BENGALURU: Cancer ranks among the top three causes of premature mortality among women, according to a recent, thought-provoking report published in The Lancet. Of the 2.3 million women who die prematurely from cancer each year, 1.5 million deaths could be averted through primary prevention or early detection strategies, while a further 800,000 deaths could be averted if all women everywhere could access optimal cancer care.
As an oncologist practising in India, I am mindful of the socio-economic inequalities and lack of awareness that hinder early cancer detection and timely cure. Most women in our country are detected with stage 3 and stage 4 of breast cancer, unlike the West, where breast cancer is usually diagnosed at stage 1 and stage 2. Another challenge is the average age of breast cancer patients in India, which is 47-49 years, almost a decade earlier than the western counterparts.
Better awareness
As conversations about cancer take centre stage, following Catherine, the Princess of Wales’ recent cancer diagnosis message, we have the opportunity to shine light on the fact that cancer can impact anyone, even seemingly healthy individuals. There must be no stigma attached to seeking medical care – whether it is regular cancer screenings, such as mammogram or PAP smear, or recommended treatments, such as chemotherapy, radiation therapy or surgery.
Better awareness can save countless lives. Nearly two lakh new cases of breast cancer are reported every year in India, of which around 90,000 patients die in the first year. Studies show that most deaths occur among the unscreened population as the cancer is typically detected at a late stage. In most parts of the country, women are uncomfortable to discuss symptoms and go in for a physical examination. Irrespective of economic resources, women are more likely than men to lack the knowledge and the power to make informed cancer-related healthcare decisions. This has to change. The emphasis needs to be on prevention and early detection.
Treating an early-stage cancer is almost 80 per cent more cost-effective than treating it at a later stage. Furthermore, the survival rates are five times higher at the early stage.
Informed action
The common risk factors for cancer include obesity, gene mutation, exposure to carcinogens like tobacco, alchohol, lack of physical exercise and excess blood clotting, among others.
It’s important to note, though, that having a risk factor does not necessarily mean you will get cancer. Just as not having any risk factors cannot completely rule out the likelihood of cancer.
It’s important to include cancer screenings, along with annual health checkups, in individuals who are 40 years or older. And even earlier, in those with risk factors. If you have a family history of breast cancer or mutation of BRCA gene, for example, it’s advisable to get the screening done 10 years earlier than the age of detection in the family member.
Mammography with clinical breast examination is recommended annually as an early detection measure.
In terms of preventive measures, the recommendations are simple. Regular exercise, healthy diet, no smoking, moderate, if at all, intake of alcohol, and managing stress levels are the key factors to reduce your risk of getting cancer.
That said, a cancer diagnosis is no longer equated with a death sentence. The number of cancer survivors continues to grow, as newer isotopes for diagnosis and treatment yield improved results. Today, the
development of immunohistochemistry (IHC), liquid biopsies, genetic tests, targeted therapy, CDK inhibitors, and CAR-T cell therapy have transformed the way we diagnose and tailor cancer treatments. Many cancers are curable.
Let’s break the stigma and empower women to make informed health decisions.
(The writer is senior consultant and director - breast oncology, Cytecare Hospitals)