Methodically closing the cancer-care gaps

Authored by Dr Vikram D Kekatpure, Senior Consultant, Head and Neck Oncology, Aster CMI Hospital, Bengaluru

Every year since 2000, February 4 is observed as World Cancer Day to create cancer awareness and encourage its prevention, early detection and treatment. This is an opportunity to renew our commitment to reduce cancer-related suffering and deaths. In the last few decades, we have made significant progress in our understanding of the cancer biology, standardisation of treatment protocol, development of newer diagnostics, innovative drugs, better realisation of the survivorship and quality of life issues. One of the main challenges in cancer care is to ensure uniform delivery of care. The treatment tends to get influenced by availability of resources, both technical and socioeconomic. To address this issue, theme for this year’s World Cancer Day is ‘Close the care gap’.

Covid-pandemic has disrupted normal life for more than two years. About 5.5 million people have died due it. Compare this to cancer mortality of 10 million deaths a year, which still is fairly unnoticed. Even alarming is the projection that cancer-related deaths will increase to 13 million per year over the next few years. In such a situation, we need to redouble efforts of cancer awareness, prevention, early detection and innovative therapies. But the real challenge is to deliver a standard of care to everyone and overcome the gaps in cancer care.

Gap in awareness
As many as 90 per cent of head and neck cancers are associated with the habit of tobacco chewing/ smoking. Therefore, primary prevention with effective tobacco control could reduce this number drastically. Each one of us should join efforts to create awareness and discourage particularly the youth from trying out tobacco even once. Cancers detected in early or precancerous stage have a good outcome and treatment protocol are less intense.

Gap in resources
Equitable distribution of health care is always a challenge and more so for the cancer care. A comprehensive cancer care requires a multidisciplinary team supported by resource intense imaging facility, radiotherapy machine, chemotherapy suite, operation theater etc. Most of these resources are concentrated in major cities with limited availability in rural parts. In recent years, both government and private sectors have invested in improving the rural health care.

Gap in finances
Affordable health care is an elusive goal. A diagnosis of cancer not only devastating but financially draining. The cost not only includes the direct treatment related expenses but often overlooked are indirect cost due to loss of employment, hospital travels, special dietary and support requirements. Indirect costs have to be borne by the patient and family even if treatment cost is covered insurance or government schemes. Lack of resources is primary reason for cancer patients to discontinue the treatment mid-way.

Gaps in learning
Quality healthcare can be only delivered trained health care personals. There is need to strengthen oncology specific educational programs for doctors, nurses, technicians with capabilities of delivering care in rural set up. There has to be a greater engagement between industry particularly pharma and tech companies, researchers and medical staff.