Cancer & Palliative Care – Can We Catch up?
In a day and age like ours, good lifestyle practises are comprised. We have breakfast that is instant, processed and easy to eat, on the go, work long hours while sometimes skipping meals, stay up late and grab just a few winks and most importantly, do not find time to exercise or meditate. We are caught up in a race for time, money, power and in general, life itself. When on the one hand technological advancements have made life easier, they have also successfully tipped the scale onto the other side with the plethora of side effects their existence brings with them.
It’s not of surprise that unhealthy lifestyles have paved paths for the onset of different types of diseases, cancer being most prevalent among them. We’ve all heard our friends or family members say that the incidence has exponentially increased over the last decade or two. Of course, there are other causes for cancer such as pollution, food adulteration, lack of hygiene, tobacco and alcohol abuse, and the list goes on.
Cancer related mortality is a hot subject of research conducted in various universities the world over and many a time, in collaboration with the WHO. A study on the Indian cancer statistics conducted a few years ago reported a staggering 5,55,000 cancer deaths in India, in 2010 alone. Also, research led by Dr. Prabhat Jha, the Director for Centre for Global Health Research, St. Michael’s Hospital, Toronto, in year 2012 resulted in a model that is now being used as a reference to compute cancer deaths in India. A notable agency is the International Agency for Research on Cancer (IARC) that aids in recording cancer incidences in India. Similarly Dr. Jha’s model is used to study cancer mortalities in India. India Today iterated that cancer deaths worldwide were approximately 8.2 million in year 2012 and it’s been projected that by year 2020, the total number of cancer mortalities in the country will reach 17.3 lakh. With such daunting statistics that have been proven and projected through research, it is of great relief to come to the realization that advanced medical procedures are now available that have been found to increase the human life span by almost 30 to 40 years.
Organizations that specialize in palliative care for terminally ill patients are the new go-to centres for families with patients suffering from chronic illnesses. This type of treatment is not only directed towards alleviating physical symptoms but also aims to address psychological symptoms of both patients and their family members.
Palliative Care in India
In India, the utility of palliative care in improving the quality of life of terminally ill patients took long to be fully recognized by the law. Some key reasons were uncertainty and fear of use of morphine and other opium-based drugs for alleviation of painful symptoms, policies that were existent in the 1980s and 1990s-when it began to gain momentum-that strictly prohibited this practice, and a general lack of awareness and interest in the subject. The establishment of the Narcotic Drugs and Psychotropic Substances Act (NDPA) in 1985 further made it difficult to convince the government about the advantages of palliative medicine. Eventually, the central government initiated measures to implement it but its instructions to the state governments to soften their narcotic regulations fell on deaf ears. The NDPA has since been considerably modified over the years.
Palliative care approach slowly gained popularity in mid 1980s with the advent of “hospice and palliative care movement”. The very first hospice centre to be established in India was Shanti Avedna Sadan in Mumbai. Such care centres were also established in Gujarat in the 1980s following which Indian Association of Palliative Care (IAPC) was formed and till date is considered one of the milestones in the history of palliative and hospice care.
Today, Kerala is one of the states in the country to house maximum number of such centres, with Tamil Nadu and Karnataka following closely behind. Reports stated that less than 1% of our country’s inhabitants have had access to palliative care and this called for measures that are conducive to making it easily available. Continued advocacy by the palliative care community bore fruit in 2010 when the Medical Council of India accepted palliative medicine as a medical specialty and announced a post graduate course in the subject. This step was crucial to the expansion of this practise in the country.
Karunashraya is a non-profit organization located in Bangalore, that recognized the need for a care centre for terminally ill cancer patients and made offering free palliative care to them, its mission. It adopts palliative care measures which constitute medical treatment procedures that reduce pain and other agonizing symptoms and improve the quality of life of such patients. The first hospice of its kind in India, their team aims to help patients who seek their support, get a life free of pain and one filled with dignity and peace. Having been operational since year 1995, they offer both inpatient care and homecare with the flexible option of the patient shuttling between the hospice and his/her home. Their work has been acknowledged by 15 awards. As is the case with many such centres, they extend psychological support through counselling, etc. even to the family members and other dependents of the patients.
It is run by a Board of Trustees who leave no stone unturned in dedicating time to this cause and ensuring its efficient functioning. The organizational structure is orderly and favourable to the mission of providing free palliative care in a manner that gives respect and dignity to the patients. The homecare and inpatient teams comprise well trained and dedicated doctors, multi-disciplinary nurses, physiotherapists, health assistants and social workers who give free palliative care including counseling and non-curative treatment. This endeavour is ardently supported by patron organizations and corporations who extend funds to Karunashraya.
They have more than 150 staff members who diligently work day in and day out to tend to their patients in the best manner possible. They have extended inpatient care to as many as 14000 cancer patients and homecare to 3500 patients. Whether inpatient or homecare, their services are free of cost. A good number of volunteers get on board every year to lend their services to this cause.
Education & Research
As is primary to any organization that aims to deliver top quality services, even Karunashraya gives priority to education and research. Since the concept of palliative care is fairly new and was introduced in India only in the 1980s, they pursued and currently have tie-ups with reputed centres and universities such as NIMHANS, Severn Hospice and Cardiff University to leverage and foster education, research and training in the fields of hospice and palliative care.
Located on Old Airport-Varthur Main Road, its calm and clean atmosphere and dedicated workmanship have been testified by the loved ones of many patients who were under Karunashraya’s care.