BANGALORE : The government is talking of capping the prices of essential drugs for cancer. That should come as welcome news to patients in Bangalore, many of whom give up after a few months of treatment.
A significant number of patients (some put the number at over 50 per cent) stop visiting hospitals after two or three cycles of chemotherapy. They also drop out from regular follow-up visits, say doctors.
Oncologists say cancer patients are diagnosed mostly in the advanced stages, calling for a longer duration of treatment involving surgery, chemotherapy and radiotherapy, besides medication and check-ups.
Umesh (name changed) has to take care of a family of five. His wife suffers from breast cancer, diagnosed at the third stage. She started on chemo two years ago and was prescribed a 21-day cycle of Herceptin every year.
The price of Herceptin came down recently by half. It is still out of reach for many. "For someone like me, it is just impossible to afford it. I hope the government looks into the pricing of cancer drugs," he told City Express.
Suresh (65), who was suffering from recurrent bouts of stomach pain for three years, died recently after he was diagnosed with third stage of colon-rectal cancer.
His daughter says, "With the high costs of drugs, chemo and radiotherapy, my father refused treatment saying it was a drain on our meagre resources."
When patients reach the third stage (of four), the survival rate is just 50 per cent, says consulting surgeon Dr Bhaskar Pai of Mallya Hospital.
"Even after they notice a lump, unusual bleeding, weight loss or ulcers, they come so late that the mortality rate is high. Cancer strikes silently, with many patients not feeling any pain or discomfort," he said.
Every month, BGS Global Hospital gets about 100 new cancer cases. If women are afflicted with breast cancer, the other most common complaints are cancer of the stomach, food pipe, and colon. Most of these are a result of poor lifestyles, sedentary habits, smoking and chewing tobacco, says Dr Venkatachala, Surgical Oncologist, BGS Global Hospital.
"Cancer is not always covered under insurance. The cost of treatment for advanced cases comes to about Rs 12 lakh a year. Only a few patients are able to bear the cost," he explains.
Government health schemes like Yashaswini, Arogyashri, and Vajpayee Arogya Yojane do not cover cancer. Even the government is not in a position to allocate funds for cancer under the National Health Scheme.
A government doctor explains, "A third stage patient from a village who comes to Bangalore has to spend at least Rs 2-4 lakh to start with." Even if the family sells its land and house, there is no guarantee the patient will survive. "Compare this with heart surgery where the patient not only survives but also manages to lead a healthy, productive life," he says.
Patients are known to suffer relapses after some years, and are again subjected to the difficulties of chemotherapy and high costs.
Chances of relapse
The last eight years, Sharmila (name changed) has been suffering from breast cancer. She was improving, but had a relapse last year.
She has to take an Aromycin every day. It costs `800 each. "If I purchase this drug in Kidwai Hospital, it comes to around Rs 29,000 a month while in the open market, it is Rs 33,000. I have undergone six chemos that cost me Rs 4.5 lakh while four or five PET scans have cost me Rs 1.65 lakh," she told City Express.
Hospital costs have set her back by a few more lakhs. "Last year, another round of chemo therapy cost me Rs 4 lakh as my cancer was back," she says.
Kathy, receiving treatment at HCG, has undergone 12 chemo and 20 radiotherapy sessions followed by regular dosages of Herceptin. She is now recovering from her prognosis of third stage breast cancer which has spread to other organs.
It is a losing battle. She has exhausted all her resources, even after several well-wishers pooled in some money to help her. "I am in a dilemma as I am supposed to follow a regimen of Herceptin every day so that the disease does not relapse," she said.
It is indeed very tough for the family to take any decision in such a situation, say doctors. The government is worried by the high costs, too. Is it possible for the National Health Programme to cover cancer when there are many other diseases like blindness, diarrhea, tuberculosis, and leprosy that have to be tackled and controlled first?
In India, seven lakh people are diagnosed with cancer every year. Over half of them die. Karnataka has about 1.5 lakh cancer cases at any given time, and an estimated 35,000 new cases are added to this number each year. The data from the Hospital Based Cancer Registry of India has shown that cancers of the cervix (28 per cent) and breast (16 per cent) in women are most common, while cancers of the head and neck region constitute about 30 per cent of all cancers in males and females. According to the World Health Organisation, every year, 1.45 lakh women are diagnosed with breast cancer in India. In 2008, nearly half of them died from it.