By Dr. Ankur Bahl, Senior Director of Medical Oncology and Hemato-oncology at Fortis Memorial Research Hospital, Gurugram
Cancer is certainly growing in incidence. The cause may not be easily attributable to a particular cause but tobacco, alcohol, and certain viruses have been implicated in the causation of cancer. Cancer is caused by a complex interplay between genes, environment, and lifestyle factors. Another reason why cancer is being seen so often is also because of better diagnostic modalities which are able to pick up this disease more frequently than before.
The challenges in oncology practice are still huge in our country. Firstly, cancer in the Indian setting is detected at an advanced stage. To detect cancer in the initial stage, physicians at community centers and primary healthcare providers should be trained to detect symptomatology of early-stage cancer and order appropriate investigations to arrive at a faster diagnosis. The comprehensive Cancer unit is constituted of a team of medical oncologists, radiation oncologists, Surgical Oncologists, and Allied Services. Comprehensive cancer centers are mainly located in metropolitan cities and availability in smaller cities and towns is still a challenge in our country. Other challenges in cancer care in our country include diagnostic, financial, and hospice care. There is a lack of these resources in India and to make a comprehensive unit available in our setting, we still have got many miles to cover.
Cancer is known as a lifestyle disease and may be closely linked to the way we live our lives. Stress has not been proven to be a risk factor in the development of cancer but our fast-paced lives have left us with very little time to take care of ourselves. Fast foods dominate our diet and seemingly healthy foods may have liberal doses of pesticides, in the absence of a strong regulatory body to monitor the same. Polluted air and water further compound the problem. To minimize the risk, one has to address these problems in a concerted manner and on an individual level, ensure that you exercise for at least 3-4 hours a week and consume food after it has been cleaned adequately!
Affordability and Oncology care in India?
Yes, affordability is a big question in oncology. So, it drains our money and empties our bank lockers. But we have seen in the last 5 to 10 years that if we use these resources judiciously with the right precision and with the right test, the cost of treatment can be reduced. When these therapies were introduced, their cost was enormous. But with the availability of biosimilars and generic compounds, the cost of therapy has drastically come down. Various government initiative such as the Ayushman Bharat scheme and the companies providing the Patient Assistance Program has helped bring down the cost substantially in the last 5-10 years. Nevertheless, it is still beyond the reach of most of our population. We have a long way to go to achieve the target of availing immunotherapy to the Indian population.
What are the challenges related to Health Insurance in Oncology?
I would like to highlight the fact, that most of our patients or caregivers don’t have health insurance. Before opting for health insurance, one must ensure the clause of provision of cancer care. There has been a tremendous rise in cancer incidence in our country in the last few decades. I would say that almost every family has one cancer patient or a cancer survivor. In a way, cancer is an endemic disease and health insurance with a clause about cancer care is a must for every family member. There should also be a clause for the provision of targeted and immunotherapy which is an emerging treatment option for cancer.