Search

Introduction Advanced cancer patients often require clinic or hospital follow-up for their symptom control to maintain their quality of life. But it becomes difficult for the patients to attend the same due to financial, commutation, and logistic issues. Objective The aim of this study was to audit the telephonic calls of the service and prospectively collected data to understand the quality of service provided to the patients at follow-up. Materials and Methods An ambispective observational study was conducted on the advanced stage cancer patients referred to the palliative care department at Kolhapur Cancer Center, Kolhapur, Maharashtra. We conducted an audit of the 523 telephonic calls of our service—“PALLCARE Seva” from June 2020 to February 2021. Prospectively, we assessed the quality of service based on 125 telephonic calls (n = 125) for this; we designed a questionnaire consisting of 11 items on the 5-point Likert scale for satisfaction by the patients or their caregivers at the follow-up. After a pilot study, the final format of questionnaire was used to collect the data. Results Of the 523 calls attended, we provided 30.11% patients with dosage change of medications for their symptom management, 16.25% patients have liaised with local general practitioners, and 14.34% of cases had to be referred for emergency management to our hospitals. We provided 23.9% of them with emotional and bereavement support and 6.21% with smartphone-based or video-assisted guidance to the patients and caregivers. Conclusions Liaison of general practitioners was possible in more than one-tenth of cases. The core components of our service were politeness and caring attitude, helpfulness, handling doubts regarding the illness, and an opportunity to share thoughts from the patients or caregivers. More than three-fourth of the callers have rated their experience as satisfactory and would recommend this service to other patients in need. more...

Megestrol acetate is one of the pharmacological agents used for cancer-associated fatigue. To date, there are no studies on its use in the treatment of post-COVID-19 (coronavirus disease 2019) fatigue. So, we report a case of metastatic carcinoma lung with a partial response with three cycles of palliative chemotherapy. He was contracted with mild COVID-19 infection post three cycles of his chemotherapy. Post this episode, fatigue was his main and most troublesome symptom. After a thorough clinical history, physical examination, and investigations, type 2 post-COVID-19 syndrome was diagnosed. After explaining the risks and benefits, we started the patient on low-dose megestrol acetate (160 mg/d per oral) with low to moderate benefits. However, upon increasing the dose to 480 mg/d, the benefit on the subjective quality of life was significant. Studies with a larger sample and randomized controlled trials have to be conducted to substantiate the hypothesis and actual effect of megestrol acetate in the treatment of post-COVID-19 fatigue. more...