On the eve of World Cancer Day, which is being observed on 4th February every year, I want to highlight the importance of Palliative care by bringing you a true story of a patient.
It was just two months back, when Mr Bhat (Name Changed) was brought on a wheelchair to my OPD, accompanied by around seven attendants which I could count.
He was 75, suffering from cancer colon and had undergone surgery followed by chemotherapy in 2019, as per the attendants. He was not taking meals, even tea for last two weeks.
Day by day he is becoming weak and is not able to walk, or even talk. At the same time, the attendants were whispering to each other that he will not survive now.
One of the attendants even loudly said to others, ‘it is a futile exercise to get him to hospital, when he is almost at death bed.
On seeing Mr Bhat I found him gasping, wearing an angry look. He was trying to say me something, but could not. While examining, I found his abdomen was distended, tense, tight, which has resulted into breathing difficulty and pain, even refusal to accepting meals.
I immediately referred the patient to Pain and Palliative Day Care ward with the impression of massive Ascites (fluid in Abdomen cavity), and after draining around 4-5 litres of fluid patient started becoming active.
His breathlessness was gone, pain too subsided, the flushing and angry look of face was aslo gone. It was a joyful moment to the attendants when patient asked for water in his normal tone.
You will not believe that the lips of the patient did not stop from praising the doctor, who did (Ascitic) Abdominal Fluid Drainage. The patient, after taking a cup of water, loudly cried, saying, “Thank God, now if I die, I will die comfortably, I am fine, I can walk and talk now, my whole problem is gone within no time.
Thank Doctor, you gave me new life.” This is where the role of Pain and Palliative care comes. It can do miracles in making patients comfortable, happy, pain free during their last stage of disease, last days of life. Palliative care is an approach that improves the quality of life of patients and their families; caregivers, who face problems associated with life threatening illness.
It prevents and relieves sufferings through the early identification, correct assessment of pain and other problems, whether physical, psychosocial or spiritual. 40 million people are in need of palliative care, of which 78% live in low and middle income countries.
Worldwide only 14% of people get palliative care treatment as per WHO report. With the advancement in the diagnosis and treatment, people with cancer are being managed as chronic disease, like diabetes, hypertension etc. Unfortunately in our region patients continue to present at an advanced stage, when the chances of cure are less and palliation becomes the main treatment modality.
The goal of palliative care is the achievement of the best quality of life for patients and their families by providing relief from pain and other distressing symptoms, integrates the psychological and spiritual aspects of care, thus offers a support to help patient live as actively as possible, focus on quality of life rather than counting the days.
Further, early delivery of palliative care reduces unnecessary hospital admissions and the use of health services. Adequate national policies, programmes, resources and trainings on palliative care among health care professionals is urgently needed in order to improve the care of terminally ill patients.
Dr. Nazir Ahmad Khan Professor Radiation Oncology, Head Pain and Palliative care SKIMS Soura, Srinagar
Disclaimer: The views and opinions expressed in this article are the personal opinions of the author.
The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK.