Close the Care Gap
4 February is observed as World Cancer Day to raise awareness about cancer and press the governments and individuals to act. The day is chosen for observing as the world cancer day is as on this day at the beginning of the millennium, the Charter of Paris Against Cancer is signed by the then French President, Jacques Chirac and then General Director of UNESCO, Koichiro Matsuura. The Union for International Cancer Control (UICC) initiative for global unity raises awareness, educate people, and works together to make cancer treatment and care equitably. It attempts to address the global burden of cancer and an opportunity to pay tribute to the healthcare workers who continuously attend to the affected and work towards both preventing and curing this disease.
Cancer is a disease caused by an uncontrolled division of abnormal cells in a part of the body. It can happen almost anywhere in the human body. Some of the body’s cells begin to divide without stopping and spread into surrounding tissues. Usually, human cells grow and divide to form new cells as the body needs them and replace the old cells. A situation would develop where the old cells survive, and new cells form when they are not required, resulting in tumour growth. The uncontrolled growth results from the cancerous cells ignoring signals to stop growing, resulting in uncontrolled growth. It is reported that over 100 types of cancers affect humans.
The decade passed by has seen an increase of cancer cases by 21% and deaths by 26%. Around 10 million people die from cancer each year, more than HIV/AIDS, malaria, and tuberculosis combined. As per a report from National Cancer Registry Programme, more than 1.39 million people in India had cancer in 2020, and it is projected to increase to 1.57 million by 2025. Breast, lung, mouth, cervix, uteri, and tongue were identified as the five leading sites of the disease. Fortunately, the overall cancer incidence in India is low (94 per 100,000 people). About a third of that is recorded in more developed countries (268 per 100,000). It is estimated that as India continues to age, cancer cases will double every 20 years. States like Uttar Pradesh, Bihar, Jharkhand, and Odisha would bear the brunt in the coming two decades. Lung, breast, cervical and colorectal cancer are some cancers that are most common in India.
As per WHO, around one-third of deaths from cancer are due to preventable factors like tobacco use, high body mass index, alcohol use, low fruit and vegetable intake, and lack of physical activity. More than 20% of deaths due to cancer are caused by using tobacco, about 10% are due to lack of physical activity or excessive drinking of alcohol. Genetic defects also result in cancer (5-10%). Unlike cancer in adults, most childhood cancers do not have a known cause. Most childhood cancers can be cured if prompt and essential treatment is given. Some of the most common cancer types, including breast cancer, cervical Cancer, Oral Cancer, and Colorectal Cancer, have high cure rates when detected and treated early. If detected early, another third can be cured and treated correctly.
Most cancers get diagnosed later, and precious time is lost to give a patient a quality life ahead. There is a need to implement effective screening methods for early diagnosis. When one encounters a life-threatening disease like cancer, the first step towards its prevention is awareness. Simple lifestyle changes can reduce your risk of cancer and, for that matter, many other lifestyle-related diseases too. As a modern civilisation, we have come up with a cure for everything. However, still, the life-threatening problem of cancer remains intact.
When we discuss care for cancer patients, it is an opportunity to recall and pay tribute to the great soul of late Dr V. Shanta for her extraordinary contributions to cancer care. As Chairperson of Adyar Cancer Institute, Chennai, she concentrated on making quality and affordable cancer treatment accessible to all patients in her country. Another significant contributor to cancer care and treatment is Tata Memorial Hospital, a DAE institution providing high-quality cancer care across the country.
COVID pandemic has its impact on almost every aspect of life, and cancer care is not an exception. Lockdowns, restrictions, and hearth care systems burdened and forced cancer patients’ treatment to take a back seat. Cancer screening and early detection was most impacted and has left a visible impact with more patients battling advanced stage of the disease than in the years before.
Cancer exists, and it could happen to anyone and everyone. While creating a robust health infrastructure is essential, there is a need to talk about it and adopt healthy habits. It is equally important that people talk about cancer and make simple lifestyle changes to prevent its spread. Once a family member is diagnosed with cancer, gloom looms over the family. Fear of death, draining of resources, financial and time. Ensuring emotional support to the patient and, more importantly, the family members.
Lack of access to healthcare workers and services continues to be one of the biggest hindrances affecting cancer in the country. It is the commitment of governments, communities, and people themselves. Only the responsibility to act will lead to progress in reducing the global impact of cancer.
In India, the number of healthcare providers available to treat cancer is inadequate considering the large number of cancer patients. We have only around 4000 oncologists for our entire 1.3 billion population. Most of the cancer care centres are overcrowded and patients wait for a long period to get their treatment.Dr Shabber Zaveri, Consultant – Surgical Oncology
Inequity is everywhere. From all walks of life, people worldwide are deprived of cancer care. Understanding inequity is the first step. One of the avoidable barriers is deeply ingrained prejudices in our cultures and healthcare systems.
Emerging technologies like AI are transforming cancer care, both in early detection and treatment. Ancient Indian medicine systems like Ayurveda gives importance to cure but also for prevention, it advises holistic approach through the concept of Rasayana (Rejuvinative therapy), Sadvrutta (Code of conduct), Satvavajaya (Psychotherapy). Need to focus on enhancing the adoption of such systems for giving holistic health care.
There are many contributing to raising awareness about cancer. Shiva Ravi, an ultra-endurance cyclist, is one enthusiast who decided to pedal from Chennai to Vizag to create awareness, raise funds for cancer care and encourage people to fight against cancer. We need many more such efforts.
This is the equity gap. Even though it is more pronounced in low- and middle-income countries, dramatic disparities are seen in prosperous societies also. And it’s costing lives and affects everyone. Ignorance is not bliss. As individuals, we have an essential role to play too. It is not about you and me. It is about everyone.
Yesterday is gone, tomorrow has not yet come. We have only today, let us begin.Mother Teresa
As Mother Teresa professed, yesterday is gone, and the consequences of tomorrow are yet to be known. We have today, and let us begin to close the care gap for cancer patients and families. It is our time to act now.
Close the Care Gap
Our time to act is now
The ToonLogs posted earlier on the theme can be accessed at: