By Dr. MA Raja
Cancer is on the rise in India, with an estimated two million new cases in 2022. One in 10 Indians will develop cancer in their lifetime, and one in 15 will die from the disease. The World Health Organization (WHO) ranking puts India third in the world for the number of new cases per year, although other reports say this may be an underestimate, given the number of undiagnosed or misdiagnosed cases.
The Indian Council of Medical Research (ICMR) predicts a possible 12% increase in cancer rates in India over the next five years. According to the report on ‘Burden of Cancers in India’, seven cancers account for 40% of the disease burden: lung, breast, oesophagus, mouth, stomach, liver and uterine cervix (lower part of the uterus). Breast cancer, in particular, accounts for about 25 percent of all cancers in women. The reasons for the increase in various cancers are many. First, life expectancy in the country has gone from about 45 years in the 1960s to almost 70 now. The longer a person lives, the incidence of cancer automatically increases. Tobacco and alcohol cause many types of cancer. He estimated that more than a third of all cancers would be stopped if tobacco were completely eliminated. In recent decades, a number of new risk factors have emerged, including diet, obesity, sedentary lifestyle, pollution and infection.
Is it all doom and gloom? Definitely not. To effectively counter and reverse the previous trends, a two-pronged strategy is essential. First, measures to reduce the risk of cancer must be implemented systematically, throughout the country. This will involve better education of the public, starting with school children, awareness campaigns about the potential harm of tobacco and alcohol, improving physical condition by encouraging healthier eating habits – more natural foods, reducing high-fat foods and regular consumption of red meat, increasing consumption. vegetables and fruits, eating in moderation, improving cooking methods, regular daily exercise, avoiding obesity, combining efforts and prioritizing pollution reduction/elimination.
The second approach is to make cancer treatment more accessible, affordable and to educate people about early cancer screening and available treatments. That cancer is an inevitable death sentence with inevitable suffering is no longer accepted. About two-thirds of people with cancer survive more than five years, which will improve with early diagnosis and more timely treatment. For example, early breast cancer diagnosis in India is around 30 percent, while in the US it is over 80 percent. Paradigms of cancer management have been changing over the decades as new knowledge emerges.
Historically, surgery was the first modality used in the treatment of cancer. At first, it was thought that cancers spread centrifugally, like ripples caused by a stone in water, which led to extensive, often mutilating procedures. When it became known that cancers mostly spread through blood, surgery became more conservative. This led to better cancer outcomes, better functioning of the concerned organs and improved cosmesis (appearance). The same is true of radiation oncology, the second available treatment modality. With smaller radiation fields and new machines that deliver high-precision beams, the immediate toxicity of common nearby problems is becoming negligible, and more serious long-term sequelae such as second cancers, major organ dysfunction, are becoming a thing of the past.
The third and most commonly applied treatment is medical, with the awareness that cancers are more widespread than we think and that medical therapy can eradicate even microscopic diseases that are not visible anywhere in the body, unlike surgery and radiation, which require visible, defined and necessary targets. to be successful It was the first chemotherapy to break down cancer cells, and it still remains the basis of many cancer treatments. With advances in molecular biology, therapies specifically targeted against gene alterations responsible for promoting a particular cancer are becoming increasingly successful. Cancers can grow
blocking a person’s immune system, and a new class of drugs that can undo that block, called immunotherapy, is widely used in clinical practice. Next is genetic engineering to restore the gene abnormalities that trigger cancer. So the march to conquer cancer is steady but sure.
Dr MA Raja, Senior Consultant, Medical Oncology, Director of Oncology Services, MGM Healthcare
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