Is India truly equipped to beat the dreaded C ?

“There is a ‘can’ in ‘cancer’ because we can beat it.”

With 1.22 billion people, India is the second most populous country in the world. Cancer is said to be one of the most common conditions amongst Indians and the sad part is that we are listed as the third highest in cancer deaths in the world.By 2020, researchers forecast an estimated increase of 25%. These are by far alarming figures. So, we need to be ready to fight the dreaded diseases and the first step to it is awareness about the conditions and its treatments.

Challenges for Oncology in India

It is no hidden fact that we are struggling with inadequate infrastructure and poor access to healthcare.In fact,India has just 0.98 oncologists per million population and just 62 dedicated cancer care hospitals in the country, including both regional and national facilities, according to the National Cancer Grid 2018!

The government has realized that cancer burden is increasing and hospitals treating cancer are small in number. That is why the investments in cancer hospitals is going on. Still, this is very little when we look at the increasing number of patients per year”, says a leadingoncologist specialist in Pune. Given India’s massive population and geography, the limited number of specialists severely limits treatment of cancer, especially in rural areas. We need more affordable medicines, supportive care, and supplements to be accessible in the vast rural communities.

So, when you consider that the ratio of patients seeking health care to the availability of qualified health care providers is heavily skewed, you can imagine the result: overcrowded health care facilities and long waiting periods in outpatient clinics. This needs to change.

Specialisedcancer care is critical

Every cancer is different, as is every patient battling the condition. As Cancer Specialists in Maharashtra, we at Onco Life Cancer Centre, notice differences not only between cancer cells from different patients, but also between cancer cells within the same patient. When it comes to Leukemia Treatment in India,we always stress on the importance of adopting a multi-disciplinary approach to cancer care, one that is customised to each kind of cancer and, finally, personalised for each patient. Unfortunately, most oncology protocols that are practiced in India have been developed in the West. What we need is to develop protocols based on India’s own population characteristics, centred on the country’s diverse people and their constitutions.

Specialised cancer care is important for many reasons, including avoiding a misdiagnosis. For example, tuberculosis and lung cancer symptoms overlap, as do several of their findings on chest x-rays and CT scans. In India, where tuberculosis is common, patients with limited access to experienced health care providers get treated first with tuberculosis drugs before a diagnosis of lung cancer is ultimately made. Greater awareness about lung cancer and the approach needed to establish its diagnosis can help reduce the percentage of patients in whom this misdiagnosis occurs.
Onco Life Care Centre is one of best cancer hospitals in Pune and it is our idea is to translate the understandingwe have of the biology of cancer towards creating better patient care in India. Cancers that arise in any organ are not just one disease, but rather a collection of distinct diseases with varying responses to different treatment strategies. The challenge is to identify the most effective, minimally toxic treatment for each patient.

Cancer treatment must be made affordable

There’s no denying that cancer treatments are mostly expensive. In most developed countries, health care expenses, including cancer treatment, istaken by insurance bought by patients or offered by the federal government. In India, patients typically end up paying for the treatment from their own savings.
However, the central government recently started a universal health care insurance program called Ayushman Bharat PMJAY in which all eligible citizens get access to free health care, including chemotherapy and supportive medications.While the government has permitted use of biosimilar and other generic drugs to be available at a fraction of the cost, a lot more needs to be done. We need to focus on diagnostics and invest in modern diagnostic services, such as nuclear medicine, radiology, biopsy, endoscopy and colposcopy.When patients are diagnosed at later stages – this not only increases treatment costs, but also leads to higher mortality. Diagnostics and preventive medicine can tackle this effectively. For instance, once Health and Wellness Centres (HWCs) under Ayushman Bharat-PMJAY (India’s very own Government health insurance policy) succeed in screening effectively for cancers, we will be able to detect cancers early.

Technology can pave the way for new treatment

From a proton-powered therapy to specifically target cancer cells to navigation systems that allow surgeons to accurately map the contours of cancerous tumours with real-time data, hospitals like Onco Life Care Centre are leveraging the latest technologies to offer better patient experience and improve treatment outcomes.
Cutting-edge technologies such as Cyclotron, PET-CT. Nuclear medical oncology and molecular oncology departments are not alien to the top leading Indian hospitals which utilise the most advanced technology in the treatment of cancers. However, these examples of technological advancement are in sharp contrast to the many unscrupulous hospitals who continue to purchase outdated technology, due to budgetary constraints or simply to improve profit margins.
The use of technology to reach rural outposts is another angle we should explore. Teleradiology, video/audio connectivity, and sharing of expertise is the only way we can increase access and affordability. Oncology needs to be taught by oncology specialists earlier in the medical education process. This applies to physicians, nurses, and other paramedical professionals. Education of the community at large about cancer risks should be expanded, along with cancer screening and other preventive strategies that need greater emphasis.

Progressive therapies must be explored and encouraged

Apart from current treatments, including immunotherapy, chemotherapy, radiation therapy and surgery, there are other routes of treatments that will change the way we deal with cancer in the future.
For example, targeted therapies are a big shift from the conventional toxicity-prone chemotherapy. One of the targeted therapies, Imatinib, used in a form of chronic blood cancer, has not only helped control the disease much longer than we could do earlier using the conventional chemotherapy, but also considered to have cured several patients. Another major advancement over the past few years is Immunotherapy, in which the patient’s immune cells are helped to fight and eliminate cancer.
The downside is to all thesetherapies,howeveris that they are very expensive and will require financial help from both government and nongovernment organizations for them to become a mass reality.

What does the future hold for cancer care in India?

For India, diffusion and adoption of the proven advances in cancer therapy rather than looking for new cures, should be a priority. Efforts to lower the costs of therapy by re-engineering both generic drugs used in chemotherapy and treatment devices used in radiotherapy, need to be focused on. Early detection is critical to successful cancer care, so spreading greater awareness would also help. India must innovate faster and smarter to be able to truly live up to the slogan ‘We CAN beat CANCER!”