Cabinet Committee on Economic Affairs (CCEA) has approved a scheme to strengthen the tertiary care cancer facilities at a cost of Rs.4,697 crore. The central government will help the state and union territory governments in setting up State Cancer Institutes’ (SCIs) and Tertiary Care Cancer Centres (TCCC).
The plan will help in increasing oncology-related facilities in underserved areas and augmenting of bed capacities for in-patient treatment. It is only with such dedicated and concerted efforts that India can battle the terror of cancer. The government has taken the right steps to enhance the state of cancer care in India, Dr Kshitish Chandra Mishra, radiotherapy, High – Tech Medical College and Hospital, Bhubaneshwar told Pharmabiz in an email interaction.
Access to cancer detection technologies like quality pathology labs, imaging equipment, especially PET/CTs that can detect cancer at least five years earlier than any other technology needs to be improved. India requires at least 500 PET/CTs to manage the present cancer incidence and 1,000 units by 2020. Another issue is the high treatment costs making it out of reach. Further, a skewed doctor-to-patient ratio only worsens the situation. The Union ministry for health and family welfare is working to achieve the doctor-patient ratio of 1:1000 by 2021, which at present is around 1:2000, he added.
A key issue with rising cancer incidence is the need to implement the preventive measures, map disease changes over time by cancer type, relative to the population at risk is a technical challenge, said Dr Mishra.
Further, different cancer forms with distinct causes requires different treatment approaches. Some factors that posed challenges to develop anti-cancer therapies include the inherent biological complexity of the disease. In addition, there are roadblocks to translational medicine. The challenges of early detection also surmount to the problems of drug approval process and access to human subjects with suitable tumour tissue for research, he said.
In India, cancer occurrence is 2.5 million annually with one million new cases. It is one of the leading causes of fatality with a chance of the disease rising five-fold by 2025. However, there is a high probability to treat if detected early in Stage I or Stage II.
Quoting the Boston Consulting Group study, Dr Mishra said 70-80 per cent patients are diagnosed late when treatment is less efficient and 60 per cent of them do not have access to quality cancer treatment. Out of over 300 cancer centres in India, 40 per cent are inadequately equipped with advanced equipment. India will need at least 600 additional cancer care centres to meet the requirements by 2020.
Latest developments in treatment are targeted therapy with 50 drugs for various cancers. These include trastuzumab for breast cancer, imatinib for chronic myelogenous leukaemia, sunitinib and everolimus for advanced kidney cancer. Cancer vaccines are another breakthrough in prevention and treatment with the potential to treat cancers of prostate non-small cell lung, pancreatic, ovarian, melanoma, and multiple myeloma and cervix. In radiation therapy, minimizing doses delivered to nearby healthy tissue via 3D Conformal Radiation, stereotactic radiosurgery and brachytherapy and CyberKnife are available. Conservation surgery for breast and cosmetic reconstructive surgery for oral cancer is gaining momentum. Combination chemotherapy has become a standard for treating many cancers because it has shown to increase survival and remission rates, stated Dr Mishra.