By IRNA,
New Delhi : India is staring at an explosion of cancer burden as the disease is likely to double or triple among its population in the next 20 years, oncologists said.
The incidence of cancer for the last decade has been a straight line as there has been a rising trend in some cancers offset by a reduction in others.
However, epidemiological findings of some unique cancers in North-east suggested the explosion of cancer burden in the next two decades, the scientists said.
‘It must be noted that in spite of the rising trend, the number of cancer cases are still about a third or fifth of what is seen in the developed world. However, India is at the beginning of an explosion of cancer burden due to several factors and drastic steps need to be taken to prevent the explosion,’ Tata Memorial Centre(TMC), Director, R A Badwe said.
‘In general, the outlook for cancer appears bright due to low incidence in India and efforts to reduce mortality without much increase in the incidence are unique globally,’ pti reported quoting Badwe said at the 21st Indian Nuclear Society’s annual conference at Mumbai, capital of Maharashtra state.
But in future with factors like increasing population, increasing longevity, less of physical activity (obese cancer) and urbanisation of rural India, the burden of cancer is likely to double or triple by 2030, said K M Mohandas, Director, Centre for Cancer Epidemiology of TMC.
TMC has also found some unique cancers in some parts of India – nasopharyngeal and esophageal (food pipe) cancer in Northeast and gall bladder cancer in Gangetic and Brahmaputra river belt, he said.
‘Few large epidemiological studies are underway to find out etiology of these cancers and a large screening study with Barium swallow is also underway to see if early detection of esophageal cancer is possible,’ Badwe said.
Figures related to tobacco-related cancer (smoking and non-smoking), which constitutes 50 per cent of the cancer cases in the county, may remain as it is, Badwe said.
‘Over, 65 per cent of cancer in India is contributed by tobacco related, breast and cervical cancer. Thirty per cent of cancers arise in head and neck region is caused due to non-smoking tobacco used in India and this is amenable to prevention as well as early detection,’ he said.
An alarming rise in breast cancer and ovarian cancer is very fortunately matched by a corresponding and welcome reduction in uterine cervical cancer, maintaining the overall incidence of cancer relatively unchanged in women, the TMC director said.
Uterine cervical cancer is due to infection which is amenable to prevention and early detection, he said.
In men, it is lung cancer which is on the rise and is a major killer, whereas two other forms of the disease — stomach and penile cancers — have shown a downward trend, he added.
The data on screening for oral cancer is not robust enough to implement screening as service but it is suggestive of being beneficial in saving lives, the cancer expert added.
Cancer scenario in India is quite alarming with nearly 25 lakh patients in the country currently suffering from the deadly disease, according to the Indian Council of Medical Research.
‘Cancer scenario in India is not very comfortable and every year there is an increment of 10,000 new cancer patients and the number of total victims stands at about 25 lakh all over,’ Indian Council of Medical Research (ICMR) Director General Viswamohan Katoch has said at a seminar on ‘New Frontiers in Haematology and Oncology’.
According to the data of National Cancer Control Program (NCCP), started in 1975-76 in India, Cancers in all forms are causing about 12 per cent of deaths throughout the world. In the developed countries cancer is the second leading cause of death accounting for 21 per cent (2.5 million) of all mortality.
In the developing countries cancer ranks third as a cause of death and accounts for 9.5 per cent (3.8 million) of all deaths. Tobacco alcohol, infections and hormones contribute towards occurrence of common cancers all over the world.
Meanwhile, World Health Organisation (WHO) has estimated that 91 per cent of oral cancers in South-East Asia are directly attributable to the use of tobacco and this is the leading cause of oral cavity and lung cancer in India.
Cancer usually occurs in the later years of life and with increase in life expectancy to more than 60 years, an estimate shows that the total cancer burden in India for all sites will increase from 7 lakh new cases per year to 14 lakh by 2026.
Cancer is an abnormal growth of a cell or an organ due to a specific stimulus (carcinogen). This growth is an uncoordinated, purposeless one, which continues to grow even after the cessation or withdrawal of the stimulus.
Cancer can originate from any organ or part of the body. The natural behaviour of a particular cancer depends upon the site of involvement and the histopathological type of the cancer. Some of the cancers are very mild and can be controlled very easily while some are very aggressive and results of treatment are very poor.
As Cancer grows it invades the surrounding structures and interferes with the local function. It spreads to the draining lymph nodes through the lymphatic. Through the blood streams it spreads to the other parts of the body. The common organs of distant metastasis are lung, liver, bones, brain etc.
Exact cause of cancer is not yet known. However, there are certain risk factors, which may cause this disease in individual prone to develop Cancer. Among the common factors, chemicals are one of the important causes. These chemicals may be in the form of Tobacco or chemicals present in food, air, water, etc. These chemicals are known as carcinogens. Till now about 60 agents have been identified.
Some Common Risk factors for Cancer are Tobacco (smoking and somekeless), alcohol, Electromagnetic radiation (ionising radiation, ultraviolet rays, others), Occupational exposure to carcinogens, Pollution (air/water/food), Reproductive hormones
In majority of Indian patients, cancer can definitely be prevented. About 50 per cent cancer are Tobacco related e.g. Lung Cancer, Oral Cancer (Cancer of Mouth), Laryngeal Cancer (Voice box), Oesophageal Cancer (Food pipe), etc. and they can be prevented to a large extent by avoiding intake of Tobacco.
Certain other Cancers like bowel Cancers can also be prevented by Dietary habits.
The signs and symptoms of cancer depend upon the body part affected by the disease.
The primary tumour or the spread of tumour to lymph nodes or distant parts of the body may cause symptoms.
In general, cancer has a tendency to start as a nodule or mass of tissue, which keeps on growing.
The growth rate of cancers is variable with some cancers growing very rapidly and others growing slowly.
With further growth, cancers, which affect external or internal body surfaces, can form wounds or ulcers leading to dirty discharge, bleeding etc. Common symptoms of cancer can be described as follows.
Lump or swelling, A sore that doesn’t heal, Recent change in a wart/mole, Unusual bleeding or discharge, Changes in bladder or bowel habits, Nagging cough or hoarseness, Difficulty in swallowing or dyspepsia.
Cancer is curable if detected early. The results of treatment in stage I and stage II (early stage Cancer) are about 80%. In late stage diseases (Stage III & Stage IV) the results are very poor. (Less than 20%). In India, about 70% of patients are present in advanced stage diseases and hence difficult to treat.
Basically, there are three main modalities of Cancer treatment – Surgery, Radiotherapy and Chemotherapy (Drugs).
The treatment of cancer is described as a multimodality approach as a large number of patients need to be treated with a combination of the approaches available.
Thus, some patients may need only one modality of treatment, some need a combination of two modalities and some need to be treated with all three modalities to achieve the best results.
To decide the best treatment for a given patient, initial testing is done to make the diagnosis (diagnostic investigations) and decide the stage of disease (staging investigations).
After the initial treatment plan, the treatment is started. The progress of treatment and response of disease is assessed from time to time.
A review of the progress is made in subsequent tumour board meetings to decide whether any change in the treatment plan is required or not.
Once the planned treatment is completed, cancer patients need regular follow-up.