Dr Meenu Walia, Director, Oncology, Max Super Speciality Hospital, Patparganj gives an insight on the growing incidence of cancer in India and recommends measures to curb the menace
In order to defeat cancer, the most dreaded disease in the world, it requires a country like India to aggressively work on awareness and identify those at risk. The latest figures published in the British medical journal The Lancet show that around one million new cancer cases are being diagnosed in India each year, projected to nearly double to 1.7 million new cases by 2035. Around 7,00,000 people are dying from cancer in India annually, projected to rise to around 1.2 million deaths in 2035. Approximately four years back, the breadbasket of India – Punjab was reported as the cancer belt of India giving rise to hair raising headlines like ‘18 people succumb to the disease every day in Punjab’ or ‘90 cancer patients per 1,00,000 people’. A common thought resounded across the nation – We know the problem but how are we resolving it?
Today, we yet again have a new cancer belt identified in India. Shockingly, less than an hour’s drive from the heart of the capital – Delhi, is Greater Noida with five villages and already 57 residents have succumbed to death due to cancer. And many continue to battle the disease every day. Most of the cancers in these afflicted villages are related to the organs in the gut, including the liver, blood cancer and an extraordinarily high number of cases of hepatitis, liver ailments, stomach problems and skin diseases. Majority of gut-related cancers got experts suspecting to carcinogens in water. The industrial area (over 100 factories) in Greater Noida leads in manufacturing adhesives, cosmetics, pesticides, TV tubes and also the parboiling and dehusking of large quantities of rice. Allegedly, the industrial effluents are being dumped into the ground through wells, oblivious to its repercussions, residents have been consuming the same water for different purposes including drinking and cooking.
In India, less than 30 per cent of cancer patients survive for more than five years after their diagnosis and with the recent development of cancer belt in Greater Noida, urgent actions are the need of the hour.
Max Super Speciality Hospital, Patparganj has been over the years working to spread awareness and educate people about the fast-spreading disease – dire need for aggressive awareness and affordable and accessible medical care. While it is well known that there has been a steep increase in the number of cancer cases in India, awareness and screening campaigns continue to remain few and far between and are conducted intermittently by a minority of institutions and healthcare players. To challenge the dreaded ‘C’ word in India, we have to first revisit the problem at the grassroot level. It is time to change the mindset. Nobody wants to know that they have cancer. It is a common mindset to choose to live in denial than hear the bad news early. While this may be a natural reaction, it has the potential to kill and must be overcome through well informed and sustained campaigns.
The extent to which cancer will actually increase in the next two decades will depend a lot on measures of healthcare delivery systems cancer research, clinical trials, and extent of public awareness. A key reason that factors for the excessive cancer mortality in the country is the big void between the demand and supply for cancer care. 95 per cent of the medical colleges in India do not have comprehensive cancer care services comprising surgical, medical and radiation oncology departments in the same campus. In almost all remote or rural areas even the most basic cancer treatment facilities are non-existent. As a result, healthcare institutions in urban areas are overcrowded and under-resourced, thus, resulting in long waiting queues, delayed diagnoses and further delayed treatment. While it is a challenge for India, but delivering affordable and rightful care for cancer is a challenge we must rise to if we are to defeat the disease before it engulfs the nation.
40 per cent of cancer in India is directly attributed to tobacco. While much has been spoken about it, yet oral cancers and cancers of the lung and oesophagus continue to take lives. The average Indian teen continues to puff away smoke rings while nonchalantly glancing at the cancerous lung on his cigarette pack. We need to move away from just printing ‘Smoking Kills’ to driving it home that ‘Smoking Does Kill’. Tobacco also continues to influence cancer of the uterine cervix which is a major killer of women in rural India. The irony is that while tobacco, ingested or smoked, continues to enjoy social sanction, the human papilloma virus vaccine, which prevents cancer of the uterine cervix, continues to remain under scrutiny because of certain reservations. It is important to act and act fast at changing this mindset as improving cancer outcomes in India not only depends on addressing shortfalls in the medicines and treatment facilities available to patients, but will also need far more concerted efforts towards preventing people from getting cancer in the first place.
Key steps to increase awareness amongst Indians:
- Most cancers do not have specific symptoms, but a clinical examination and a thorough medical history which covers habits, lifestyles and diseases in the family can give pointers. For example, it is now mandatory in the Western world to first rule out ovarian cancer for any woman who fits the ‘three Fs’ is female, 40 and fatwhen she comes to a clinic with symptoms. The same is true for long-term smokers and men over 50 years of age with prostate problems; cancers of the lung and prostate must be eliminated first
- Extensive campaigns and advertorials to teach young women and men on how to examine their breasts and testicles so as to detect abnormalities early. With breast cancer on the rise, discovering a lump early leads to better survival as does visiting a doctor for a smelly vaginal discharge which could be a precursor to cancer of the cervix
- Nationwide screening programmes for the most prevalent cancers It is important for as a nation to realise that cancer does not discriminate. It affects all of us whether a daughter, mother, father, friend, sister brother, movie star, beggar or a doctor. It is on us to let go of our prejudices and help each other in defeating the disease before it can defeat us. There is a famous saying and I completely believe it ‘There is a ‘can’ in cancer because we CAN beat it’.