On the important occasion of World Cancer Day today, Dr Niti Krishna Raizada, director, Medical Oncology and Hemato-Oncologist, Fortis Cancer Institute, Fortis Group of Hospitals, La Femme, Bangalore, says almost 1 in 10 Indian is at a risk of developing cancer in their lifetime, a risk that increases with age.
“Lifestyle factors, which include tobacco-alcohol, stress, poor physical activity and diet, contribute to cancer. Breast cancer, oral cavity cancer, cervix cancer, lung and colon cancer are the most common cancers in our society. All of them can be diagnosed early and most have pre-invasive (pre-cancerous) stages that can be diagnosed with simple tests and prevented,” she adds.
The doctor states that screening programmes hold extreme value, and that all individuals from age 40 year upwards should visit an oncologist once a year for an annual check-up. “This may include basic blood profile and gender-specific and/or risk-specific tests.”
“If there are any suspicious lesions, an oncologist would opt for a needle test or a biopsy. If the biopsy confirms cancer, certain biomarkers decide the treatment; along with it, we may do certain scans to stage the cancer.
“Treatment is in the form of radiation therapy, surgery, systemic therapy, which could be chemotherapy, biologic therapy or immunotherapies or transplant. Most of the treatment now is individualised or customised based on certain tumour and patient characteristics. Surgeries are becoming more organ-preserving. Radiation is highly specialised. Systemic therapy is often based on expression of certain molecular markers. This has led to an entire era of precision oncology and tests like blood or tumour mutation analysis are often performed,” Dr Raizada explains.
Keeping with the theme of this year, which is ‘Close The Care Gap’, the doctor adds that knowledge about problems and addressing the barriers to access care is important.
How can this be done?
1. Identify high-risk groups, like people with certain addictions, occupations, family history etc for screening and preventive programmes. These risk groups can be subjected to focused counselling and testing.
2. Patients who are already diagnosed with cancer and possibly not taking treatment due to poor social support or economic reasons should be identified and a holistic approach should be taken to manage them.
3. There may not be enough facilities in the area where the patient lives. Developing a care facility which includes talent and technology such that more and more population can be addressed is the key.
4. Patients may not have enough information about their condition. This requires better communication on the part of the caregiver and the healthcare provider and also having more coordinators working to address these issues.
Patient engagement strategies by healthcare providers can include:
* Risk-stratification or basically segmenting the population into risk groups such that high-risk groups can be addressed appropriately. This also includes vaccination programmes and preventive care.
* Outreach programme where healthcare providers reach out to high-need population to close the care gaps.
* Patient education, which can be done by reaching out to schools, colleges and the workplace, by marketing campaigns and media activities.
* Work towards addressing barriers like geographical area, racial bias, income group and transportation.