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Department

Palliative Medicine

Integrating Comfort with Cancer Care

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Comprehensive Cancer Care. Providing ethical and accessible treatment since 1954.

MV
Message from the Head of Department

Dr. Meenakshi V V

MBBS MD • Professor and Head
“The team at the Department of Palliative Medicine leave no stone unturned to deliver compassionate care best aligned to the preferences of patients and their families. We are able to do this by our collaboration with the oncology team who share the same vision. We aspire to provide a continuum of care to all patients with cancer who seek treatment at our institution, no matter the stage of the disease and its final outcome.”
About the Department

Department Overview

The Department of Palliative Medicine provides specialized, patient-centered care aimed at improving the quality of life of patients and families facing cancer and other serious illnesses. As an integral part of a tertiary cancer institute, the department works alongside oncology teams to address pain, distressing symptoms, psychological concerns, and supportive care needs throughout the course of illness.

Our multidisciplinary team—including physicians, nurses, psychologists, social workers, and allied health professionals—focuses on comprehensive symptom management, psychosocial support, communication about goals of care, and support for patients and families during advanced illness and end-of-life care. Care is delivered across multiple settings including outpatient clinics, inpatient services, intensive care units, and home-based care, ensuring continuity and accessibility of support.

The department also contributes actively to education, training, research, and quality improvement initiatives to advance palliative care practice. Through collaboration with national professional bodies such as the Indian Association of Palliative Care and academic initiatives like the Academy of Palliative Medicine, the department supports the development of skilled palliative care professionals and promotes evidence-based care.

By integrating palliative care early in the cancer care pathway, the department aims to relieve suffering, enhance dignity, and support patients and families in making informed decisions aligned with their values and goals.

When Should You Visit This Department?

If you or a loved one experiences any of these symptoms, consult our specialists:

At any stage of a serious illness, particularly when symptoms or supportive care needs arise
Uncontrolled pain or distressing symptoms such as breathlessness, nausea, vomiting, fatigue, or loss of appetite
Advanced or metastatic cancer, where additional supportive care is required alongside ongoing oncological treatment
Side effects from cancer treatments such as chemotherapy, radiotherapy, or surgery that affect comfort or daily functioning
Emotional or psychological distress experienced by patients or family members
Need for guidance on goals of care, treatment decisions, or advance care planning
Requirement for home-based care, supportive care planning, or end-of-life care
Support for caregivers who need assistance in managing symptoms and providing care at home
How We Diagnose

Diagnostic Techniques & Procedures

Clinical Assessment and Evaluation

  • Comprehensive pain assessment using standardized pain scales
  • Symptom assessment tools (e.g., Edmonton Symptom Assessment System - ESAS)
  • Performance status evaluation (ECOG / Karnofsky Performance Scale)
  • Psychological and distress screening for patients and caregivers using NCCN Distress Thermometer
  • Nutritional assessment and functional status evaluation

Supportive and Interventional Procedures

  • Opioid titration and monitoring for pain management
  • Parenteral medication administration for symptom control
  • Subcutaneous infusion therapy (syringe drivers)
  • Management of malignant wounds and pressure ulcers
  • Palliative procedures for symptom relief (e.g., ascitic / pleural fluid drainage in collaboration with other specialties)

Communication and Care Planning

  • Goals-of-care discussions and advance care planning
  • End-of-life care assessment and symptom management planning
  • Use of laboratory and imaging investigations available within the institute when required to support clinical decision-making
What We Treat

Conditions Treated

Severe or refractory pain
Breathlessness and respiratory distress
Nausea, vomiting, constipation and anorexia
Fatigue and weakness
Anxiety, depression, and psychological distress
End-of-life care needs
Diagnosis of advanced cancer
Patient or caregiver request
Psycho-social needs
Assistance with the decision making
Request for hastened death
Plan or requiring home visit or hospice
How We Treat

Treatment Options

Pain Management

  • Pharmacological management of cancer pain using WHO analgesic ladder
  • Opioid therapy including morphine and other strong opioids
  • Adjuvant medications for neuropathic and refractory pain
  • Interventional pain procedures in collaboration with relevant specialties

Symptom Management

  • Management of symptoms such as breathlessness, nausea, vomiting, constipation, delirium, fatigue, and anxiety
  • Nutritional and hydration support when appropriate
  • Management of malignant wounds, pressure ulcers, and other distressing physical symptoms

Psychosocial and Emotional Support

  • Psychological counselling for patients and caregivers
  • Social work support for financial, family, and community-related concerns
  • Spiritual care and emotional support when needed

Supportive and End-of-Life Care

  • Advance care planning and goals-of-care discussions
  • End-of-life care and comfort-focused treatment
  • Bereavement support for families

Continuity of Care Services

  • Outpatient palliative care consultations
  • Inpatient supportive care for admitted patients
  • Hospice and home-based palliative care services
  • Telephone and tele-consultation follow-up for symptom monitoring and medication titration
Stay Ahead

Prevention & Screening

Early Identification and Screening

  • Screening for palliative care needs in outpatient and inpatient oncology services
  • Early referral of patients with advanced or complex symptoms
  • Routine symptom assessment to detect and address distress early

Prevention of Symptom Burden

  • Proactive management of pain and other distressing symptoms
  • Prevention and management of treatment-related side effects from chemotherapy, radiotherapy, and surgery
  • Early nutritional and functional assessment to prevent decline

Prevention of Complications

  • Pressure ulcer prevention through regular assessment and skin care
  • Constipation prevention in patients receiving opioid therapy
  • Prevention of delirium through careful medication review and supportive care
  • Maintenance of oral hygiene and oral care to prevent infections
  • Opioid stewardship and safe opioid dispensing systems

Psychosocial and Caregiver Support

  • Routine psycho-social assessment to identify emotional distress in patients and caregivers
  • Counselling to reduce psychological distress in patients and families
  • Referral to psychiatrist when indicated, following assessment of psychological or psychiatric concerns
  • Education for caregivers on symptom monitoring and home care practices

Continuity and Follow-up

  • Regular follow-up through outpatient visits, home-based care, and telephone consultations
  • Early intervention for symptom exacerbations to prevent avoidable hospital visits or admissions

Request an Appointment

Schedule a consultation with our specialists

Book Appointment
Meet the Team

Our Experts

MV

Dr. Meenakshi V V

Professor and Head

DR

Dr. Daniel Raj Joseph Thangasamy

Palliative Care Physician

JN

Dr. Jefrilla Nancy J

Palliative Care Physician

RT

Dr. R. Thendral

Assistant Professor

Infrastructure

Facilities & Equipment

Our Heritage

Legacy & History

The Department of Palliative Medicine has played a pivotal role in advancing comprehensive, compassionate, and patient-centered supportive care within the institute. Over the years, the department has contributed significantly to the integration of palliative care into routine oncology practice, ensuring that patients receive holistic care addressing physical, psychological, social, and spiritual needs throughout the course of illness.
The comprehensive palliative care service at the Cancer Institute began as part of the Department of Anaesthesia, later evolving into the Department of Anaesthesia, Pain and Palliative Care. The palliative care outpatient service was initiated in 2010, initially operating two days per week, and has since expanded into a full-fledged outpatient palliative care service functioning six days a week.
Home-based palliative care services were introduced in 2014 to provide continued support for patients unable to frequently visit the hospital, and daily outpatient services began in 2015. In 2017, the institute established its dedicated hospice facility, Mahaveer Ashray at Sriperumbudur, providing inpatient hospice and end-of-life care.
Today, the palliative care team has grown into a multidisciplinary team of nearly 20 members, comprising physicians, nurses, psychiatrists, psychologists, medical social workers, volunteers, and a data management team. Care is delivered through a collaborative multidisciplinary approach, with close involvement of disease-specific oncology specialists to ensure integrated patient care.
The department remains committed to ensuring accessible and equitable care. Outpatient palliative care services are subsidized and free for general ward patients, while home-based care and hospice services are provided entirely free of cost to patients and their families.
The growth and sustainability of the department have been supported by the generous contributions of partners such as the Cipla Foundation, along with other donors and sponsors who have helped strengthen palliative care services and expand support for patients in need.
Milestones

Key Achievements

Community

Support Groups

Bereavement Support Group

A compassionate space for families who have lost loved ones to cancer. This group offers grief counselling, emotional support, and community connection to help navigate the journey of loss and healing.

2nd Saturday of every month

New Patients & Families Support

Designed for newly diagnosed patients and their families, this group provides guidance on understanding the diagnosis, navigating treatment options, coping strategies, and connecting with resources available at the institute.

Every Wednesday

Ryles Tube Care & Caregiver Support

A specialized support group focused on educating caregivers about Ryles tube management, feeding techniques, hygiene practices, and troubleshooting common issues to ensure safe and comfortable care at home.

1st and 3rd Friday of every month

Caregivers Support Meeting

A dedicated forum for caregivers to share their experiences, learn self-care strategies, manage caregiver fatigue, and receive emotional and practical support from peers and professionals.

Last Saturday of every month

Contact the Department

ppc@cancerinstitutewia.org

Book Appointment