Need of the hour: Addressing Challenges in Cancer Care
Shomali Johri & Manju Mulchandani, Co-Founders, Life Wins Foundation
We hear the word cancer and feel that nothing can be done to prevent it. But many cancers are preventable. As per experts, adopting a healthier lifestyle like eating a balanced diet, regular physical activity and most importantly avoiding use of tobacco in any form can have a major impact on reducing the chance of cancer in our lifetime. However cancer is a disease that is constantly on the rise in the modern world. It is the second most common disease after cardiovascular disorders causing maximum deaths in the world. In India too, the scenario of cancer is worrisome and has seen a remarkable increase in its incidence in the last few years.As per GLOBOCAN more than 1 million new cases of cancer are reported in India every year. As per doctors, cancer patients are more susceptible to coronavirus now as they are in an immunosuppressive state because of the malignancy and anticancer treatment. Hence detection of coronavirus infection early is more important as cancer patients are at much higher risk for unfavorable outcomes.
Unfortunately, the burden of cancer is not the sole point of concern in our country. Despite Indian oncology attaining various breakthroughs and advancements over the past years, few basic concerns have remained the greatest challenges in cancer care. Identification of each of these barriers is a must to tackle and overcome them in order to establish comprehensive care towards cancer. Here are a few key challenges that require immediate attention of the stakeholders.
Low awareness: This is a major area of concern as low awareness in India leads to late detection and treatment of cancer that claims a majority of lives. As per experts, the leading cancers in India like breast, cervical and oral cancers can be completely cured if detected early. However, lack of awareness leads to delayed identification of the symptoms and most patients are not adequately informed about the symptoms, prevention and diagnosis of cancer in the country. Hence one of the first steps for better cancer care is to bring more awareness about cancer and help them overcome the stigma around it.
Lack of access & infrastructure: Nearly 70 percent of the population in India resides in rural areas where there is a severe shortage of cancer care facilities and healthcare professionals. Despite the leaping cancer burden, India suffers from inadequate infrastructure that can support the required pace of detection, diagnosis and treatment of the chronic issue. The skewed geographical location of the tertiary cancer center is creating a dip in the percentage of people receiving proper treatment owing to a severe disparity in the resource allocation. For diagnosis, medicines and ongoing treatments, many patients have to travel a few hundred kms. This becomes a major deterrent. Travelling back and forth or staying in a new urban city takes a toll on the physical and mental health of the patient.
Dearth of oncologists: We have very few oncologists compared to what is needed to treat and manage the cancer burden. Hence, the dearth of oncologists makes it extremely difficult to offer adequate delivery of treatment in rural areas as most of the oncologists are concentrated in tier 1 cities. Even with the increasing cases, the country is facing severe shortage of care – givers with approximately 2000 oncologists for a population of 1.3 Billion.
High diagnosis and treatment cost: Cancer treatment in India is very expensive and remains out of the bracket of affordability for middle – and low-income groups. Starting from detection to treating procedures (surgery, chemotherapy and radiotherapy) to follow-up procedures to palliative care, cancer treatment leads to whopping cost, thereby claiming lives among the economically weaker section of the population compared to the wealthy. The economic burden comes hand-in-hand for families fighting cancer as both, the diagnostics, as well as treatment costs, are extremely expensive.
Call to action
Over the last few years, cancer treatment has seen tremendous progress. While there has been an eventual growth in investment in cancer care centres across the country in the urban areas, tier 2, tier 3 cities and the remote villages continue to remain deprived of proper investment in cancer care. India needs a greater number of cancer treatment centres compared to what it has now. Hence one of the ways to address the lack of access to cancer care is by creating treatment facilities in rural locations. While a lot of initiatives by the government have provided affordability, it needs to be supported by reforms that encourage medical professionals and infrastructure in tier 2 and 3 cities. A partnership model between large hospitals and smaller hospitals in rural areas can help in building cancer care infrastructure.
Technology can play a key role in creating better access to cancer care. With internet penetration in rural areas, it’s now easier than ever before to have a virtual consultation with doctors. Companies offering second opinions in vernacular languages have made rural communities a bit closer to the solution stage, and they help the patients to understand and guide through the treatment journey. Notwithstanding the medical breakthroughs, cancer care also requires a holistic approach. Many patients even after recovery, continue to face several psycho-social problems that impact their normal lives. Education of the community at large about cancer risks should be expanded, along with cancer screening and other preventive strategies that need greater emphasis for early detection.
Across the world, there are many funds and grants being established to tackle the impact of Covid-19. In a circular recently, the ministry of corporate affairs (MCA) announced that funds spent on measures to tackle the Covid-19 outbreak will be counted towards the corporate social responsibility (CSR) activity of companies. Hence this has impacted the funding of many companies towards cancer care. Many patients suffering from curable cancers are helpless due to lack of funds.The coronavirus has triggered a funding crisis for NGOs and the economic downturn also means future aid budgets and donations are likely to decline. We should devise a strategy to ensure funding for NGOs working towards cancer care by giving them a fair chance to fight cancer.
The old proverb “prevention is better than cure” applies to cancer. No matter where we are in our journey, it’s never too late and there’s always hope for new beginnings. No matter what the statistics say, there is always a way.
