Early Detection Can Turn the Cancer Tide

What the issue also requires is a multi-pronged response from all stakeholders, whether its health organizations, governments, physicians, or civilians. At a time when Covid and other health crises can, at any time, disrupt screening and treatment of patients, thereby increasing the cancer burden, we must re-invent the cancer care system in India.  

A report by the Indian Council of Medical Research (ICMR) and National Centre for Disease Informatics & Research (NCDIR) claimed, through their National Cancer Registry Programme, that the number of cancer cases stood at 13.9 lakh in 2020. While the rate of incidence of cancer is rapidly rising, the cancer care system has not been able to keep up pace. While experts are of the opinion that this trend is likely to grow even further, we must institute a specialised care system and increase awareness to help detect as many cases as early as possible. 

Cancer care is cost- and time-intensive. The gradual shift of care to tier 2 & 3 will bring a huge respite to the patients who can avail best care in his hometown, or at least, closer to their home. The prolonged treatment programmes, support system for specialised care and palliative care for survivors must be in place to make this shift impactful. While the efforts towards this end are on course, they need further boost as India stares at a greater cancer burden in the coming days, slated to go from 1.39 million to 1.57 million by 2025. The risk factors for this increase are said to include high exposure to tobacco and alcohol, obesity, and poor diets. 

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“It is of immense importance to maintain a good lifestyle and healthy habits, avoiding consuming tobacco, alcohol, smoking marijuana, cigarettes, e-cigarettes and vaping. Imagine the paradox; I’m buying cancer, delaying cancer and then blaming cancer for everything.” _Dr Pankaj Chaturvedi

The treatment module for immuno-compromised cancer patients is to visit a hospital/care centre often, if not daily. So far, highly specialised cancer care facilities have remained centred in the metros of the country. However, post pandemic, this trend is changing rapidly as more and more hospitals from tier 2 and tier 3 cities in the country are acquiring technology and developing infrastructure to provide the best oncology care possible. 

“We’re definitely seeing a shift of awareness and investment in technology and quality of care in Tier 3 cities as well.” _ Srikanth Suryanarayanan

A case in point is this: until a few years ago, only about 70 to 100 Positron Emission Tomography – Computed Tomography (PET – CT) machines were available across the country. However, in the past five years, this number has moved to around 175. This is an encouraging trend but there is a lot that needs to be done to enable technology prowess in these cities, especially for a technology intensive cancer care. Early detection is a prerequisite for defeating cancer, and as these technologies are adopted pan-India, more lives can be saved. 

The shift of cancer care from metros to the hinterland must remain in sync with development of modern infrastructure, installation of state-of-the-art technology and training of specialised doctors & clinical staff. The government must continue to play a pivotal role in this regard. Some progress in this regard has already been made as regional chapters of high-end clinical facilities like AIIMS are now being developed across the country. 

The success of Public Private Partnerships (PPP) in building capacity for cancer care across the country should also be evaluated so that the turnaround time to deal with the growing cancer burden can be shortened without compromising on the quality of care. Even the Hub & SPOC model can be useful to train the clinicians and technicians to optimally utilise the modern technologies like PET CT or Molecular imagining or even Artificial Intelligence-empowered detection and treatment solutions. Concepts like a “Tumour Board”, which is the foundation of successful cancer care centres, can be initiated using this model to bring in the much-needed exposure to educate clinicians. 

The fact remains that cancer is a serious health threat and is only going to become more of a challenge in the days to come. We must acknowledge this fact and start building an ecosystem of cancer care which is world class in infrastructure, technology, and skilled workforce (comprising doctors and caregivers). Moreover, simple lifestyle modifications, like reducing tobacco and alcohol intake, eating well, exercising, and getting adequate sleep can reduce cancer risks multifold. The advancement in detection and treatment has been encouraging but this progress must percolate down to the patients who suffer from this disease in the areas where such ecosystems are at a nascent stage or even absent. The technology is available for us to provide solutions that are affordable, accurate and accessible.

(Source: Podcast titled Cancer Awareness: Prevention Detection and Treatment, part of the campaign Cancer Care Matters in association with GE Healthcare. The panelists included Dr Pankaj Chaturvedi, Deputy Director, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai and Srikanth Suryanarayanan, Head, Imaging at GE Healthcare.)