Featured ArticleFeb 22

Roots and Routes of Cancer

The route of financial planning in a cost-effective manner, with the involvement of the health insurance industry, is an important dimension in cancer management. Dr Vikas S Kavishwar, Consultant in Histopathology, GRL,
Metropolis Healthcare gives an insight

It is our choices, Harry, that show what we truly are, far more than our abilities

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–Dumbledore (JK Rowling)

Whenever I feel down and defeated, this quote gives me new energy. Though the world of Harry Potter is magical, it has its roots in the moral principles of our world and it stands on the route of Harry’s faith, irrespective of his abilities. Every day, when I look at cells under the microscope, I wonder if I had magical powers to read their mind – where cancer has its roots – before it takes a route towards a full-blown disease. Every cell has the
potential to turn into cancer but every mechanism is there in place to prevent that occurrence. The natural choice of a cell must be not to become cancerous so is it a limitation to fight abilities of cell or is it a wrong choice in the mind of cell…which transforms it into a cancer cell? – A million-dollar question with no satisfactory answer.

During the COVID-19 pandemic, about 5.7 million people have died. Cancer deaths per year are much more (About 10million) and even higher than HIV/AIDS, malaria and tuberculosis combined. More than one-third of cancer cases can be prevented. Another third can be cured with proper routes of diagnosis and management. Unfortunately, the focus on COVID-19 management had roots of delay in the treatment of other diseases, including cancer.

The theme for 2022-2024 is “Close the Care Gap”. Today 65 per cent of cancer deaths are happening in the least developed parts of the world. Equitable access to cancer prevention, diagnosis, treatment and care can save lives and improve quality of life. PPPs could be one practical route to achieve this goal.

Today public sector government hospitals are flooded with patients but need to organise their resources. Corporate hospitals are well equipped and can deliver the best possible healthcare, however, the expenses arebeyond the reach of many patients. The cost involved gets augmented further when the tests get repeated in another hospital. We need to tackle the roots of all these issues. In India, out of about 1.1 million new cases reported every year, two- hirds are diagnosed at an advanced stage. Cancers of the oral cavity, lung and breast are mainly responsible for morbidity and mortality. Traditionally, cancer management has been the teamwork of oncosurgeon, oncophysician offering chemotherapy and radiation medicine expert for radiotherapy. With ongoing research, new routes of targeted and customized therapies are becoming available.

Techniques like IHC, Flow cytometry, cytogenetics, tumour marker studies are an integral part of the diagnosis. Molecular testing for cancers in the brain, lung, breast and colon has become a part of cancer management protocols. Thus, the route of the cancer diagnosis also has become a team-work of histo pathologists, haematopathologists, micro biologist, genetic experts and dedicated technicians. The team needs to get trained and to adapt as per the need. Digital Pathology was a classic example in COVID-19 pandemic, histopathologists who could not visit the laboratory had to learn to report on the digitised slide. Technology and expertise do not come free, but it is the need for time. Hence, the route of financial planning in a cost- effective manner, with the involvement of the health insurance industry, is an important dimension in cancer management.

COVID-19 has taught us to unite the strengths of roots and routes of the private and public sector, upgrade ourselves to face challenges, improve the delivery of the healthcare system and be compassionate with the sufferer. Let us carry on the same route for cancer patients… to turn on the light in the darkest of cancer times.

As JKRowling’s Dumbledore has already said… “Happiness can be found, even in the darkest of times, if one only remembers to turn on the light.”

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