The Department of Palliative Medicine and Supportive Care is a specialist clinical department that caters to patients with cancer and non-cancer conditions. It aims to relieve symptoms and improve patients' quality of life and their families facing serious life-threatening or life-limiting illnesses like cancer, neurodegenerative disorders and end-stage organ impairment. Most patients with chronic and critical illnesses where curative treatment is not possible are often neglected and suffer needlessly.  Palliative care has much to offer to these patients.  It provides an environment for holistic whole-person care and addresses the physical and psychosocial problems of the patient and their families. It enables the management of complex pain and physical symptoms, and psychosocial and spiritual issues of patients and their families. It also facilitates improvement in quality of life, shared decision-making, goals of care discussion, and advanced care planning. Providing continuity of care, support, early assessment and management of symptoms improves the physical well-being and makes the treatment experience more acceptable. It also helps patients with advanced and terminal illnesses to have a peaceful, comfortable and dignified end of life care experience. Palliative care is not just about curing the disease or producing long-term remissions, but about managing symptoms, easing suffering, and improving the quality of life.  It is a teamwork, provided by an interdisciplinary cohort of clinicians who meet regularly to discuss patient care and develop a comprehensive care plan for each patient.

Kasturba Medical College, Manipal is the fourth institute in the country and the first private medical college in India to start MD Palliative Medicine. Most of the MD Palliative Medicine programs in India are situated in cancer centres. However, cancer only constitutes 1/3 of palliative care practice, and 2/3 of palliative care needs are in non-cancer conditions. The Palliative Medicine department at KMC Manipal provides a unique advantage to the prospective trainees in terms of clinical exposure to cancer and non-cancer conditions. Moreover, the department is already offering subspecialty palliative care services in paediatric, renal and ICU settings, and the scope of these services will be shortly extended to neurology, cardiology and pulmonology. At present we have postgraduate trainees pursuing MD Palliative Medicine Program in our department.

The department is already recognised in national and international circles. It is one of India’s five institutes recognised by the European Society of Medical Oncology (ESMO) as the designated centre for Integrated Oncology and Palliative Care. The department is the first in the country to be recognised as the International Reference Centre for End of Life Care by the International Collaborative, United Kingdom. Furthermore, the department is first in the Asia to be accredited as the designated centre for Supportive Care in Cancer by the Multinational Association for Supportive Care in Cancer. 

The department has several national and international collaborations; the noteworthy few are collaborations with UK Universities like Cardiff, Hull and Lancaster, collaborations with US universities like Northwestern, UCSF, and MD Anderson. Moreover, the department has several academic-industry collaborations like Roche, Cipla and Philips. The department is part of the National Cancer Grid of India and contributes to its guidelines. Moreover, the department was part of the ICMR commissions and have regularly contributed to the guidelines of ICMR and Ministry of Health and Family Welfare, Government of India. The department is part of the ambitious national program involving setting up palliative care centres in various cancer treatment centres in India in collaboration with AIIMS Delhi and Asia Pacific Hospice Network Singapore.

Pursuing MD Palliative Medicine Program at KMC Manipal will enable competency-based training in symptom management, supportive care, awareness of a range of medical and non-medical options available for the disease management of palliative care patients, psychosocial support to patients and families, working in a multi-disciplinary/inter-disciplinary team, working in different clinical settings, communication skills, decision-making skills, procedural skills relevant to Palliative Medicine, ethics-based good practice, leadership, teaching and research.

At present, there is a significant demand for MD Palliative Medicine specialists in India. An increase in cancer and chronic illnesses in India, the creation of many cancer centres and chronic care services, and the establishment of palliative medicine departments in medical colleges across India has created this demand. Moreover, the new CBME curriculum and AETCOM section of the MBBS curriculum taught predominantly by the palliative medicine specialists has also contributed to this demand. It facilitates employment opportunities for MD Palliative Medicine specialists after course completion. 

For more information about the department please click this link for the video- Click here to watch

https://manipal.edu/mu/academics/phd.html

The Department of Palliative Medicine and Supportive Care is a stand-alone clinical department situated at the Kasturba Hospital’s cancer centre. It has outpatient services running all days of the week, an acute palliative care in-patient unit, consultation-liaison and hospice referral service. It offers sub-specialist services like oncology palliative care, paediatric palliative care, renal supportive care and intensive care palliative care. 

Core Competencies:

1.     Expertise in pain and symptom management

2.     Supportive care during disease-directed therapies

3.     Advanced health-related communication

4.     Holistic and Whole-Person Care

5.     Multi-disciplinary team approach

6.     Patient Controlled Analgesia

7.     Interventional Pain Management and Pain Procedures

8.     End-of Life Care

Speciality Services:

1. Oncology Palliative Care

Integrated simultaneous oncology and palliative care in a single setting. Optimisation of symptoms, supportive care and communication during cancer-directed therapy and after its cessation.

2. Chronic and Interventional Pain Division

Guided interventional procedures for chronic low back pain, head and neck pain, chronic post-operative pain, neuropathic pain, trigeminal neuralgia, radiculopathies and cancer pain. Common procedures done by this division include nerve blocks, joint injections, epidural steroid injections, ozone therapy, neuroplasty and radiofrequency ablation.

3. Paediatric Palliative Care

Integrated child and family directed care in general paediatrics, neonatology, paediatric surgery and paediatric oncology towards symptom management, family support, and long-term care in children facing chronic and life-limiting illnesses.

4. Renal Supportive Care

Integrated and simultaneous renal and palliative care for all patients with End-Stage Renal Disease (ESRD) and symptomatic patients with Chronic Kidney Disease (CKD) towards symptom management, treatment decision-making, advance care planning, long-term care and end of life care.

5. ICU Palliative Care

Working together with the intensive care and high dependency units towards early recognition of medically futile conditions, family communication, limitation of treatment and end of life management in an intensive care setting.

1.     Lewis S, Pandey S, Salins N, Deodhar J, Patil V, Gupta T, Laskar SG, Budrukkar A, Murthy V, Joshi A, Prabhash K, Nair S, Chaturvedi P, Noronha V, Agarwal JP. Distress Screening in Head and Neck Cancer Patients Planned for Cancer-Directed Radiotherapy. Laryngoscope. 2021 Mar 15; doi: 10.1002/lary.29491

2.     Maruti Patil V, Singhai P, Noronha V, Bhattacharjee A, Deodhar J, Salins N, Joshi A, Menon NS, Abhyankar A, Khake A, Dhumal SB, Tambe R, Muckaden MA, Prabhash K. Effect of Early Palliative Care on Quality of Life of Advanced Head and Neck Cancer Patients: A Phase III Trial. J Natl Cancer Inst. 2021 Feb 19; doi: 10.1093/jnci/djab020.

3.     Lewis S, Rao C, Shenoy P, Salins N, Viveganandan R, Shanbhag A, Mukhopadhyay C, Prabhu K, Rao S. Is hackathon in oncology a plausible way to foster innovation? An experiential narrative account of conducting Hacking Cancer. BMJ Innov. 2020/12; bmjinnov-2020-000464. doi: 10.1136/bmjinnov-2020-000464.

4.     Salins N, Ghoshal A, Hughes S, Preston N. How views of oncologists and haematologists impacts palliative care referral: a systematic review. BMC Palliat Care. 2020 Nov 23;19(1):175. doi: 10.1186/s12904-020-00671-5. 

5.     Ghoshal A, Salins N, Damani A, Chowdhury J, Chitre A, Muckaden MA, Deodhar J, Badwe R. To Tell or Not to Tell: Exploring the Preferences and Attitudes of Patients and Family Caregivers on Disclosure of a Cancer-Related Diagnosis and Prognosis. J Glob Oncol. 2019 Nov; 5:1-12. 

·        European Society of Medical Oncology (ESMO) designated centre for Integrated Oncology and Palliative Care – awarded by ESMO in 2019 at Barcelona

·        Partner of CTC program for developing palliative care centres across India in collaboration with AIIMS Delhi and Asia Pacific Hospice Network Singapore

·        Designated centre for conducting EPEC Palliative Care training program in collaboration with Northwestern University Chicago

·        Designated centre for conducting IACA Palliative Care training program in collaboration with MD Anderson USA

·        Designated centre for conducting IACA Palliative Care training program in collaboration with MD Anderson USA

·        Designated centre for conducting IAPC Palliative Care training program in collaboration with Indian Association of Palliative Care 

·        First centre in India to offer dedicated Renal Palliative Care Services

·        First centre in India to offer ICU Palliative Care Services

·        First Private Medical College in India to start MD Palliative Medicine program

·        First Medical College (both Government and Private) in Karnataka to start MD Palliative Medicine Program

·        Contribution towards development of Palliative Care guidelines for the National Cancer Grid of India

·        Contribution towards development of Tele-Medicine guidelines of Indian Council of Medical Research

·        Contribution towards Palliative Elderly Mental Health (PEM) program of Government of India

·        First Centre in India to conduct International Master Classes on Renal, Pulmonary, Cardiology and Neurology Palliative Care

·        First centre in India to develop guidelines on methodised action plan for limiting life-sustaining treatment and end of life.

.        European Society of Medical Oncology (ESMO) designated centre for Integrated Oncology and Palliative Care 2022-2025

.       First centre in Asia to be certified by Multinational Association for Supportive Care in Cancer as Designated Centre for Excellence in         Supportive Care in Cancer for the period of 2022 to 2025.      

.       First and only centre  in India, to be recognised as The International Reference Centre for End-of-Life Care by the International Collaborative for         Best Care of the Dying Person. The international collaborative is a Europe based Organisation, situated in the University of Liverpool UK, with 22         member countries from the 6 continents, which plays a major role internationally in end-of-life care policy, education, and advocacy.     

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Email: pmd.kmc@manipal.edu

Phone Number: +91-820-2922221