637: Strengthening Cancer Pain Services by Government -NGO Partnership in regional cancer centre in India

Topic: Education, Societal Impact, and Others
Subtopic: Organisation of clinical pain care

Background and Aims: Provision of Cancer Pain and palliative care services is essential part of comprehensive cancer treatment. Acharya Tulsi Regional Cancer Treatment and Research Institute (ATRCTRI) Bikaner is one of the largest centre in northwestern India. There is immense need for dedicated services which should includes outpatient, daycare, inpatient and home-care.
The major problem in government institute was inconsistency of staff due to non-availability/frequent transfers. Due to this resource constraint, we were able to offer only OPD service limited to provide morphine and other pain medications. Hence We started a project with help of Cipla Foundation to strengthen the existing services

Methods: Project Brief:
Scope: To strengthen Cancer Pain and Palliative OPD and start Day Care, IPD and Home Care services at ATRCTRI Bikaner
Geography: Bikaner and adjoining areas, patients come from Punjab, Rajasthan, UP, Haryana and MP.
Services – IPD/OPD/Homecare/ Day Care
Major Challenges
Difficulty in getting patient referrals from oncology
Awareness about Palliative Care and services available under the project
Collecting and Managing patient data
Training of team and other colleagues, formation of clinical pathways for smooth service delivery

Results: Outcome data:
(01 April 2025–31 Dec 2025)
1. Number of patients : OPD-1127, Day Care-346, Home Care-256
2. Quality Indicators: ESAS filled and triaging done for all patients: 69% reported reduced pain and symptom burden, 4% no change and 28% reported increased pain and symptoms indicating progression of disease and/or inadequate pain control.
3. SOPs for outpatient, day care and homecare patient pathways were designed and implemented.

Plans for Future:
More inpatient referrals
Community Awareness and capacity-building programs
Streamlining service delivery and execution: analysis of SOPs and pathways at every quarter based on time to attend patients, Quality indicators, patient feedback and other parameters.

Conclusions: Cancer Pain and Palliative services can be strengthened by bringing in novel approaches otherwise difficult to introduce in government setups through partnerships and cooperation between different stakeholders and government. This model works well and may help us to optimise our care and gradually inculcate these practices into government health system.

References: 1. Gupta, M., Kankaria, A., Garg, L. et al. Barriers and facilitators to accessing and providing palliative care to people with cancer in the Bathinda district in Punjab: a qualitative study. BMC Health Serv Res 25, 1565 (2025). https://doi.org/10.1186/s12913-025-13751-0
2. Doyle KE, El Nakib SK, Rajagopal MR, Babu S, Joshi G, Kumarasamy V, Kumari DP, Chaudhuri P, Mohanthy S, Jatua D, Lohman D, Amon JJ, Palat G. Predictors and Prevalence of Pain and Its Management in Four Regional Cancer Hospitals in India. J Glob Oncol. 2018 Sep;4:1-9. doi: 10.1200/JGO.2016.006783. Epub 2017 Apr 13. PMID: 30241192; PMCID: PMC6180789.

Presenting Author: Vivek Mehta
Submitting Author: Mohd Yunus Khilji

Senior Author: Mohammed Yunus Khilji

IASP 2026 Global Year theme of Neuropathic Pain: Yes

• Raj Kumar Nirban: MD - Acharya Tulsi Cancer Centre, S P Medical College Bikaner