Need of more cancer care facilities in Assam

Dr Dharmakanta Kumbhakar

(The writer can be reached at drkdharmakanta@yahoo.com)

As per the latest report by the Indian Council of Medical Research, Kamrup (Metro) district of Assam has the third-highest incidence of cancer in the country (213.0 per 100,000 populations) in men and third highest in women also (169.6 per 100,000 populations)

The Cachar Cancer Hospital and Research Centre, Silchar is providing free and heavily subsidized treatment to thousands of poor cancer patients per year.

Assam is witnessing an alarming rise in the number of cancer patients and a corresponding high fatality rate in recent years. As per the latest report by the Indian Council of Medical Research, the Kamrup (Metro) district of Assam has the third-highest incidence of cancer in the country (213.0 per 100,000 populations) in men and third highest in women also (169.6 per 100,000 populations). The lifestyle-related cancers top the chart in Assam. Data from different Population-Based Cancer Registries and hospital-Based Cancer Registries in India show that in Assam, the most common anatomical sites of cancers in men are the oesophagus, lung, stomach, hypopharynx and mouth, while in women these are the breast, cervix uteri, gall bladder, oesophagus and lungs. Cancers of these anatomical sites are mostly linked to lifestyle-related risk factors. Childhood cancer also has a high fatality incidence in Assam.

Over 20,000 new cancer patients are being diagnosed every year in Assam. Over and above, Assam also gets cancer patients from other NE states and neighbouring Bangladesh. Despite the heavy burden of cancer in Assam, the available infrastructure for cancer care is inadequate. Hence, people are compelled to seek treatment outside the state. There is still an acute lack of expert oncologists and adequate treatment infrastructure – hospitals, diagnostic centres, etc- for the cancer-affected people of Assam.

Assam has a dearth of well-equipped government cancer hospitals. The existing government cancer hospitals of Assam have a huge deficiency in cancer treatment infrastructure. There is no special childhood cancer care centre in Assam. There are no satellite cancer care centres in the remote areas of Assam. The medical college hospitals of the state cannot provide proper treatment to cancer patients. The BBCI in Guwahati, which was established in 1973, and the State Cancer Hospital attached to GMCH are the only government full-fledged cancer care institute in Assam. They cannot bear the load of such a huge number of cancer patients alone. Of course, the Cachar Cancer Hospital and Research Centre, Silchar is providing free and heavily subsidized treatment to thousands of poor cancer patients per year. A few private cancer hospitals, like the Northeast cancer Hospital and Research Institute, Jorabat, are also providing care to cancer patients in Assam.

There is a need for more cancer care facilities in Assam. The State Government has already decided to create more cancer care facilities in Assam. The construction of 100-bed cancer wings with LINAC machines in the medical college hospitals of Assam are in full swing. The Government will run an OPD cancer unit in every civil hospital across the state. Two doctors will be trained and appointed in these OPDs to detect cancer symptoms and give basic treatment. The good news is that the BBCI is now an affiliate of the Tata Memorial Centre for Cancer, Mumbai. Now onwards, the BBCI will offer cost-effective management and absolute cure for many of the cancers without having to go elsewhere to distant places for treatment. It will also produce more oncologists and train manpower in Assam which will boost the better cancer care facilities of the state.

The treatment of Cancer in Assam is largely unaffordable for the poor and the middle-class due to the high costs of cancer medicines. The rich go outside Assam for better cancer care facilities, but the poor and middle-class cancer patients either sell their properties for their treatment outside the state or die due to lack of treatment. Most of the poor and middle-class cancer patients of the State die due to lack of chemotherapy and a significant number of cancer patients stop visiting hospitals after two or three cycles of chemotherapy due to the unaffordable expenditure. Though the BPL cancer patients get benefits and financial assistance for treatment and care from various State government and Central government schemes, the middle-class cancer patients get nothing in Assam. There is an urgent need to develop a comprehensive cancer control programme in Assam. Extensive research is needed that is focused on the state to highlight the different aspects (e.g.to know the exact causes, genetic or otherwise) for reducing the incidence of cancer. Efforts toward cancer prevention will be immensely helpful to lower the burden of cancer in Assam. Apart from Government initiation, it requires the cumulative efforts of hospitals, administrative bodies, medical organizations, NGOs, media and more – to impart the right awareness and lifestyle guidance. Since the problem of tobacco consumption is so deeply rooted in Assam, tobacco control programmes need to be more aggressive. People in Assam need to adopt healthier lifestyle habits. At an individual level, people need to quit the bad habits (smoking, chewing tobacco, consumption of betel nut and alcohol, etc), change their food habits (reduce the consumption of extremely spicy and salted foods, smoked meat and piping hot beverages) and lifestyle.

The State and Central governments should make efforts to offer the best treatment possible to all the cancer patients of the state for free, irrespective of their socio-economic status. No one should be denied access to treatment due to want of money. The data on specialized workforce should be collected and collated. There is an urgent need for trained personnel at the primary and secondary level healthcare facilities that could identify risk factors, screen the patients, and guide them to the relevant facilities. Cancer treatment facilities for palliative care, radiotherapy, etc., need to be established and strengthened. There should be satellite clinics in the remote areas of Assam for cancer patients who are unable to travel long distances to visit the hospital. The oncologists of Assam should start going to the villages to provide treatment to cancer patients. They should provide phone consultations and stay in touch with cancer patients who have returned home with prescriptions. Home Care Services as well as facilities to train the family members for taking care of terminally ill cancer patients should be launched. The NGOs should also come forward to help the cancer patients of the state in their treatment, and by providing information and support for getting financial aid from different schemes.