vv Archives of Community Medicine and Public Health ISSN: 2455-5479 DOI CC By 054 Medical Group Citation: Atreya S, Giri PA (2017) Palliative Care for Cancer: A Public Health Challenge in India. Arch Community Med Public Health 3(2): 054-057. DOI: http://dx.doi.org/10.17352/2455-5479.000025 Abstract Palliative care is an emerging discipline worldwide which focuses on improving the quality of life of patients with chronic life threatening condition like cancer. Globally, palliative care is sparsely distributed in developing countries including India where the need is immense. While there is extensive coverage of this issue in palliative care literature, there is limited coverage in public health literature, which suggests that the challenges of palliative care have not been generally recognized as a priority in public health. The present article will embark upon various challenges and solutions for implementing palliative care in the country. By considering this discipline in the field of public health literature, it is hoped to raise awareness and stimulate thoughts among public health professionals and health policy makers. In addition to this, a model based on preexisting research has been proposed, that will facilitate palliative care services to be delivered through the existing health care system, which will not only be accessible to the needy in remote parts of the country, but also at a cost the community and country can afford. Short Communication Palliative Care for Cancer: A Public Health Challenge in India Shrikant Atreya 1* and Purushottam A Giri 2 1 Consultant in Palliative Medicine, Department of Palliative Care and Psycho oncology, Tata Medical Center, Major Arterial Road, Newtown, Kolkata, West Bengal, India 2 Professor, Department of Community Medicine, IIMSR Medical College, Badnapur, Jalna, Maharashtra, India Dates: Received: 30 May, 2017; Accepted: 13 July, 2017; Published: 17 July, 2017 *Corresponding author: Dr. Shrikant Atreya, Consul- tant, Palliative Medicine, Department of Palliative Care and Psycho oncology, Tata Medical Center, Major Arterial Road, Newtown, Kolkata 700160, India, E-mail: https://www.peertechz.com Introduction Today India is experiencing an epidemiological transition from the high burden of infectious diseases to an increasing incidence of chronic life threatening diseases; with cancer being the third most common cause of morbidity and mortality [1]. While in developed countries more than half of all cancer deaths occur in individuals greater than 70 years of age, in India most deaths occurs at less than 70years of age [2]. This paradox could be due to multiple factors like infection, tobacco use and poor access to screening facility and early stage case finding services. Poor accessibility and availability of an organized and regulated health care systems in the country compounds this effect leading to poor utilization of the service with resultant delayed diagnosis and treatment. The International Agency for Research on Cancer GLOBOCAN [2]. project has predicted that India’s cancer burden will nearly double in the next 20 years, from slightly over a million new cases in 2012 to more than 1·7 million by 2035. These projections indicate that the absolute number of cancer deaths will also rise from about 680 000 to 1·2 million in the same period. Thus greater than 70% of this population will suffer from distressing symptom often unaddressed and under treated. India ranks at the bottom of the Quality of Death Index. The Quality of Death Index, commissioned by the Lien Foundation [3], Singapore, measures the quality of Palliative Care in 80 countries around the world, using 20 quantitative and qualitative indicators across five categories: the Palliative and Healthcare environment, human resources, the affordability of care, the quality of care and the level of community engagement. While the UK and the US rank 1st and 9th respectively; India ranks 67th. Kerala is often cited as a “beacon of hope”, contributing to two-thirds of India’s palliative care services, being the home of only 3% of India’s population [4]. Cancer is a social problem affecting both the patients and family threatening their social stability. This warrants a multidisciplinary support system to navigate patients and family through the problem which is more complex than just physical needs. Patients with advanced cancer at the terminal stage of the disease suffer from a multitude of physical and psychosocial problems which when left unaddressed results in a debilitating quality of life [5]. Among the problems pain is the most distressing symptoms followed by anorexia- cachexia, fatigue, anxiety and depression [6]. Palliative care addresses these problems of the patients providing a holistic healing through a multidisciplinary team approach. The fact sheet on palliative care developed by the National Summit on Non Communicable Diseases initiated by the Ministry of Health and Family Welfare and the WHO country office in 2011, states that more than 98% of the needy in India do not have access to palliative care [7]. This article will discuss the challenges of implementing palliative care in the community and development of a community based model attuned the health care delivery system in the country. Challenges for developing palliative care in India Distribution of palliative care services: Currently, there are over 908 Palliative Care centers in India, which are accessible