Healing Touch does not cure—but helps you heal—or become whole. This means that it works to balance all of you—physically, emotionally, mentally, and spiritually. In the midst of overwhelming circumstances in cancer treatment, Healing touch is an oasis of peace and calm. It works with all aspects of cancer treatment, such as the physical side effects from radiation, chemotherapy and anaesthesia. And it also helps with the emotional issues of loss, grief, hopelessness, depression, and anxiety said Dr. D Ragunatha Rao, Advisor – Medical Oncology, Rashtriya Ispat Nigam Ltd(RINL).
It is estimated that the cancer burden in India is likely to increase from an approximate incidence of 1 million cases in 2012 to about 1.7 million in 2035. The increasing burden of the disease coupled with diversity of patient population and multi-disciplinary and complex nature of cancer-care necessitates creation of a dynamic network for efficient patient navigation for addressing diverse patient needs. With the ever-increasing number of patients visiting the Hospital each year, it is impossible to do justice to every interaction a doctor has with a patient.
As level of awareness of healing touch remains extremely low, Tata Memorial Centre (TMC), in collaboration with Tata Institute of Social Sciences (TISS) and with support from Tata Trusts, introduced one year full time Advance Diploma in Patient Navigation Programme called KEVAT, named after the boatman who had helped lord Ram, Sita and Lakshman cross the river Ganga, for the first time in India to help caregivers hone skills. The course will address the need for a structured patient support system for cancer care that will form a bridge between patients and access to care.
The aim of initiating a patient navigation program is to create a trained taskforce to facilitate patient’s journey right from entry to the Hospital to follow-up and getting back to normalcy; taking care in addition of emotional, economic and various other needs in a holistic way. However, there is not much awareness across the country about these programmes. “It is a vast and effective course; cancer is not a disease that can be dealt with easily as it is extremely painful and takes a heavy toll on patients. It destroys the mental stability of the person. It is not only difficult for the patient, but for the caretakers and the family members too,” Dr. Rao pointed out.
The patient navigators or margdarshaks are placed in strategic locations like the outpatient departments, palliative medicine department and wards. After the doctor’s consultation, patients and their relatives have many questions. From basic things like ensuring that the patient reaches the right department for tests to answering their queries about the disease, we do everything,” said Shruti Shinde, a 26-year-old patient navigator. “Many times it starts from explaining to patients what chemotherapy or radiation therapy is,” said Ms. Shinde. Patients who are advised radiation often come to them saying, “Doctor ne current lene bola hai (the doctor has asked me to take electric current)”. Besides the treatment, they also help patients navigate treatment funding, availing of subsidies, and so on.
Dr. Jayita Deodhar from the palliative medicine department of TMH says patient navigators are a unique cadre of trained people. “They cannot be equated with laypeople working as volunteers with NGOs. They are also not like survivor volunteers recruited by many hospitals. While that is an altruistic thought, it is also essential to be objective from a psychological point of view,” said Dr. Deodhar. Empathy and objectiveness set patient navigators apart, said Dr. Deodhar.
The programme consists of a clinical oncology module that covers every aspect of four main cancers: head and neck, breast, gastrointestinal and gynaecological. There is a psychosocial module that covers mental health, networking and advocacy, and communication skills. While the first batch graduated four months ago, the second batch of 30 is under training. Dr. Rajendra Badwe who heads the Tata Memorial Centre hopes to recruit the navigators in all their cancer hospitals in Sangrur, Guwahati, Varanasi and Visakhapatnam. “Doctors at Tata always have a very high patient load. When we divert patients for investigations and treatment, there is a fear that the patient may simply not get there. But with Kevats, there is a relief that the patients will be guided,” said Dr. Shripad Banavali, head of paediatric and medical oncology at TMH. He said Kevats are the intermediaries who play a vital role in improving treatment outcomes.