Doctors say palliative care not given its due worth

New Delhi: Most patients referred to the All India Institute of Medical Sciences for palliative care are those who are terminally ill and all treatment has failed for them.

"That's the wrong approach," says Dr Sushma Bhatnagar, head of palliative medicine at AIIMS.

Palliative care is specialised medical care to alleviate pain and improve the quality of life of patients with life-threatening medical conditions. It focuses on symptoms and not on the cause or cure of the ailment.

Also called comfort care or symptom management, it involves psychological, emotional and spiritual support to patients and their families.

Palliative care should begin early in the course of treatment of a life-threatening disease and continue with the treatment. "It is best to start it with the diagnosis of disease," says Dr Bhatnagar.

Research has shown that cancer patients who receive palliative care with treatment live longer than those who are just treated medically.

Over 80 per cent of cancer patients in India are diagnosed with cancer when it enters stage III or IV. "Many need emotional counseling as they slip into depression," she adds.

"A patient could have better quality of life for a longer duration if palliative care begins before they become terminally ill," says Dr Randeep Guleria, Director, AIIMS.

An estimated six million people in India require palliative care every year. However, due to a long roster of patients, palliative care doctors like Dr Bhatnagar can spend only a few minutes with each. The AIIMS center receives around 80-90 patients daily.

"During those five to ten minutes, our priority is to relieve the patient of disease symptoms and pain and make them understand the stage of their disease," she adds.

Oncologist Dr GK Rath, chief, Dr BR Ambedkar Institute Rotary Cancer Hospital, at AIIMS, believes he can give his patients emotional support during his regular consultations. "A few minutes are enough," he says.

Oncologists refer patients for palliative care only when the ailment is incurable. "It is a kind of end-of-life care," the senior doctor adds.

Dr Rath believes that doctors delay reference to palliative care because they have never been taught about its benefits. "That is why they don't have a clear idea about what is it and when it should begin," he said. "It is not entirely their fault."

Medical Council of India accepted palliative care as a medical specialty only in 2010 and announced a post graduate course at Tata Memorial Hospital in Mumbai two years later, and in AIIMS only recently.

However, palliative care is not taught as a subject during MBBS education as many suggest it should be.