Just like a game of boxing, cancer patients usually have two options – to go down with the opponent’s punches or fight it out with all of one’s might. Surely, cancer isn’t a game but a lethal disease. When diagnosed, it takes every effort to hold on to life.
Years ago, when 12-year-old Canadian Melinda Rose was diagnosed with a rare type of blood cancer, she didn’t let it deter her course of life. She dealt with the cancer, spreading joy that inspired many fellow cancer patients. Today, in her memory, World Rose Day is observed in dedication towards the welfare of cancer patients across the world and to spread awareness about the disease.
A disease like cancer is treated according to the stage at which it is diagnosed. Surgery, chemotherapy, radiotherapy and even recent advancements like immunotherapy are used to combat the disease and improve the health of the patient. With advances in the medical field, surgery has evolved to focus on saving the patient’s organs as compared to sacrificing them, as was done previously.
“I have witnessed the shift firsthand. Earlier, surgical procedures for breast cancer were primed at the removal of the whole breast, whereas now we try to preserve the breast to an extent possible without compromising the outcome. This has a great motivating and physiological impact on the patient,” informs Dr Shekhar Salkar, Chief of the Department of Oncology, Manipal Hospital, Dona Paula.
After being surgically operated, patients require chemotherapy, radiotherapy and even hormone therapy to prevent further spread of the disease to other vital organs like the heart, the kidneys, etc.
The key to battling cancer is timely detection and intervention. The mortality rate is linked to the stage of detection. “If a patient comes early at stage one, the chances of recovery are almost 95 %. In stage two, it drops to 85 %, and by stage three, it lowers to 60 %. At stage four, it is a dismal 10 to 20%,” Dr Salkar explains.
Goa has a fragmented reporting mechanism for cancer cases. It currently lacks an official cancer registry.
“From data available in the public domain and with my 35 years of experience, Goa adds approximately 1500 new cases of cancer each year. Out of these, the highest incidence is of breast cancer, which amounts to 300 to 350 cases per year. The least common type is cervical cancer with 60 to 70 cases detected each year,” Dr Salkar points out.
The news of cancer detection can be devastating to a patient and conveying it is no easy task. In the interest of the patient, a fair amount of secrecy is usually maintained, especially during the initial days. No matter how progressive we’ve become, cancer still has a social stigma attached to it, and therefore it’s important to prepare patients psychologically.
It’s emotionally daunting as doctors when it comes to younger cancer patients. “While it’s easier to communicate with adult patients, when treating children, extra efforts are required in understanding the underlying medical conditions and needs. Moreover, with advanced medical treatments available and early detection, life expectancy in such cases has significantly improved,” Dr Salkar states.
Dr Salkar considers being an oncologist a tough profession, but something he takes the utmost pride in. “A successful doctor’s biggest attribute is compassion. It’s essential that doctors have a panoramic view of the patient’s medical, social and financial background. A noble profession like this can be challenging, but it’s equally satisfying to watch a patient recover and become fit again,” he adds.
He further says, “Prevention is simple. The three magic bullets are – to have a lot of leafy vegetables, fruits and water, keep yourself fit with just a simple walk for 30 minutes a day and stay away from vices of tobacco and alcohol. I always tell my patients that there can be only one winner in your fight against cancer. Either you win or cancer wins, so we all should work to defeat the Big ‘C’.”
In the government sector, Goa Medical College and Hospital has facilities to detect and manage cancer patients, however, there is an urgent need to upgrade the existing infrastructure. In a recent decision, the Health Ministry’s tie-up with Tata Memorial Hospital is a step in the right direction to ensure the availability of advanced treatments to the people of Goa.
As far as private hospitals go, Manipal is one hospital that is equipped with state-of-the-art facilities under one roof, with the latest LINAC machines and equipped with CT scans, MRI, CT guided biopsy and other supportive care. Apart from the treatment, they also have a robust mechanism to deal with emotional and financial aspects.
For this, the Goa government’s DDSSY scheme has come as a blessing for patients from the lower socio-economic group. There are also initiatives by Manipal Hospital in collaboration with the Goan Cancer Society that ensure the financial burden is reduced. There’s a check-up scheme for cancer detection at a subsidised package cost, the health package “Dr Sharad Vaidya Cancer Health Check” consists of tumour markers, chest x-rays, ultrasounds and mammography.
Much support to tackle cancer will come with consorted efforts, especially by creating awareness amongst the public. It will take many like-minded people to come forward to create an ecosystem to help cancer patients emotionally and financially.
As challenging as it seems, understanding what cancer is and the changes we can make to knock it out can make it bearable if not easy. And as Dr Shekhar Salkar says, it’s not the sympathy that is needed but empathy that is fundamental to winning the war against cancer.
