It is necessary to make cancer screening mandatory

The Indian Council of Medical Research (ICMR) has said in a research that the number of cancer patients in India is expected to increase by seven percent in the next two years i.e. by 2025. The number of people dying from cancer is also increasing in India. In the last 22 years, more than 1.5 crore cancer patients have died in India. Despite this, cancer is not included in the notified diseases in India. For this reason the National Cancer Registry cannot claim that it has absolutely accurate data. States like Jharkhand, Odisha and West Bengal have declared cancer as a notifiable disease at their level. Bihar government should include cancer in the category of notified diseases. Jharkhand Chief Minister Hemant Soren has also done this recently. Cancer is now a notified disease in Jharkhand and this is a testament to the government’s sensitivity towards its seriousness. This is a small but precise step.

National Cancer Awareness Day is celebrated every year on 7th November in India. But, is this enough? Are there complete arrangements for cancer diagnosis and treatment in every state of India? Is the central government worried about its magnitude? For a patient like me, who has been living with last stage cancer for the last three years, the answers to these questions are disappointing because they are negative. Doesn’t the question arise that when 70 percent of cancer cases in western countries are caught in the early stages, then why does this not happen in India? What is the reason that more than 90 percent of cancer cases in India are detected in the last stage? Then doctors have very few options to cure the patients. Research related to cancer in India is at the lowest level. Despite the recommendations of its own parliamentary committee, the Indian government is turning a blind eye to the menace of cancer.

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It is also true that promising politicians like Manohar Parrikar, Ananth Kumar and Arun Jaitley, who were in Prime Minister Narendra Modi’s cabinet, died due to cancer. His cancer was also caught at a later stage because no meaningful campaign for screening is run in our country. There are no complete treatments for cancer in hospitals. Leave aside treatment and tests using new technologies, even chemotherapy, the most accurate and globally accepted method of cancer treatment, is not available in all district headquarters. Even if we do not discuss the high cost of cancer medicines for a while, lack of facilities has become a major reason for the death of cancer patients.

Is having Ayushman card a guarantee of complete treatment of cancer? Do you know that the cost of immunotherapy done in advanced stage can be up to Rs 10 lakh per dose. The annual expenditure on medicines for targeted therapy is up to Rs 60 lakh per year. Chemotherapy, operations, radiation, hospitalization expenses and frequent trips to other cities in the absence of a hospital leave patients devastated. In such a situation, it is natural to raise questions as to what kind of awareness programs are being run in India. Is the government in a position to explain what has been achieved through these programmes? Awareness programs cannot actually be mere chapters of a book. If the Indian government has to show real seriousness, it will have to make cancer screening mandatory.

All people above 40 years of age who come to the hospital for treatment of any disease will have to undergo cancer screening according to their vulnerability. For example, if a 40 year old woman has gone to the hospital, then get her checked for breast cancer, cervical cancer etc. If a man of the same age comes to the hospital, then get him screened for cancer of mouth, lungs, prostate, liver etc. Children should be examined separately. Put such packages separately in the Ayushman Card Scheme. This will not cost much. Cervical cancer vaccine is available in India, it will have to be administered free of cost to every woman aged 18 to 45 years. Why can’t tests like mammography and Pap smear be made mandatory?

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Why can’t every hospital have cancer specialist doctors? Why can’t there be a socio-economic survey of cancer patients? If the government wants, nurses can be engaged in chemotherapy after proper training and oncologists sitting far away can give them instructions over video call. If possible, there should be a provision for free cancer treatment. Responsibility for every death occurring due to this will have to be taken and compensation will have to be decided. Otherwise, people will keep dying and we will keep issuing media releases in the name of awareness programs.

(These are the personal views of the author.)

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