The number of cancers cases in India is rising dangerously. 11,57, 294 cancer cases have been reported in the country this year as compared to 10 lakh in 2012, according to Global Cancer Observatory (Globocan), September 2018.
The Globocan 2018 data is published by the International Agency for Research on Cancer (IARC) and it reports cancer incidence and mortality across 185 countries and includes 36 types of cancers.
The number of people who died due to cancer in India has gone up by 12.1 per cent in the last six years. While 7 lakh people died due to cancer in 2012, 7,84,821 cancer deaths were reported in 2018. The incidence of lip, oral cavity, and breast cancer has gone up drastically.
However, there is a 21.2 per cent fall in cervical cancer cases. Their number has come down to 96,922 in 2018 from 1.23 lakh in 2012.
Cancer alters the cell metabolism in the body
Understanding cancer
Out of millions of cells in the body, if even one starts multiplying uncontrollably, it forms a tumour which can be benign or malignant. Benign are local tumours which do not spread to other parts of the body and are relatively harmless.
But malignant tumours grow fast and spread. They have the capability to disrupt the functioning of the body. They grow uncontrollably and may spread to other organs if left untreated.
There are many known and unknown factors that trigger cancerous growth in the body. Age, doctors say, is the biggest risk factor for cancer. No wonder, most of the cancers occur in people above 50 years of age. As one age, the cell metabolism and its repair mechanism get affected. "A major proportion of cancer incidence can be attributed to the increase in life expectancy. In India, life expectancy has increased from merely 30 years at the time of independence to 70 years now," says Dr Amit Aggarwal, a noted oncologist with BLK Hospital, Delhi.
What triggers the deadly disease
Some 5-20 percent cancers, doctors say, can be attributed to the defected genes--some of these are inherited, and some mutations occur during the fetus formation. The rest of the cancers are a result of acquired mutations, which means the damage to genes in a particular cell occurs during a person's life.
"Each and every cell of the body has a life. It dies after a specific period. All of us are born with cancer-causing and cancer-protective genes. When the cancer-causing genes get activated and overpower the protective ones, these genes alter the programmed cell death. And that's when a tumour is formed," explains Dr Siddharth Sahni, a leading onco-surgeon at Indraprastha Apollo hospital, Delhi.
Common factors that cause mutations in the cells are obesity, smoking, chemical exposure, radiations, etc. "In the last 10 years that I have been practicing as an oncologist, I observe that most of my patients were obese. Most either smoke or drink. And most eat food which is high-carbohydrate and low-protein," says Sahni.
Then there are several environmental factors that are contributing to the increasing incidence of cancer in India-- air pollution, water contamination, food adulteration. "Metro cities are like gas chambers as far as poor air quality is concerned. The popularity of mass-produced food-- be it milk, eggs, packaged food-- has severely compromised the nutrition quality of the food. Canned or pickle food has lots of preservatives,” says Dr Amit Bhatt, a leading Pune-based medical oncologist.
“Besides, water has high levels of antibiotics, insecticides and industrial waste which penetrate into the fruits and vegetable we eat. All these chemicals can cause cancer-causing mutations in the cell."
Adds Dr Agarwal:" We have observed a direct relationship between cancer-causing triggers and the number of cancer cases. The sudden spike in the cancer incidence is the reason why we have not been able to tame the deadly cancer despite new modalities to treat complicated cancers."
Doctors say they have never been better equipped to treat cancer. Today, there are many treatment options -- surgery, chemotherapy, radiation therapy, hormonal therapy, immunotherapy, targeted therapy or biological therapy-- that can control and cure many forms of cancers. "Even some stage-4 breast cancer can be cured by immunotherapy. The outcomes, however, depend on the organs involved," says Dr Sahni. "Pancreas and brain cancers are harder to treat in late stages."
The cure
Genetic testing has enabled doctors to design special treatments in specific cases or mutations. For example, in case of EGFR mutations in breast or lung cancer, oral targeted therapy is very effective.
But doctors feel that to be able to control the burgeoning cancer cases in a developing country like India, it is important to work towards prevention and detecting cancer early. "There is a lot one can do. Obesity is an important factor and people can control it by following a healthy lifestyle. People can easily choose fresh food over the packaged. Quitting smoking and tobacco, limiting alcohol and refined sugar will help a lot in preventing cancer," says Dr Vikas Goswami, senior consultant, medical oncology, Max Hospital, Vaishali, Ghaziabad.
