As India strides into the 21st century, the spectrum of disease has changed from mainly infectious diseases to more chronic disease (such as heart disease & diabetes), while cancer has assumed epidemic-like proportions. This is due partly to lack of awareness of health promotion & disease prevention as well as lack of amenities for early diagnosis and treatment.

The increasing prevalence of cancer in India can be attributed to a combination of factors, including lifestyle changes, aging populations, environmental exposures, and genetic predispositions. Common cancers such as oral, cervical, breast, and lung cancers are particularly prevalent due to specific regional and socio-economic influences.

Efforts to combat this growing burden include promoting healthy lifestyles, implementing widespread screening programs, and enhancing access to advanced treatments. By focusing on prevention, early diagnosis, and equitable healthcare delivery, India aims to address the challenges posed by cancer and improve outcomes for affected individuals and their families.

Understanding Cancer & Its Types
Most Common Cancers
Cancer Prevention: Key Strategies for a Healthier Life
The Importance of Cancer Screening
Cancer Detection
Comprehensive Cancer Treatment
Myths and Facts
Challenges in Cancer Control in India
Frequently Asked Questions

Understanding Cancer & Its Types

cancer refers to an abnormal & unregulated growth of tissue, which may invade surrounding normal structures as well as spread to sites distant from that of origin. Cancers are broadly of 3 types:

Carcinomas (70%): arise in membranes (coverings) and glands/ ducts of glands; commonest type of cancer; usually spreads to neighbouring sites, then to distant sites; important sites include head-neck, lung, prostate, breast, oesophagus, colorectum & anus
Sarcomas (10-20%): arise from bone/muscle/nerve; less common; spreads to distant sites early
Blood cancers: Leukemia, Lymphoma & Myeloma

Most Common Cancers

The commonest cancers worldwide in men are lung cancer & prostate cancer, and in women, are Breast Cancer and Lung Cancer. However, in India, the commonest cancers in men are Head-Neck cancers (especially Oral cancers in the Eastern part of the country), while in women, the commonest cancer is Uterine Cervical Cancer. Ironically, both of these are preventable diseases, since head-neck cancers are almost always related to the use of tobacco, while cervical cancer arises from chronic infection by Human Papilloma Virus.

Cancer Prevention

Cancer Prevention: Key Strategies for a Healthier Life

The prevention of cancer in India is crucial to reducing its growing burden and saving lives. You can significantly lower the risk of developing cancer by adopting these strategies:

Avoiding smoking and other tobacco products (khaini, etc) can prevent many cancers (head-neck, lung, urinary bladder, etc) as well as chronic heart & lung diseases.
Lower consumption of red meat & processed meat
Increased consumption of green, leafy vegetables
Vaccination against Human Papilloma Virus (prevents cervical cancer) & Hepatitis B virus (prevents chronic liver disease & liver cancer)

The Importance of Cancer Screening

Many diseases can be diagnosed at a very early stage, even before they produce symptoms, and when treatment will have a much greater benefit. Such diseases can be actively searched for in the general population by a process called “screening”.

Successful screening is possible for: -

Cervical cancer (all women in reproductive age group should have a Pap smear done annually)
Prostate cancer (all men beyond age 50 years should have an annual blood test called PSA)
Breast cancer (all women beyond age 40 should have an annual X-ray of the breasts, called Mammography).

Cancer Detection

Cancer symptoms vary according to the site of disease. However, any abnormal lump/ sore anywhere in the body, along with any abnormal bleeding or discharge needs to be reported to the nearest community physician, who can then arrange for further investigations & hospital consultations. Cancer often requires a battery of tests, including blood tests, X-ray, endoscopies, CT scans/MRI scans. Cancer diagnosis almost always involves getting a tissue/ cell sample from the suspicious growth, called a biopsy.

Comprehensive Cancer Treatment

Various treatment modalities are required in the treatment of common cancers. These include surgery, radiotherapy & chemotherapy/ targeted therapy. Surgery involves operative removal of the tumor with a margin of healthy tissue and most centres have specialised surgeons for each organ system of the body. Radiotherapy refers to treatment of cancers by X-rays & Gamma rays, from outside the body (teletherapy) or inside (brachytherapy).

Chemotherapy & targeted therapy are systemic treatments acting on the entire body, usually to prevent or tackle disseminated disease. Treatment modality varies according to site & stage of disease. Many common cancers in stage I or II can be treated by single modality, either surgery or radiotherapy. More advanced disease usually will also require systemic therapy (chemotherapy/targeted therapy), while metastatic disease & blood cancers are almost solely treated by such systemic therapy.

Myths and Facts

Myth 1. Cancer only affects older adults.
Fact. While cancer is more common in older adults, it can affect people of all ages. Certain cancers, such as leukaemia and lymphoma, are more prevalent in children and young adults, emphasising the need for awareness across all age groups.

Myth 2. Cancer rates are the same everywhere.
Fact: Cancer prevalence varies by region, influenced by lifestyle, environmental exposures, and access to healthcare. For example, oral cancer rates are higher in India due to widespread tobacco use, while skin cancer is more common in countries with high sun exposure.

Myth 3. All cancers have the same risk factors.
Fact: Different types of cancer have different risk factors. For example, lung cancer is strongly linked to smoking, while cervical cancer is often associated with HPV infection. Understanding the specific risks for each type is crucial for prevention and early detection.

Challenges in Cancer Control in India

Cancer control in India faces significant challenges, primarily due to an imbalanced focus that prioritises treatment over prevention and early diagnosis. This approach overlooks the fact that many cancers are preventable, and early detection can dramatically improve treatment outcomes. A more structured system is needed, with an organised network of primary care providers who maintain continuous engagement with specific communities. This requires adequate funding, comprehensive education for primary care providers, and a systematic allocation of population groups to designated providers based on catchment areas.

In terms of treatment, India lags considerably behind in the availability of infrastructure, trained personnel, and equipment to address the overwhelming number of cancer patients. The shortage of specialised institutes, doctors, and support staff compounds the challenge, leaving many patients without access to timely and effective care.

Addressing these gaps demands increased investment in cancer care, the establishment of new treatment centres, and accelerated training programs for medical and support staff. Cancer treatment is inherently costly, and the financial burden often prevents patients from accessing or completing care. A collaborative approach, combining resources from government and private sectors, is essential to bridge this gap. Additionally, a state-level supervisory authority is necessary to streamline patient guidance, ensuring timely and appropriate treatment pathways.

Dr Jyotirup Goswami Consultant Radiation Oncologist, Narayana Health Cancer Institute, Narayana Superspeciality Hospital, Howrah, West Bengal

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