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Winning the war against cancer

Cancer prevention at primary, secondary and tertiary levels as well as early detection hold the key

Winning the war against cancer

Governments and healthcare providers must proactively insist on awareness and regular screening. istock

BS Ajai Kumar

Due to the constantly emerging  innovations across the globe, cancer therapies and procedures are getting better by the day, thereby reducing the great divide between research and actual usage. This transformation has made cancer diagnosis and treatment remarkably decisive, which is why new therapies are becoming more effective and sustainable. However, the sad fact is that close to 80 per cent of cancer cases in developing countries are detected at an advanced stage. 

Even in the post-modern era of cancer care, prevention doesn’t get the attention it deserves, ditto for early detection of cancer. Given the slow pace at which technology is transferred from the developed to the developing world populations, it is imperative that early detection should be made the key weapon towards improving patient outcomes and making them sustainable to the extent possible. 

Cancer prevention must be explored at three levels: primary, secondary and tertiary. Primary prevention refers to the policy interventions like bans or restrictions on tobacco usage and public awareness on wellness and well-being. Secondary prevention implies early detection of cancer, while tertiary prevention is all about surveillance and prevention of cancer recurrences.    

Unfortunately, most patients present themselves at an advanced stage of cancer (stages 3 and 4) and rarely during the early stages (1 and 2). An intervention as simple as early detection is a game-changer in cancer care as it averts the ensuing complexities of advanced cases that often become life-threatening. This is precisely why governments of developing countries must aggressively invest in cancer-screening programmes to go hand in hand with path-breaking initiatives like genomics and molecular genetic research. 

A regular self-examination (in certain cancers like breast cancer) goes a long way towards ensuring early detection. Every woman has an innate awareness of her body and the changes happening within it. If and when she finds any lumps or knots, she should immediately visit a specialist. 

Needless to say, a proactive push is imperative from doctors and patients alike. Healthcare providers must proactively insist on early diagnosis, and so must the public at large. This elementary vigilance will go a long way in minimising the cost and time of treatment, while maximising the survival rates and successful clinical outcomes. Screening programmes must be regularly conducted to detect the silent cancers, which may become imminent over time due to genetic or other factors like lifestyle and environmental pollution. In future, epigenetics will play a pivotal role in cancer care, especially in the case of younger age groups. 

In fact, technology plays a crucial role in the early detection of cancer, ideally at stage zero (pre-malignant stage) and necessarily at stages 1 or 2. Going forward, rapid advances in genomics, proteomics, and metabolomics are set to transform the cancer-care landscape for sure. However, the role of policy reforms, awareness campaigns and early detection will remain key to winning the war against cancer.  

— The writer is an oncologist and executive chairman, Healthcare  Global Enterprises Ltd, Bengaluru


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