Ambika, a 40-year-old lady (name changed), came to Karunashraya as an end-stage bone cancer patient with amputated legs, where the tumour had also spread to her lungs. Upon admission, she was in immense pain and discomfort. She refused to talk to anyone, did not cooperate with the palliative care team, shouted at nurses, threw her plate when food was offered, and did not allow any caretaker to assist her. She would simply lie on the bed, yell, cry, and avoid interacting with others.Today, we stand on the threshold of World Cancer Day 2024 in solidarity with countless individuals like Ramu, who are not only battling a relentless adversary like cancer but are also victims of the gross inequities associated with cancer care. The statistics for cancer are grim in India. One in nine individuals is expected to get cancer in their lifetime, with every second person affected by cancer likely to die (mortality of >55%). Equally concerning is the fact that less than 30% of individuals in low-income countries have access to cancer treatment as compared to 90% in high-income countries. Differences in income and educational levels; geographical locations (urban-rural divide); discrimination based on ethnicity, race, gender, sexual orientation, age, disability and lifestyle; and poor infrastructure impact the cancer journey. Ramu not only needs treatment for cancer but also respite from the pain he is experiencing. They need emotional support and help in making healthcare decisions. In addition to oncological care, this couple needs palliative care and psycho-oncology support. Unfortunately, cancer care is very fragmented in India, with less than 4% of Indians having access to palliative care and even fewer having access to psycho-oncology and counselling services. Ramu and his wife abandoned treatment halfway and chose to go back home against medical advice. Ramu died at home two months later in agony, reiterating the narrative of cancer being an incurable disease. In the current scenario, the outcome of the illness depends upon who you are, where you live, and how much money you have.Many people tend to assume that their health is fine and that their symptoms are minor issues, neglecting to take them seriously. India, being a developing country and a hub for IT, is amazing. However, not many people are aware of what cervical cancer is and how to prevent it. In the 21st century, where Chandrayaan (India’s lunar mission) is a great success, I believe it is important to spread awareness about cervical cancer to the general population.World Cancer Day was established on February 4, 2000, at the World Summit against Cancer for the New Millennium in Paris. Its goal is to save lives by raising awareness about cancer and fostering a collective commitment to its prevention, detection, and treatment. At Karunashraya, we believe it is an opportunity for everyone to come together and lessen the impact of cancer on the world.Today, we stand on the threshold of World Cancer Day 2024 in solidarity with countless individuals like Ramu, who are not only battling a relentless adversary like cancer but are also victims of the gross inequities associated with cancer care. The statistics for cancer are grim in India. One in nine individuals is expected to get cancer in their lifetime, with every second person affected by cancer likely to die (mortality of >55%). Equally concerning is the fact that less than 30% of individuals in low-income countries have access to cancer treatment as compared to 90% in high-income countries. Differences in income and educational levels; geographical locations (urban-rural divide); discrimination based on ethnicity, race, gender, sexual orientation, age, disability and lifestyle; and poor infrastructure impact the cancer journey. Ramu not only needs treatment for cancer but also respite from the pain he is experiencing. They need emotional support and help in making healthcare decisions. In addition to oncological care, this couple needs palliative care and psycho-oncology support. Unfortunately, cancer care is very fragmented in India, with less than 4% of Indians having access to palliative care and even fewer having access to psycho-oncology and counselling services. Ramu and his wife abandoned treatment halfway and chose to go back home against medical advice. Ramu died at home two months later in agony, reiterating the narrative of cancer being an incurable disease. In the current scenario, the outcome of the illness depends upon who you are, where you live, and how much money you have.Today, we stand on the threshold of World Cancer Day 2024 in solidarity with countless individuals like Ramu, who are not only battling a relentless adversary like cancer but are also victims of the gross inequities associated with cancer care. The statistics for cancer are grim in India. One in nine individuals is expected to get cancer in their lifetime, with every second person affected by cancer likely to die (mortality of >55%). Equally concerning is the fact that less than 30% of individuals in low-income countries have access to cancer treatment as compared to 90% in high-income countries. Differences in income and educational levels; geographical locations (urban-rural divide); discrimination based on ethnicity, race, gender, sexual orientation, age, disability and lifestyle; and poor infrastructure impact the cancer journey. Ramu not only needs treatment for cancer but also respite from the pain he is experiencing. They need emotional support and help in making healthcare decisions. In addition to oncological care, this couple needs palliative care and psycho-oncology support. Unfortunately, cancer care is very fragmented in India, with less than 4% of Indians having access to palliative care and even fewer having access to psycho-oncology and counselling services. Ramu and his wife abandoned treatment halfway and chose to go back home against medical advice. Ramu died at home two months later in agony, reiterating the narrative of cancer being an incurable disease. In the current scenario, the outcome of the illness depends upon who you are, where you live, and how much money you have.Many people tend to assume that their health is fine and that their symptoms are minor issues, neglecting to take them seriously. India, being a developing country and a hub for IT, is amazing. However, not many people are aware of what cervical cancer is and how to prevent it. In the 21st century, where Chandrayaan (India’s lunar mission) is a great success, I believe it is important to spread awareness about cervical cancer to the general population.
After observing her condition and behaviour for a few days, the palliative care team developed a personalized care program for Ambika in the hopes of gaining her trust and encouraging her to communicate and express herself. In addition to a multidisciplinary approach to pain management, the doctors and counsellor treated Ambika as a holistic person, taking into account her hopes and fears. This wasn’t the standard approach she had expected. Ambika felt a shift in Care, and gradually open up and engage with her medical team.
Today, cancer care is no longer a one-size-fits-all treatment. Personalized care involves tailoring treatment to meet the individual needs of patients, including pain and symptom management, emotional and psychological support, fulfilling the patient’s last wishes, addressing social and lifestyle needs, and facilitating communication with family. However, what truly distinguished Ambika’s care was the holistic palliative care approach – she was not just another patient in a line. She was a woman, a mother of two children, a provider for her family, a decision-maker, and an individual with her own unfinished business.
To initiate customized care for Ambika, the nurses began by placing her bed in the sun every morning for positivity and showed more understanding and empathy towards her. Upon learning about her family’s worries and concerns, the hospice care team helped her husband secure employment and enrolled both her children in schools. They also collaborated with her family to fulfil Ambika’s final wishes. This act of care and compassion brought immense comfort to Ambika, leading her to develop trust and cooperate with the team to better manage her physical and emotional pain and symptoms.As a social individual, I have always been open about my cancer condition with the outside world. However, I soon realized that many other cancer patients do not share the same sentiment. Misconceptions, fear, and societal stigma surrounding cancer have prevented many individuals from seeking timely care. World Cancer Day is an opportunity to dispel myths and encourage patients to start conversations. Let’s not silence our courage, but silence cancer! Research has shown that cancer patients have numerous unmet needs regarding their last wishes and preserving dignity at the end of life. Karunashraya has compassionately gone the extra mile to fulfill the last wishes of end-stage cancer patients. Experienced therapists have encouraged patients to express themselves, and the hospice ensures that the end of their lives is filled with high-quality care.Despite living in a time of remarkable advancements in cancer prevention, diagnosis, and treatment, many of us are denied basic care. During my breast cancer treatment, I realized how fortunate I was compared to those around me who lacked adequate finances and access to quality care. Cancer is a burdensome disease, both emotionally and financially, and the inaccessibility of care feels like a death sentence. Since 1994, BHT-Karunashraya has bridged this gap by providing free and equitable palliative care to all cancer patients. It ensures that every patient, regardless of their socio-economic background, receives comprehensive support from a team of competent healthcare professionals. The theme for the 2024 World Cancer Day campaign is “Close the Care Gap,” which emphasizes the need for unity and action. The care gap extends beyond medical treatment and encompasses a holistic approach to supporting patients throughout their journey.
The theme for World Cancer Day 2025, “United by Unique,” perfectly reflects Karunashraya’s commitment to personalized care—an approach that goes beyond medicine by listening, understanding, and adapting to the unique needs of every patient.As a social individual, I have always been open about my cancer condition with the outside world. However, I soon realized that many other cancer patients do not share the same sentiment. Misconceptions, fear, and societal stigma surrounding cancer have prevented many individuals from seeking timely care. World Cancer Day is an opportunity to dispel myths and encourage patients to start conversations. Let’s not silence our courage, but silence cancer! Research has shown that cancer patients have numerous unmet needs regarding their last wishes and preserving dignity at the end of life. Karunashraya has compassionately gone the extra mile to fulfill the last wishes of end-stage cancer patients. Experienced therapists have encouraged patients to express themselves, and the hospice ensures that the end of their lives is filled with high-quality care.Despite living in a time of remarkable advancements in cancer prevention, diagnosis, and treatment, many of us are denied basic care. During my breast cancer treatment, I realized how fortunate I was compared to those around me who lacked adequate finances and access to quality care. Cancer is a burdensome disease, both emotionally and financially, and the inaccessibility of care feels like a death sentence. Since 1994, BHT-Karunashraya has bridged this gap by providing free and equitable palliative care to all cancer patients. It ensures that every patient, regardless of their socio-economic background, receives comprehensive support from a team of competent healthcare professionals. The theme for the 2024 World Cancer Day campaign is “Close the Care Gap,” which emphasizes the need for unity and action. The care gap extends beyond medical treatment and encompasses a holistic approach to supporting patients throughout their journey.
Author:
Dr. Kavita Reddy, Palliative Care Consultant at Karunashraya
Shilpi Agrawal, Volunteer at Karunashraya