Written By: Longjam Dineshwori | Updated : February 3, 2023 6:09 PM IST
A leading cause of mortality, cancer continues to devastate people globally. Currently, cancer is also one of the leading causes of death in India, after cardiovascular diseases. Ahead of the World Cancer Day, healthcare experts have highlighted some of the factors contributing to increasing cancer deaths in India and shared their suggestions on how to reduce the country's cancer burden.
World Cancer Day is observed on 4 February every year worldwide to raise awareness about cancer and to encourage actions towards its prevention, detection, and treatment.
Vineet Gupta, Director-Government Affairs at Varian Medical Systems, pointed out that many cancer patients in India do not have access to radiation therapy, one of the main pillars of cancer treatment.
He stated, "For treatment, there are three main pillars surgery, chemotherapy, and radiation therapy. Globally, nearly 50 per cent of the cancer patients have access to radiation therapy, however, in India, these figures stand at 18 to 20 per cent. As per the World Health Organisation (WHO) guidelines, India needs one linear accelerator per million population."
To fill this gap, he suggested, "The government needs to create a holistic programme to provide cancer care infrastructure in 300 to 400 districts over a period of 4-5 years and further needs to collaborate with private players for setting up radiation therapy centres. It can create a policy paper, listing down the guidelines for setting up radiation therapy centres. The success of such PPP (Public-Private Partnership) models has been observed in the diagnostics and pathology spaces."
Further, he noted that linear accelerators are currently being imported, making cancer treatment expensive. "The government can come up with a centralized procurement programme to make cancer care more affordable. It can also take measures under the Make in India initiative to encourage local manufacturing of the equipment," he suggested.
Social stigma and lack of awareness lead to an increase in deaths from chronic conditions in the country, according to Dr Suversha Khanna, Director, Dharamshila Rahat Supportive and Palliative Care Centre.
"In the case of breast cancer, women in some parts of the country still hesitate for mammography and self-examination. Similarly for other cancer conditions, people do not visit the doctor until it is too late to cure the situation. Also, factors like urbanization, population explosion, and unemployment, are contributing to the rise in the incidence of incurable, chronic, progressive and life-threatening diseases."
Concerningly, approximately 60-70 per cent of cancer patients report to the hospital when it is too late. "This is mostly due to the lack of facilities for early diagnosis, standard treatment and palliative care. There are very few dedicated palliative care centres in India for providing palliative care to improve patient's quality of life and survival rates. Cancer mortality is so high because of a lack of awareness about the risk factors of getting cancer, carelessness, late diagnosis, poor treatment and palliative care facilities in small towns. Palliative care is an age-old tradition and hence most people have no idea about its holistic approach in helping patients with chronic conditions," said Dr Khanna.
He believes that spreading education about such facilities can help a lot of people to heal spiritually, socially, emotionally, and psychosocially, rather than focusing only on medications like mainstream hospitals.
Dr. Sunita Kapoor, Director and Consultant Pathologist at City X-Ray & Scan Clinic, is of the opinion that awareness about cancer prevention, diagnosis, and treatment should be increased in rural areas.
She stated, "Prevention of cancer is only possible if one is fully aware of the disease and knows what steps to take if a need arises. It is always a good idea to stay abreast of cancer prevention, its diagnosis, and treatment. Organizing camps in rural areas is a great way to reach out to people who do not have access to healthcare resources."
Dr. Kapoor wants people to know that smoking tobacco, drinking alcohol, exposure to carcinogens such as specific chemicals and harmful radiation including UV rays from sunlight, obesity, and family history are leading risk factors for different types of cancer.
According to her, the most common cancers affecting the Indian population are breast, oral, cervical, gastric, colorectal and lung malignancies.
"Some symptoms may give early warning of cancer: a lump in the breast, for instance, could be due to a cyst, which usually goes away on its own. You need to check in with a doctor and not from the internet whenever you experience an unfamiliar signal. The treatment regimen is usually adopted based on the stage at which diagnosis is made, the presence of comorbidities, age, sex, and other factors. At times, the malignancy is advanced, and the treatment may not be able to get rid of the malignancy, in these cases, all measures would be taken by the medical professionals to provide palliative care, enhance the quality of life and prolong it," Dr. Kapoor added.
On World Cancer Day, Dr. Manjula Rao, Consultant Breast Surgical Oncologist & Oncoplastic Surgeon, Apollo Proton Cancer Centre, wants to remind people to go for regular health checks and annual cancer screening.
She commented, "With considerable advancements in medical science over the last few decades, and landmark discoveries, tremendous progress has been made in the field of cancer management, and survival outcomes have improved dramatically. Early detection is key. Breast cancer for example, may be detected even before it is felt by the patient by annual mammographic screening. This ensures less extensive treatments and related morbidity."
"In early breast cancer, if the axillary lymph nodes are not felt, it may be sampled by sentinel lymph node biopsy, thereby reducing the rate of complications such as shoulder weakness, lymphedema, etc., and improving the quality of life. Latest advancements such as in-vivo Fluorescence Imaging visualization technology allow surgeons to precisely trace the lymphatic pathway and localize the involved lymph node. This improves the accuracy of cancer staging," she added.
Reminding people that prevention is better than cure, Dr. Rao advises people to adopt an active healthy lifestyle, eat a balanced diet, keep a watch one's weight, abstain from alcohol and quit smoking.
On World Cancer Day, Dr. B.M. Makkar, Senior Diabetologist, President RSSDI (Research Society for the Study of Diabetes in India), wants to highlight the importance of monitoring the blood sugar levels before, during, and after undergoing cancer treatment.
"It is worth mentioning that people with diabetes are more prone to developing certain types of cancers. These may include increased risk for pancreatic, colon, liver, breast, and endometrial cancers. The choice of therapy adopted for treating cancer depends on various factors among which the presence of comorbidities such as diabetes is included. Moreover, it has been found that some newly developed cancer treatments might trigger underlying diabetes or exacerbate preexisting diabetes. Therefore, it is highly recommended that people with cancer and diabetes monitor their blood sugar levels before, during, and after they undergo cancer treatment."
He also emphasizes that regular screening for cancer is crucial as early detection and timely treatment are vital to defeating the malignancy.
