The very word strikes terror in the hearts of patients and physicians alike.
But often we consider cancer as a problem of the west and one that does not really affect India. Except for tobacco related cancer, there is hardly any public outreach program either from the Government or the private health sector.
India has almost 3-4 million cancer patients. The number could be much higher as the detection mechanisms in India are almost not present. 70% of these cancer patients come in at stage 3 or 4 where the prognosis is very bad. Almost a million cancer are detected annually and the number of cancer patients in India could be around 7 million in the next couple of years.
Women though less prone to tobacco related cancer are more prone to Cervical and breast cancer. These two types account for almost 80 % of cancers in women. Every year almost 130,000 cases of breast cancer are detected in India and according to the Indian Medical Association the situation will get worse.
Rural women are more affected as the cancer is detected at a much later stage. The increase in awareness and education has also resulted in the rise of the cases from 54,000 ten years ago to 130,000 today. Almost 30,000 women would die due the breast cancer every year, which is a sad statistic as breast cancer is not terminal. If detected at early stages can be dealt with effectively. Incidentally October was breast cancer awareness month and a series of events were held in India to take stock of the situation. Overall there were some key reasons why the situation was getting worse in India.
Some of the reasons for increase in the cases detected include
1) Awareness and education
2) Late marriages and pregnancies
3) Use of contraceptives
4) Hormonal imbalances
5) Stress and change in life style
Not surprisingly Bangalore has emerged as the breast cancer capital of India. Bangalore has an incidence of 36.6 per lakh cases. Thiruvanathapuram and Chennai follow closely and these figures are also an indication of higher awareness in these cities.
The real challenge is to get women to take charge of their lives and get serious about screening. High risk categories are advised to undergo screening once every 2 years especially after the age of 38. Those in high risk include women who have an incidence of breast cancer in their family.
A good example in news was the extreme step taken by actress Angelina Jolie who got her breasts removed once she realized that she was in the high risk category. Her mother it seems had been diagnosed with breast cancer and she had a 80 % chance of developing the condition herself.
So what can we do as a nation?
In the next part of this series I will discuss what can the various parts of the healthcare ecosystem do to combat breast cancer in India.
As always views, suggestions and comments are welcome.