Chennai: Pain relief management in terminally ill cancer patients, is a real challenge, especially when patients opt to take treatment at home. Chennai is witnessing an increase in the number of elderly affected by cancer availing home care.
The problem is further compounded by lack of diagnostic tools in rural areas.
According to V. Shanta, chairperson, Cancer Institute (WIA), here, for the number of affected, trained personnel are not adequate. “This inadequacy is essentially in rural areas. In general, we are not lacking in diagnostic or therapeutic technology in urban areas but this (such facility) is inadequate in rural areas. Another major shortcoming is the lack of follow up of patients treated,” she says.
As per the health ministry data, out of over 300 cancer centres across India, 40 per cent are not adequately equipped with advanced cancer care equipment.
The country would require at least 600 additional cancer care centres by 2020 to meet the growing needs.
Many of those who prefer treatment at home live alone as their children are settled abroad or work in other parts of the country. “Even in the case of those who live with their family members, it is rather difficult for the family to take care of the terminally ill patients. Pain management is something a qualified health professional can provide and both Chennai and Bengaluru are seeing an increase in the number of end-stage cancer patients opting for home healthcare treatment,” says Anitha Arockiasamy, president of India Home Health Care (IHHC).
Of the nearly 300 cancer patients availing such treatment at home, 60 per cent are women and nearly 70 per cent of them are aged 60 and above. Home care - palliative care to patients with cancer is preferred when the disease advances. Oncologists and trained nurses are sent to the patient’s house to provide the care and support that they need.
On an average, a daily expenditure of about Rs 2,400 is incurred by those availing palliative care at home. “In India insurance coverage for home healthcare as in the US or Europe is not provided. So, this adds to the financial burden of the patients,” says Anita who advocates insurance coverage for home healthcare.
Standard protocol in screening, eliminating cancer needed: Shanta
Anti-cancer crusader Dr V. Shanta, recently conferred Padma Vibhushan award, has called for a standard protocol to screen and take appropriate measures to prevent cancers and also the inclusion of the rural areas in the preventive programmes.
Expressing concern over the incidence of tobacco related cancer despite the campaign against tobacco, she said all the efforts aimed at lowering the incidences of cancers are “not organised.” “There should be a guided standard protocol on screening and to collate particulars for action. Only then all the rural areas can be covered and thereby social justice ensured,” she said on the eve of World Cancer Day (observed on February 4).
The commonest cancers in India are oral cavity, lung and stomach in males and breast and uterine cancer in females. About 50 per cent of the cancers in men and 20 per cent of cancers in women are related to tobacco use. Tobacco control can be a major area of work which can greatly reduce the burden of cancer in India. Another area for potential control is by dietary modification and reducing alcohol consumption.
“It may be politically difficult to enforce a ban on tobacco use but its adverse effects could be highlighted through education,” she said and added when many countries have succeeded in banning tobacco, it should not be difficult for India to do so.
Speaking to reporters here on Wednesday evening, Dr Shanta who is chairperson, Cancer Institute (WIA), here, said her institution has proposed to launch HPV vaccination on a pilot project basis in Villupuram near here soon.
“Though the success rate of this shots is 60 per cent, the compliance from patients is essential,” she added. (HPV vaccines are available to prevent cervical cancer. The shots are recommended for children 11 to 13 years of age for maximum benefit, though girls of any age before the onset of sexual activity can receive the vaccines).