Professor Goura Kishor Rath - All India Institute of Medical Sciences, New Delhi, India
Cancer prevention and treatment in India
India has about a 1.1 billion population, and we have 900,000 new cancer cases in a year. At any time, we will be having 3 million prevalent cases. Every year, 400,000 die due to cancer. The major problem also comes from the fact that 45% of all these cancers are tobacco-related. The people in our country are habituated to tobacco in many forms. They smoke of course, and they chew tobacco, they keep tobacco in their mouth, sleep overnight. Because of all these things 45% of all cancers like cancer of the head and neck region, the lung and stuff like this are tobacco-related. And basically they are preventable cancers.
In fact another major problem which I should add here is that about 80% of these cancers out of these 900,000 cancers present in stage three and four, that is also another problem. Only 20% of them present early. We teach our students the formula of 80 and 20, that says that 20% of cancer in our country presents early, out of which 80% can be cured; and 80% present late, out of which only 20% can be cured. That is why cancer is thought to be so bad. It is not actually so bad if they come early.
And we have a national cancer control programme in this country and that programme is running well. The major objectives and aims of this programme, number one is prevention of the preventable cancers, like tobacco-related cancers can be prevented just by stopping tobacco. So that programme is having an effect gradually. The second preventable cancer in our country is cervical cancer. As you know, cervical cancer is a virus-related cancer, HPV16 and 18. And in our ladies, cervical cancer is number one. So what is being done now is health education programmes are being promoted, propagated; we are now trying to propagate hygiene, good personal hygiene, so that you can avoid this HPV16 and 18 contact by these persons.
The second aim of the programme is the early detection of the several early-detectable cancers. I can tell you that almost 60% of cancer can be detected early in our country, and are being detected with this programme. The early cancer of the head and neck region, like tongue, mouth, cheek, breast, cervix, all these cancers can be detected early, so that is the second aim of the programme.
Third is the augmentation of the treatment facilities. Treatment facilities which mainly include the surgery, radiotherapy and chemotherapy are being augmented. And the next aim is the palliative care. Many patients in our country require palliative care so what the plan aims is to provide palliative care on their doorsteps, giving them morphine, practically free of cost, and giving them other facilities which alleviate their pain and symptoms. So these are the major problems.
The problem which we are facing right now is the number, the large number, a population of 1.1 billion, and 900,000 cases. Gradually we are trying to tackle this problem, but it will take some more time until all the problems are tackled.