The Telegraph
Since 1st March, 1999
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Pain-relief regimen for cancer patients

Shilpi Mathur, 45, is a Stage IV breast cancer patient. She was in excruciating pain, caused by a second malignant tumour in the neck. Having been told that she had just a few months left, all she wanted was for them to be painless. That seemed an impossibility till she was administered a bracheal nerve-blocker injection under local anaesthesia. This has given her the hope to “live without pain and die with dignity”.

More and more terminally-ill cancer patients like Shilpi in Calcutta are now opting for “pain relievers” to improve the quality of life during their last few days. The pain relievers come in the form of oral medication (analgesics) to morphine, transdermal patches and injections in the form of nerve blockers.

And throwing them the relief-line are Gautam Mukhopadhyay, oncologist-surgeon, and Udayan Bakshi, pain-care specialist, who have set up Bengal Oncology Centre.

Backing them are around half-a-dozen leading oncologists of the city. “This is not euthanasia. And it is certainly not a form of cancer cure. All we are trying to do is improve the quality of the lives of patients who cannot handle the unbearable pain,” says Mukhopadhyay, who was with the Tata Memorial Centre in Mumbai before moving to Calcutta.

Around 5,000 patients, going by conservative estimates, are detected with Stage III and Stage IV cancer every year in the city. At least 55 out of every 100 patients here are detected at a stage where cure is impossible, say doctors. Around 20 per cent of such patients commit suicide, unable to bear the pain.

At the Bengal Oncology Centre, near Deshapriya Park, the pain-relief regimen for terminally-ill cancer patients goes through several phases. At the outset, a patient is put on analgesics for a week, along with psychological counselling. The next level involves morphine or morphine-based drugs, available in only two outlets of the city, under the strict control of the excise department.

When even morphine does not work, patients are administered transdermal patches, containing the Fentanyl group of drugs. The patch on the chest wall provides relief for 72 hours, at a cost of Rs 420. When all else fails, nerve-blockers — injections administered on nerves at the pain site — come into play. The drug that is 100 per cent pure alcohol gives instant relief and the effect of a dose lasts six months. The cost, including hospital stay, comes to around Rs 2,000.

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