An unspoken pandemic | Rising cancer incidence in J&K especially in elderly

RISING CANCER INCIDENCE IN JK(UT) AN UNSPOKEN PANDEMIC. Understanding The Rising Cancer Burden in The State of Kashmir; A Cause For Concern https://www.greaterkashmir.com/todays-paper/op-ed/an-unspoken-pandemic-rising-cancer-incidence-in-jk-especially-in-elderly/ The valley of Kashmir, nestled in the northern part of India with accessibility constraints, has witnessed a significant rise in cancer cases in recent years. This alarming increase in cancer incidence has raised concerns about the state's ability to provide adequate cancer care and treatment to its residents.The leading types of cancer in Kashmir include lung cancer, breast cancer, cervical cancer, and gastrointestinal cancers. Overall, around 51,000 cancer cases have been registered in J&K over the past four years. Around 36,000 patients have died in Jammu and Kashmir in the last five years after being diagnosed with cancer, and the number of such deaths in J&K is increasing. (Gk jan 2023 ). This rise can be attributed to various factors, including lifestyle changes, environmental factors, and improved detection and reporting mechanisms. The exact causes of this increase need further research, but it is essential to address this growing concern, A study by Sher-e-Kashmir Institute of Medical Sciences (SKIMS) attributed the rising cancer incidence to “dietary practises and lifestyle choices” as well as the intake of foods with high salt content. The State of Kashmir has witnessed a concerning increase in cancer incidence over the past few decades. October being celebrated as cancer awareness month through this we will explore the challenges faced by Kashmir in addressing the rising cancer burden and discuss potential strategies to overcome these challenges. To effectively combat cancer, it is crucial to have a comprehensive cancer registry that records and tracks cancer cases, treatments, and outcomes. Unfortunately, Kashmir currently lacks a well-established cancer registry, many patients don’t report to RCC Kashmir, and are under treatment at Mumbai- Delhi; Chennai and Chandigarh making it difficult to gather accurate data and plan targeted interventions. Challenges in Cancer Care in Kashmir: Diagnosing and treating cancer is not what it was two decades before. Cancer management has advanced too much, in many cases almost cure has been achieved. All different, unique diseases, which require different approaches, for treatment. To get treated at the best available facility is a patient's right. Concerns about the quality of care, access to modern equipment, advanced treatment protocol cutting-edge treatments, clinical trials, or specific cancer specialists that are not available locally., can prompt patients to look for care in more developed healthcare systems. The only dedicated Regional Cancer Centre at SKIMS is always seen busy in treating patients from across the valley and is facing challenges on waiting times. Overburdened healthcare systems may result in long waiting times for cancer treatment, prompting patients to seek faster care options outside. Some patients may choose to go outside for holistic cancer care, which includes not only medical treatment but also psychological and emotional support, dietary counselling, and complementary therapies. Resource allocation: Kashmir has a shortage of specialized cancer treatment centres equipped with modern technology and expertise required for complex cancer cases. As a result, patients often have to travel long distances to receive adequate care, which can be physically and financially taxing and hampers early cancer diagnosis and timely treatment. The shortage of trained oncologists and healthcare personnel in Kashmir is a significant barrier to delivering quality cancer care. The few available specialists are overburdened, leading to delays in diagnosis and treatment, and lucrative salaries in the corporate sector have led to exodus of many trained oncologists. The costs associated with cancer diagnosis and treatment can be overwhelming for many families in Kashmir. High medical expenses, travel costs, and lost wages due to illness create significant financial burdens. Not a day passes when we don’t witness an emotional crowd appeal for financial assistance-Sadly, all oncology treatment doesn’t fall under –PMJAY insurance scheme. Late presentation is still an issue. Cultural and societal stigma surrounding cancer often leads to delayed diagnosis and treatment. There is a lack of public awareness about cancer risk factors, prevention, no dedicated cancer screening program for early detection in Kashmir. People may hesitate to seek medical help due to fear, shame, or misconceptions about the disease. Educational campaigns are needed to empower individuals to take proactive steps for their health. Perceived Quality of Care: Some patients may perceive that the quality of care is better in hospitals outside of Kashmir, and they may choose to go where they believe they will receive the best care. Strategies to Overcome Challenges in Cancer Care; To overcome the challenges in cancer care in Kashmir, a multi-pronged approach is required: Expand Access to Healthcare Facilities; The Government is investing in building Oncology healthcare infrastructure, especially in rural and remote areas. Pending that mobile healthcare units and telemedicine services can be utilized to reach underserved populations. Building accessible and affordable specialized cancer treatment centres in Kashmir equipped with state-of-the-art technology and a team of expert oncologists is essential. Our Cancer burden is the strategic case for establishing public-private partnerships in cancer care Initiatives should be undertaken to train, recruit, retain more oncologists and healthcare personnel in Kashmir. Much-needed relief to affected families can be brought through State sponsored financial support programs like PMJAY by widening its scope to assist cancer patients and their families with the high costs of treatment, travel, and lost wages through schemes. Investment in Healthcare Infrastructure: Expanding and upgrading cancer care facilities in Kashmir, including the acquisition of advanced medical equipment and the recruitment and training of more healthcare professionals, can help improve local access to cancer treatment. Reducing Treatment Costs: Efforts to reduce the overall cost of cancer treatment, including the availability of affordable medications and financial assistance programs, can help alleviate the financial burden on patients. Telemedicine and Outreach: Telemedicine programs and outreach efforts can help provide expert consultations and support to patients in remote areas, reducing the need for extensive travel. Awareness and Education: Promote cancer prevention and early detection by raising awareness about available cancer care resources within Kashmir and educating the public about the importance of early detection, screening and prevention can help in tackling the disease at an earlier, more treatable stage. Research and Partnerships: Collaborations with national and international Cancer care organizations can help bring advanced cancer care and research opportunities to the region. Collaboration with non-governmental organizations (NGOs) and international health organizations to build a not-for-profit cancer hospital can bring in expertise, funding, and resources to improve cancer care in Kashmir. It's essential for governments, healthcare organizations, and communities to work together to improve cancer care and reduce the need for patients to seek treatment outside of their region, ultimately ensuring better access to quality care for all. Addressing the rising cancer burden in Kashmir is a multifaceted challenge, marked by several key obstacles and possible solutions . The rising cancer burden in the State of Kashmir is a cause for concern and requires urgent attention. The challenges in cancer care, such as limited access to healthcare facilities, the shortage of specialized centres and personnel, and the stigma associated with cancer, need to be addressed systematically. Implementing a comprehensive approach that includes the establishment of a cancer registry, expansion of healthcare facilities, public awareness campaigns, and financial support programs can help alleviate the burden of cancer in Kashmir and improve the quality of care provided to its residents. It is imperative that both the government and civil society come together to combat this growing health crisis and ensure that cancer patients in Kashmir receive the care and support they need. Dr Fiaz Fazili is a consultant surgeon and member of the international community on cancer prevention and awareness programme and is team leader of the Group campaigning for Not for Profit State of art Cancer hospital in Ut of JK. can be reached at drfiazfazili@gmail.com