Clinical profile of palliative care Patient at the state cancer institute of a North-eastern state of India : a cross-sectional study

Background and aims: With the patient’s limited scope to palliative care in India’s North-eastern state, this service has been a decade since it was available. The people of this region are unaware of this department’s role at the State Cancer Institute (SCI) to promote life with a debilitating illness from diagnosis to death. Palliative care is one of the essential components of cancer care which has lots of ethical and legal issues and has been present in India for decades now but still limited data regarding palliative care from India’s North-Eastern state. Therefore, we aimed to study the clinical profile of cancer patients in the palliative setting. Material and Methods: The present study was a cross-sectional study on patients attending the outpatient department (OPD) of the pain and palliative care of SCI, Gauhati Medical College and Hospital (GMCH), Guwahati, for twelve months from January 2020 to December 2020. In the study, we recorded the patient’s age, sex, performance status, symptomatology and primary diagnosis during their visit to the pain and palliative care department. The data were analyzed using SPSS version 22. The ethical clearance was taken from the “Institutional Ethics Committee” of SCI of GMCH, Guwahati, Assam and India. Informed consent was also taken from the participating patient. Results: A total of 1002 cancer patients were included in the study. The median age of presentation was 41.5 years (range 18-86 years). The male and female ratio was 1:1.12. The majority, 443 out of 1002 patients, had Eastern Cooperative Oncology Group (ECOG) Performance Status (PS)-2, followed by ECOG PS-3 (32.2%) with 323 patients. Overall, head and neck cancer were the most common cancer (20.6%) with 206 patients, followed by 162 patients with carcinoma gall bladder (16.2%) and 132 patients with oesophagal cancer (13.2%), while in female, breast cancer was the most common and out of 101 breast cancer cases 97 were females. In the symptomatology, the pain was the most common symptom (82.1%), followed by anorexia (73.2%) and generalized weakness (66.7%). Most of the patients (45.9%) were assessed with severe pain. Skeleton was the most common site of metastasis (49.7%), followed by lung (24.1%) and liver (17.2%). Most patients attending the pain and palliative OPD were in stage IV (n=581,58%), followed by Stage III (n=290,29%) cancer. Conclusion: Pain was the most common symptom that adversely affects cancer patients’ quality of life. Therefore, an early referral for palliative care needs to be ensured.

Keywords: Pain relief; terminally ill; clinical profile, quality of life.