Poonam SINGH (name changed) moved in and out of four hospitals with her son who had lung cancer, for a fortnight, before landing up at BLK Super Speciality Hospital. Eye cancer patient Vikas Yadav’s family visited 22 hospitals before finding succour at Cankids. Both families were at their wits end trying to figure out what was wrong with their children. Thankfully, they reached in time and could save their children’s lives. But many don’t make it in time.
India sees about 50,000 new childhood cancer cases every year. Of the 3,00,000 cases reported globally, 76,000 are from India. But treatment facilities are mostly limited to Tier 1 cities. Data collected from the Cankids Research Department states there are 250 centres to treat kids with cancer, but fewer than 30 per cent make it to a cancer centre. Also, the Top 10 centres see no more than 13-15 per cent of children. As a result, a large number of children die for want of treatment and incorrect diagnosis.
“We only have a handful of Paediatric Oncologists in India though the overall burden is very high. Also the infrastructure is limited, treatment facilities are available only in tertiary centres like AIIMS, Tata, which Tier II and III cities totally lack,” says Dr Vivek Verma, Head, Orthopedic Oncology, Max Hospital, Patparganj. “Cancer spreads faster in children than adults, making timely diagnosis the most important component of treatment and cure. And because children are very sensitive to chemotherapy, the treatment process is complex,” says Dr RC Joshi, Clinical Oncologist, Columbia Asia Hospital, Palam Vihar, Gurugram.
“Almost 50 per cent cancer cases go undiagnosed. Even after diagnosis, reaching the correct treatment is difficult due to lack of facilities. There is a usual lag of 3-4 months. The third hurdle is financial constraint. So, many opt out of treatment. Though Ayushman Bharat has helped, much more needs to be done,” says Dr Verma. However, the recovery rate among children is very high, “and much as 90 per cent of cancer in children can be cured,” says Dr Joshi, adding, “This is what makes the current mortality rate (50-70 per cent) totally unacceptable.”
In early February, kids suffering from cancer and their parents, wrote letters to the PM demanding a National Plan and Policy for Childhood Cancer. Childhood Cancer Survivors of KidscanKonnect have collected 300,000 pledges — ‘one for each child who has cancer somewhere in the world’. These pledges were collected online and through pledge books and sheets from patient beneficiaries such as parents and survivors, health care professionals as also civil society members. They are holding an awareness rally from AIIMS to PM’s house at Lok Kalyan Marg, and a street play at India Gate, today.
The need for a national policy
Not enough attention is given to awareness, detection, drugs and treatment development of childhood cancer as compared to adult cancers. A national policy would put a plan in place. It would mean better facilities, more paediatric oncologists, affordable and quality medication and a robust support system.
“Cancer in children is quite different from that in adults and therefore requires a focussed approach in terms of policy for quality, affordability and accessibility of treatment.
Having a national policy will help in making people aware of the signs, set up more hospitals offering the service and decentralise the treatment to allow people in rural or remote areas access it,” says Dr Joshi. “A comprehensive policy would ensure early diagnosis through a shared care model and integrate palliative care into paediatric oncology practice in the form of well-structured and collective studies,” says Dr Neha Singh, Consultant Pediatric Hematoncology, Paras Hospitals, Gurugram, adding that it should also ensure a reduction in the geographical gaps in treatment facilities.
“We need support from a comprehensive national agenda that is sponsored and supported by national and State Governments. We owe it to India’s children,” echoes Piyush Gupta, CEO of DBS Global and a Cankids donor and ambassador. “WHO Global Initiative for Childhood Cancer has set a target of 60 per cent of survival for children with cancer in low middle-income country like ours and to reduce the suffering for all children with cancer by 2030.
In the low- and middle-income countries, only 20 per cent of kids survive as against 80 per cent in the high-income countries. It’s time we have a National Childhood Cancer Plan and Policy to make it a health priority of India,” sums up Cankids Chairman Poonam Bagai.