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29 March 2017 | Last updated 01:21 AM
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‘Early diagnosis translates into cure’
Dr Chaitanyanand Koppiker, Prashanti Cancer Care Mission, Dr Anand Bang, Senior Advisor-Health, Tata Trust, C disease, Ambika Shaligram
Dr Chaitanyanand Koppiker, Prashanti Cancer Care Mission and Dr Anand Bang, Senior Advisor-Health, Tata Trust emphasise on early detection of the dreaded C disease.
On Sunday, Tata Trusts in association with Prashanti Cancer Care Mission, will flag off three state-of-the-art mobile vans from Police Parade Ground, Shivajinagar. The mobile vans, which will travel in the Pune district, are equipped with trained medicos who will do on the spot screenings.
Dr Chaitanyanand Koppiker and Dr Anand Bang explain the initiative and methods to treat cancer.
It is said that Indian women are diffident about getting themselves tested and screened. Is that a worldwide trend too?
Dr Bang: At Tata Trusts, cancer is one of our major focus areas. For example, in a rural hospital in Gadhchiroli we observed that women were more aware about breast cancer than cervical cancer. Rural women generally go to hospitals with small lumps and explain that they are afraid that this could be a lump of cancer.
In the case of cervical cancer though, signs such as white discharge or blood stained discharge, may not be considered as abnormal by many rural women. Hence they seek assistance late. We have to build up on awareness.
Dr Koppiker: Yes, the trend is that breast cancer incidence in India is on the increase especially in urban India because of lifestyle factors. It is estimated that 1 in 22 women will suffer from the disease. The other alarming fact is that breast cancer peaks at a very early age of about 45 in India as against 60 + in the West.
It is also true that Indian women are diffident about getting themselves tested and screened because they believe that diagnosis will lead to death and mutilation. They are not aware that early diagnosis translates into cure and that losing the breast is not an option of treatment anymore.
It’s said that radiation in mammography can cause cancer cells and hence women are reluctant to go for screenings. Is that true?
Dr Bang: Though the radiation from one sitting of mammography is insignificant, theoretically, frequent mammography examination could be problematic.
Dr Koppiker: Mammography and especially digital machines with Tomosynthesis give out radiation that is miniscule. The amount released is what a lady will be exposed to if she spends one day in natural sunlight. It does not cause cancer.
Is breast self-examination also a useful technique?
Dr Bang: Absolutely. Training women in systematic self-examination is vital. It is crucial that men are also involved in this endeavour. I will refer to our experience in the rural hospital in Gadchiroli. We had found that in 82 cases out of 100 consecutive women, who came to the clinic with a breast lump, it was the husband who had detected it! Hence through life skill education programmes, the men must be made aware of the signs of malignancy.
Dr Koppiker: In India, where mammography has not been adopted widely and where most cancers are detected in late stages, breast self-examination will definitely help identify tumors in an earlier stage.
Another method would be to get trained medics and paramedics to carry out physical examinations for screening.
The best solution to the problem is a three-tier system where there is a tertiary center of affordable excellence which also confers primary and secondary diagnostic care to the women community. The secondary care is through the mobile vans with mammography and trained paramedics doing clinical exam. And primary care is through sensitisation, awareness programmes and clinical examinations. This three-tier system is the basis for the new project that has been authenticated by many experts in the field from India and abroad.
Do we need to hammer in through TV and other mediums that ‘prevention is better than cure’?
Dr Bang: Definitely. At the same time, we must not focus on just generic messages, but emphasise on specific symptoms such as, the nature of the lump, how to identify it and what does cancer mean exactly. Also, what are the risk factors of breast cancer, what life style changes are required to be made by women to counter it etc.
Dr Koppiker: This is absolutely necessary so that the community can adopt lifestyle changes that can prevent breast cancer. Proper diet and exercise can prevent the disease to the extent of 30 per cent.
There are reports on reduction of prices of cancer drugs. What else can be done to make cancer treatment affordable?
Dr Bang: There can be compulsory licensing of the cancer chemotherapeutic drugs and addition of cancer medications to the list of Essential Drugs. While drugs are critical, one must keep in mind that diagnosis would play an equally important role. Hence Fine Needle Aspiration Cytology (FNAC), excision biopsy and histopathology should be made widely available.
Dr Koppiker: Every specialty of medicine should be accessible with excellence to all irrespective of the cost. Philanthropic organisations can create institutions of affordable excellence. They should take care of the poor with free-ship or highly concessional treatment and those who are insured or affluent pay for their treatment. This is the only solution to our problem if treatment of excellence is to be handed out to all.
About the mobile vans-
The mobile van project is designed on a telecommunication concept. Trained doctors, paramedics and technicians will travel in the vans. All the data collected will be digital and transmitted to the centre of excellence. Mammography and colposcopy pictures will be transmitted and read by highly qualified experts form breast diagnostics and gynecology. All suspicious cases will be rescreened at the centre.
Trained social workers will also be a part of the vans who will educate, counsel and follow up with the patients who will be referred to the tertiary centre. They will also ensure that cases picked up receive the right treatment. A large percentage of treatment will be free. Corporates and affording societies and associations will pay a very nominal charge per screening for their employees or members.
Puneites will run in ‘Our Marathon’ to spread awareness about Breast Cancer, organised on January 31. It will be flagged off from Pune Police Parade Ground. For details visit, www.OurMarathon.ORG
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