Increasing bandwidth in cancer control

THIRUVANANTHAPURAM: World Cancer Day is observed on February 4 every year. It is the singular initiative under which the entire world can unite together in the fight against this global malady.World Cancer Day-2012 is particularly important as it falls almost half-a-year after the first UN high-level meeting on Non-Communicable Diseases (NCDs), and the signing of the political declaration supporting prevention and control of these devastating conditions, including cancer. This year’s World Cancer Day has ‘Together it is possible’ as its theme because it is only by individual and collective effort of every person, hospital, organisation, government, and civil society doing their best that the world would be able to reduce premature deaths from cancer and other NCDs by 25 per cent by 2025.World Cancer Day is a global observance that helps raise people’s awareness of cancer and how to prevent, detect or treat it.Cancer, like other contemporary evils like crime and corruption, has to be dealt with on a war-footing. Ironically, several social evils are described as being ‘cancerous’ owing to their morbid trajectory, the good news being, like social evils, cancer can be prevented or controlled. Every hour more than sixty patients die from cancer and in pain across India.Around a million new cancers are diagnosed in India every year, and around 14,000 in Kerala, of which more than a third register at the Regional Cancer Centre, Thiruvanathapuram. Cancer is the uncontrolled division of cells in the body. Any part of the body and any organ for that matter is vulnerable. Normal division of every cell is regulated for proper development and functioning. When cells lose this control, repeated division leads to a mass of abnormal cells called a ‘tumour’, in layman’s parlance. A tumour does not have any function in the body, instead, as it grows, it obstructs passages, pushes tissues and organs around it drawing their nutrients obstructing their vital function causing symptoms like pain. Unless its growth is arrested early enough, it has the potential to wreak havoc regionally and in distant organs, the process being called a ‘metastasis’ - or a ‘secondary’ as distinct from a ‘primary’ which is the site of origin. The ‘rule of thirds’ says that we can prevent a third of all cancers, cure a third and unfortunately in a third we are constrained to focus on quality of life as we may fail to improve on the quantity. Cancer often is the cumulative result of the effects of a ‘carcinogen like tobacco or environmental chemicals. Several risk factors like radiation, genetic predisposition, nutritional factors, immunological deficiencies or viruses can contribute. Even theories abound to its causation due to lifestyle changes and stress, all contributing to natural cellular changes that predispose to cancer.The government’s ambitious NCCP (National Cancer Control Programme) envisages prevention, early detection, treatment, and palliative care. Today, early detection with a multimodality approach that includes surgery, chemotherapy and radiation, most cancers are cured or patients have extended disease-free periods. The RCC at Thiruvanathapuram has several firsts to its credit. The country’s first Community Oncology Department and the first Paediatric Oncology Department were started here. The country’s first Palliative Medicine Division had its genesis here, and to the RCC goes the credit for being the only cancer centre with its own morphine manufacturing plant, where both morphine liquid and capsules are manufactured, to be given free of cost to poor patients in agonising pain.   The RCC made a difference and led by example with its insurance programme ‘Cancer Care for Life’ (CCL). NGOs that work alongside see patients at their homes. The RCC also boasts of an ambitious Telemedicine division connecting centres across the country and beyond its borders. Today the RCC, Thiruvanathapuram has become the trusted destination for early detection of cancer, treatment, palliative care research and training. The RCC believes that there is ‘life beyond cancer and care beyond cure.’ Whenever and wherever we may not be able to add years to life, we definitely add ‘life to years.’(Additional Professor and Head,Division of Palliative Medicine,Regional Cancer Centre,Thiruvananthapuram)