Sometimes cancer treatment stops working. This means that when all types of treatment is not sufficient to control the spread of cancer, it is time to understand the risks involved in continuing treatments. When you have tried all methods of treatment, none of which has controlled the cancer, it is time to consider whether the continuation of treatment is of any use at all.

Usually, when the patient, medical care team and family/friends have arrived at the decision of not continuing treatment, it is important to understand that the patient still needs care. There are symptoms of the growth cancer (pain, nausea etc.) which have to be addressed. This is where palliative care comes into the picture.

Palliative care helps in addressing the symptoms, probably by relieving pain, but does not address the disease itself. In no way does palliative care centre cure the disease. Sometimes this is done alongside cancer treatment, and sometimes it is done after treatment has been stopped. Largely, it helps improve the quality of life of a patient who has a life-limiting disease. This could include a combination of medication, radiation and chemotherapy.

According to WHO, “Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.”

In India, considering that a large number of cancer is diagnosed in the later stages, a large percentage of cancer patients need palliative care. However, in India only 1% of the population has access to palliative care facilities. We do not have sufficient doctors trained to offer palliative care. Though the National Program in Palliative Care was created in 2012, only a small part of the program has been implemented owing to lack of budgetary allocations. There are several barriers in India which do not allow for quality palliative care here.

However, the state of Kerala has groundbreaking work done in this aspect. Kerala has the more palliative care centers in the country than all other states put together – it houses two-thirds of all palliative care centers of the country. Kerala has long identified the need for palliative care and it is provided as an extension of primary care.

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