Oncologists are of the view that cancer treatment is increasingly becoming challenging owing to availability of several novel drugs and also new treatment modalities. The challenge is mainly in detecting cancer early, providing right treatment at affordable cost, ensuring that organs are protected and finally managing the disorder well so that patients can lead a quality life post treatment.

India reports around 10 lakh cancer patients annually. The major causative factors are life style related to tobacco chewing, smoking, dietary factors, alcohol and lack of exercises. The World Cancer Report reveals that the incidence of cancer is set to increase at an alarming rate globally, with 50 per cent new cases by the year 2020.

Even as cancer incidence is increasing, several new treatment modalities including targeted therapies/nano technology have been developed to treat wide varieties of cancers like chronic myelogenous leukaemia, acute myelogenous leukaemia, lung, breast, colon, Glioblastoma multiforme (brain tumour), renal, head and neck cancers. The biggest advantage of targeted therapy is the lack of side effects, though the same are generally not cost effective.

Between 2008-2009 new drugs being prescribed include Cetuximab for head and neck, colon cancer; Biomab for head and neck cancer; Avastin-for renal, breast, lung, colon and GBM; Abraxane for breast and pancreatic cancer; Xempra for breast cancer; Temsirdimus for renal cancer and Sorafenib for renal and liver cancer. Along with this, oncologists have recommended surgery, radio therapy, chemotherapy, hormonal and biological therapies to ensure effective management.

The challenge is to be able to integrate new drugs with surgery, radio therapy or chemo. Cost is another formidable factor making it difficult for medical experts to treat, said Dr Radheshyam Naik, Consultant Medical Oncologist, HCG.

The theme for the World Health Day 2010 observed annually on April 7 was Urbanization and Health. With growing cancer incidence, its emergence as a life style disease that threatens to become the number one killer by 2012, oncologists opined that challenge now is far more greater than ever before. It may be noted that more people are dying of cancer than TB, diabetes and malaria combined.

According to P Marimuthu, Department of Biostatistics, National Institute of Mental Health and Neuro Science who has reported in the Indian Journal of Cancer that around 26.6 per cent increase is expected in the registered number of cancer cases in five cities - Bangalore, Chennai, Delhi, Bhopal and Mumbai.

“The changing demographic scenario in India is declining fertility level and increasing life expectancy. As the life expectancy at birth increases, proportionately the percentage of geriatric population increases. Higher incidence of non-communicable diseases, especially cancer is positively associated with percentage of aged population of a country,” said Marimuthu.

Dr Jagannth Dixit, consultant surgical oncologist, BGS Global Hospitals, said that infrastructure and human resources are lacking even in urban places for treating cancer patients. Compared to the population affected by cancer, the existing tertiary care hospital ratio is not adequate especially with reference to availability of qualified oncologists and radiation facility.

Since cancer care requires comprehensive treatment, the high cost of drugs and side-effects have led to increased number of patients dropping out of treatments. In-complete treatment may result in recurrence and thereby increasing mortality rate, added Dr Dixit.