Moves afoot to make cancer a notifiable disease

New Delhi: As the country observes `World No Tobacco Day` today, moves to make cancer a notifiable disease are making progress with two states Kerala and Punjab agreeing to such a proposal.

A meeting of various states will be held in the Health Ministry here next week to discuss the issue.

Punjab and Kerala are already registering all cancer cases and are creating a database of all patients in their states.

"We are working on possibilities of making cancer a notifiable disease and an expert group is already looking into this," Health Secretary P K Pradhan told PTI.

He, however, said before doing so, steps to improve infrastructure for cancer treatment and detection have to be strengthened across the country.

Meanwhile, leading oncologist Vinod Raina said that in India`s context, statistics related to tobacco -- a major cause of cancer -- are shocking as one in every five male deaths and one in every 20 female deaths are caused by smoking and other forms of tobacco use.

"India has now around 12 crore tobacco users, which means every 9th Indian consumes tobacco," Raina said, adding that "one-third of cancers in India are related to tobacco/smoking."

Raina, who is head of Medical Oncology at AIIMS, said "Tobacco smoke is responsible for 80 to 90 per cent of all lung tumours."

He said more than 56 per cent of lung cancer cases are detected at the 4th stage where chances of survival are three to four months. He blamed lack of awareness and facilities for screening as being responsible for this, saying less than 10 per cent of cancer cases are reported right now.

Pradhan said, "Government is working out ways and means to strengthen the existing cancer centres and improve the screening process, besides creating more human resources for cancer detection and treatment."

According to Raina, there are now 19 cancers for which there is strong evidence that they are caused by cigarette smoking.

He said lung cancer is directly linked to cigarette smoking, which is also one of the leading causes of death in the country.

Raina cautioned that cigarettes contain over 4,000 toxic chemicals, 50 of which are known to cause cancer and Nicotine is one of them.
"At low doses it can stimulate nerve cells, but at high doses it is a poison that has been used as an insecticide. One can inhale 1-2 mg of nicotine while smoking a cigarette, but 60 mg of it is enough to kill most people," he said.

He warned that when inhaled, nicotine first goes to the lungs and bloodstream and within seven seconds, one quarter of nicotine has gone straight to the brain.

"It has a powerful effect on the brain and the central nervous system. It causes your brain to release a `pleasure` chemical called dopamine which gives you a false sense of well-being and soon you want more of it on a regular basis," he explained, adding that "this is the beginning of an addiction and the reason why people find it hard to quit."

But if someone wants to quit, he or she has to prepare for it as there is no "magic wand" to give up smoking, he said.

According to the Global Adult Tobacco Survey (GATS) 2009- 2010, nearly 241 million or 35 per cent of Indians (47 per cent men and 20.3 per cent women) are currently using some form of tobacco, which kills nearly 10 lakh people in the country every year.

The WHO 2012 Global Report on Mortality claims that seven per cent of all deaths for people aged 30 and over in India are attributable to tobacco.