National cancer awareness day November 7: Poor follow-up in 50-60 % cancer cases
Experts say accessible and affordable treatment ‘closer’ to homes of cancer patients is the need of the hourpune Updated: Nov 09, 2018 14:12 IST
As many patients do not follow up in most of the cancer cases, experts cite that accessible and affordable treatment ‘closer’ to homes of cancer patients is the need of the hour. Earlier, five years ago, around 70 to 80 per cent cases were reported where the patients did not follow up but now the rate has improved, but it is still around 50 to 60 per cent. Doctors’ stress that poor follow up rate is caused due to high treatment cost and lack of affordable facilities in their own districts of the patients, as many often are forced to travel to bigger cities like Mumbai, Pune and Delhi for surgery and treatment which leads to impoverishment.
Dr Dinesh Pendharkar, president of the Indian society of oncology, said, “There is a huge fall in the cases where patients do not follow up. Around 50 per cent patients do not follow up in cancer cases every month due to expensive treatment, travel woes and logistics as well. This can be improved only if the state health departments improve their facilities when it comes to cancer. We have developed a ‘Pendharkar model’ which includes training of government staff at district hospitals in handling cancer care and providing chemotherapy as well. This is for patients who have undergone surgical interventions.”
As of now, we have tied up with four states including Rajasthan, Madhya Pradesh, Orissa and Himachal Pradesh and now we will be approaching Maharashtra state as well. As of now we are providing training to the district government staff in around 125 districts and have even rolled out this model where patients can access the cancer treatment for free and can even have drugs for further control of the disease. The model is around three-years-old and we are waiting to start the same in Maharashtra as well. Drugs and treatment under the project are free for all the patients who just have to produce their cancer reference cards made by their respective hospitals where they were treated earlier, said Pendharkar.
Dr Pendharkar said, “Every month we visit 20 to 25 districts to provide free training to staff at the government hospitals.”
He also said that every year, around 15 lakh new cancer patients are registered in India of which eight to nine lakh patients die due to cancer. Cancer is life-threatening and according to WHO it is the second life-threatening disease that has huge mortality rate.
“We need cancer awareness and a pathway for treatment,” he further added.
Any patient spends around Rs 2 to Rs 3 lakh every month when it comes to treating cancer and hence it can be called as a disease which leads to impoverishment, he said.
At the occasion of national cancer awareness day we demand to the state health department to make cancer treatment available to patients unto death, he said.
Dr Sultan Pradhan, director and in charge of the cancer unit, at Prince Aly Khan hospital, said,” The follow-up rate of cancer patients is extremely poor, however, we can still see a bit of improvement in the last few years because of awareness and good detection facilities.”
While speaking about the waiting list of patients Pradhan, said, “In certain cancers, the waiting list is huge and around 400 to 450 patients are forced to wait every month at hospitals like Tata, to get surgeries done which further leads to the advancement of cancer. This rate even though is subjective and depends on hospitals, we have observed that waiting list of patients for cancer surgery is huge. The wait can be anywhere between three to four weeks and even more. This further adds to the vulnerability of the case making the patient more critical. This can be resolved by providing cost-effective treatment in all districts so that patients do not have to travel more to other cities for treatment every month, which includes chemotherapy and surgical intervention.”
There is definitely a rise in cancer cases in the last few years—due to air pollution, chemicals in food, change in eating habits, smoking and other lifestyle habits.
50% to 60% of patients do not follow-up on treatment because of high costs and lack of facilities in their own district◼ Any patient spends around Rs 2 to Rs 3 lakh every month when it comes to treating cancer◼ Waiting list is huge and around 400 to 450 patients are forced to wait every month at hospitals like Tata where the wait can be anywhere between three to four weeks and even more.◼ Poor follow-up rate leads to loss of lives and further mortality◼ Among all the other cancers, brain and neck are most common and have a high mortality rate
Recently, there are new treatments that have been introduced, known as cancer immunotherapy. This is extremely expensive and is not suitable fo all patients as only five per cent of patients can afford this. Also, the therapy is still under research
◼ There is a drop in number of cases in Pune by 50% in the last five years.
◼ Pune has improved detection facilities, treatments and surgical departments when it comes to oncology.
Dr Padmaj Kulkarni, a medical oncologist at Deenanath Mangeshkar hospital and executive committee member, Indian society of medical and paediatric oncology, said, “Early detection is a must and increasing awareness is needed. However, we are seeing more cases also because there is an improvement in diagnostic techniques, facilities, Indian generic drugs and experts in oncology.”
The follow-up rate is poor but it needs improvement which can be done by creating awareness and strengthening cancer programme at the state level, he said.
Also, when it comes to data related to cancer from all over the country, there is no proper registry but of all the cancers, head and neck is more prevalent due to tobacco usage in men and breast cancer cases are on the rise in women. In new cases of cancer, we are also seeing more of lung cancer in women which was not the case earlier. “Due to rise in smoking habit among women more cases of lung cancer in women are coming from urban areas only, which can be curbed if lifestyle changes are made,” said Kulkarni.
Tata Memorial Hospital reports 50 per cent drop of cancer cases from Pune
Doctors at Tata memorial hospital revealed that patients suffering from cancer at their outpatient department (OPD) and inpatient department (IPD) are seeing less number of cases from Pune. There is a drop in number of cases from Pune by 50 per cent in the last five years. The patients who came to Tata for surgery, treatment and second opinion are now only visiting the hospital for consultation and second opinion.
Dr Rajiv Sarin, incharge of cancer genetic unit and radiation, Tata hospital said, “Earlier we saw many patients from Pune but now the percentage has gone down. Every year we are seeing less number of patients from Pune in the last few years. The reason being Pune has improved detection facilities, treatments and surgical departments in the field of oncology.”
While speaking about advancements in the cancer treatment he said, “There are newer treatments that have been introduced recently known as cancer immunotherapy. These are extremely expensive and so many patients do not opt for it. Only five per cent of the patients can afford the treatment and can be cured depending on their immunity while undergoing the treatment. However, this therapy is still under research.”
Sarin, said, “Also there is a reduction in side effects due to radiation as newer therapies in radiation are evolving. There is also a new treatment known as targeted therapy which again does not suit every patient and in 100 cases, only 10 benefits due to its suitability and patient’s immune system and the therapy is under study now.”
Sarin said, “Cancer has good survival rates when it is detected early. In stage one a patient has an improved survival rate by 90 per cent and when it comes to treatment of cancer, symptom control is important. It is also suggested that manpower training and multi-disciplinary approach towards cancer is important given the longer duration of cancer treatment.”
Agreeing to Sarin’s statement, Dr Ashok Bhanage, chairman cancer centre, Ruby Hall Clinic said, “Ten years ago, we hardly did a case or so in a day but now we are doing more than five major surgeries in oncology. Also, we saw around 50 cases per day in OPD ten years ago but now the number had gone up by 200. This shows the increased rate of cancer and also awareness levels among masses. Besides that, given the rise in number of patients we have decided to add more radiation machines and expand our facility which is currently spread over 40,000 square feet. Now, we are adding more 28,000 square feet to the current facility and have also started genetic clinic where patients are tested for cancer which they can develop in future and treated for the same. Also, Tata hospital’s claim of seeing less of Pune patients is true.”
First Published: Nov 07, 2018 15:31 IST