Palliative and end-of-life care initiatives for people dying from cancer in India: a narrative review.

Abstract

India is facing a growing burden of cancer, resulting in high cancer-associated mortality. However, the rise in cancer incidence is disproportionately high compared to access and provision of palliative care. This review aims to identify gaps in Indian cancer palliative care and recognises initiatives instituted to mitigate them. The narrative review was conducted using the four-step method described by Demiris et al., synthesising both empirical and non-empirical literature. A lack of capacity to provide palliative care was identified as a significant barrier. Initiatives such as setting up palliative care services in cancer treatment centres, improving community palliative care access, structured palliative care training to develop specialists, improving opioid availability and creating policies have been helpful. A significant proportion of people in India experience health-related suffering, and developing a tool to identify this suffering proactively would be beneficial. Several cancer centres are testing integrated cancer palliative care models in various cancer subsites. However, these are preliminary works and are yet to be established. People in India face distress due to high health-related costs, and initiatives like hospices and home-based palliative care services with no cost to patients and families provide significant relief. Caregivers experience a considerable burden while caring for their loved ones with life-limiting illnesses, and they are supported through respite palliative care services offered in some parts of India.