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Early detection can halve cancer deaths

Say experts as over 2 lakh die of cancer in Bangladesh every year

M Rahman
More than two lakh people die of cancer in the country every year. But early detection of the deadly disease can save half of these lives since cancer at its primary stage is curable, according to experts.
While many developed countries are combating cancer by detecting it at the initial stage, many cancer patients in Bangladesh die prematurely owing to the government's failure to introduce cancer treatment or set up early cancer detection centres at upazila and district hospitals.
Prof Mollah Obayedullah Baki, chief of National Institute of Cancer Research and Hospital (NICRH), says that apart from treatment facilities at the institution, 20 other public medical colleges have arrangements with oncologists for cancer treatment.
“Of the 20 medical colleges, only eight have Radio Therapy Machines of old models, though as many as 70 percent of cancer patients need radio therapy,’’ he said.
He added that the country requires at least 150 such machines as per the World Health Organization's ideal ratio of patients and therapy machines.
Against such a background, the country today observes World Cancer Day 2012 on the theme, “Together it is possible”.
Cancer, known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body.
Determining what causes cancer is complex. Many things are known to increase the risk of cancer, including tobacco use, certain infections, radiation, lack of physical activity, poor diet and obesity, and environmental pollutants.
A large number of people diagnosed with cancer succumb to premature deaths as they cannot receive treatment because of a lack of medical equipment and oncologists in the country, experts say.
On an average, three lakh people, mostly from rural areas, are diagnosed with cancer every year. But thanks to the shortage of early detection centre, many of them seek treatment when it is too late, said ProfBaki.
According to him, over two lakh people die from cancer every year while over 10 lakh have cancer at present, which is about 0.07 percent of the total population.
However, oncologists say, these figures may not reflect the ground reality, as there is no community-based registry of cancer patients, which is an internationally recognised method of collecting patients' data.
They emphasized the need for the creation of a registry. They argue that such a database is crucial because if the actual number of the patients and their whereabouts are not known, the government cannot take proper steps to set up adequate hospitals and prepare oncologists to treat patients.
Among women, cervical cancer tops the list while among men it is lung cancer, said Baki, who is also president of Bangladesh Cancer Society.
Around 60 percent of the country's cancer patients suffer from cervical, breast, oral cavity, lung, and larynx cancer which can be prevented by changing lifestyles through creating awareness.
In developed countries cobalt machines of the old model have been replaced by the latest Linac Machines for providing radiotherapy to treat cancer with greater precision. In Bangladesh, though, there are only five Linac Machines — three at NICRH and one each at Dhaka Medical College Hospital and Bogra Medical College Hospital.
Prof Baki told The Daily Star on Wednesday that two more Linac Machines would be installed at NICRH soon. Additionally, the number of beds would be increased to nearly double from its present 150.
The situation is grave for cervical cancer patients as the government has only one Brachytherapy Machine required for their therapy.
For every 10 lakh people there should be one cancer institute equipped with modern technology, including a Brachytherapy machine, and with a suffi-cient number of oncologists, NICRH officials said quoting the WHO ratio.
Many patients requiring immediate therapy have to wait for one to three months for their turns due to lack of therapy machines. As a result, the condition of these patients worsens and often turns incurable, they add.
For example, it took Farhad Mridha, 67, of a remote village of Shariatpur, nearly one year to know that he has cancer.
Poor Farhad from Bahirkoshia village of the district reached NICRH on December 26 last after his lung cancer spread to his brain.
He told this correspondent that he had visited many doctors in his district seeking treatment for "his constant fever", a sign of cancer, in vain. It was only a few months ago that a doctor advised him to come to Dhaka.
Accordingly he visited a doctor in the Old Town. The doctor referred him to NICRH where he was diagnosed with cancer.
Prof Baki says just by creating awareness among the people, 40 to 50 percent cancer can be checked.
To create public awareness, he stressed the need for a campaign by the government and the media similar to the one that created awareness in favour of the use of oral saline to prevent diarrhoea.
Food rich in fiber can prevent certain types of cancer and avoidance of alcohol, tobacco, junk food, red meat, early marriage of girls and frequent pregnancies can also prevent cancer, he added.
Prof Syed Akram Hussain, former national consultant, WHO and senior consultant, oncology department of LabAid Hospital, said the taskforce formed by the government had prepared a guideline and a road map to deal with the ever-increasing threat of cancer. But if the government does not take steps accordingly, the threat will take a turn for the worse.