Interview with Dr Chitresh (Medical Oncologist): Hospice and Palliative Care

Dr. Chitresh Aggarwal is a specialist in Oncology and has completed his MD in General Medicine from Maharashtra University of Health Sciences, Nashik in 2015, DNB-Medical Oncology from DNB board, New Delhi in 2018, and MBBS from URGHS in 2010. He is an expert in all Solid Organ Cancers and blood Cancers like Lymphoma, Leukemia, and Multiple Myeloma. He has proficiency in cancer consultation and diagnosis, Chemotherapy and Hormonal Therapy Planning and Administration, Day Care Chemotherapy Administration, Targeted Therapy, Immunotherapy, Neutropenia Care, Intensive Cancer Care and Special Procedures like Bone Marrow, Aspiration and Biopsy, Long Term Venous, Access Devices, and in implantable Chemotherapy Ports.

Difference between Palliative Care and Hospice Care

Both these terms are intermixingly used in our country, but the primary difference is that palliative care can be started at any point of the treatment. In contrast, hospice care is for chronic patients where the cure is not there and where the patient’s life expectancy is not more than six months.

How can palliative care help?

In palliative care, the intention is to cure the disease, but it requires many factors like emotional support, giving symptomatic relief, and offering financial and emotional help to the patient. All these components together will encompass palliative care. The ultimate goal is to provide a good quality of life to the patient so that even with all the chronic conditions and the tough treatments, the patient’s quality of life remains manageable.

Hospice and Palliative Care treatment plan

In hospice care, the patient has reached a point where the life expectancy is usually not more than six months, so we do not give them any aggressive treatment for the disease. The main intention is to support these patients with nutrition, infection prevention, Pain management, and emotional support. Meanwhile, palliative care can be started at any point in the treatment. The doctor explains to the patient the treatment options and the possible complications. It also includes managing side effects, finding out the best possible cures for the patient, and giving emotional and financial support.

Different levels of Hospice Care

Hospice care can be offered at various levels. Hospice care is a treatment where our intention is not to cure the disease but to make the patient and the family comfortable. It all depends on where the patient belongs to, the patient’s background, how regularly the hospice care and palliative care physicians can see the patients, and the nature of the disease. Hospice care can be offered at home, nursing home, specialized hospice center, or even a hospital depending on the patient’s need.

Comprehensive Hospice Care

The most important aspect is communication and making the patient and family understand the disease’s exact nature and what exactly we intend to do. The family and the patient should accept reality while going for hospice care to benefit the patient ultimately. Proper communication, giving them a clear thought, and chalking out a clear path for them are the essential points in the scenario.

Deciding the best treatment for the patient

We have some quality of life questionnaires that we use to assess the patient. We see if the patient can walk or not, the patient’s nutritional status, and how well the patient is. We take into consideration the age of the patient, other co-morbidities like diabetes, heart problems, the primary diagnosis of cancer, the kind of malignancy, was there any response to the previous treatment or not, what all treatments have been done till now, and the present status of the patient in terms of nutrition, mobility, emotion, and financial aspect. After analyzing all these things, we decided whether it is beneficial to go ahead with the treatment or not.

Listen to the podcast here

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