Union government has sanctioned Rs 2,500 crore under the 11th five year plan for the National Cancer Control Programme. The funding is a 10-fold increase compared to the 10th Plan allocation of Rs 250 crore. The assistance comes in to diagnose cases early. Indian cancer care is abysmal because of lack of diagnostic facilities and shortage of oncologists.
The National Cancer Control Programme promoted by the World Health Organization has been actively pursued by India. The key areas of WHO focus are tobacco control, palliative care and human resource development.
Late stage diagnosis is the cause of poor survival rate from cancer in India. The late presentation is mainly due to no 'Cancer Detection and Prevention Clinic' in district hospitals. The current oncologist-patient ratio is 0.98: 1 lakh cases. India is reporting 3 million cases of cancer annually. There are only 43 qualified oncologists DM (medical oncology) passing out of colleges in the country. The number needs to be increased by five fold, professor Purvish M Parikh, managing director AmeriCares India and president-elect, Indian Society of Medical and Paediatric Oncology told Pharmabiz.
Early detection is the one of the answers in the successful treatment of the dreaded disease which is affecting around 3 million annually in the country. While in the US half of the patients are being cured because of initial detection, in India it is only one-third of the patients who comes in early. We need to optimally utilize the funds to increase the number of oncologists and provide faster access to diagnosis, said Prof. Parikh.
The oncology drug market in India is valued at Rs 800 crore which covers both chemotherapy and supportive medicines. Companies like AstraZeneca, Biocon, Dr Reddy's and Sun Pharma are all vying for a share of the cancer market pie.
Globally there are 200 molecules under development. A visible trend is the shift from chemotherapy to targeted drug treatments like monoclonal antibodies. Drugs like cetuximab and tyrosine kinase inhibitors (TKIs) like sunitinib, imatinib and gefitinib are prescribed to prevent the activation of receptors that are found on the surface of particular cancer cells affecting colorectal, chronic myeloid leukaemia (CML), lung cancer and head & neck regions.
Advanced radiation delivery technologies like Cyberknife, IMRT and IGRT are only applicable for a small fragment of the population. The cost of the drugs and technology make it unaffordable for patients. The result is discontinuing check-ups and stopping drugs once symptoms are gone, which increases the morbidity of the disease. The challenge before the oncologists is to handle one million new cases diagnosed annually at various stages of the disease. In fact the incidence of cancer is on the rise among the ageing population. India is reporting an increasing number of head & neck and lung cancer across all sections of the population because of tobacco use. Among women in the 25-60 age-groups, breast cancer cases have increased and above 35 years cervical cancer cases are increasing.