World Cancer Day: Amid the rise in non-communicable diseases (NCDs) in India, the menace of cancer, a major NCD, is also rising. As India continues to share a high burden of preventable communicable diseases, resource allocation to effectively fight NCDs like cancer may pose a challenge.
Cancer accounts for nearly one in six deaths in 2020 (GLOBOCAN 2020 data- latest report from WHO).
Every year, on February 4 is marked as World Cancer Day to raise awareness about the disease and to spread awareness about the its prevention, detection, and treatment. World Cancer Day is led by the Union for International Cancer Control to support the goals of the World Cancer Declaration.
This year, the theme of World Cancer Day is “Close the Care Gap” to highlight inequity in access to advanced cancer care and treatment.
Cancer is a disease in which some cells in the human body start growing uncontrollably and it also spreads to other parts of the body. Studies suggest that cancer can start almost anywhere in the human body.
According to cancer.gov, there are more than 100 types of cancer. There are also various categories of cancer, depending on the specific type of cells, some which include: Carcinoma, Sarcoma, Leukemia, Lymphoma, Multiple Myeloma, Melanoma, among others.
What is the status of cancer in India?
According to a 2022 report in India Medical Journal, the estimated number of incident cases of cancer in India for the year 2022 was found to be 14,61,427.
According to the study, one in nine people are likely to develop cancer in his/her lifetime in India. The study also pointed out that lung and breast cancers were the leading sites of cancer in males and females, respectively.
“Among the childhood (0-14 yr) cancers, lymphoid leukaemia (boys: 29.2% and girls: 24.2%) was the leading site. The incidence of cancer cases is estimated to increase by 12.8 per cent in 2025 as compared to 2020,” the study revealed.
According to cancer registry data, it is predicted that approximately 8,00,000 new cancer cases will be diagnosed in India each year.
“At any given time, the load is likely to be three times that of 240,000 instances. Tobacco use is linked to 35% to 50% of all cancers in men and about 17% of cancers in women. The predicted number of cancer incidents in India for the year 2022 is 14,61,427. In India, one in nine persons will develop cancer over their lifetime. According to an ICMR study based on data from population-based cancer registries, one in every nine Indians will develop cancer during their lifetime. Lung cancer affects one out of every 68 males and 29 women will develop Breast Cancer,” Dr. Babina NM, Chief Medical Officer, Jindal Natuecure Institute, Bangalore told Financial Express.com.
Breast cancer is the most common malignancy in women worldwide. In India, it accounts for 13.5% of all cancer cases (both sexes, all ages) and 10.6% of all deaths in India due to cancer (GLOBOCAN 2020-India data). According to ICGA Foundation, the survival rate of BC patients is poor in India, primarily due to earlier onset age, late-stage presentation of the disease, late commencement of decisive management, and inadequate treatment.
As compared to the West, a higher percentage of breast cancer occurs at a younger age in India.
How has cancer care advanced in India over the years?
According to Dr. Babina, India’s high incidence problem is aggravated by late detection, insufficient and unequal access to multimodality, and low affordability, resulting in a substantial death load.
However, cancer treatment in India has improved significantly due to the increased availability of advanced technologies such as genetic testing and personalised medicine, improved imaging techniques, minimally invasive surgery, targeted chemotherapy drugs, and radiotherapy, as well as better-trained medical professionals and improved infrastructure.
“There is a growing network of specialized cancer hospitals and treatment centers offering patients state-of-the-art services. However, access to high-quality cancer care remains a challenge in many parts of the country, particularly in rural and underserved areas,” Dr. Suveera Dhup, Chief Operating Officer, ICGA Foundation told Financial Express.com.
Dr Anil Heroor, Director-Advanced OncoSurgery Unit, Fortis Hospitals Mumbai told Financial Express.com that patients now have a variety of therapy options available to them to either cure or control the growth of cancer.
What are the commonly prevalent cancers in India?
According to Dr. Babina, lung, oral, cervical, breast, and stomach cancer are the most frequent cancers in India. According to data from the Indian Council of Medical Research’s National Cancer Registry, an estimated 14.6 lakh new cancer cases were diagnosed in 2022, up from 14.2 lakh in 2021 and 13.9 lakh in 2020. (ICMR).
“Death rates fell fastest in lung cancer and melanoma (by 4% to 5% each year) in both men and women. Malignancies of the pancreas, brain, bones, and joints killed more males than cancers of the pancreas and uterus killed more women,” Dr. Babina said.
Dr. Dhup pointed out that because of increased awareness and access to screening and vaccination programs, cervical cancer incidences have decreased.
‘Challenges still persist among cancer patients in India’
According to Dr. Babina, the treatment of cancer is complicated further by the patient’s lifestyle and attitude, their different physiology and the rate at which their bodies metabolize drugs, the blood supply to the tumor, tumor physiology, and the fact that the tumor can continue to change.
“Another issue with cancer treatment is the disease’s ability to spread. Certain malignancies are asymptomatic, and the lack of detection allows cancer to spread to different sections of the body from the place of genesis without medical intervention,” she told Financial Express.com.
Dr. Dhup also told Financial Express.com that cancer care is often unavailable or inadequate in rural and underserved areas, leading to delayed treatment and poor outcomes.
“There is a shortage of trained workforce – oncologists, radiologists, pathologists, and other healthcare professionals. Many cancer care centers lack the necessary facilities and equipment to provide advanced cancer treatment. The treatment is often unaffordable for many patients, leading to financial hardship and decreased access to care,” Dr. Dhup said.
“Stigma and myths are still associated with cancers such as breast, cervical, prostate, and lung, leading to decreased access to care and diminished quality of life for patients and their families,” she added.
Dr. Dhup also pointed out that late-stage cancer diagnosis and poor treatment outcomes significantly strain the country’s cancer care.
“To promote cancer prevention, early detection, and fair access to cancer care across the country, targeted measures are required to overcome the demon of cancer.” she added.
Dr. Heroor told Financial Express.com that there are nearly about 13,00,000 to 15,00,000 patients diagnosed every year and the number of oncologists to treat them is less.
“Reports suggest that there is about one oncologist for every 2000 patients. Another challenge is infrastructure, as there are only about 60 to 70 cancer care centers in India and about 300 multi-specialty hospitals for such patients,” he added.
‘No need to remove cancerous organ anymore’
Dr. Babina pointed out that there was a time when cancerous organs, such as the jaw or breast, were removed. Now, organ preservation surgery is achievable with targeted radiotherapy and chemotherapy where the particular cell is curtailed from growth to maintain the organ intact, which is a significant step forward, she said.
“Oncology imaging biomarkers are distinct in that they may assess and diagnose tumor size and stage. Oncology imaging comprises two major procedures: Oncology imaging biomarkers are distinct in that they may analyze and diagnose tumor size. Apart from this, people are now taking other healing methods like Naturopathy. Naturopathy includes therapies like Acupuncture, Cognitive Behavioural Therapy, Massage and Meditation,” Dr. Babina told Financial Express.com.
Some of the recent medical breakthroughs in cancer care include:
Precision Oncology: Using genetic and molecular information to guide individualised treatment for cancer patients, leading to improved outcomes and reduced side effects. Large-scale studies accounting for molecular profiling of cancers in a population can be a useful resource in this direction.
Targeted Immunotherapies use the power of the patient’s immune system to attack cancer cells. Chimeric antigen receptor (CAR) T cell therapy, immune checkpoint inhibitors, monoclonal antibodies, treatment vaccines, and immune system modulators are some that have shown great promise for multiple types of cancer during clinical trials.
Artificial intelligence and machine learning are being used to analyse large amounts of data, such as medical images and genomic data, to improve cancer diagnosis and treatment planning.