Context

According to data shared by the annual Health of Nation report by Apollo Hospitals, India is rapidly emerging as the “cancer capital of the world”.

Rise in Non Communicable Diseases in India

• Rise in Non Communicable Diseases in India: The report sheds light on the rise of Non-Communicable Diseases (NCDs) in India, which significantly impact the nation’s overall health.
  • These NCDs include cancer, diabetes, hypertension, cardiovascular diseases, and mental health issues.

What Is Cancer?

• Cancer: It is a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body. 

• Mechanism: Cancer starts when a gene or several genes mutate and create cancerous cells. These cells create cancer clusters, or tumors. 

Status of Cancer Cases in India

• NCD-Related Deaths: Around 63 percent of all deaths in India are due to NCDs. 
• Economic Cost of Cancer: By 2030, these diseases are projected to cost India $3.55 trillion in lost economic output.
• Median Age for cancer diagnosis in India: The median age for cancer diagnosis in India is lower than in other countries.
• Cancer Screening Rates in India: Cancer screening rates in India remain very low. Ex-Breast cancer screening in India is 1.9% compared to 82% in the US, 70% in the UK, and 23% in China
• Extrapolation of Western data in India:  The report highlighted the threshold for Prostate-Specific Antigen (PSA) – a blood test – in Indian men was different from the current standards suggesting the need for local data.
• Rise in Colon Cancer: The hospital found that colon cancer cases were increasing among young people, with 30% of colon cancer patients at Apollo Hospitals aged less than 50 years.
• Rise in Prostate Cancer Cases in India: According to the Latest Lancet Commission paper, prostate cancer accounts for three per cent of all cancers in India, with an estimated 33,000-42,000 new cases diagnosed annually.

Reasons for Rise of Cancer Cases in India

• Smoking and Alcohol Use:  Smoking, alcohol use, high BMI (Body Mass Index) and other known risk factors were responsible for over 37% of cancer deaths in India in 2019, as per Lancet report.
• Obesity: Studies have linked it to an increased likelihood of breast, colorectal, pancreatic, and kidney cancers.
• Unhealthy Diet: An unhealthy diet that is high in fat, and low in fibre may increase the risk of many cancers including bowel, lung, prostate and uterine cancers.
• Stress: Chronic stress can have disastrous effects on your health, including an increased risk of cancer.
• Poor Oral Hygiene: Chronic inflammation and infections in the mouth, often associated with poor oral hygiene, have been linked to an increased risk of oral cancers.
• Occupational and Environmental Exposures: Exposure to certain chemicals and toxins in the workplace or environment, such as asbestos, benzene, and radon.
• Infections: Certain infections, such as human papillomavirus (HPV), hepatitis B and C viruses, and Helicobacter pylori, are linked to an increased risk of specific cancers.
• Others: Lack of Physical Activity, Excessive Sun Exposure

Need for Early Cancer Awareness and Detection

• Lack of Symptoms: For example, Prostate cancer may cause no signs or symptoms in the early stages and it is only in the advanced stages that patients report symptoms.
• Regular Screening: Although lifestyle can be managed, early screening in Indian men, especially those above 60 years, are required. 

Challenges with Cancer Care in India

• Access to Radiotherapy: There are inadequate radiotherapy facilities in India and most of them are concentrated in  urban areas.
  • The WHO recommends one megavoltage radiotherapy unit per million people. 
• Shortage of Opioid Use for Pain Relief:  In 1985, the legislation to regulate narcotic misuse and trafficking decreased the  medical use of morphine by 97 percent which severely limits access for pain management. 
• Lack of Sufficient Infrastructure and Resources:  The healthcare facilities lack the necessary equipment, trained personnel, and treatment options required for comprehensive cancer care. 
• Affordable Cancer Treatment: The high cost of cancer drugs push patients and their families into financial distress. 
• Shortage of Skilled Oncologists and Healthcare Professionals: It affects the delivery of cancer care and contributes to disparities in access to specialized treatment.
• Social Stigma: The stigma attached to cancer can lead to isolation and discrimination, severely impacting the mental health and well-being of patients. 

Initiatives for Cancer Treatment and Prevention in India

• CAR T cell therapy:  India’s first home-grown gene therapy launched for cancer at IIT Bombay.
  • It is the world’s most affordable CAR T cell therapy.
• First Cancer Care (FCC) initiative: Introduced in 2022, it utilises advanced technology to transform cancer prevention and treatment, focusing on quality, timeliness, precision, and fairness. 
• Tertiary Care Cancer Centres (TCCC) scheme: It aims to set up state cancer institutes and tertiary care cancer centres across the country to improve facilities for cancer treatment. 
• ProHealth Score: It is a digital health risk assessment tool for assessing an individual’s health and well-being, and evaluates factors such as family history, lifestyle and current symptoms.

• Other Initiatives for Cancer Treatment and Prevention in India:

• • Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY)
  • National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases & Stroke (NPCDCS)
  • Rashtriya Arogya Nidhi (RAN)
  • State Illness Assistance Funds
  • Health Minister’s Cancer Patient Fund (HMCPF)
  • Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) 

Way Forward to Cancer Prevention and Control in India

• Investment in Research and Development: Investment in research and development is needed to discover and develop innovative cancer treatments. 
• Collaboration with Healthcare Providers: Collaboration between pharmaceutical companies and healthcare providers is essential to ensure the effective delivery of cancer care. 
• Patient Assistance Programs: This includes offering discounts, subsidies, or access to free medications for eligible patients, thereby reducing the financial burden of cancer care.
• Streamlining Regulatory Environment: The regulatory authorities need to streamline the approval process for cancer drugs and ensure timely access to innovative therapies.
• Public awareness campaigns: Concerted efforts are needed in the form of awareness campaigns, community engagement programmes, and educational initiatives.