People have wondered, on more occasion than one, whether cancer may be the post-modern equivalent of the Black Death. As one of the world’s most steadily proliferating ailments, cancer has killed over 8 million people annually in recent years. More than radiation and surgery, the key to a cure often lies in early detection. Yet in developing countries like India, screening and early detection remains a challenge.
Pune-based oncologist Dr. Shona Nag has made it her mission to encourage everyone to understand cancer better, particularly women.
Dr Shona, who wanted to be a doctor since she was 10, chose oncology when she lost her father who was suffering from cancer. It was the late 80s and she accepted a fellowship in oncology at Mumbai’s Tata Memorial Hospital, followed by a stint in Australia.
On her return she became the first doctor to start clinical trial units in Pune. Under her aegis Nag Foundation—formed in 1989 to promote art and culture — reinvented itself as a cancer research foundation. “We believed that we needed more investigator trials as there is not enough study done on Indian patients,” she says, emphasizing on the need for cancer research that focuses on India.
As she discovered, inadequate infrastructure combined with social taboos had led to a crisis in cancer detection and treatment in India. Women are often at a greater risk. “In India, we do not take our health seriously. Especially women,” she says. “Our health is not a priority and we do not take care of ourselves, always giving in to family, time they need and more. I’ve seen cases when the woman has cancer – the whole family falls apart. We see women coming to chemotherapy while they are breastfeeding and what a burden it places on the entire social fabric!”
Dr. Shona uses outreach and multimedia activities to rope in women from all walks of life in her initiatives.
The focal point of their outreach programmes is breast cancer. “Breast cancer remains the most common form of cancer for men or women,” Dr Shona says. One in every 25 woman in India is a patient. For me, it’s a social issue and the largest disease impacting us and hence deserves the attention.”
The foundation runs support groups for women survivors from cancer, with a campaign titled Breast Friends Pune. Monthly meetings encourage the women to share their stories and spread information on the subject. “All our survivors are ambassadors for us,” Dr Shona says. “They influence and help others with early detection and awareness especially in their peer groups.”
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The Foundation has created calendars and cookbooks in collaboration with the women. It also recently produced In & Above Her Heart, a documentary on two breast cancer survivors, which has been screened at festivals around the world.
Dr. Shona hopes to use information as the starting point to understanding the terminal disease, whose detection and treatment is hindered by several factors in India.
Patients hesitate, seek opinion from other doctor or opt for alternative treatment methods, and often come back for treatment in an advanced stage. Those belonging to the poorer sections of society are unaware of even basic detection practices, and also lack the resources for treatment.
“Unlike the West, there is no accountability, no health insurance from the government,” Dr Shona says. “Here, any treatment has to be paid from your pocket. Health insurance companies are stepping up but they do not cover too much. A Rs 5 lakh cover can only take care of a third of the cost and doesn’t cover a relapse or when cancer returns. Existing cancer patients do not get any health cover at all.”
The Nag Foundation offers subsidized chemotherapy and radiotherapy for underprivileged patients. In 2016, the team raised funds to subsidize 10 cancer surgeries, 10 radiations and over 120 chemotherapies.
The Foundation also trains volunteers and local citizens to spread the word. The Foundation recently set up a six-month camp in the city’s Thite basti to screen the area’s 350 women residents for cervical and breast cancers. “What the team understood was how the conversations need to figure around their extremely busy and pressured lives,” Dr. Shona says. “They don’t have time to have lunch. They are battling alcoholic husbands, issues of multiple partners, tobacco and more.”
Knowledge can be the ultimate gamechanger for cancer treatment, and Dr. Shona encourages awareness over everything else. She says, “Should breast cancer or cancer awareness strike a chord, then give it your attention. Teach people around you how to check for symptoms. Give time or a meal or transport to someone undergoing cancer. Even if you share discussions or posts on social media – you create awareness. Do whatever you can!