Cancer is one of the most prevalent non-communicable diseases in India. The number of Indians suffering from cancer is expected to rise from 26.7 million in 2021 to 29.8 million in 2025, according to a recent report by the Indian Council for Medical Research (ICMR). The Covid-19 pandemic has severely affected cancer care in India as screening has dropped sharply and patients have missed regular check-ups and tests, leading to a huge backlog of people in urgent need of treatment. .
Although cancer treatment in India is on par with the best in the world, it is not affordable for many people. While the world is still in search of a magic potion to cure cancer, an immunotherapy drug, Dostarlimab, has hit the headlines across the world this year for eliminating colorectal cancer in a group of patients at New York. It is hailed as a miracle drug, although it is not a panacea for all cancers.
Tata Memorial Hospital also showcased its relatively cheaper innovation with another immunotherapy drug to prolong the lives of head and neck cancer patients.
Recently, authorities have given the green light to the Serum Institute of India (SII) quadrivalent human papillomavirus (qHPV) vaccine against cervical cancer. According to SII, the vaccine will likely cost between ₹200-400 per dose and will be available within a few months. Cervical cancer is the second most common cancer among women in India.
Furthermore, there are discussions in the public domain that a few pharmaceutical companies in India and start-ups are likely to offer cell therapy based treatment for cancers at a fraction of global and US prices. While these examples of innovation offer hope to many cancer patients, there is a need to create a more efficient and innovation-driven ecosystem involving technology, people, patient communities, strategies and collaborations to solve various problems in cancer care, including the development of new drugs.
Need for comprehensive support
Cancer care should be given high priority because it carries a huge economic price. India suffered a total productivity loss of $6.7 billion in 2012 due to cancer, which represents 0.36% of GDP, according to a study published a few years ago in the Journal of Cancer Epidemiology.
Emphasis must also be placed on patient-centred treatment models to reduce the cost of cancer care that pushes thousands of people into poverty.
Chemotherapy for breast cancer costs around ₹1.7 lakh in India and adding newer forms of therapy could add between ₹20,000 and ₹200,000 per cycle depending on the type of breast cancer.
Recently, a parliamentary panel suggested that the government consider scrapping the GST on cancer drugs and taking strict measures to check the prices of drugs and radiotherapy. It remains to be seen whether his proposals will be duly taken into consideration.
In particular, post-treatment follow-up should also be more patient-centred. Telemedicine tools should be used to review treatment progress and recovery status to ease the burden of patient travel to distant centers. As cancer patients need significant support after hospitalization, arrangements should be made to provide suitable underwear, compression sleeves for lymphedema and prostheses for survivors. of breast cancer. More support groups need to be created for their healing and rehabilitation.
India’s pharmaceutical sector, which has overstretched itself during the Covid pandemic to produce affordable vaccines and drugs, needs to show a similar zeal for innovation to produce easily accessible cancer drugs.
For innovation to be successful, there must be open communication between industry and all key stakeholders for market growth, better product approval processes, and the development of new and innovative therapies. Government support is also needed to streamline regulations and speed up approvals without compromising quality.
India has enormous potential to become a global center of innovation for cancer care.
But it is essential to create a whole innovation ecosystem linking the collaborative efforts of several groups of actors such as pharmaceutical companies, start-ups, entrepreneurs and academic and clinical researchers. The efforts of these stakeholder groups must also be supported by catalysts for growth such as financing, infrastructure and supportive policies.
Academia is critical to innovation, as it provides the foundation for a strong talent and research base. Clinical research institutions and hospitals also have an important role to play in complementing research capabilities to drive innovation.
Since medical institutions/colleges are the primary centers for biomedical research, physician expertise and access to large volumes of patient data can significantly improve research outcomes.
Startups that have now emerged as a catalyst to boost the pharma industry’s innovation ecosystem are using AI and ML to screen cancer cases, which can significantly help doctors detect and treat tumors early, especially in rural areas where people are handicapped by a shortage. oncologists and medical care institutions.
The use of teleradiology can extend the reach of services to understaffed remote areas of the country. A well-trained radiographer or technician can take an X-ray or ultrasound and electronically transmit it to a nodal center for a detailed diagnosis. Telemedicine has also brought a certain comfort to the women of the village who can discuss confidential matters and ask questions without hesitation to a doctor on screen, 100 km away.
Health insurance must also be integrated into the cancer care ecosystem. The Pradhan Mantri Jan Aarogya Yojana has been a game changer for millions of disadvantaged Indians who were not covered by health insurance before. However, 30 percent of Indians still lack health insurance and this gap needs to be filled.
Education, awareness and screening can contribute to the early detection of cancer, which increases the chances of treatment success and longevity. The pandemic has brought about a considerable change in behavior regarding testing and screening and this must be maintained. For early detection of cancer, it is important to recognize any abnormal or warning signs and act quickly for prompt diagnosis. Increased public awareness can increase the overall disease reporting rate and address the key challenge of late-stage detection.
There are different types of screening tests like physical examinations and history, laboratory tests, diagnostic procedures, imaging procedures and genetic tests to detect different types of cancer.
Preventive checkups are also important to detect cancer in time for successful treatment. We must not forget that up to 40% of cancer-related deaths are preventable. This in itself is reason enough to make cancer prevention awareness a priority area.
The author is President of Indian Cancer Society Delhi Branch
September 05, 2022