MNJ Institute of Oncology is a 300 bedded tertiary care hospital for the state of Andhra Pradesh, India (population of 65 million). Every year the hospital sees around 10000 new patients with different cancers. MNJIO Pain Relief and Palliative Care Program, a collaboration of the International Network for Cancer Treatment and Research (INCTR/www.inctr.org and Pallium India, www.palliumindia.org) with MNJIO, started department of palliative care to their service in the year 2007. The primary goal of the program is zero-tolerance to pain – every effort is made to keep the patient, pain free and to incorporate palliative care into the care of the patient right from the time of diagnosis. The services offered are outpatient care and, in-patient care and home based care for patients in the twin cities of Hyderabad and Seunderabad with the help of an NGO.