Dr Deepak Abrol
We are witnessing an increase in the incidence of cancer. This is mainly ascribed to urbanization, industrialization, lifestyle changes, population growth and increased life span (in turn leading to an increase in the elderly population). In India, the life expectancy at birth has steadily increased from 45 years in 1971 to 62 years in 1991, indicating a shift in the demographic profile. It is estimated that life expectancy of the Indian population will increase to 70 years by 2021-25. This has caused a paradigm shift in the disease pattern from communicable diseases to non-communicable diseases like cancer, diabetes and hypertension.
Among men, lung, esophagus, stomach, oral and pharyngeal cancers are more prevalent, while in women; cancers of cervix and breast are most common, followed by those of stomach and esophagus.
Advocacy for cancer control is required in any situation in order to persuade decision-makers to create an environment conducive to improving the way cancer control knowledge is put into practice. It is also needed to make General public conducive to Awareness and Screening drives. There is no single right way to advocate. The guidance provided in this article is thus not intended to be prescriptive but rather to be selected as appropriate to the regions context, and revisited as the advocacy process progresses through its planning, implementation and evaluation phases.
Every year, thousands of people die or suffer from an advanced cancer that we know could be prevented, cured or cared for. Now is the time to act and stop this needless suffering!
80% of cancer patients are diagnosed late when treatment can no longer be effective. We must therefore focus on two urgent actions:
* palliate the suffering of all advanced cancer patients;
* promote early detection and treatment of frequent cancers and cancers that are amenable to early detection, in particular, breast and cervical cancers.
The majority of low-income and disadvantaged people are at higher risk and have less power to protect and improve their health. For their sakes, the time to act is now. An integrated, comprehensive cancer control strategy allows for a more balanced, efficient and equitable use of limited resources. A cancer control plan that is goal-oriented, people-centered, realistic and carefully prepared through a participatory process is more likely to translate into effective implementation. In lower-resource settings, a plan that considers the gradual implementation of a few, affordable, cost-effective and priority interventions will have a better chance of succeeding.
For Example a simple way to prevent cancer and do early detection is to aware the public about benefits of cleanliness and promote and inculcate the habits of self examinations. Breast Self Examination is widely publicized by western literature but in country like ours Self oral examinations, Self examination of Private parts and self appraisal of body habits should be encouraged.
We all know that 40 percent of cancer is tobacco related, another 20 percent is life style related and infection related. So by promoting healthy life style without Tobacco and Alcohol and following Vaccination for HPV and HBV we can prevent cancer.
Why is it important?
Cancer kills more people than AIDS, Malaria, and TB combined and the death toll is set to rise dramatically in the coming decades.
Two-thirds of cancer-related deaths occur in countries where resources available for cancer control are limited or nonexistent.
Without significant improvement, over 17 million people are projected to succumb from this disease by 2030.
Many cancers can be prevented as discussed above by reducing tobacco and alcohol consumption, decreasing exposure to carcinogens, implementing vaccination programmes and promoting healthy lifestyles.
Many cancers can be cured if detected early and treated appropriately.
The environment affects the growth and development of the person’s behaviour, body and mind. There has been a rapid increase of pollution and WHO has now marked it as a carcinogens.
There are many claims regarding association of environmental and occupational factors with cancer and few of them have been proven now.
We can improve the scenario and decrease the present rising trend in cancer incidence by testing of heavy metals in water. Manufacture, import and use of pesticides which are very injurious should be withdrawn.
Registration of some pesticides has already been refused. Farmers training camps to be conducted at village, block and district levels to educate the farmers on the judicious use of pesticides.
Already with Launch of NPCDCS — National Program of Control of Cancer , Diabetes , Cardiovascular disease and Stroke Government has made its good intentions very clear. To make treatment affordable launch of Ayushman Bharat has also helped the cause. But what is needed is a concerted effort by workers on ground level to make these success.
In conclusion I assert that Cancer is preventable, if not prevented – Curable, if not cured – treatable and if not treated- palliation and pain relief at least can be done. Thus in Resource Constrained countries like ours looking for prevention and control strategies through Awareness Activities and Advocacy programs Should be encouraged as preventing Cancer and getting it diagnosed in early stages will lead to less cost incurred per patient and hence less load on state exchequer.
(The author is Cancer Specialist GMC Jammu)
Dr Deepak Abrol