Harish Barthwal
Due to its successively rising prevalence, exorbitant cost of treatment and high mortality, cancer continues to be a challenge for the doctors, health planners and others. Despite huge spending on research, surveillance and treatment of cancer, only 70 per cent of those living with this dreaded disease survive five years from its onset.
Most of the treatment modalities viz. chemotherapy, surgery and radiation entail much pain and severe side effects. Admittedly, a little relief has been witnessed in countries like the US, Denmark, Sweden and Slovakia with new, less toxic and less painful therapies. Yet, the overall condition worldwide continues to be grim.
In India, depending on the type and location of cancer, the therapy being administered and the type of hospital, one may have to shell out between Rs 90,000 to Rs 28 lakh. And mind that not all patients are medically insured or able to afford it.
A couple of years back, The Lancet, based on 2016 findings, reported progress in managing cancers and some decline in mortality due to cancer in a few developed countries. Yet, overall it remains a serious health threat worldwide. Globally, WHO attributes around 10 million deaths to cancer in 2020, highest in breast cases (2.26 million) followed by lung (2.21 million cases), colon and rectum (1.93 million cases), prostate (1.41 million cases), skin (1.20 million cases) and stomach (1.09 million cases).
Unpredictable movement of cancer cells and its rapid growth without a set pattern transmit to other body parts, damaging the normal cells; this is unlike behaviour of normal cells. “Cancer cells come pre-programmed to … facilitate both their enhanced survival and their dissemination through the bloodstream. There is an air of conspiracy in the way tumours use chemical signals to create cancer-friendly niches in remote organs,” says Paul Davies, professor at Arizona State University. To worsen the management of cancer, most cases are detected in late stages due to horrendous lack of awareness among people.
Women particularly hide the problem, and are brought to the surgeon when the tumour stretches 8-10 cm long. Public awareness on cancer together with expanding and strengthening screening centres is thus first priority in managing cancers. Yet, the third hurdle in managing cancer in most developing countries is the resource crunch. India spends less than half of what it should be doing on cancer care, regret the experts.
The Agency for Research on Cancer (IARC), the monitoring arm of WHO, implicates physical carcinogens (like ultraviolet and ionising radiation, chemical carcinogens (asbestos, tobacco components, smoke, alcohol, aflatoxin (food contaminant), and arsenic (potable water contaminant); and biological carcinogens (like infections from viruses, bacteria, or parasites) that have increasingly imbued our entity all around.
Cancer survival rates vary from country to country. However, higher five-year relative survival rate for most cancers combined have been reported in Australia, New Zealand, Ireland, USA, Canada, Norway, Netherlands and Switzerland. Cancer is attrition of healthy cells due to little or no activity over time. Body parts and organs that remain active are able to maintain blood flow essential to stay fit and kicking.
Ironically, the close ones of the family and others ostracise the cancer patient when additional moral support is needed. Separation from mainstream activities only exacerbates the agony. The patient should be told, as William Arthur Ward, “Mountains are created to be conquered; adversities are designed to be defeated; problems are sent to be solved”.
Further, little gestures like keeping conversations normal, delivering the meals when required, accompanying to health facilities, supplying essentials, and involving them in different activities trigger good sense and facilitate recovery.
(The author blogs on health,
social and other issues)
