Various forms of cancer are rising in Bangladesh, requiring multiple specialists' management for diagnosis and therapy, said noted oncologists and physicists at a discussion yesterday.

Mass awareness, early detection and preventive intervention are the keys to combating the challenges of cancer, they said.

The Daily Star organised the discussion, “Challenges of Cancer Treatment in Bangladesh: Ensuring better diagnosis

and service to patients”, at The Daily Star Centre in the city.

Citing the International Atomic Energy Agency's prediction, Prof Shahnaz Afroz, nuclear medicine specialist at Bangladesh Atomic Energy Commission, said the number of cancer patients in Bangladesh would increase by 50 percent in the next four decades.

Five decades ago, the cancer case ratio of developed to developing country was 70:30. But the scales are tilting toward the developing countries, she said.

Diagnosing cancer and carrying out therapy and surgery require a multidisciplinary effort of oncologists, medical physicists and technicians, said Prof Hasin Anupama Azhari, chairman of the Department of Medical Physics and Biomedical Engineering at Gono Biswabidyalay.

Prof Syed Muhammad Akram Hussain, consultant oncologist at Labaid Hospital, said 66 percent of cancer patients were aged between 30 and 65, posing a huge social and economic liability.

But he feels that the government does not attach due priority to the issue because of which the exact number of cancer related deaths remains unknown.

The country has only 21 Linear Accelerators and Tele Cobalt machines for cancer therapy against a demand of300, said Akram.

Prof Dr M Anwar Hossain of Biochemistry and Molecular Biology at Dhaka University said various forms of pollution caused cancer in 95 percent of the cases while the rest were caused genetically.

Cancer accounts for 13 percent of all deaths in the world, he added.

Prof Pran Gopal Datta, vice-chancellor of Bangabandu Sheikh Mujib Medical University, said a complete team was vital for cancer treatment at any given institution.

Tobacco consumption causes 5.4 million deaths around the world each year. Stopping the habit would

reduce the number of cancer patients by 30 percent, he said.

Preventing air pollution and ensuring safe drinking water can also drastically cut the number of cancer patients, he said.

According to a 2005 estimate of the World Health Organisation, the Bangladesh government earns Tk 25 billion as revenue from the tobacco trade but Tk 51 billion is spent in treating tobacco-related cancers.

Gopal attributed the reason behind such a huge number of cancer patients seeking treatment abroad to misbehaviour from physicians, confusion about the diagnosis and mindset of wealthy people.

Dr ABMF Karim, professor emeritus of radiation oncology at Vrije University Hospital in Amsterdam, said a large number of cancer patients sought treatment abroad due to a lack of trust in local physicians and in the service system.

But the perception that foreign doctors are better is wrong, he said.

Trust must be restored in the service delivery system, said Prof K Siddique-e-Rabbani, chairman of the Department of Biomedical Physics and Technology at Dhaka University.

Mahfuz Anam, editor and publisher of The Daily Star, said cancer treatment required a comprehensive vision and roadmap.

Local medical personnel should address the reason behind patients seeking treatment abroad and make the achievements in cancer treatment easily accessible

to the masses, he said.

Prof Golam Abu Zakaria, medical physicist of Cologne University, Germany, said Bangladesh needed around 230 radio therapy centres but had only 18.

It would need 1,000 oncologists, 600 medical physicists and 500 technicians to face the emerging challenges of cancer treatment, he added.

The discussion suggested a number of recom-mendations, including bringing down the costs of diagnosis and therapy, creating awareness on food habits and lifestyle, diagnosis with molecular technology, adequate pathological facilities, easy procurement of diagnostic and therapy equipment, post-procurement service, public private partnership and designated cancer treatment centres.

They also suggested inclusion of cervical cancer prevention programme in the Extended Immunisation Programme, training of 30 radio oncologists, medical physicists and technicians from Dhaka Medical College Hospital, National Cancer Institute and Bogra Hospital and implementation of the National Cancer Control Strategy and Action Plan.

Dr Sarwar Alam, associate professor of oncology at Bangabandu Sheikh Mujib Medical University, and Dr AFM Kamal Uddin, radiation oncologist of Dhaka Dental College, also spoke at the discussion, which was moderated by Prof Karim.