Ladies, cup a feel now
In India, at least 2000 new cases of women with cancer are detected every year; but almost 1200 of these are diagnosed in the later stages.
6 Oct 2017 4:08 PM GMT
The first time I met somebody who had undergone mastectomy, was in the year 2000. I was a teenager then and yet unfamiliar with the consequences and treatment of breast cancer. A friend's aunt had been diagnosed with cancer and was recommended to get one of her breasts removed. I awkwardly wondered at the hollow space left behind and thought about the scars. Over the years, I have seen conversations and heard discussions happen intermittently to raise awareness of breast cancer. But, it has never been enough to compel women to initiate action. With October being Breast Cancer Awareness month, there is no better time than now to speak about it.
A report released by E&Y titled, 'Call for Action: Expanding Cancer Care in India - 2015', sounds the bugle on the ailment. Breast and cervical cancer have been topping the charts for women. But according to the report, while in the year 2000, cervical cancer was ruling the roost with India reporting thrice the incidence compared to the US and China; today, breast cancer has taken the lead and we should all be worried by the alacrity of its incidence.
While chatting with Anil Ahluwalia, co-founder of Sanjeevani (an NGO that works to increase awareness of the disease), I further learnt that while the timely diagnosis of cancer was key, it is still woefully low. For instance, at least 2000 new cases of women with cancer are detected every year. However, almost 1200 of these cases are diagnosed in the late stages, making treatment and recovery a life-impinging challenge. Between 2009 and 2011, only 43 per cent of breast cancer cases were diagnosed at stage I or II of the disease, in India. At least 62 per cent, 81 per cent, and 72 per cent of breast cancers were detected at an early stage in the US, UK and China respectively. India reports an early detection of only 20-30 per cent of cancers, which is a dismal less than half of US, UK and China.
The issue of late detection can be solved if greater numbers of women undergo breast screening mammograms or at least have self-examination. Unfortunately, this is not so. Less than 1 per cent of women in India between 40 and 69 years of age underwent mammograms once in 2 years. Compare this with 30 per cent women in China and 65 per cent in the US, opting for the same. Obviously, this leads to mortality rates being four to six times higher in India compared to the US, along with a higher baseline cost of treatment (Rs 3-4 lakh), the E&Y report points out.
There also lies an acute demand-supply gap between diagnosis and treatment. India has only 2,700 mammograms, which constitute less than 5 per cent of that in the US. Only 30 per cent of cancer centres in India have advanced imaging technologies, while access to multi-modal treatment is a luxury reserved for the top eight metropolitan cities. Shortage of oncologists (we have one oncologist per 1600 new patients!), a concentration of cancer care centres (40 per cent of 250 cancer centres) in the metros and few government-run centres ensure that the gap is going unfilled. With a higher incidence of cancer, the report suggests, "India requires significant physical and human infrastructure addition, with a focus on correction of the distribution inequity through increased investments in Tier 2 cities and below, and in select states such as Bihar, Uttar Pradesh, Madhya Pradesh, the North Eastern states, Chhattisgarh, Rajasthan, Jammu and Kashmir, West Bengal, Uttarakhand." Our changing lifestyle, increasing stress, consumption of alcohol and regular smoking contribute towards making cancer a familiar but unwelcome visitor. Early detection, therefore, goes a long way in fighting this disease. However, early detection is impossible if women themselves do not demand regular mammograms. So ladies, cup a feel now, so that diagnosis is early and treatment, not too late.
(The writer is a journalist and media entrepreneur. Views expressed are strictly personal.)
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