The National Cancer Institute (NCI) in the Jhajjar district of Haryana is the first in a nationwide grid of high-end public hospitals being developed to offer affordable and quality cancer treatment at the district level.
There were an estimated 1,069,000 new cases of cancer in 2016, with cancers accounting for 8.3% of the total deaths, according to India State-Level Disease Burden Initiative published in The Lancet in 2018. “Our vision is to develop a national cancer grid in the public sector with NCI as the hub. It will be connected to centres across the country, at the district level and in small, tier-3 cities, where you will have a good centre, doctors trained to administer chemotherapy and radiotherapy following national treatment protocols — all at subsidised rates,” said Dr Randeep Guleria, director, All India Institute of Medical Sciences (AIIMS), which has established the country’s biggest cancer hospital over 65 acres in Badsa in Jhajjar.
The 710-bed NCI, which has been set up at a cost of ₹2,035 crore, will focus on patient care, undergraduate teaching, research, and training specialists to provide cancer treatment in small towns, which will be networked with NCI to provide the best treatment modalities.
“The Tata Trust is supporting a national cancer grid, but my challenge in this is to make it cost effective,” said Dr Guleria. Patients who go to NCI will be given a treatment protocol to follow and referred to the grid hospital nearest to their home for chemotherapy and management. “They don’t have to come for every cycle of chemotherapy; they can come back after three-six months for a follow-up. Patients will be treated nearer to home, they will have better quality of life, and there will be a distribution of the [patient treatment] load,” he added.
{{/usCountry}}“The Tata Trust is supporting a national cancer grid, but my challenge in this is to make it cost effective,” said Dr Guleria. Patients who go to NCI will be given a treatment protocol to follow and referred to the grid hospital nearest to their home for chemotherapy and management. “They don’t have to come for every cycle of chemotherapy; they can come back after three-six months for a follow-up. Patients will be treated nearer to home, they will have better quality of life, and there will be a distribution of the [patient treatment] load,” he added.
{{/usCountry}}Electronic medical records at NCI and the cancer grid will generate an immense amount of data from across the country for medical research. “Globally, robust and validated data is very important and if we have good electronic medical records, as we will in Jhajjar and at the cancer grid hospitals, we have huge data,” Dr Guleria said.
This big data is invaluable, he explained. “We have many people approaching us because of the numbers. One example is radiology. If someone has an algorithm to screen a chest CT and pick up an abnormality, they need to run it though a large number of scans to validate. They need a hospital like AIIMS where CTs are done in bulk. Running the software through chest CTs radiologists have already classified as normal/abnormal can validate the algorithm’s accuracy,” said Dr Guleria.
India has begun screening for oral, breast and cervical cancers, which account for 34% of all cancers in India, in select districts as part of a national programme. With medical advances making it possible to treat many cancers — 80% of childhood cancers are treatable, breast cancer is curable if diagnosed early — treatment at the district level will be a game-changer, say experts. “There is huge need for higher level treatment facilities in the districts, but it must be integrated with an equally robust screening and preventive health programme for prevention, early diagnosis and treatment,” said Dr K Srinath Reddy, president, Public Health Foundation of India.
“Tamil Nadu introduced hypertension and cervical cancer screening in 2000-2001. While hypertension screening was a runway success, cervical cancer screening was not cost-effective because despite early detection, women were not getting treated because it was not available close to home,” said Dr Reddy.