Cancer continues to be one of the biggest health risks in India. Fortunately, there’s a whole new range of advances and tools that are boosting the fight against this deadly disease. Dr. Preeti Choudhary takes a closer look.
There is no doubt that cancer today is a major threat to society. Projections by the Indian Council of Medical Research (ICMR) peg the expected total number of new cancer cases in India to be around 14.5 lakh in 2016, and according to them, the figure is likely to reach nearly 17.3 lakh new cases in 2020. Over 7.36 lakh people are believed to have succumbed to the disease in 2016, while the figure is estimated to shoot up to 8.8 lakh by 2020. As per Globocan, there is now a 7.05 % increase in new cases in comparison with statistics published in 2008. What is scary is that data has revealed that only 12.5 % of patients come for treatment in early stages of the disease. Late detection is the cause of 70 % of cancer deaths in India.
These numbers are really grim, but the way to halt their increase is by strengthening our diagnostic capabilities. It seems that all is not lost, as advancements in diagnostics and screening are promising a better future for prevention and management of cancer.
How does screening help?
Screening can help doctors detect certain cancers early, when they are most likely to be curable, and this greatly increases the chances for successful treatment. Education to promote early diagnosis and screening is an important factor—recognizing possible warning signs of cancer and taking prompt action leads to early diagnosis. Increased awareness of possible warning signs of cancer—among physicians, nurses, and other health care providers as well as among the general public—can have a great impact on the disease.
Some early signs of cancer include lumps, sores that fail to heal, abnormal bleeding, persistent indigestion, and chronic hoarseness. Early diagnosis is particularly relevant for cancers of the breast, cervix, mouth, larynx, colon and rectum, and skin. Examples of screening tests include mammograms to find breast cancer, and colonoscopy to find colon cancer. Screening tests, diagnostic tests, medical exams, and self-exams all help detect a disease or other health problem early in its course before symptoms appear.
Take cervical cancer, for example
It is well known how the pap smear test changed cervical cancer detection and improved survival rates. Screening has reduced deaths from cervical cancer, as doctors have been able to find cancer early and treat it, or prevent it from ever developing. Researchers continue to find out more about what causes cervical cancer, and the best ways to screen for it.
There are two types of tests used for cervical cancer screening. The Pap test can find early cell changes and treat them before they become cancer. The HPV (human papilloma virus) test finds certain infections that can lead to cell changes and cancer. Given the benefits of these screening tests, the latest screening guidelines recommend that all women should begin cervical cancer screening at 21, and women between the ages of 21 and 29 should have a Pap test every three years.
The good news is that now, with availability of new, more efficient technology—LBC (liquid-based cytology)—the turnaround time and sensitivity is even better. Plus, it has a much better HSIL (high risk pre-cancer) detection rate too. So basically, for a woman, this new technology means quicker results, and a better chance at picking up a positive case. That’s how important right diagnostic tools and their continued evolution is.
The breast cancer epidemic
India is experiencing an unprecedented rise in the number of breast cancer cases across all sections of society. There is no way we can prevent breast cancer, but we can definitely detect it early and treat it adequately. Only with early diagnosis and detection can we achieve longer survival. To make people aware of this early detection, a lot of effort is required, especially since Indian society is so deep-rooted in myths and alternative treatment, and unusual illogical beliefs. It will take a lot of time to reverse this and get people on track. The time is now.
Presently, India already has one of the worst survival rates for breast cancer in the world. For the year 2015, there were an estimated 1,55,000 new cases of breast cancer, and about 76,000 women in India died of the disease. Yes, India has the highest number of women dying from breast cancer in the world. Things seem worse for other cancers too. The gap (between us and health care delivery in other countries) only seems to be widening with time, which means, we need to work very aggressively to strengthen our early detection prowess.
Future seems better
Thankfully a lot of new tests are changing the cancer diagnosis landscape. New cancer markers CA 15.3 (often elevated in breast cancer), CA 19.9 (for pancreatic or stomach cancer), CA 125 (measured for cancers of the reproductive system), and Carcinoembryonic antigen (CEA), a cancer marker to screen for colorectal cancer, are helping the care givers and doctors screen better. DR-70 is another new test that is a landmark discovery. It is a simple blood test that screens for 13 different cancers at the same time, and is also now available.
What is important now is to ensure that the new innovations happening worldwide and indigenously reach our people in time, so that we can win the battle against the deadly disease, and help check-mate it timely.
(The author is a Senior Consultant – Radiology at Jaipur Golden Hospital. She has almost two decades of experience in the field of radiology, and has published several high-level papers. Prior to this, she served as the Head of the Department of Radiology at Dr. Lal PathLabs.)
For more information or assistance, contact the author via email.