India is bearing a big burden of cancer and if the recent reports are to be believed, cancer will be the biggest threat in the next 10-20 years. Among women, the occurence of breast cancer is on the spike with more and more cases being detected every year. Despite regular clinical trials and studies being carried out, it seems like we are still far away from curbing this menace. We spoke to Dr Anthony Pais, Clinical Director and Senior Consultant Oncoplastic Breast Surgery, Cytecare Cancer Hospitals, Bangalore to understand the issue. Is it true that Indians are more prone to cancer than their western counterparts?While it is true that certain cancers are more common in India than in the western countries, it is a misconception that Indians are more prone to cancer. Every country has its own unique healthcare challenges. For India, oral, head and neck and cervical cancers pose the biggest problems. The causes are many from the widespread use of betel quid and tobacco to the high incidence of cervical human papillomavirus (HPV) infection and poor hygiene standards, especially among the lower socioeconomic strata of society. In many cases, the issue is far more complex. For instance, when it comes to breast cancer, Indian women are not more prone than their western counterparts. However, the average age of breast cancer patients in India is 47-49 years which is almost a decade earlier than for most women in the west. Research shows that our biology is different, causing some cancers at a younger age and typically more aggressive. This often makes timely diagnosis and treatment a greater concern.

Its scary to see so many Indian women being diagnosed with breast cancer. Why are they succumbing to breast cancer so easily?Out of the nearly two lakh new cases of breast cancer reported every year in India, around 90,000 die in the first year itself. In fact, while the incidence of breast cancer is lower in India, the mortality rate is much higher than in the west. There are several reasons for this perturbing reality.

First, theres lack of awareness. In most parts of India, women are uncomfortable to discuss symptoms and go in for a physical examination. Studies show that most deaths occur among the unscreened population as the cancer is typically detected at a late stage.

Secondly, most Indian healthcare centres lack the basic facilities for early diagnosis of cancer. And centres that have the facilities arent often armed with adequate expertise to diagnose and treat the disease in the most effective manner. Unfortunately, we see this scenario even in the so-called advanced centres of excellence!

The high cost of treatment is another factor that hinders timely treatment. Patients often have to sell their property, jewellery and valuables to avail of cancer care. In quite a few cases, the financial worries drive patients towards alternative medicine, further delaying diagnosis and scientific treatment. Unless, we offer affordable healthcare solutions, the situation is unlikely to change.

We keep reading reports about studies being conducted but how close are we in discovering the reasons behind the incidence of breast cancer?Several studies have shown that estrogen is the main culprit. Besides the hormone factor, dense breast on a mammogram, obesity, lack of exercise, stress, alcohol and smoking also play a role in the causation of breast cancer.

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India and breast cancer: The missing link and what we can do - Times of India