Cancer prevention is in our hands
Cancer treatment is a problem because people ignore early signs of ill-health. The cost of cancer treatment goes up because patients delay going to doctors. Consider breast cancer. If diagnosed early, it can be treated through a simple surgery that costs less than Rs 25,000, with 95 per cent chance of cure. If delayed by a few months, the cancerous tissue grows from 1 cm to 2 cm, requiring removal of lymph nodes from the axilla. This surgery costs Rs 40,000 and the chance of cure goes down to 80 per cent. A few more months, and the disease requires radiation therapy along with surgery. The cost then goes up to Rs 2,00,000 and the chance of cure declines to 60 per cent. If the disease remains undiagnosed for a long time, it spreads to the liver or bones, requiring chemotherapy. The cost increases to Rs 4 lakh and there is very little chance of cure.
And more often than not patients try a lot of self medication before seeking expert medical advice. Besides, many patients do not complete the planned treatment for reasons other than finances. Mostly, it is logistic issues and inability to stay away from their homes for long. At Barshi, near Sholapur in Maharashtra, the five-year survival of women with locally advanced cervical cancer was improved from 15 to 60 per cent simply by persuading them to complete the six weeks of radiation therapy without interruption.
There are some 29 regional government cancer centres and more than 300 hospitals, both public and private, with cancer departments/specialists across India. Poor people suffering from cancer can avail treatment at most of these places. The government has also introduced schemes to help these patients. Several non-profits provide financial support to cancer patients. For instance, over the last four years, Indian Cancer Society has provided more than Rs 40 crore of financial assistance to impaneled hospitals for the treatment of poor patients with curable cancers. Other non-profits, like the Indian Cooperative Oncology Network, provide free cancer medicines to deserving patients.
I am yet to come across a patient who does not say “Doctor, I want the best treatment”. So it would be wrong to say that people fail to avail treatment because it is expensive. Generic forms of Gleevec are available at costs affordable for most people in India. The drug is available for free to patients who meet the eligibility criteria. No doubt, cost of some other cancer medicines are “high”. But this is true for all healthcare. There is always a shortage of doctors in all specialties.
The government is also serious and active regarding prevention and management of cancers. For example, there are stringent norms for air quality. The Union ministry of health and family welfare is focusing on noncommunicable diseases—cancer, heart diseases, hypertension and diabetes. The government has earmarked more than Rs 3,000 crore for the National Cancer Institute of India, which is coming up on the outskirts of Noida.
We cannot estimate the quantum of disease that would increase due to increased exposure to toxins. While we have a long list of chemicals that can potentially cause cancer, not everyone exposed to them will actually develop cancer. Simple and sensible precautions can protect most Indians. But some pockets of India experience extremely high incidence of certain cancers due to environmental contamination of groundwater and excessive use of fertilisers or pesticides. Toxins in the environment are a major problem that should be addressed on a war-footing. For one, use of pesticides by poor farmers can be reduced.
The government has several programmes to help poor farmers assess their soil composition and educate them about effective farming without pesticides. Also, poor farmers using pesticides must wear protective masks and wash their body thoroughly after spraying to reduce exposure. Potable water should also be everyone’s priority. The Indian Institute of Technology, Bombay, has devised a low-cost contraption that can eliminate heavy metals from drinking water for the whole village. Such inventions should be shared country-wide. Awareness should also be spread about healthy lifestyle. Lung cancer, oral cancer and breast cancer are the three most common cancers that afflict the Indians, and most of them are caused by our lifestyle, such as consumption of tobacco or red meat, lack of exercise and obesity.
The best chance of preventing cancer is in our own hands. Greater awareness, annual checkup after the age of 40 and use of vaccines wherever appropriate can reduce the risk of cancer. The best way would be to educate school children about such facts. That would go a long way in spreading awareness to the masses.
(As told to Vibha Varshney)
This article is an extract from Body Burden 2015 - State of India's Health, a book that investigates how our health is a victim of environmental degradation.