Didactics-Palliative issues in cancer patients_Ramila Shilpakar

Video Transcription
Video Summary
Dr. Romila Silpakar, a medical oncologist, discusses the importance of palliative care in oncology. She explains that there are two models of care in medicine, disease-directed therapy and patient-directed care. While disease-directed therapy focuses on anti-cancer treatments, patient-directed care includes supportive and palliative care, which aims to improve the quality of life for cancer patients and their caregivers. Dr. Silpakar emphasizes the need to integrate these two models to provide better patient-centered care.<br /><br />In 2014, the World Health Assembly passed a resolution urging member countries to incorporate palliative care services into their healthcare systems. Palliative care should not only be practiced by specialists, but also by primary and secondary level healthcare personnel.<br /><br />Research has shown that early integration of palliative care improves patient quality of life, reduces suffering, and may even improve survival. Various guidelines, including those from the ESMO and ASCO, now recommend integrating standard palliative care into oncological practice.<br /><br />Dr. Silpakar also discusses the provision of palliative care in low-resource settings. She notes that while only 14% of people globally in need of palliative care receive it adequately, efforts are being made to integrate palliative care into low-income countries' healthcare systems.<br /><br />In Nepal, palliative care is delivered through hospitals, hospices, and home and community-based services. The Nepalese Association of Palliative Care provides training for healthcare workers in palliative care.<br /><br />Dr. Silpakar concludes by highlighting the eight domains of quality palliative care, which include the structural, physical symptoms, emotional, social, spiritual, cultural, legal, and planning aspects. She stresses the importance of assessing and treating physical symptoms, such as pain, as well as addressing emotional, social, and spiritual needs.<br /><br />Overall, Dr. Silpakar emphasizes the need for oncologists to recognize and respond to the holistic needs of cancer patients, incorporating early palliative care to improve quality of life and potentially even survival.
Keywords
palliative care
oncology
disease-directed therapy
patient-directed care
integrating palliative care
low-resource settings