Tropic of Cancer

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    Last year, the Million Death Study came out with its first findings on the nature of Cancer as a disease in the country. The main collaborators for the study, Mumbai`s Tata Memorial Hospital and the Centre for Global Health Research mapped how it resulted in almost 6 lakh deaths annually.  Seven out of every 10 deaths, it said occurs among people who are in the 30-69 age group. Nearer home, it said that a youngster living in India`s northeast is four times more likely to develop and succumb to cancer in his lifetime as compared to a youngster living in Bihar. Earlier on, cancer was thought to come calling to people who smoked incessantly or used tobacco but increasingly, it is becoming clear that more studies and scientific research needs to be initiated into looking at what really leads to cancer. Though there are no Manipur specific reports on Cancer cases, there is no denying that the disease has become common in our midst.

    In much the same way that HIV/AIDS is termed a social leveler, Cancer afflicts people without much regard for class or caste distinctions, gender, race and ethnic lines or even age. The health seeking behavior of people in the state in terms of foregoing regular health check ups also leads to its detection at later stages which impedes treatment processes. The highly expensive costs for treatment is also a major deterrent when it comes to cancer patients seeking treatment, or continuing it further. Often treatment costs for a family member living with cancer means a major drain on the family resources. With low levels of seeking and getting health insurance or in cases where the insurance is in place but inadequate to cover costs, Cancer is today becoming a death knell for many in the state. The lack of price control of various medicine components used in different stages of cancer treatment also mean that international pharma companies get away with their pricing which is way beyond the capacity of middle class and low income groups.

    The Health Ministry at both the Centre and the State have much to learn from the response to HIV/AIDS over the years. At one point of time, ART for people living with HIV/AIDS were available only at expensive rates, which people had to buy on their own. But efforts of civil society groups, NGOs working in the HIV/AIDS sector, networks of people living with HIV/AIDS, industry leaders along with political leadership led to generic drugs and prices came down and soon the National AIDS Control Organization (NACO) could roll out its free ART program. HIV/AIDS can also be largely said to have contributed to scaling up basic health care systems in the country. The HIV/AIDS chapter needs to be revisited so that the lakhs of people who are getting stricken with cancer are able to get diagnosed and treated well in time with cheaper treatment measures.

    One other area that people living with cancer or who have survived it can take from people living with HIV/AIDS is the manner in which affected and infected people come together to form support groups. The treatment process for cancer can be long and can drain not just the finances of a family but take away the emotional and mental ‘resources’ so to say. Support groups can be a health way of healing and coping for the person living with cancer and for the family members as well. A study conducted by the All India Institute of Medical Sciences (AIIMS) that started in 2006-2007 pegs the average cost across all cancer treatments at Rs.1,602 per week. This figure does not however, factor in radiation costs or expenses for seeking treatment outside of the state.

    Along with price control for cancer medicines, the Government also needs to look at supporting treatment costs. At the National level, the Health Minister`s Cancer Patient Fund was created within the Rashtriya Arogya Nidhi Scheme proposing to establish a revolving fund in the Regional Cancer Centres (RCC) to speed up financial assistance to needy patients. Under this scheme, a sum of up to Rs.1 lakh would be provided as assistance to cancer patients in the BPL category but this is far too little, too less even if it is being implemented at all.

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