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DOI: 10.4103/ijmpo.ijmpo_27_20
Palliative Care in Oncology
The word palliative is derived from the Latin word ”pallium” meaning cloak. Palliative care is the active complete care of patients with life-limiting illnesses (not only cancer) and their families when the disease is not amenable to curative treatments. “Cloaking” or palliating a patient would involve tackling the psychological, social, and spiritual aspects of the disease and its treatment apart from the conventional care for physical symptom relief. Palliative care is a patient-centered approach that emphasizes relief from pain and distress by systematic identification and assessment of problems faced by the patient [Figure 1].[1]
In India, since 2012, we have had the National Program for Palliative Care, under the National Health Mission. There are also various initiatives by the government and the nongovernment organizations to tackle the increasing demand for palliative care services in the community. The community-based palliative care service in Kerala (Neighborhood Network in Palliative Care) is a model for resource-poor settings, where the people in the community are trained for providing basic palliative care services to the neighborhood patients. However, typically palliative care for cancer patients is delivered by multidisciplinary teams including clinical oncologists, palliative care physicians, physiotherapists, psychiatrists, dietitians, and palliative care nurses.[2]
In oncology, palliative care is extremely important at all stages of cancer care, as elaborated below [Figure 2].
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At diagnosisb
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During treatment
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End-of-life care (EOLC)
Publication History
Received: 27 January 2020
Accepted: 09 April 2020
Article published online:
23 May 2021
© 2020. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)
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References
- 1 World Health Organization. Definition of Palliative Care. World Health Organization; 2002. Available from: http://www.who.int/cancer/palliative/definition/en. [Last accessed on 2020 Jan 20]
- 2 Training Manual for Doctors and Nurses under National Programme for Palliative Care. The National Institute of Health and Family Welfare; Available from: https://dghs.gov.in/WriteReadData/userfiles/file/a/5127_1558685685054(1).pdf. [Last accessed on 2020 Jan 25].
- 3 Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP. SPIKES – A six-step protocol for delivering bad news: Application to the patient with cancer. Oncologist 2000; 5: 302-11
- 4 Temel JS, Greer JA, El-Jawahri A, Pirl WF, Park ER, Jackson VA. et al. Effects of early integrated palliative care in patients with lung and GI cancer: A randomized clinical trial. J Clin Oncol 2017; 35: 834-41
- 5 WHO Pain Ladder. Available from: https://www.who.int/cancer/palliative/painladder/en/. [Last accessed on 2020 Jan 25]
- 6 Macaden SC, Salins N, Muckaden M, Kulkarni P, Joad A, Nirabhawane V. et al. End of life care policy for the dying: Consensus position statement of Indian association of palliative care. Indian J Palliat Care 2014; 20: 171-81
- 7 Indian Association of Palliative Care. Text book for Certificate Course in Essentials of Palliative Care. 5th ed. Jharkhand: IAPC; 2017
- 8 Bandewar SV, Chaudhuri L, Duggal L, Nagral S. The supreme court of India on euthanasia: Too little, too late. Indian J Med Ethics 2018; 3: 91-4