Dr KK Aggarwal
Padma Shri and Dr B C Roy National Awardee
President, Heart Care Foundation of India
The triad of early diagnosis, proper treatment and mass awareness in cancer is essential. Unless there are good centres in a city which can provide complete treatment if the cancer is detected in time then only the awareness will have an impact. If the general feeling is that what is the use of diagnosis, if there is no cure’ then the programme is going to be a failure.
In awareness, more important is to detect cancer at its early stage. Cancers of head, neck, lung and cervix are preventable. If treated in time a large number of cancers are curable. Most of the childhood tumors are curable, so are a few of the adult cancers like Hodgkin’s disease, non Hodgkin’s lymphomas and breast cancer.
The incidence of cancer is increasing in the West but the mortality is decreasing.
It is unfortunate to note that while in the U.S.A. most of the breast cancers are detected in stage 0 or 1, the same are detected in our country at stage 3 or 4.
Nobody should die of cervical cancer. In the West the mortality has come down to zero. But in India its still one of the major causes of cancer deaths. The only answer seems to be detection of early cancer by periodic PAP smear test but not more than 2% of Indian women get their annual PAP smears done.
Everybody after the age of 40 must be screened for the presence of early cancer but if a family history of cancer (e.g. breast, other organs) is present, the screening must start at the age 25.
There are a few cancers (e.g. blood cancers) which cannot be predicted or detected by annual screening. The emphasis for them has to be on the right and timely treatment.
Most of the stomach cancers in India are misdiagnosed as acidity for atleast 6 months to one year, and this loss of time is many a time responsible for progression of cancer to an incurable stage.
This is the time to create awareness amongst public and to refresh knowledge of doctors. One should remember that first treatment is the best treatment. Never leave the first chance. If at the first instance the diagnosis is missed, or only partial treatment is started, the outcome can never be successful.
All cancers are not identical. They all behave differently and the response to therapy may also be different. Mythical beliefs should be removed only then a uniform level of public awareness can be expected.