Cancer-free future: Tamil Nadu’s cancer policy to detect common cancer cases

By Sushmita Dey

Chennai, March 8

In 2019, when Meeta Bisen tested positive, the doctors did a full-body CT scan, and in the report, they detected lumps on her breasts. While the diagnosis first came as a surprise, over the time of the treatment her saving was getting leaner and she was losing all hope. 

On being asked, did she receive any help from the government, she nodded and said that she was not aware of any policy, if it’s there, then they are not very transparent and available to the general public – who can gain something from it. 

Recently, the Tamil Nadu government said, “ the state has released its first-framed policy on the treatment and early diagnosis of common cancers in the first and second stages by 2030”. But, according to doctors and cancer institutes, such a policy has always been there, this is not the first time in regards to the treatment of cancer.

“The policy lays the foundation to ensure that we can identify 66% of cancer in both men and women by 2030 during the first and second stage,” said Dr Darez Ahamed, Mission Director of National Health Mission, Tamil Nadu.

The vision of the state cancer policy is to create a healthy infrastructure and network of private and government hospitals, where facilities for screening and detection are readily available. It also sheds light on training doctors and equipping them with robotic surgery units for their effective detection and treatment of cancer in its early stages.

Many health systems face challenges in the early detection of cancer. According to the 2020-2021 Tamil Nadu State Policy for Cancer Prevention and Control, population ageing and lifestyle changes are the major drivers that further increase the cancer burden in the country. However, screening aims to detect precancerous changes, which, if not treated, may lead to cancer. 

The report also shows that 80% of oral, cervical, breast and other common cancer cases in the state are diagnosed at an advanced stage, which eventually reduces the survival rate and adds to a considerable financial burden. 

This takes us back to poor survival rates and a recent Tamil Nadu, cancer report shows that breast cancers in the state are steadily increasing by 4% every year, which leads us to the burden being greater in rural India.

Cancer Institute bus for the patients

“For example, I was able to afford my cancer treatment, but there are people who cannot afford it. Later on, I got to know that there are certain schemes by the government where our treatment is sponsored by them,” Bisen said.

“So, such a type of screening is necessary for our country, but it should be feasible for everyone, if the hospital is charging then it should not be exuberant,” she added. 

However, according to Dr Krishnamoorthy, Director of Cancer Institute, Adyar, this policy will be a breakthrough for the prevention of such types of cancer now. “The most important parameter in cancer mortality which decides the five-year survival is the stage at which cancer is detected,” he added.

So, how is it going to happen? What are the modalities by which they are going to do that?

Dr Ahamed explains the current situation of cancer in Tamil Nadu by stating that “Chennai continues to have higher cancer incidence rates in the country. If you look at the report number-wise – the biggest cancer in Tamil Nadu now is 10,000 cases of breast cancer and 7,000 cases of cervical cancer. And, the next alarming will be oral cancer.”

“The institution has some outreach programs for screening in about five to six districts of Tamil Nadu and is planning to expand more in the state,” said Dr Krisnamoorthy. 

The Tamil Nadu Cancer Registry report, compiled by the Cancer Institute Adyar, and the State Health Department for 2012-2016, showed that the Crude Incidence Rate (CIR) of breast cancer in Chennai was 47.7 for one lakh population of women. The CIR refers to the number of cases occurring in a specified population in a year.

As per Dr Krishnamoorthy, this policy has been there for decades; the government renewed it this year along with other digital elements which will play a vital role in treating cancer patients.

Cancer Cases and the Covid-19 situation 

“Covid-19 has taught us that prevention is better than cure. During the first wave, there was about a 50% drop both in the diagnostics as well in the aerobic space. But, subsequently, we met patients and well at least, we can say that with regards to the surgery that happens in our unit, we tried to treat most of them,” said Dr Krishnamoorty. 

He added that the cancer cases in 2021 were almost much higher than in 2019 as well, which is a pre-pandemic era. “The mortality of unpredicted cancer is very high, so, just for the fear of Covid-19 entering your hospital system and if the health care services, especially the cancer services stop, then this would be a great disservice. Because you ultimately have a higher mortality rate would largely be driven by cancer deaths.”

“Prevent, screen and treat ought to be the main objectives to fight against cervical cancer. We are hoping for large-scale awareness programmes at the grassroots level, financially viable population-based screening, and adequate follow-up of screened women and men is the need of the hour, ” said Dr Ahamed. 

They hope that common cancer such as Cervical, Oral or perhaps Breast cancer in both genders is preventable with regular screening –  is the message that must reach every corner of Tamil Nadu. Along with increased disease awareness and dispelling of cancer-related stigma/fear, and embarrassment to enhance the uptake of cervical screening camps.

Near the Cancer Institute (WIA), Adyar

“Community involvement and strategic partnerships with the government/NGOs as well as private entities can help make accessible and affordable screening a reality across the Date,” Dr Ahamed said.

He shared that today, we need complete commitment from all the relevant health departments to flatten the curve of common cancer mortality in our country.

On being asked how the government and the cancer institutes are going to spread awareness among the people in the state, Dr Krishnamoorthy said, “This year, we, including the National Health Mission, are especially trying to make door-to-door visits to collect samples to confirm those who are at risk for cancer.

He added that their only aim is to achieve a 1/3rd reduction in mortality by focussing on strengthening human resources, diagnostic, and treatment facilities depending on the level of health care.