In 2008, India's leading oncologists Krishnan Nair, Cherian Varghese (of Regional Cancer Centre, Thiruvananthpuram) and R. Swaminathan (of Cancer Institute, Chennai), discussed the status of cancer care in the country then, in their report Cancer: Current scenario, intervention strategies and projections for 2015. "It is now known that over one-third of cancers deaths are preventable, and one-third potentially curable provided they are diagnosed early in their course," they wrote.
It is a view shared by oncology experts in the medical field. If detected early, cancer can be treated and cured in Stage I and Stage II. Sadly, a combination of low awareness and the absence of a strong public healthcare system causes majority of the cancer cases to be diagnosed in the advanced stage (Stages III and IV) of the disease.
Doctors in India also have an added contention of having to constantly battle against the attitude and taboo associated by patients on cancer due to the belief that cancer is completely incurable. In addition to economic reasons, it is partly due to this belief that many patients do not come forward to seek treatment for cancer or conduct screening tests. To improve the overall outcomes and improve the probability of survival it is extremely crucial for survivors as well as doctors to constantly demonstrate their success stories which would motivate other patients and their families to come forward to seek treatment and participate in screening programs.
This brands cancer as a terminal disease despite it being curable and makes cancer care a daunting, and often unsuccessful task. Cancer screening is key to early detection, diagnosis and treatment. It is the second step in cancer control strategy. Primary prevention measures like awareness and control programmes, healthy lifestyle, and vaccination are the primary steps. With early diagnosis, cancer can be nipped in the bud, improving survival chances and prolonging life. Reportedly, if detected early, state-of-the-art therapy in uterine cancer, testicular cancer, cancer of the melanoma (skin cancer) and breast cancer can yield a 75% or greater 5-year survival rate. However, statistics point to a staggering rise in the number of cancer cases, especially those affecting women. Meanwhile, with advanced oncology care concentrated in urban India, treatment for patients from the rest of the country becomes unfeasible owing to factors like accessibility and high cost. "Cancer screening is not practised in an organized fashion in any part of India. There are sporadic attempts at opportunistic interventions and small-scale research studies for field interventions," the report says. These statements hold water at least in the case of diagnostic technologies such as integration of PET and CT systems to oncology care in India.
Source: Cancer: Current scenario, intervention strategies and projections for 2015
Cancer Screening
State-of-the-art technology in cancer diagnosis comprises Positron Emission Tomography (PET) and Computed Tomography (CT). PET and CT systems are advanced imaging tools which allow medical practitioners to locate the cancer within the body. While PET scanners pinpoint a disorder at molecular level, CT scanners produce a detailed image of internal anatomy. Together, these imaging technologies help physicians locate cancer, accurately pinpoint the degree of damage done by cancer and also predict the recurrence of cancer. These not only diagnose the disease at initial stages but also reveal tumours post surgery and radiation therapy – tumours that hide beneath scar tissues resulting from curative treatments. The imaging technologies help in three stages of treating cancer – diagnosing, staging and evaluating the treatment.
There has been a rise in the number of PET/CT systems being brought to India since 2004; however, the cost of such cutting edge technology (a PET scanner costs upwards of Rs.10 crores) is a huge hurdle for it being able to make it to primary healthcare centers across India. As a result, there has been a disparity in the availability of primary oncology care in India. PET scans require a special tracer (FDG) to be available and often the lack of availability of this tracer at a nearby location drives up the cost per scan to almost Rs.20000 per PET scan.
There are more than 300 cancer centres in India, but only 75 PET /CT scanners that are critical for diagnosing cancer are operational available, reported Hindustan Times recently. For about 3 million cancer cases that are reported annually in India, the above numbers are abysmal. Plus, every year one million new cancer cases are added and many others go unreported.
Undoubtedly, India is ill equipped in its race against cancer while the victims helplessly struggle to buy time to live.
Source: Cancer: Current scenario, intervention strategies and projections for 2015
A $100 billion dollar challenge
Addressing the need for more imaging centers in the country, GE has mapped out a plan that helps India and other developing countries build a strong and affordable network of healthcare systems. For India, GE is committed to enabling early detection of cancer and is exploring partnerships with local and external healthcare providers, in improving the cancer care infrastructure in India. The primary objective of GE's oncology initiative for India is to enable early detection of the disease through an affordable healthcare access program. Early detection, supported with personalized treatment, can prove that cancer is not a terminal illness, if detected and treated early. GE is further exploring the possibility of the partnerships to extend beyond just early detection to also providing affordable state-of-the-art cancer care treatment similar to global standards.
In April of this year, GE Healthcare announced a partnership with Healthcare Global Enterprises Ltd (HCG) to work together and elevate cancer care infrastructure in India. An initial pilot project setting up a cancer care centre in Bangalore will be the first step in this direction and GE will be the technology partner in this endeavour. This new partnership adds to the existing collaboration between GE and HCG on cancer bio-markers for improved cancer management.
Another such strategic partnership with Nueclear Healthcare Ltd (NHL) was announced in early 2013, to establish a network of 120 molecular imaging centers to address the increasing demand for advanced cancer diagnosis in India. These molecular imaging centres will be equipped with advanced GE Discovery PET/CT imaging systems and GE PET Trace Medical Cyclotrons that will produce glucose (FDG) to aid early detection.
By 2020, GE plans to support improved care delivery to10 million patients through its Healthymagination initiative. In September 2013, it also announced a $100 million global open innovation challenge "that seeks to identify and bring to market ideas that advance breast cancer diagnostics". More details about the challenge can found on healthymagination.com/challenge.Also, to address the growing number of breast cancer cases, GE has entered into a first-of-its-kind partnership in Wyoming, Saudi Arabia and China to expand access to mammography screening and breast cancer technology. Its new mobile mammography concept SenoCase has been transforming access to screening in underserved areas and SenoBright, an exclusive imaging technique, is credited with improving accuracy of breast exams and helping doctors better identify patients who need biopsies.
For further improving healthcare in developing countries GE Healthcare has committed US $1 Billion towards accelerating research and development of advanced oncology solutions. GE Healthcare offers a wide portfolio for oncology and a strategy that combines cellular research, medical imaging, laboratory diagnostics, biopharmaceutical manufacturing technologies, and information technology. These innovative technologies help the oncology community increase their understanding of the causes and progression of cancer and help physicians make more personalized cancer treatment and management decisions.
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