By having both breasts surgically removed even though she hadn’t been diagnosed with cancer, Angelina Jolie brought down her breast cancer risk from the earlier 87% and ovarian cancer from 50% to less than 5%. She could make the decision, which we’re sure was as tough as it was painful, because she got a genetic test done that told her that she had inherited a “faulty” BRCA1 gene, which, along with a BRCA2 gene, puts women at a higher risk of breast and ovarian cancers. Most women, especially in the developing world, don’t have the luxury of being forewarned and forearmed because they cannot afford simple mammograms to detect cancers, let alone expensive gene testing to warn them that they are at future risk.
Over the past decade, disease-free survival (life without the cancer progressing) has become longer and less painful for the few who can afford it. Innovations in cancer diagnosis and treatment are among the fastest-growing segments in medicine. While early diagnosis makes cancer treatment and management easier, new cancer treatments focus on targeted therapies that use drugs and other modalities to block the growth and spread of cancer cells without harming healthy cells.
Almost all global innovations are available in India within weeks of being approved, but most of these drugs and tools are too expensive — often priced about four to 10 times more than conventional therapies — for the majority of the 10 lakh (one million) who develop cancers each year. With the rising and ageing population, unhealthy lifestyles, pollution and tobacco use fuelling the epidemic and increasing cancer rates by 1.2% each year, the number of people with the disease is projected to rise five-fold — 2.8 times because of tobacco use and 2.2 due to ageing — by 2025. Those receiving treatment will not go up correspondingly until the government — the Centre and states combined — increases public spending on health from the current 1.2% of the GDP to 2.5% by the end of the 12th Plan, and to 3.5% of GDP by 2022, as proposed by the Planning Commission’s high-level group on universal health coverage in a meeting. The additional funds need not be used just for primary healthcare and disease prevention, but also for early diagnosis and care of lifestyle diseases such as cancers, diabetes and heart disease, which together kill more people each year than all infectious diseases put together.