Education improves early detection of cancer, V. Shanta, chairperson, Cancer Institute, Adyar, has said. Education about cancer — such as the importance of hygiene and good food habits — should be included at the school level itself, she said.
Dr. Shanta was delivering the Kamalam Ramasamy Udayar Oration on obstetrics and gynaecology at Sri Ramachandra University on Saturday.
Speaking about the decrease in cervical cancer and the parallel rise of breast, endometrium and ovarian cancers, Dr. Shanta said there was a direct relationship between literacy and the incidence of breast and cervical cancers.
Correlation
“Poorer literacy levels are associated with higher cervical cancer and lower breast cancers and higher educational levels, with higher breast cancers and lower cervical cancers,” she said.
On the late presentation of cancers — nearly 60 per cent of patients seek treatment late, she said — and the possibility of cancer being missed by physicians at the early stage, she said educating physicians was important and there was a need to improve the undergraduate medical education to incorporate the changes in disease patterns and the rise of non-communicable diseases. “Unfortunately, medical education is not in the best hands at present,” she said to media after the lecture.
Stressing the importance of prevention and early detection of the disease, Dr. Shanta said the Cancer Institute had developed an ELISA kit that could be used at the primary health centre level for the detection of the P16 protein in cervical smear cells. The kit, however, was yet to undergo clinical trials, she added.
Precision medicine
While organ conservation and precision medicine were now common in the treatment of most cancers, conservation and targeted therapy had not been possible in gynaecologic cancers and were yet to find a place there. “The trend is towards more and more radical surgery which, to my mind, is not ideal. Research should be directed here,” she said.
There was a vaccine for cervical cancer and its use in reducing the disease risk had also been generally accepted, said Dr. Shanta.
‘No definite policy’
“Despite this, India still does not have a definite policy. The vaccine would be most useful in high-risk groups — in the lower socio-economic groups — the rural poor. But the cost is high and it is not affordable for those who can benefit from it without government support. Also, the vaccine only gives about 70 per cent protection and still needs follow-up screening. The compliance rate in screening programmes varies from 25 to 45 per cent and follow up is not easy,” she said.
On the challenges that continued, she said they included the setting up of organised, State-wide policies for screening and prevention of cancers and the delivery of affordable, quality care. “Oncologists too have a responsibility here – to avoid the over use of technology and the abuse of drugs. Unethical marketing must be prevented. Treatment has to be patient-centric. Doctors must approach patients not as cancer cases, but as human beings.”
Awareness is key
While prevention and early detection of the disease are important, more research should be directed to targeted therapy and follow-up screening
