Cancer

Context:

• A recent study led by a group of researchers at the University of Texas MD Anderson Cancer Center has found that adding a drug, ribociclib, to hormone therapy significantly increased the overall survival in relatively younger women suffering from advanced breast cancer.
• Recently it is cited by researchers that an immunotherapy treatment helped significantly boost survival rates among patients suffering from advanced lung cancer.

About:

What is Cancer?

• A disease in which abnormal cells divide uncontrollably and destroy body tissue.
• It can start almost anywhere in the human body, which is made up of trillions of cells. Normally, human cells grow and divide to form new cells as the body needs them. When cells grow old or become damaged, they die and new cells take their place.
• When cancer develops, this orderly process breaks down. As cells become more and more abnormal, old or damaged cells survive when they should die and new cells form when they are not needed. These extra cells can divide without stopping and forms tumors, which can spread through the blood or the lymph system and form new tumors far from the original tumor.

Causes of Cancer

• Biological or internal factors, such as age, gender, inherited genetic defects and skin type.
• Environmental exposure, for instance to radon and UV radiation, and fine particulate matter.
• Occupational risk factors, like carcinogens such as chemicals, radioactive materials and asbestos.
• Lifestyle-related factors.

Cancer Detection and its treatment

• Its detection is based on biopsy and histopathological studies of the tissue and blood and bone marrow tests for increased cell counts in the case of leukemias.
• Techniques like radiography (use of X-rays), CT (computed tomography) and MRI (magnetic resonance imaging) are very useful to detect cancers of the internal organs.
• Antibodies against cancer-specific antigens are also used for detection of certain cancers.
• Techniques of molecular biology can be applied to detect genes in individuals with inherited susceptibility to certain cancers.
• While treating Cancer, body is robed off many vital nutrients. It is necessary to replenish those nutrients in the body to create conducive environment for better recovery.
• The common approaches for treatment of cancer are surgery, radiation therapy, chemotherapy and immunotherapy.
• Several chemotherapeutic drugs are used to kill cancerous cells. Some of these are specific for particular tumors. Majority of drugs have side effects like hair loss, anaemia, etc.

Cancer in India

• Top most frequent cancers in men and women are breast, cervical, oral cavity, lung and colorectal. Breast cancer more aggressive and to be associated with poorer prognosis in younger women than in older women.
• According to WHO, it is the most frequent cancer among women, impacting 2.1 million women each year, and also causes the highest number of cancer-related deaths among women — 6,27,000 or 15% in 2018. In India, breast cancer accounts for 14% of all cancers in women.
• Besides, cancer is the second most common cause of death in India after heart disease. Use of tobacco products through cigarettes are the single most preventable cause of death worldwide.

Challenges in India

• In India, most cancer research is carried out in tertiary cancer centres and specialised institutions of biomedical science, against well-developed cancer research networks in high-income countries.
• The rising burden of cancer in India acts as a major drain on research time, particularly for clinical staff. According to estimates, there are only 2,000 cancer specialists in India for 10 million patients. Besides, infrastructure to support cancer research has a long way to go.
• Treatment of cancer is quite expensive and not every patient can afford it. The cost of the drug is around Rs. 50,000-60,000 per month and the duration varies from patient to patient.

Social and Emotional Side Effects of Cancer

• Loss of self-esteem and body image: Patients face scars, weight changes, the loss of a breast or other body part, or other changes to your body. Some parts of body might not work the way they used to.
• Depression: Depression affects about two in 10 people with cancer, according to the National Cancer Institute.
• Fear that cancer will return: It's normal to worry that every ache or sniffle could signal cancer's return, especially in the year after treatment. Medical appointments, anniversaries and other things can trigger or intensify these fears.
• Finding meaning: Over time, many patients find meaning and new beginnings in life after cancer. Some feel stronger or more capable. Some are inspired to try new things, and some find they savour each day more. New insights can develop slowly over years, however, and may not appear right away.
• Grief: It's common, even expected, to feel a sense of loss for your old life. Yet many patients are surprised by the intensity of emotions surrounding the need to adjust to a new normal.
• Guilt: Some people feel guilty about surviving, knowing that other patients didn't. Some worry that they burdened caregivers and family members. Counselling or a support group can offer the chance to talk through your feelings.
• Relationships: Cancer can strain relationships with friends, family and co-workers. People might treat you differently or not know what to say.
• Spirituality: Some survivors, finding a new connection and fellowship, renew spiritual practices. Others find themselves questioning their faith.
• Stress: The changes that come with cancer, treatment and survivorship can increase anxiety. Exercise, talking with others, relaxation techniques, meditation and creative activities can help.
• Work related: After cancer, re-entering social and professional life can be challenging. Many fear an increased risk of infection, lack of energy, and anxiety about work performance. At the same time, work can bring a sense of normalcy.

Economic Impact of Cancer

• The financial costs of cancer are high for both the person with cancer and for society as a whole. The Agency for Healthcare research and Quality (AHRQ) estimates that the direct medical costs (total of all health care costs) for cancer in the US in 2015 were $80.2 billion.
• One of the major costs of cancer is cancer treatment. But lack of health insurance and other barriers to health care prevent many people from getting optimal health care.
• Uninsured patients and those from many ethnic minority groups are substantially more likely to be diagnosed with cancer at a later stage, when treatment can be more extensive, costlier, and less successful.

Index of Cancer Preparedness (ICP)

• Prepared by Economist Intelligence Unit (EIU), created in 1946, is the research and analysis division of The Economist Group and the world leader in global business intelligence.
• The aims of the ICP are to allow benchmarking of national efforts and identify best practice in addressing the cancer challenges.
• India and ICP: India's overall rank is 19th with a score of 64.9. India ranks 17th in cancer policy and planning, but it has a relatively high score of 80.8.

Recent Initiatives taken by government

• National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) are being implemented under the National Health Mission (NHM). The primary components include awareness generation for cancer prevention, screening, early detection and referral to an appropriate institution for treatment.
• 'Tertiary Care for Cancer’ scheme was launched with primary purpose to set up individual units in every state.
• National Tobacco Control Programme is launched to create awareness about the dangerous effects of tobacco consumption, reduce the demand and supply of tobacco products.
• Rashtriya Arogya Nidhi (RAN) was launched to meet the financial demands for cancer treatment
• The recent finding of a drug for breast cancer patients will be able to extend the life duration. The drug has an advantage over chemotherapy and may have less side effects compared to standard treatment.

Way Forward

• Patients should pay attention to symptoms and get check-ups regularly.
• Advice persons who addicted to tobacco to avoid at any cost. Vaccines also help lower the cancer risk in human.
• Government should cap the prices of cancer medicines as these are very expensive.
• Finally, changes in diets can make big difference in cancer prevention. Eat organic and loading up with good dose antioxidants can help in prevention of cancer.

Practice Question:

‘Cancer is somatic; the suffering from it, psychic.’ In light of this statement discuss how cancer is a dreaded disease and what steps have been taken in India against it?