so that while some Canadians can access excellent services, other patients are unable to die with dignity in the setting of their choice.

Uniform, high-quality support for any person dying of cancer should be available no matter where they live, says Gillian Bromfield, the senior manager of cancer control policy with the Canadian Cancer Society. What Canada really needs is a national program for providing end-of-life care.

"The quality of care that's available across the country can vary between provinces and also within provinces. And that's not acceptable," she told CTV News Channel Wednesday, following the report's release.

The report found that oftentimes palliative care services do exist in an area, but they are not being used.

Bromfield says it's not exactly clear why that is, because not enough research is being done on the issue of end-of-life care.

"We don't know yet if it's about availability of services, or whether it's about knowledge of those services -- there's a lot of information we need before we can make recommendations," she said.

The issue of how to care for dying cancer patients is a pressing one, the society says. That's because 29 per cent of all deaths in Canada in 2005 were from cancer -- making the disease the leading cause of death in Canada.

This year, an estimated 76,200 Canadians will die from some form of cancer -- a number that will grow with Canada's aging and growing population.

With so many patients, families, and even doctors not wanting to broach the subject of death and palliative care, misunderstandings can result. The report found that oftentimes, patients and their families delay accessing palliative care services for their loved ones. By the time patients and their families start to seek out help for palliative care, the delays can mean a patient doesn't get the care they need in time.

Not only are many patients suffering but so are the family members who care for them, the report found. The report found a lack of solid support for families who choose to offer palliative care themselves at home.

Not only do these family members need help with offering physical and medical care, they themselves need emotional -- and financial --support that often isn't there for them.

The Canadian Cancer Statistics 2010 report estimates that a family caring for a terminally-ill cancer patient at home incurs costs of more than $1,000 a month on average. And that doesn't include the costs of lost income from taking time off work.

The Cancer Society is calling on Ottawa to extend compassionate care benefits to 26 weeks from the current six weeks. They also want to see a tax benefit to help families with costs. They say the government should be willing to support people whose caregiving relieves some of the burden from the health-care system.

Dr. Larry Librach, who runs the Temmy Latner Centre for Palliative Care, at Mount Sinai Hospital in Toronto, says he knows all too well that palliative care doesn't get the funding it needs. At any one time, his program is offering care to about 600 patients in the community, many of whom are dying of cancer.

But he says he knows there are many patients that his program can't help.

"The estimates are we're serving about 25 to 35 per cent of cancer patients who are dying. We'd like to serve as many as possible who want to be served," he told CTV.

He says when he saw the Cancer Society's report, he thought he had "died and gone to heaven" because the report was bringing to the forefront something he's been trying todraw attention to for years.

He says he's glad the Cancer Society is not just talking about how cancer can be beaten, but also talking about what happens when cancer can't be beat.

"It brings it right into the open. Palliative care should not be a secret. It should be there for every dying patient," Librach says.

"Some patients and families don't know about palliative care. So when you speak to the patients, they'll say, ‘Where were you when I needed you early on?' We are a well-kept secret."

With a report from CTV's medical specialist Avis Favaro and producer Elizabeth St. Philip