Although there have been significant clinical advancements in cancer care over the years, the reality is that if cancer mortality is to be decreased in India and around the world, much more than simply medical innovation is required, writes Bishnu Panigrahi, Group Head, Medical Strategy & Operations at Fortis Healthcare.
Every year, India reports approximately a million new cases of cancer, two-thirds of which are found to be in an advanced stage, decreasing the patient’s chances of survival. India was also ranked third in the world by the 2020 WHO in terms of the number of new cases of cancer that were recorded each year, after China and the United States, respectively.
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Although China and the US have higher cancer incidences than India, the rate of cancer-related deaths in India is higher due to a lack of awareness about early detection, treatment options, post-operative care.
Given the rising burden of cancer disease and the suboptimal quality of outcomes, it is crucial to comprehend the existing challenges and tailor interventions to each stage of disease management with a strong emphasis on:
Emphasis should be on early intervention and empowering communities
In India, screening is also not a common practise, so, based on family history, age, and other risk factors, primary care physicians must advise patients to seek regular cancer screenings. Further screening and diagnosis will be made easier by focusing on high-risk populations using contemporary technology. The cost of treatment would be significantly lower if cancer were discovered sooner rather than later. If patients underwent screening as soon as the first symptoms appeared, the mortality rate from these cancers might be dramatically decreased.
Although there have been significant clinical advancements in cancer care over the years, the reality is that if cancer mortality is to be decreased in India and around the world, much more than simply medical innovation is required. And it will be possible by empowering communities through a multi-sectoral strategy that includes the involvement of the public sector, the commercial sector, and civil society.
On the other hand, there is always a stigma associated with cancer, which can be greatly reduced by increasing community awareness. We must make sure that health systems are improved so that more people have access to screening, vaccination, early detection, and prompt, reasonably priced treatment.
Breaking the socioeconomic barrier by increasing access
There is a socioeconomic barrier to receiving cancer treatment, because the bulk of public and private healthcare facilities with oncology specialisations are situated in urban regions and patients from rural areas frequently travel vast distances for treatment and follow-up. Equitable access includes making sure there is an adequate supply of affordable medications, encouraging preventative health practises, enforcing strict screening guidelines, offering personalised treatment that balances the risks of cancer progression, and even enabling telemedicine. In order to give cancer care to those who need it most, such barriers to access and equality must be removed.
Programs for patient access are one such endeavour, but more cancer centres need to be constructed in the country to make treatments widely available.
Bringing the application of newer technology to manage cancer
India has achieved significant advancements in cancer management, including a rapid increase in the usage of advanced technologies like telemedicine, artificial intelligence, CRISPR, the Infinium Assay, cryo-electron microscopy, and robotic surgery to better accelerate progress against cancer. Along with others, surgical innovation is one of the significant impacts on the variety of technology development, which is without a doubt evolving. As a result, surgeons are able to handle even the most challenging and exceptional cancer cases.
Robotic assisted surgery has no doubt improved patient outcomes, decreased hospital stays, and decreased mortality and morbidity over the previous two decades, in particular. It enables the surgeon to do surgeries beyond the present capabilities of humans, notably at the microscale or by sparing nerves.
Even in locations that might seem impossible or difficult for a human hand to reach, surgeons can carry out precise surgical procedures employing minimally invasive techniques. With the use of contemporary surgical devices like the daVinci, the surgeon may do procedures with the utmost precision and offer patients advantages like fewer incisions, diminished discomfort and scars, a shortened recovery time, and faster healing.
Implementing and raising awareness about cutting-edge technologies like robotics would surely increase accessibility in Tier 2 and Tier 3 cities, as well as help India gradually achieve its health goals. A growing proportion of cancer cases are now being treated with robotic-assisted surgery (RAS), thanks to its benefits over open surgery for both patients and doctors.
A holistic strategy for the way ahead
There is a compelling case for the need for a holistic strategy for cancer prevention that incorporates community initiatives, strengthens PBCRs, and offers medical education. As an illustration, opportunistic screening mostly aids in the detection of cases in their last stages.
Community screening and early detection aid in the early diagnosis of cancer, but they depend on an effective cancer health system for referral and reasonably priced treatment. The differences in cancer burdens between and within states must be taken into account when developing effective cancer preventive measures.
This covers variations in cancer type prevalence as well as overall cancer prevalence due to variations in the positions of the states within the epidemiological transition. In addition, civil society organisations, which are becoming more and more crucial to these activities and initiatives, must be appropriately involved. It is necessary to look into new approaches for providing cancer prevention and treatment services, and the involvement of community and civil society organisations in this process must be fully incorporated.
It is the responsibility of everyone involved in the healthcare system, including pharmaceutical companies, hospitals, and the government, to collaborate in order to solve the issues related to health equity in cancer care. We must collaborate when it comes to improving the oncology ecosystem for everyone. We must continue to confront the challenges we currently face as well as those of the future with one overarching goal in mind—a world in which where you live does not decide whether you live.
—The author, Bishnu Panigrahi, is Group Head, Medical Strategy & Operations, Fortis Healthcare. The views expressed are personal.
(Edited by : C H Unnikrishnan)
First Published: Feb 4, 2023 4:53 AM IST
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