Cancer control is vital for not only National Health Policy goals but also for economy

New Delhi, February 17, 2019: Government of India’s National Health Policy (NHP) 2017 promises reduction of non-communicable diseases (NCDs) such as cancers by 25% by 2025 (this goal is also part of UN Sustainable Development Goals). But many cancer rates are rising, not declining.

Prof Surya Kant reiterated that according to the WHO, at least one third of common cancers are preventable through tobacco and alcohol control, healthy diet, maintaining healthy weight and being physically active.Tobacco use is the most important risk factor for cancer and is responsible for approximately 22% of cancer deaths.

Dr Pooja Ramakant, noted breast cancer expert and Associate Professor, Endocrine Surgery Department, KGMU said in World Cancer Day Webinar that early detection, screening and diagnosis saves more lives, improves quality of life and reduce cost and complexity of treatment of breast cancer.

Thuy Khuc-Bilon of Union for International Cancer Control (UICC), official convener of World Cancer Day global campaign, said in this Webinar that there is a compelling financial argument for committing resources to cancer control. Financial investment can be cost-effective and can potentially save the global economy billions of dollars in cancer treatment costs and offer positive gains in increased survival, productivity and improved quality of life. The total annual economic cost of cancer is estimated at US$1.16 trillion. Prof Surya Kant said that tobacco costs our global economy US$ 1.4 Trillion loss, whereas revenue of tobacco business is a tiny fraction!

Lung cancer is preventable and treatable
Dr Nguyen Viet Nhung, Director of National Lung Hospital, Vietnam; head of national tuberculosis programme of Vietnam and honorary faculty at University of Sydney, Australia said in World Cancer Day Webinar that lung cancer is not only the most common cancer but also the deadliest of all cancers worldwide. If we detect cancers early then five-years survival could be much higher.

“Tobacco smoking causes over 71% of lung cancer. If we are to reduce lung cancer disease burden and avert untimely deaths, we have to ensure tobacco use ends. But major challenge is to ensure that essential health services are available for all people in needs at all levels. Patients need to access modern techniques for comprehensive care and treatment of lung cancer at reasonable costs without overloading central healthcare system” said Dr Nhung.

Breast cancer is deadliest cancer among women
“Breast cancer (along with lung cancer) incidence is highest among cancers globally, but in this case, winner is a loser. Breast cancer is also the most common cancers in India among women, and deadliest cancer among women” said Dr Pooja Ramakant, breast cancer surgeon at KGMU and Associate Editor of Indian Journal of Surgery.

“Breast cancer incidence is occurring more in younger women in India.In India, breast cancer incidence peaks around 30s-40s-50s age groups, but in the developed countries it peaks around 50s-60s age groups.Breast cancer is very aggressive in biology when it happens in younger women. Women present late to us unfortunately as 50-70% of patients who present to us are already in advanced stage or metastatic when they are first diagnosed. Late diagnosis of breast cancer is directly proportional to survival rates” said Dr Pooja Ramakant, who is former member of Editorial Board of Indian Association of Endocrine Surgeons (IAES).

Lack of breast cancer awareness and screening programmes, and other modifiable and non-modifiable risk factors are responsible for the public health challenge breast cancer is posing said Dr Pooja Ramakant. “There are factors that are modifiable, such as, obesity, unhealthy diet and sedentary lifestyles. Tobacco and alcohol in any amount (no safe level of tobacco and alcohol) is also responsible for carcinogenic mutations. Exposure to certain environmental compounds also increase breast cancer risk, such as, polycyclic aromatic hydrocarbons (PAH). Alarmingly India is among the top countries emitting PAH, but this could be modifiable if we protect environment. Non-modifiable risk factors are like genetic (5-10%) and early menarche and late menopause but majority of 90% risk factors for breast cancer are modifiable. This World Cancer Day we all must act upon reducing cancer risks and addressing the risk factors that are modifiable, appealed Dr Pooja Ramakant.

In USA for instance, the five year survival for breast cancer is around 90% but in India it is 66.1%, mostly because of late stage of diseases when women present. In other developing nations such as South Africa it is as low as 40.1%.

Educating women, men and transgender people (small part of breast cancer incidence also happens in men and transgender people) about healthy lifestyles to reduce cancer risk is important. We have to raise awareness about breast self-examination, and if any change or inconsistency is found then people should check with the doctor, said Dr Pooja Ramakant.

Patient support groups play a key role in helping complement healthcare as well as give moral boost for patient and families too. Quality cancer care includes dignity, respect, support and love and considers not just the physical impact of cancer but respects the emotional, and social wellbeing of each individual and their carer, emphasized Dr Pooja Ramakant.

Tobacco is single largest preventable cause of cancer