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When cancer strikes, panic tends to set in. But the fear psychosis that is associated with the 'dreaded' disease is absolutely unwarranted. Cancer is no longer incurable if a patient reaches the right doctor at the right time. As treatment facilities improve by leaps and bounds in India, cancer specialists armed with state-of-the-art medical technology are increasingly helping patients lead better and longer lives. Cancer isn't the end of the road and public awareness is the key, leading cancer specialist Dr P K Das, Senior Consultant Hematology/Medical Oncology at Apollo Indraprastha Hospital New Delhi, tells TSI in the course of a long conversation touching upon various aspects of the disease.
Cancer is the second largest killer in the country, next only to heart ailments. Why?
In the next few years, India will become the cancer capital of the world. In fact, by 2020, every 12th person in the world will be affected by some kind of cancer. Today, cancer is a lifestyle-related disease. In the past, average life expectancy of was 50-60 years; now it has increased to 80-90 years. Longer lives mean long-term inconsistencies as well. People used to have tobacco, hukka and pan masala in earlier generations also, but cancer cases were low, because fast food, adulterated spices, artificial colours, preservatives, pesticides and carcinogens created by industrial pollution were hardly existent.
What are the different types of cancer?
In India, the most common cancers which affect males are prostate, lungs, mouth, bowel, bladder and stomach while women suffer from cervical, breast and ovarian cancer. Data reveals that tobacco chewing or smoking accounts for 50 per cent of all cancers in men. Among the main causes of cancer in urban women are late marriage and late pregnancies, no breastfeeding, excessive use of birth control pills, which may disrupt balance of hormones, having multiple sex partners and unhealthy sexual behaviour. You would find that women in rural areas are less prone to cancer because they are normally married by age of 18-22 years and become mothers at the age of 20-24 years. They actively breast feed their children and avoid birth control pills. Their lifestyle is relatively normal and their diet is better.
Is it possible to detect cancer in the early stages? What should be done?
Yes, cancer detected and diagnosed at an early stage can save a lot of patients. Preliminary tests need to be done regularly. Late detection and wrong diagnosis can have adverse effect on the outcome of cancer treatment. Consulting the right doctor at the right time is absolutely essential. How prepared are we in India to counter this fast growing epidemic?
We have world class hospitals like Apollo, AIIMS and Tata, and several other large private and government hospitals for cancer treatment. We also have world class doctors and specialists. However, our preparation to counter cancer is grossly inadequate compared to the growth rate of cancer in India. Many well known hospitals do not have dedicated oncology departments. Advanced facilities for cancer treatment are available only in big cities. Imagine, Orissa has only one cancer specialist! We have to enhance our resources for cancer treatment and take it to small cities and towns.
In your view, what should the government do?
The main problem is lack of public awareness, due to which lots of misconceptions about the disease have formed and hence people are scared of it. So, public awareness campaigns should be organised more often. Preliminary investigations of certain cancers are neither expensive nor complex. You just need to do an ENT test for face, nose, including head, throat, pap smear test for women, stool, mamograph and x-rays. Hospitals can give this cancer screening test facilities for Rs 2000 only. The government can facilitate this in district hospitals at a discounted rate of Rs 500-600 only. There are many terminally-ill cancer patients who don't get proper care and treatment and are neglected by their relatives and forced to die a painful death. The government should have palliative care facilities for such patients. Is there any cancer vaccine? What are the new technological advancements available to arrest the spread of cancer?
Normally vaccines are made for diseases that are caused by bacteria or viruses. That is why cancer vaccines are rare. Most women get cervical cancer due to human Papilloma viruses, so there is a vaccine for this type of cancer. And this vaccination is normally given to girls at the early age of 9-12 years. Vaccine for other cancers are being developed. New discoveries have led to better cancer treatment and the disease is not as fatal as it used to be. Targetted treatment in chemotherapy, I.G.R.T in radio therapy have brought revolutionary changes in the treatment of cancer. The cyber knife stereo tactic radio surgery system transmits small beams of radiation into a tumour and minimises healthy tissue's exposure to radiation. Now with a healthy lifestyle and active life, and regular medicines, cancer patients can survive for decades.These newer treatment options have not only added years to life but also life to years. I have numerous such examples in my clinical experience.
If that's the case, why hasn't the fear factor subsided?
Cancer spreads to other parts of the body very fast, and cancer spreading cells can have different impact on different parts of the body. To rectify this problem, medication is also different. Lung and oral cancer or blood cancer affect patients aggressively. End stage patients are given multidisciplinary treatment in cancer ' chemotherapy, surgery radio therapy, making the whole treatment very complicated. The incomplete knowledge, temporary toxicities and the cost of treatment methodologies also lead to unnecessary fears for patient and care givers. The development of insurance coverage and support from the government towards helping the treatment of poor patients would enable more patients to go in for necessary treatment well in time.
Have you personally made any efforts in spreading awareness?
I have been involved in many public awareness campaigns against cancer for over ten years. I make it a point to go to as many cancer awareness programmes as possible, be it in schools, colleges, private companies or NGOs. I have spoken to many hospitals in Punjab and the north-eastern states and done video conferencing with many patients there. I have also authored a book for public awareness. It has 100 FAQs regarding cancer and it is available free of cost.
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An array of unconventional career optionsWhen cancer strikes, panic tends to set in. But the fear psychosis that is associated with the 'dreaded' disease is absolutely unwarranted. Cancer is no longer incurable if a patient reaches the right doctor at the right time. As treatment facilities improve by leaps and bounds in India, cancer specialists armed with state-of-the-art medical technology are increasingly helping patients lead better and longer lives. Cancer isn't the end of the road and public awareness is the key, leading cancer specialist Dr P K Das, Senior Consultant Hematology/Medical Oncology at Apollo Indraprastha Hospital New Delhi, tells TSI in the course of a long conversation touching upon various aspects of the disease.
Cancer is the second largest killer in the country, next only to heart ailments. Why?
In the next few years, India will become the cancer capital of the world. In fact, by 2020, every 12th person in the world will be affected by some kind of cancer. Today, cancer is a lifestyle-related disease. In the past, average life expectancy of was 50-60 years; now it has increased to 80-90 years. Longer lives mean long-term inconsistencies as well. People used to have tobacco, hukka and pan masala in earlier generations also, but cancer cases were low, because fast food, adulterated spices, artificial colours, preservatives, pesticides and carcinogens created by industrial pollution were hardly existent.
What are the different types of cancer?
In India, the most common cancers which affect males are prostate, lungs, mouth, bowel, bladder and stomach while women suffer from cervical, breast and ovarian cancer. Data reveals that tobacco chewing or smoking accounts for 50 per cent of all cancers in men. Among the main causes of cancer in urban women are late marriage and late pregnancies, no breastfeeding, excessive use of birth control pills, which may disrupt balance of hormones, having multiple sex partners and unhealthy sexual behaviour. You would find that women in rural areas are less prone to cancer because they are normally married by age of 18-22 years and become mothers at the age of 20-24 years. They actively breast feed their children and avoid birth control pills. Their lifestyle is relatively normal and their diet is better.
Is it possible to detect cancer in the early stages? What should be done?
Yes, cancer detected and diagnosed at an early stage can save a lot of patients. Preliminary tests need to be done regularly. Late detection and wrong diagnosis can have adverse effect on the outcome of cancer treatment. Consulting the right doctor at the right time is absolutely essential. How prepared are we in India to counter this fast growing epidemic?
We have world class hospitals like Apollo, AIIMS and Tata, and several other large private and government hospitals for cancer treatment. We also have world class doctors and specialists. However, our preparation to counter cancer is grossly inadequate compared to the growth rate of cancer in India. Many well known hospitals do not have dedicated oncology departments. Advanced facilities for cancer treatment are available only in big cities. Imagine, Orissa has only one cancer specialist! We have to enhance our resources for cancer treatment and take it to small cities and towns.
In your view, what should the government do?
The main problem is lack of public awareness, due to which lots of misconceptions about the disease have formed and hence people are scared of it. So, public awareness campaigns should be organised more often. Preliminary investigations of certain cancers are neither expensive nor complex. You just need to do an ENT test for face, nose, including head, throat, pap smear test for women, stool, mamograph and x-rays. Hospitals can give this cancer screening test facilities for Rs 2000 only. The government can facilitate this in district hospitals at a discounted rate of Rs 500-600 only. There are many terminally-ill cancer patients who don't get proper care and treatment and are neglected by their relatives and forced to die a painful death. The government should have palliative care facilities for such patients. Is there any cancer vaccine? What are the new technological advancements available to arrest the spread of cancer?
Normally vaccines are made for diseases that are caused by bacteria or viruses. That is why cancer vaccines are rare. Most women get cervical cancer due to human Papilloma viruses, so there is a vaccine for this type of cancer. And this vaccination is normally given to girls at the early age of 9-12 years. Vaccine for other cancers are being developed. New discoveries have led to better cancer treatment and the disease is not as fatal as it used to be. Targetted treatment in chemotherapy, I.G.R.T in radio therapy have brought revolutionary changes in the treatment of cancer. The cyber knife stereo tactic radio surgery system transmits small beams of radiation into a tumour and minimises healthy tissue's exposure to radiation. Now with a healthy lifestyle and active life, and regular medicines, cancer patients can survive for decades.These newer treatment options have not only added years to life but also life to years. I have numerous such examples in my clinical experience.
If that's the case, why hasn't the fear factor subsided?
Cancer spreads to other parts of the body very fast, and cancer spreading cells can have different impact on different parts of the body. To rectify this problem, medication is also different. Lung and oral cancer or blood cancer affect patients aggressively. End stage patients are given multidisciplinary treatment in cancer ' chemotherapy, surgery radio therapy, making the whole treatment very complicated. The incomplete knowledge, temporary toxicities and the cost of treatment methodologies also lead to unnecessary fears for patient and care givers. The development of insurance coverage and support from the government towards helping the treatment of poor patients would enable more patients to go in for necessary treatment well in time.
Have you personally made any efforts in spreading awareness?
I have been involved in many public awareness campaigns against cancer for over ten years. I make it a point to go to as many cancer awareness programmes as possible, be it in schools, colleges, private companies or NGOs. I have spoken to many hospitals in Punjab and the north-eastern states and done video conferencing with many patients there. I have also authored a book for public awareness. It has 100 FAQs regarding cancer and it is available free of cost.
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