The Silent Suffering: Reimagining Psychosocial Palliative Care for Indian Elderly Cancer Patients

Abstract

The unprecedented growth of the worldwide ageing population is significantly influencing the epidemiology and management of cancer, with individuals aged 60 and above representing a growing proportion of cancer incidence and mortality both globally and within India. The convergence with rising cancer rates presents multifaceted clinical, psychosocial, and policy-related challenges. Psychosocial palliative care plays a pivotal role in alleviating the complex suffering of elderly cancer patients. Despite policy efforts and innovative care models, access to comprehensive palliative services in India remains limited and disproportionately concentrated in urban centers, reaching fewer than 2% of those in need. Systemic barriers such as stringent regulations, inadequate healthcare workforce, societal stigma, age-related discrimination, and cultural hesitations continue to hinder timely referrals, open communication, and the delivery of effective psychosocial support. The community-led palliative care initiative in Kerala exemplifies a transformative model rooted in grassroots participation, volunteerism, and public health integration, offering a scalable blueprint for other regions. Nonetheless, stark disparities persist across rural-urban divides, socioeconomic groups, and state health infrastructures, highlighting the urgent need for context-specific and adaptable interventions. This review consolidates current literature on the psychosocial dimensions of palliative care for elderly cancer patients in India, critically analyzing systemic, cultural, and infrastructural impediments while spotlighting avenues for innovation and policy advancement. Through this examination, it seeks to inform stakeholders: researchers, clinicians, and policymakers, on the development of culturally appropriate, age-responsive, and sustainable models that uphold dignity, autonomy, and holistic care in the evolving landscape of geriatric oncology in India.