Cancer can be a mysterious disease, not only in knowing what exactly causes and triggers the disease, but also how it is treated and the prognosis. Different patients face different trajectories of disease, treatment, recovery, remission and prognosis. What are the major factors affecting remission/death besides age and general health? Dr Sandeep Goyle, head, medical oncology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, says: Besides age and general health, various other factors affect cancer prognosis:
1. Early diagnosis of the disease can help in curing the patient as treatment can be initiated at an earlier stage.
2. The stage and extent of disease at diagnosis also significantly affects prognosis and chances of remission.
3. The type of treatment and where it is received plays a crucial role. We are in the age of super-specialisation, and every cancer patient should ideally be treated in a tertiary care oncology set-up.
4. Affordability and accessibility of treatment affects prognosis, as financial limitations may restrict access to optimal therapy. However, with the availability of good generic drugs, the cost of treatment has reduced significantly, making cancer treatment more accessible. Also, government schemes in hospitals provide oncology care at affordable cost to most patients.
How much cancer burden increase do you observe due to environmental factors like pollution, stress, lifestyle, etc, in the past two decades or so?
Cancer incidence and prevalence have increased over the last two decades and one of the major factors is changes in lifestyle. About 30% of all new cancer cases that we see are linked to preventable and modifiable risk factors, including environmental, occupational, and behavioural factors. There has been an increase in cancer cases due to increased tobacco use, smoking, air pollution, obesity, dietary factors, alcohol consumption, low physical activity, occupational hazards and certain viral infections.
The internet is flooded with information how Ivermectin reverses cancer. How true is that clinically?
There has been recently a big buzz around the use of Ivermectin to treat cancer. Ivermectin is known to have potential anti-cancer effects. However, most of the evidence so far comes from cell culture and animal studies and not from large human clinical trials.
How available is personalised and targeted therapy for cancer in India?
Precision oncology (personalised medicine) is the new paradigm shift in cancer therapy, where cancer treatment is tailored for each individual patient according to each patient’s tumour biology and characteristics. It is now increasingly available in India, with the use of molecular profiling of tumours, targeted therapy, immunotherapy and chemotherapy.