Homi Bhabha Cancer Hospital and Research Centre in Visakhapatnam was established as a unit of Tata Memorial Centre (Mumbai) under the aegis of the Department of Atomic Energy (Government of India) in 2014 with a vision to provide comprehensive, multi-disciplinary, evidence-based, and affordable cancer care. Since its inception as an operational outpatient unit providing medical, gynecological, and preventive oncology services, palliative care has been an important part of multi-modality care. A dedicated Palliative Medicine department with full-day out-patient services was started in February 2015. Subsequently, specialties including head & neck, surgical, and radiation oncology services were initiated, along with a 75 bedded in-patient facility.
The Palliative Medicine Department is co-located with oncology services. Early and concurrent palliative care is provided for all patients irrespective of the intent of treatment (radical or palliative). Early assessment and management of pain and symptoms right from diagnosis, alongside treatment, and after, helps patients comply with their treatment and preserve Quality of Life. The department helps to manage psychological, social, and spiritual concerns of the patients and their families along the trajectory of the illness. Patients are routinely followed up with and concerns are communicated and resolved by shared decision making.
Goals of care discussion and advance care plans help to facilitate smooth transitions. Ensuring continuity of care and good end-of-life care practice is a constant endeavour. The Department has a Consultant, a resident, and a nurse and incorporates the services of the psycho oncologist, medical social workers, and occupational and physiotherapists in the hospital.
The hospital currently provides comprehensive and holistic care, with services in Medical Oncology, Paediatric Oncology, Radiation Oncology, Surgical Oncology, Critical Care and Anaesthesiology, Radio diagnosis, Palliative Medicine, Nursing, Pathology, Biochemistry, Microbiology, Psycho-oncology, Haemato-Oncology, Preventive Oncology, along with ancillary services like Medical Social Work (MSW) and Rehabilitation Services. This has helped to provide multi-disciplinary and multi-modality (including palliative care) comprehensive cancer care to every patient.
Palliative Care is provided across all site-specific cancers. The hospital is a coordinating centre for training doctors and nurses in the essentials of palliative care. It is also one of the national hubs for the Quality Improvement in Palliative Care, a Collaborative with Stanford University initiated in 2017 and now incorporated into the National Cancer Grid as the EQuIP (Enable Quality Improve Patient Care) programme for both oncology and palliative care.
Palliative and Supportive Care
The outpatient department of Palliative Medicine works everyday through the week and provides early, concurrent and supportive care to ambulatory patients and the responsibility is shared with the primary oncology consultants. For in-patients, palliative care works on a consultative model where patients admitted under medical, radiation and surgical oncology services, in the High dependency units or intensive care are referred for symptom control, psychological issues, needs assessment, transition of care and end of life care. When needed, patients are referred to the community hospice and telephonic follow up continues. The hospice prepares the patient for future admissions, empowers the caregiver and facilitates smooth transition to end of life care. The palliative care team works with the hospital and the hospice team to support patients and empower caregivers and families. Continuity and coordination with the hospice supports the patient and provides respite to the caregiver.
Last update: August 2021