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Cancer: The next epidemic - Is it time to conquer?
- December 09, 2023
Medical Expert,
Dr Narasimhaiah Srinivasaiah, Oncologist,
Senior Consultant Apollo Hospitals,
BANGALORE BOWEL CARE,
Singasandra, Hosur Road.
Dr Narasimhaiah Srinivasaiah, Oncologist,
Senior Consultant Apollo Hospitals,
BANGALORE BOWEL CARE,
Singasandra, Hosur Road.
Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Disruption of any of the above components leads to illness.
Non Communicable Diseases (NCDs) like Cancers and Cardiovascular Diseases account for over 60% of morbidity and mortality in India (WHO Report – Sept 2017). Cancer is a major burden amongst the non communicable diseases. It therefore deserves due attention.
History: The oldest description of human cancer was found in Egyptian papyri written between 3000-1500 BC. It was Hippocrates who coined the term karkinos (the Greek name for crab. In English it is translated to carcinoma or cancer. Longevity, awareness, early diagnostics, early intervention, newer chemo-therapeutic agents, targeted treatments and advancing surgery have all made cancer treatment a challenging area of medicine.
Cancer – The molecular basis: Disruption in the orderly transfer of genetic material from cell to cell as a consequence of damage to the chromatin (DNA mutations) leads to abnormal cells. Their uncontrolled, disorderly growth leads to cancer. Causation of cancer is multifactorial.
Risk factors: Majority 95% of cancers are sporadic. 5% of them are genetically driven. The causation is multifactorial. Lifestyle, exposure to carcinogens, lifestyle and diet have a significant role to play. Irradiation, chemicals and pesticides, obesity, smoking, red meat, lack of fibre, fried fast food, oral contraceptive pills, delayed pregnancy, lack of breast feeding , air pollution etc are a few to mention.
Cancer burden in India: ICMR & National Centre for Disease Informatics and Research, Bangalore, India have provided the Emerging trends from consolidated reports of 27 population-based and 17 hospital-based registries between 2012 – 2014. It suggests that there is an increasing incidence & prevalence of cancers. There is increase in Lung cancer in females & colon cancer in males. Breast cancer is the most common cancer in India and continues to increase. Cancers of the uterus, ovary, and lung are increasing in females in urban areas. Overall incidence of cervical cancer is decreasing. Cancers of colon, rectum, & prostate in men are increasing in urban Bangalore, Chennai, and Delhi. North eastern part of India has the highest incidence throughout India for several cancers. Cancer burden in India is estimated to be 1·45 million new cases each year.
Cancers are seen to be increasing due to Longevity, awareness, affordability, early diagnostics, treatment, increasing insurance coverage and ever increasing risk factors.
Cancers are seen to be increasing due to Longevity, awareness, affordability, early diagnostics, treatment, increasing insurance coverage and ever increasing risk factors.
Decision making in cancer: Skilled surgeons, Surgical Robotics, Artificial intelligence (Decision making tools – IBM Watson) and cancer clinicians are all making the decision making in cancer surgery an exciting field of medicine.
“Incisions are easier than the decisions”- goes the saying. Repetitiveness makes the surgeons skilled, Robotic Technology is helping in precision surgery, Artificial intelligence software such as IBM Watson is helping in treatment decisions and above all the clinicians are applying their minds in making decisions.
It is intriguing to dwell into the science of decision making. The Science behind Decision making is complex; it is not only a science but an art that matures with experience, judgement, expertise and intellectual ability to understand the patient factors and psychology. Nothing can replace the human mind for it is the mind which created the machines and the artificial intelligence.
“Incisions are easier than the decisions”- goes the saying. Repetitiveness makes the surgeons skilled, Robotic Technology is helping in precision surgery, Artificial intelligence software such as IBM Watson is helping in treatment decisions and above all the clinicians are applying their minds in making decisions.
It is intriguing to dwell into the science of decision making. The Science behind Decision making is complex; it is not only a science but an art that matures with experience, judgement, expertise and intellectual ability to understand the patient factors and psychology. Nothing can replace the human mind for it is the mind which created the machines and the artificial intelligence.
Making a difference: To improve cancer care joint effort is required. The stakeholders are the people, professionals and the policy makers. The interventions required would include providing important leads for prevention and treatment of cancer in India. The regional differences point to the need for context specific interventions. The increasing rates of breast and colon cancer suggest that changing lifestyles associated with urbanization. Therefore awareness on diet and lifestyle is important. 30% — 60% of cancers in some regions are tobacco-related. Hence stronger action is needed on tobacco control. Prevention is the key and creating awareness about tobacco and other risk factors is important. Promoting vaccines, reduction of pollution, passive smoking, regulation of fast food are some of the measures that can help. 87% of patients come for diagnosis and treatment at advanced stages of the disease and One third of them do not complete treatment for various reasons. It is therefore important to create awareness about cancers and encourage people to seek help early.
