The Incidence of Cancer cases and deaths is rapidly rising in India and is a Serious Public Health Problem. Across all States, cancer is emerging as a major public health threat and is one of the leading causes of deaths in India. Every year nearly three million people suffer from cancer and over seven lakh people die due to this life threatening disease.
According to the Indian Council of Medical Research (ICMR) data, in 2016 the total number of new cancer cases is expected to be around 14.5 lakh while Over 7.36 lakh people are expected to succumb to the disease.
The number of cases are likely to increase to 17.3 lakh while about 8.8 lakh deaths are likely to be reported.
There are many types of cancer. Of all the forms of cancers, Breast cancer, Lung cancer and Cervix cancer are ranked the highest in terms of putting patients at high risk of death.
Among males, there was also a significant increase in the cases of cancers of colon, rectum and prostate, while among women there was a significant increase in the rate of cancers related to breast, uterus, ovary and lung.
Currently, the number of breast cancer is estimated 1.5 lakh (over 10 per cent of all cancers) — the number one cancer overall. Cancer of the lung is the next estimated to be 1.14 lakh, about 83,000 cases in males and 31,000 in females).
Cancer of the cervix is the third most common cancer with estimated 1 lakh new cases which are likely to increase to 1.04 lakh in future.
Cancers associated with the use of tobacco account for about 30 per cent of all cancers in males and females, the ICMR said and unless addressed will continue to be life threatening.
Environmental factors such as air and water pollution, and pesticides are also related to cancer.
The first signs of cancer in infected patients are a lump in the breast, change in digestive and bowel movement, persistent cough, excessive blood loss as well as weight loss.
The magnitude of the problem in these infectious diseases is closely related to unhealthy dietary habits physical inactivity, stress as well as consumption of tobacco use and alcohol. While diets high in fat are associated with obesity, which increases the risk of endometrial cancers, breast cancer, colon, prostate and kidney cancer.
Smoking tobacco causes oral cancer, lung cancer and kidney, bladder, pancreas and stomach cancer. About 48% men and 20% women have lung cancer due to tobacco.
The primary cause of death due to Cancer is because most patients do not come for treatment at the early stages of the disease. Due to lack of awareness and failure to undergo timely screening, which is an important factor for survival of patients, the delay in getting medical care and treatment leads to death.
The Indian Council of Medical Research (ICMR) data shows that only 12.5 per cent of patients come for treatment in early stages of the disease, who are therefore able to survive. On the other hand, it is clear that lakhs of people are battling the disease and facing death due to poor access to early diagnosis, treatment and care.
Besides, it has been found that many patients have been denied complete treatment at the hospitals.
Since more than one-third of patients do not appear to receive cancer treatment, patients have to go elsewhere for treatment
Therefore, across several states, the situation remains grim. For instance, the northeast reported the highest number of cancer cases in both males and females. Aizawl in Mizoram reported the highest number of cases among males while Papumpare district in Arunachal Pradesh recorded the highest number among females.
Cancer of the uterine cervix has been the most common cancer among women in India. However, breast Cancer in women is emerging as the leading cancer in women. A familial history of breast cancer in the mother or in a sister can also cause breast cancer.
The new disease that has a serious health impact is mouth cancer, which is also impacting both men and women. In western states, mouth cancer is wide spread in men. It it has been found that East Khasi hills in Meghalaya recorded the highest number of cases of mouth cancer among women.
Childhood cancer incidence appears to be increasing in India as well. In India about 70% of children with cancer die due to lack of awareness, late detection and late diagnosis as well as inadequate paediatric cancer treatment facilities and lack of supportive care.
Across states a large number of children have been found to be prone to cancer. The proportion of childhood cancers relative to cancers in all age groups varied between 1.2% and 10.5%. The relative proportion (out of all childhood cancers) in the age group 0-4 varies across states.
The relative proportion was lowest in boys in Guwahati where 1.7% boys reported cancer. However, for girls the numbers were higher. About 48.1% girls reported cancer. In Dibrugarh, Assam while 1.2% girls reported cancer 43.8% boys reported cancer.
Whereas in New Delhi 10.5% boys reported cancer, in Chandigarh, 6.3% girls reported cancer. In Mumbai, 33.7% in boys reported cancer while 34.1% girls had cancer.
In Childhood different types of cancer afflict children. While Leukaemia is the predominant form of childhood cancer in both boys and girls, Lymphomas is a common malignancy in boys and girls were found to have brain tumors.
The other forms of cancer causing diseases are Retinoblastoma, Renal Tumours, Hepatic Tumours, Bone Tumours, Soft-Tissue Sarcomas, Germ-Cell Tumours, Carcinoma and other Malignancies, which severely impacts children.
According to ICMRs data, one in eight Indians is likely to develop cancer in their lifetime. However in North East State like Mizoram, it has been found that in Aizawl the chances are one in four. So far, the total number of patients who have received complete treatment and their treatment status was not known.
Overall it has been found that more than one-third of patients do not appear to receive cancer directed treatment, therefore these patients are driven to go elsewhere to receive treatment, which is often of poor quality.
Prevention and control of Cancer.
Prevention is the most effective method to control cancer cases. In order to prevent the rising number of cancer deaths, steps that need to be taken are early detection, timely diagnosis and treatment as well as provision of Palliative care.
Besides, lifestyle and behavioral change also plays an important role in preventing cancer.
For instance, proper intake of healthy food, engaging in physical activity and stress management can curb the growing number of cancer cases. Reduction in the intake of high calorie food, especially fatty food and consumption of healthy diet rich in green and yellow vegetables and fruits and unprocessed food has a preventive role as it reduces the risk of colon cancer, breast and prostate cancer.
Intake of Vitamin A and Vitamin C nutrients also has a protective influence on lung cancer and stomach cancer and prevents infections. Besides, increasing physical activity also needs to be part of comprehensive cancer prevention strategy.
To prevent Stomach Cancer it is essential that diets high in fruits and vegetables particularly raw vegetables, citrus fruits and vegetables, foods with high levels of carotenoid, high vitamin C intake and green tea is consumed. Such dietary supplements will ensure the patient is healthy and safe.
Prevention of Cancer in Women
Cancer of the uterine cervix can be controlled to a certain extent by practicing genital hygiene and safe sexual practices.
Regular Cervical Pap Smear tests should be done routinely for women to detect the cancer at the earliest.
Besides regular breast self-examination by women can also detect breast cancer in early stages. Mammography in women older than 50 years is also useful in early detection of cancer.
Addressing Childhood Cancer Cases
Cancer causes inability in children to learn. It is essential that they are provided timely adequate treatment and care to provide knowledge as well as ensure their well-being. Children have the right to good quality health care, clean water, nutritious food and a clean environment so that they will stay healthy.
Cancer Protection for Men
Lung Cancer continues to be a major health risk among men and survival from lung cancer is poor. The steps that need to be taken to prevent disease and death is to stop tobacco smoking, and drinking alcohol.
Apart from banning tobacco smoking, reduction in exposure to occupational and environmental carcinogens in particular indoor pollution, increase in consumption of fruits and vegetables and regular physical activity can prevent men from cancer.
However, if there are no changes in these behavioral practices, it is estimated that there will be about 800,000 new cancers cases in India every year.
And unless it is addressed by the government, private and public sector health system, the numbers are likely to increase to about 24,00,000 cases in India and the risk of cancer deaths will continue to have a severe health impact on the public.
(Mohuya Chaudhuri is a senior journalist and researcher)