Zee Media Bureau/Salome Phelamei
New Delhi: Even as the number of cancer cases in India is accelerating with a million new cases being reported every year, experts warn that the incidence of the killer disease is expected to rise five-fold by 2025.
Nearly 500,000 people die of cancer in India yearly. However, this number is expected to rise to 700,000 by 2015, according to the World Health Organisation (WHO).
Despite its high prevalence rate, it's a huge concern that the country’s healthcare infrastructure is poorly prepared to deal with all facets of cancer care – prevention, early detection, treatment and palliative care.
In this not so encouraging story is the positive aspect that, in pockets latest advances in cancer treatment have become available in India simultaneously as they are available/ approved for clinical application in the West.
Dr. Sapna Nangia, Cancer specialist at the Indraprastha Apollo Hospital, New Delhi, tells us some of the latest advances in cancer treatment.
Targeted treatment: Various cellular pathways, often specific to the type of cancer, allow cancer cells to become immortal, acquire blood supply, divide in an uncontrolled manner and spread, leading to accumulation of large numbers of abnormal cancer cells. Targeted treatments are designed to disrupt these pathways, thus interfering with the cancerous characteristics of these cells.
According to Dr. Nangia, the earliest targeted treatment, imatinib, was approved for treatment of chronic myeloid leukemia, a kind of blood cancer, in 2001. It acted on an enzyme that was unique to the cancerous cell and was thus “targeted therapy”. Since then, targeted therapies have lead to dramatic improvements in the life span of breast cancer and lung cancer patients, by the administration of the drugs trastuzumab and tyrosine kinase inhibitors respectively, in patients whose cancer cells carried pathways that were targeted by these drugs. In addition, targeted treatments like sorafenib, sunitinib and pazopanib have lead to improvement in the life span of patients suffering from liver and kidney cancer, respectively, cancers which were considered resistant to treatment.
Stereotactic Ablative Radiosurgery: Radiotherapy, i.e. the use of x-rays to kill cancer cells has seen dramatic improvements in radiation delivery machines, linear accelerators as well as in computer software. This has led to great precision in the delivery of radiotherapy to tumours and avoidance of the same in neighbouring normal structures.
As per Dr. Nangia, this ability has been harnessed very effectively to give very large focused doses of radiation in one to five fractions to destroy early stage lung cancer. This technique which is also called Stereotactic Body Radiotherapy (SBRT) results in excellent cure rates in early stage lung cancer patients who are unable to undergo surgery and is under investigation as the first option for lung cancer patients.
This treatment technique is also a possibility of cure in patients with limited spread from breast cancer, large intestine cancer, kidney cancer and others.
Mass screening for cervical cancer using VIA technique: A simple method of screening for cervical cancer using vinegar , carried out by health workers, has led to a 30 % reduction of dying from cancer of the opening of the uterus, i.e. cervical cancer. Greater participation of NGOs, organizations like Rotary, Lions etc. along with greater governmental action is required to reduce the incidence of this preventable cancer. A quarter of the world’s cervical cancer patients are in India.
Robotic Surgery for Prostate Cancer: Robotic surgery marries the benefits of laparoscopy i.e. surgery using scopes rather than large incisions to reach the surgical field, highly manoeuvrable surgical instruments and magnification to the tune of 40 times normal vison, to allow the surgeon to effectively perform surgery in the narrow male pelvis. This is rapidly becoming the preferred approach in carefully selected patients. Image Guided Radiotherapy is the treatment of choice in advanced patients not fit to undergo surgery for prostate cancer.
Research is ongoing in all aspects of cancer diagnosis and management and doctors and patients can look forward to a slow and steady improvement in the cure rates for cancer.