World Cancer Day: ‘Not Beyond Us’

For tomorrow's newspaper: World Cancer Day

Today is World Cancer Day. It is a day for the world to unite in the fight against cancer. This year, it is being observed under the tagline ‘Not beyond us’, which means to say that we should not lose hope but fight cancer positively. It is to highlight that we have the resources and they are within our reach.

8.2 million people die from cancer every year worldwide and 4 million of them die prematurely (aged 30-69 years). The estimated prevalence rate of cancer in Nagaland is 4353 cases in 2013 and 4307 cases in 2012, as per data provided by ICMR. 709 cancer deaths were reported in the State in 2013. It is estimated that 90% of the oral cancers are due to tobacco. Another study in 2009 estimated that 57% of adults in Nagaland are current users of tobacco. According to District Level Household and Facility Survey IV (DLHS IV) which was released recently, 64% of men and 34.5% of women in Nagaland use smokeless tobacco. 35% of men and 1.4% of women smoke. 

Another important modifiable risk factor for cancer is harmful use of alcohol. As per DLHS IV, 40% of men and 4.5% of women consume alcohol in the State. Other causes of cancer are long term exposure to sunlight, ultraviolet and radiation exposures, artificial tanning, high fat diet, little physical activity, and infectious agents like HIV, EB virus, Hepatitis B and C. 

World Cancer Day 2015 campaign explores how to make use of the knowledge we have in prevention, early detection, treatment, and care so as to positively impact the global cancer burden. Enforcing the ban on advertising and sales of tobacco products to minors, especially around schools is an important step in reducing incidence of a very important risk factor. Promoting healthy outlook on life by eating rightly, exercising regularly, and avoiding harmful behaviour (alcohol abuse, fatty diet, and sedentary lifestyle) are important cancer prevention measures. Regular check-up and early detection of cancer is important because certain cancers can be controlled and/or cured when detected early. The 7 danger signs of cancer are:

1. Change in bowel/bladder habit

2. Sore that does not heal

3. Unusual discharge/bleeding from any body part

4. A lump in any part of body

5. Chronic indigestion or difficulty in swallowing

6. Obvious change in wart/mole

7. Persistent cough/hoarseness

If any of the above signs/symptoms are observed, one should seek early medical advice. Cancer detection doesn’t mean a ‘death warrant’. Many people are surviving cancer and are leading relatively healthy and productive lives. Appropriate treatment and management, along with rehabilitative and palliative care are important measures for which the health systems will need to be strengthened. ‘Not beyond us’ slogan of the World Cancer Day 2015 envisages that ‘all people have the right to access quality, effective cancer treatment and services on equal terms, regardless of geography and without suffering economic hardship as a consequence’. There was a news report that in Nagaland, over Rs. 20 crores are spent every year by the department of health and family welfare on medical reimbursement for cancer care. It was estimated that over this, about 60 crores is spent every year from the patients’ pockets for cancer care every year. Catastrophic health spending can be minimised through strengthening health services for cancer prevention, access to accurate cancer diagnosis, essential medicines and technologies, rehabilitative, support and palliative care. Till date, the initiatives by the central and state governments are very limited in cancer care, especially in diagnostics, treatment, rehabilitative and palliative care. It has mostly concentrated on creating awareness. Tertiary Cancer Care hospital which is being sponsored by the central government is an important initiative. More such hospitals are in the pipeline. Through National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS), cancer medicines are provided through NCD clinics in select district hospitals. The budget allocation to Health by the State government however remains a chronic challenge, as it always falls short of requirement to provide even the basic health care to the people.