Palliative care is specialised medical care focused on relief from the symptoms, pain, and stress of cancer — at any stage of illness, alongside any treatment. It is not about giving up. It is about living as well as possible, for as long as possible, with the best possible support.
"Palliative care is an approach that improves the quality of life of patients and their families facing life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems."
— World Health Organization (WHO)Palliative care is not the same as end-of-life care — this is the most important misconception to correct. Palliative care can and should begin at diagnosis, running alongside curative or life-prolonging treatments. It addresses physical symptoms, emotional distress, practical concerns, and spiritual wellbeing — for the patient and the entire family.
Research consistently shows that patients who receive early palliative care alongside active cancer treatment report better quality of life, fewer emergency hospital admissions, better tolerance of treatment, and in some cancers — longer survival. It is not an alternative to treatment; it makes treatment more bearable and effective.
In surgical oncology, palliative care takes on a unique dimension — including surgery specifically performed not to cure, but to relieve obstruction, control bleeding, restore function, or reduce tumour burden and improve quality of life.
In 30 years of cancer surgery, I have seen how profoundly good palliative care changes the experience of illness — not just for patients, but for their entire families. A patient whose pain is well controlled, who can eat, breathe, and sleep — that patient has dignity. That is what we are working towards.
Palliative surgery is a real and important part of my practice. Sometimes the most meaningful operation I perform is not a cure — it is a bypass to relieve an obstruction, a stoma to restore bowel function, or a procedure to stop bleeding that was stealing someone's final weeks. These operations matter enormously.
I believe palliative care should begin at the first consultation — not when all other options are exhausted.
— Dr. Vinod T. Gore, MBBS MS FAIS FIAGES FARIS (Edin)Palliative care is not reserved for the final weeks of life. It is appropriate from diagnosis — and its role evolves as the patient's journey evolves.
Palliative care starts at diagnosis, running alongside surgery, chemotherapy, or radiotherapy. Manages treatment side effects, anxiety, pain, and fatigue — allowing patients to tolerate and complete curative treatment more successfully.
Early / ConcurrentWhen cancer cannot be cured, palliative care becomes the primary focus — controlling disease, managing symptoms, maintaining function and independence, and supporting the patient and family through uncertainty.
Primary GoalIn the final weeks and days of life, palliative care focuses on comfort, peace, and dignity — ensuring the patient is free from pain and distress, and the family is supported through the process of loss and bereavement.
End of LifeCancer survivors often carry lasting effects of treatment — pain, fatigue, psychological distress, lymphoedema, and altered body image. Palliative and supportive care addresses these long-term needs after active treatment ends.
SurvivorshipPalliative care manages the full spectrum of cancer-related symptoms — physical, psychological, social, and spiritual. Every symptom that reduces quality of life is within its scope.
The most feared symptom — and the most treatable. Managed with the WHO pain ladder, nerve blocks, patches, syringe drivers, and adjuvant drugs.
Dyspnoea from pleural effusion, lung involvement, or anaemia — managed with oxygen, opioids, drainage procedures, and anxiolytics.
From cancer itself, bowel obstruction, or treatment side effects — managed with antiemetics, steroids, bowel interventions.
The most common cancer symptom — addressed through treatment of reversible causes (anaemia, hypothyroidism), activity pacing, and nutrition.
Cancer cachexia and treatment-related anorexia — managed with appetite stimulants, nutritional supplementation, and feeding support where appropriate.
Psychological distress is universal in cancer — addressed with counselling, psychiatry review, anxiolytics, antidepressants, and peer support groups.
Limb or facial swelling from lymph node involvement or surgical clearance — managed with compression garments, manual lymphatic drainage, exercise.
Fungating wounds, radiation skin reactions, and pressure sores — managed with specialist wound care, dressings, and odour control.
Cancer pain is manageable in over 80% of patients using the WHO three-step analgesic ladder — a systematic approach of escalating medication strength matched to pain severity. No patient should suffer uncontrolled pain.
For mild cancer pain — simple analgesics that provide effective relief without opioid side effects. Given regularly around the clock, not just when pain peaks.
When non-opioids alone are insufficient — a weak opioid is added. Continue non-opioids for synergistic effect. Reassess frequently.
For moderate-to-severe or uncontrolled cancer pain — strong opioids are the standard of care. When titrated correctly, they are safe and highly effective.
Morphine does not hasten death when used correctly for pain relief. This is one of the most harmful myths in oncology. Properly dosed opioids relieve suffering and can actually extend comfortable life. Fear of opioids should never lead to untreated pain — a patient's right to adequate pain relief is fundamental.
A surgical oncologist performs operations specifically to relieve symptoms and restore function in patients with advanced cancer — not to cure, but to give back quality of life. These operations are carefully selected and carry a clear benefit-to-risk justification.
When cancer causes intestinal obstruction, a surgical bypass or stoma restores bowel function — relieving distension, vomiting, and pain, allowing the patient to eat and regain comfort.
Gastric / Small Bowel / ColorectalObstructive jaundice from pancreatic or biliary cancer causes severe itch, fatigue, and liver failure. Surgical bypass or endoscopic stenting restores bile flow and dramatically improves quality of life.
Pancreatic / Biliary / Liver HilumRecurrent haemorrhage from an unresectable tumour — gastric, bladder, or uterine — can be surgically or endoscopically controlled, preventing chronic blood loss and the need for repeated transfusions.
Gastric / Bladder / GynaecologicalIn head and neck cancers causing progressive airway compromise, tracheostomy provides a safe, permanent airway — eliminating the distress of breathing difficulty and allowing comfortable breathing.
Head & Neck / Thyroid / LarynxPEG tube or surgical gastrostomy in patients unable to swallow due to head and neck, oesophageal, or neurological cancer — restoring nutrition, maintaining weight, and enabling oral medications.
Head & Neck / OesophagealPathological fractures from bone metastases and spinal cord compression from vertebral disease are surgical emergencies — fixation and decompression restore mobility, relieve pain, and prevent paralysis.
Bone Mets / Spine / Pathological FracturePalliative care is surrounded by fear and misunderstanding. These misconceptions prevent patients from accessing care that could significantly improve their wellbeing.
Palliative care runs alongside curative treatment from the very beginning. It does not replace surgery, chemotherapy, or radiotherapy — it makes them more bearable. Early palliative care actually improves treatment completion rates and outcomes.
When correctly dosed for cancer pain, opioids do not shorten life — they relieve suffering and often allow patients to rest, eat, and be more active. Physical dependence is not the same as addiction. Fear of opioids leads to unnecessary suffering and is not justified by evidence.
WHO and all major oncology guidelines recommend integrating palliative care from the point of diagnosis. Studies show that patients who receive early palliative care live longer, feel better, and require fewer emergency admissions than those who receive it only at the end of life.
Palliative care is delivered by a coordinated team — each member addressing a different dimension of the patient's and family's experience.
Performs palliative surgery, manages surgical complications, coordinates the overall oncological care plan and goals of treatment.
Specialist in pain management, symptom control, and goals-of-care conversations. Coordinates the palliative care plan holistically.
Provides hands-on symptom assessment, wound care, medication management, and is often the primary point of contact for patients and families.
Addresses anxiety, depression, fear, and existential distress — for both the patient and family members who are also affected by the illness.
Manages cancer cachexia, treatment-related nutritional deficiencies, and optimises dietary intake to maintain strength and treatment tolerance.
Maintains mobility, manages lymphoedema, provides breathing exercises, and reduces the functional decline that can accompany advanced cancer.
Supports patients and families with spiritual, religious, and existential concerns — regardless of religion or belief — when facing serious illness.
Enables patients to receive palliative care at home where preferred — home nursing, medication delivery, equipment, and family support coordination.
The surgical oncologist is often the lead clinician in a cancer patient's journey — and therefore central to initiating, coordinating, and delivering palliative care at every stage.
"To cure sometimes, to relieve often, to comfort always — this is our work as surgeons and physicians. The patient in front of me is a person, not a diagnosis."— Dr. Vinod T. Gore, Surgical Oncologist, Pune
Whether you or your family member needs symptom management, a palliative surgery opinion, or simply honest guidance on the path ahead — Dr. Gore and the team are here. You do not have to face this alone.