Know it, to control it

Infrastructure for cancer care in India

According to a recent report, roughly one million new cases of cancer are diagnosed every year in India.

However, fewer than 30 percent of Indian patients with cancer survive five years or longer after diagnosis. This means, nearly 70 percent cancer patients succumb to this disease. Yet, the provision of adequate infrastructure and health personnel remains a serious obstacle in ensuring proper care to cancer patients.

There are approximately 2500 trained oncologists including both Radiation and Medical oncologists in the country. They are concentrated in metropolitan cities. The undergraduate program does not have training in cancer management as one of the core subjects and this leads to lack of awareness of symptoms/signs of cancer amongst the general practitioners. This shortage is particularly problematic in rural regions and in north India. Not only doctors, well trained nurses, technicians etc are also a continuing challenge. This results in more than 50% cancers, presenting in stage III-IV where the cure rates are <40%. We do not have any national screening program nor do we have the infrastructure to do the basic diagnostic tests for cancers at the state level.

As per a study in 2010, India needs at least 1000 cancer centers, against 250 in existence. The government has many regional cancer centers, where the poor can avail treatment, but they are equally stressed due to lack of manpower, infrastructure or funds. The investment in high technologies is more concentrated in the urban tertiary hospitals, thus depriving the poor rural patients.

Delayed diagnoses and inadequate, incorrect, or sub-optimum treatment are the other key factors for poor cancer survival in India. Nearly 92% patients from rural households first consult health care givers, 79% of whom are not qualified in allopathic medicine.

Furthermore, the care provided at many cancer centers is often not standard of care but is dictated by the facilities available. A linear accelerator, used for radiation treatment, costs about Rs 7 crore or more. It is difficult to set up such advanced facilities in rural areas because of lack of electricity and infrastructure. For example, many centers across India do not have access to radiotherapy, resulting in a ratio of 2.5 million people per radiotherapy machine.

With concerted efforts to upgrade existing infrastructure and trained health-care staff, the regional or tertiary cancer centers will be capable of providing quality treatment for patients diagnosed with cancer.

Extending an Integrated approach the health care givers can join hands across the various streams of medicine, including Allopathy, Homeopathy, Ayurvedic, Sidha and Unani to approach the cancer problem in the country.

The Indian Cancer Society has initiated Prashanti, the healing centre, which offers holistic treatment to overcome trauma of cancer and its treatment. These include Pranayama, Yoga, Laughter Therapy, Reiki, Reflexology, Massage, Visualization, Guided Meditation and Acupressure.

It is expected that holistic treatment may help improve the recovery from cancer treatment and/or increase the immunity of a person and prevent to cancer from relapsing.