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Some thoughts on the eve of World Cancer Day 2017

A 20-year long perpetual cancer campaign throughout the year on the National Cancer Calendar Dates has done wonders. Thanks to internet and the modern electronic media.

Dr Manoj Sharma
Dr Manoj Sharma

Acknowledged or unacknowledged… Inspired by these perpetual campaigns the proactive oncologists have indeed started sparing time on cancer campaigns of various types. CMEs, pubic lecture or chemotherapy training in the areas where facilities are non-existent, radio and television programmes in regional languages, preventive oncology as a theme in many of the conferences and the Symposia of various learned bodies, emergence of hitherto unknown dates of observance such as International Lymphoma Day and International (15th Feb) and National (14th Nov) Childhood Cancer Awareness Day, Neurological cancer Day, Palliative Care Day, Cancer Survivors Day… even survivorship issues, early detection or investigational camps, creation of cancer awareness materials, more NGOs related to cancer work coming in existence, commercially successful cancer treatment centres coming in existence in the areas where free cancer treatment centres do not exist, even attempt to declare cancer as a notifiable disease in some states, linking of all the cancer treatment centres to the National Cancer Registry Project on the persistent request to DGHS.

But enough is not enough and we have to maintain a high tempo in cancer campaign. What has been initiated by many has to persist and continue on the respective dates.

Needless to say that a single cause of cancer mortality and morbidity in India is tobacco.

We also know some of the state chief ministers have been taking pride in banning alcohol in their state for some reason that they have understood better or perhaps they have not understood it in totality for their states. A state marred by the tobacco menace like Khainee, Gutka, Naswar Gudakhoo and Biri; a state that contributes maximum patients to Delhi hospitals and neighbouring state hospitals because it is not able to provide adequate health services or may be saving its health budget by getting its people treated in other places; shamelessly becoming burden on the health services of other states and corrupting the bed occupancy to doubling and tripling in the hospitals must be helpless of a common man with cancer in these states. And then their leaders talk about Asmita and state pride.

Interestingly their elites, socialites, doctors, journalists and reporters, from this ‘backward state’, are now busy making a human chain (for what?) and making noise in the national capital instead of picking up reforms in their own state.

A state that should have banned any kind of tobacco product first before banning alcohol, though banning alcohol is never disputed, it is a good step. But banning tobacco should have been prioritised much vehemently before alcohol ban, with all the support by police and judiciary.

Somehow, we are living in the era of Surgical Strikes – first, on the border and second on black money and on many other, every day adding, reasons.

Why doesn’t the oncological community now convince the Crusaders of Surgical Strike and the Honourable Prime Minister of India to do a Surgical Strike on Tobacco and Tobacco Products?

A complete planned programme has to be put forward before the PM as to how the Surgical Strike on tobacco can be done instantaneously and the rehabilitation programme of tobacco workers shall follow quite akin to demonetisation and subsequent phased arrival of new currency notes. I am sure there will not be any added misery in the form of queue and failing industry or personal frustrations.

What’s the harm? There is no harm, as after tobacco ban we are not annihilating the farmers or tobacco growers’ land; instead their farming land is intact and so are the available choices and alternatives to produce other useful or golden crops. The golden crops may be many apart from olive, barley and many others.

Of late, there are lot of articles and representation in electronic and print media that cancer is an industry, a business and a commercial opportunity.

This looks like truth only but can we, the oncologists, break this myth by stressing more on cancer prevention… a step no one else is suitable to take — the cancer prevention through surgical strike on tobacco.

I am very optimistic as our present prime minister has taken up many such ideas and reforms for the greater benefit of people.

The Hygienic Sexual Habit and HPV Spread

A lot of discussion goes on HPV as a causative agent in oropharyngeal cancers. If we see the statistics on non-tobacco users oropharyngeal cancers and go into the details of their personal sexual habits the truth will be revealed in no time.

As the male sexual habit analysis was being carried out for almost last 30 years there wasn’t a slightest inkling that the findings will give a clue to this HPV related oropharyngeal cancers.

Stunningly the oral sexual habits were found to be quite common and prevalent in youngsters as well as the generation that has become middle aged.

In that case should we start investigational studies on HPV estimations in the oropharyngeal cancer patients with details, if possible of their personal sexual habits, at least the males can be interrogated if they indulge in any kind of oral sex, as many of the institutions are carrying out.

My adventure on radio and TV to mention this truth of oral sex and unhygienic sex has been successful and I feel that it is about time that we make this fact public before it is too late. Talk of sexual hygiene has been in practice since ages although not so vehement.

There is hesitancy in discussing the probable route of pathogenic transmission to oropharyngeal areas and this can be done easily.

The Mobile Phone Carcinogenesis and Related Awareness

The WHO has already classified it as Potentially Hazardous and it is about time that a public awareness campaign with regard to its usage in thin skulled children and others is created. Like tobacco it should not be too late before we wake up. As such mobile companies are undeterred to bring about changes in tower technology so that they are less hazardous. I did not see a single microwave tower in Houston!

The School Cancer Awareness has to be envisaged in the Proposed School Health Education Syllabus. Anyone interested can take my book on School Cancer Education — Increasing Carcinogenesis of the Various Kinds. The propagation of “self examination” in youngster and adolescent will go a long way in early detection of breast lump, testicular lump phimosis and nodal swellings (self examination of private parts and self nodal examination apart from self breast examination and self oral examination). Good diet and bad carcinogenic diet; anti cancer agro-forestry, compulsory annual school health check ups and cancer preventive advice etc are the other issues.

Strengthening the Movement of Declaring Cancer as a Notifiable Disease

One way the oncological community can convince the policy makers in expediting the government’s plans for tertiary cancer centres and also state cancer institutes would be to get a correct cancer statistics or the actual national cancer burden. The stepwise method of notification can be obtained from me.

The best would had been if the order was issued by the Directorate of Health and Family Welfare, like it was issued for tuberculosis. The move was stalled by certain “not down to the earth expert” who felt that “there is a stigma attached to cancer so people may not reveal or provide information about their cancers!”

Any way if strong oncological community of every state convinces the health ministers, this can be done like other states have done.

The Tamil Nadu Model of State Cancer Registry could be another alternative to map out the exact cancer burden that subsequently help in rapid implementation of State Cancer Institutes and Tertiary Cancer Centres, creation of Oncological Sciences Units in every medical college.

I hope the esteemed members of the oncological community will initiate some programmes on this occasion.

(4th February is WHO International Cancer Awareness Day.)

by Dr Manoj Sharma

One Comment

  1. Dr.Ashok Jahnavi Prasad Dr.Ashok Jahnavi Prasad Monday, January 23, 2017

    Professor Sharma poses a very valid interrogatory : Why doesn’t the oncological community now convince the Crusaders of Surgical Strike and the Honourable Prime Minister of India to do a Surgical Strike on Tobacco and Tobacco Products? I doubt if any politician in India would be prepared to honestly respond! A crude scan of the business interests of all the parliamentarians reveals that at least 31 have direct interest in the tobacco industry-maybe even more! And it cuts across party lines!

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