Bengaluru, June 22 (IANS) About 12 cancer survivors from Bengaluru on Tuesday made an appeal to Prime Minister Narendra Modi and Karnataka Chief Minister B. S. Yediyurappa to take steps to impose a ban on tobacco sales, smoking, and spitting in public places which would help mitigate the spread of Covid-19 in the anticipated third wave and future waves.Besides appealing to Modi and Yediyurappa, these survivors have also sent copies of the letter to Union Health Minister Harsha Vardhan, Karnataka health minister, K. Sudhakar and Deputy chief minister, C. N. Ashwath Narayan, who is also the chairman of the Karnataka Covid Task Force.Citing the findings of the World Health Organisation (WHO), cancer survivors from the city in their letter dated June 22, said that smokers are at a high risk of developing severe complications when infected with the Covid-19 virus."Smokers are at a greater risk for hospital admission, need for ventilators, ICUs, and even death due to Covid-19. While chewing tobacco products increases saliva production and when the user spits it out, he/she spreads germs and viruses. Therefore, it is in the larger interest of the society that governments take stringent measures to ban sale of tobacco and its allied products," Nalini Satyanarayana,a cancer survivor and health activist, noted.She added that people who are nearby could inhale it (smoke) or touch the contaminated surface, getting infected and leading to the spread of the virus.The letter by these survivors asked both the state and Union governments to ban smoking at hotels, airports, pubs and hookah bars to prevent the spread of the virus."The governments must take steps to introduce vendor licensing to reduce accessibility of tobacco and its allied products. Besides this, the governments must also effectively implement a ban on public spitting, which will help in reducing the spread of deadly virus now and in future too," the survivors said in their letter.Meanwhile, oncologist Dr Vishal Rao, who is also a member of Karnataka's High Power Committee on Tobacco Control, highlighted that Covid-appropriate behaviour like wearing masks and social distancing cannot be followed in designated smoking areas (DSAs)."The current provisions of the Cigarette and Other Tobacco Products Act (COTPA) allows smoking in DSAs at restaurants, pubs, bars, and airports and these DSA are often very congested places where droplets can survive in such closed chambers with them having a possibility to become super-spreaders of Covid-19," he argued.The Consortium for Tobacco Free Karnataka's honorary advisor, Vijayalakshmi Balekundri, said the state should enforce the ban on spitting in public places, which is already imposed, by slapping fines on the violators."As the state is gradually unlocking, it is the right time for the government to consider banning DSAs and to amend COTPA," she said.--IANSnbh/bg
Thane (Maharashtra), June 21 (IANS) Spelling relief for the citizens of the city and surroundings, the Thane Municipal Corporation will set up a state of the art dedicated cancer hospital, officials said here on Monday.Through the efforts of Urban Development Minister Eknath Shinde, the government has approved allotment of land at a nominal rate on a 30-year lease for the project coming up through the TMC, Mumbai's Tata Memorial Cancer Hospital (TMCH), and the JITO Educational and Medical Trust."Taking into account the rising number of cancer patients, costly treatment and the pressures on the TMCH in Mumbai, Thane Guardian Minister Shinde had been making efforts for a well-equipped, modern cancer hospital. The TMC discussed the issue with the TMCH which expressed interest in the project," an official said.The TMC approved the proposal, and will give a plot of land for the cancer hospital at Majiwade.The Urban Development Department has given approval to the decision to give this plot for a period of 30 years at a nominal rate for the major medical project in the city adjoining Mumbai.The TMCH was started in a modest way, 80 years ago, at Parel, with 80 beds and now has 629 beds, and ranks among the most renowned facilities globally for oncology.--IANSqn/vd
Bengaluru, June 21 (IANS) Doctors here have successfully treated a 74-year-old patient from Afghanistan diagnosed with stage II oesophagus cancer along with a tumour in the kidney. While cancers of the esophagus are not uncommon, double cancers such as synchronous oesophageal and kidney cancer have been rarely reported in medical history, said the doctors at Fortis Hospital, Bannerghatta Road on Monday.The patient was in a poor condition and was suffering from progressive inability to swallow food for seven months. He was being fed through a pipe inserted into his stomach.The patient's condition required immediate surgical intervention along with chemotherapy. The team of doctors decided to treat both the cancers simultaneously under one administration of anaesthesia considering his advanced age and the risk factors involved in performing the procedure."For patients with oesophageal cancer, chemotherapy and radiotherapy play a crucial role before opting for surgical treatment. Thus, we adopted chemoradiation as the initial line of treatment to control local disease and to contain the spread of cancer. Additionally, chemoradiation would also improve the survival rate with better clinical outcomes as compared to surgery alone," said Dr Niti Raizada, Director - Medical Oncology and Hemato-Oncology, Fortis Cancer Institute, in a statement."Post completion of chemoradiation therapy, he was further considered for robotic oesophagostomy, but as he was also diagnosed with kidney tumour, a robotic assisted partial nephrectomy was also done at the same time," Raizada added.Through oesophagectomy, the doctors removed the oesophagus that had tumour, along with a portion of the upper part of the stomach, and nearby lymph nodes to prevent the spread of cancer in the body."Generally, in such procedures there are chances that patients might face respiratory problems, but since we had performed robotic assisted procedures, it reduced the post-surgery complications. The patient is now able to eat food normally without any difficulty in swallowing," said Dr Mohan Keshavamurthy, Director Urology, Uro-oncology, Andrology, Transplant & Robotic Surgery, Fortis Hospitals, Bengaluru.As per studies, synchronous development of oesophageal and kidney tumours is extremely unusual, which can lead to difficult problems in healing. While surgical resection of both tumours is the only chance for cure, in resectable cases, it is often associated with an increased risk of postoperative complications along with mortality, such as leakage or infection, induced renal dysfunction due to a large degree of surgical stress.--IANSrvt/bg
New Delhi, June 20 (IANS) Multiplying the cost per unit of early and advanced cancer as per the results of a study, India spent approximately Rs 2,386 crore in 2020 on oral cancer treatment, paid for by insurance schemes, government and private sector, spending out of pocket payments and charitable donations or a combination of these.
This is a significant portion of the healthcare budget allocation the government made in 2019-20, towards a single disease. Without any inflation in costs, this will result in an economic burden on the country of Rs 23,724 crore over the next ten years.
Tata Memorial Centre Published the first of its kind study on the cost of illness and treatment of oral cancer in India.
"This straining economic impact of oral cancer treatment strongly suggests that prevention must be one of the key mitigation strategies for addressing affordability," said the study, adding that almost all oral cancers are caused by some form of tobacco and areca nut use, either direct or as a secondhand intake.
It is very important for our country to take adequate measures to curb this menace and mitigate the economic burden caused by just one of the hundreds of diseases caused by tobacco consumption, it said.
"Early detection strategies leading to just 20 per cent reduction in advanced stage disease could save almost Rs 250 crore annually."
According to the World Health Organisation (WHO), the study further said cancer is the second leading cause of death globally, with approximately 70 per cent of cases occurring in low and middle-income countries.
'India's cancer scenario is burdened with oral cavity cancer being the most common among men. In fact, India accounted for almost a third of the global incidence in 2020."
Dr R.A. Badwe, Director, Tata Memorial Center said, "As per the GLOBOCAN statistics, the rate of new cases being diagnosed has increased by a staggering 68 per cent in the past two decades alone, making it a real public health crisis.
"To add to this, accessibility to health services is low, which coupled with poor health literacy results in a majority of cases presenting with advanced stage disease that is often difficult to treat."
Approximately, 10 per cent of the patients have progressive disease that makes them untreatable and can only be offered supportive care for their symptoms.
Most of those who do receive some forms of treatment are left unemployed and become an economic burden on their friends and family. Even patients with health insurance and/or government aid, typically seen as immune to the cost of healthcare, face serious challenges as most schemes do not provide the actual amount needed for treatment.
This eventually increases their out-of-pocket expenses, pushing a significant proportion of the patients themselves and their families into a never-ending cycle of debt.
To tackle these issues, a Tata Memorial Centre team, headed by Dr Pankaj Chaturvedi, set out to conduct a cost of illness analysis that would provide invaluable information for policy makers that make appropriate allocation of resources towards cancer.
This is the first such study in India and among a handful globally, whose estimates were calculated, utilizing a bottom-up approach where data was collected prospectively for each service as it was used.
This enormous data collection has resulted in determining the direct healthcare costs of treating oral cancer, that is, the per patient cost borne by a healthcare provider that is directly attributable to treating oral cancer.
Dr Arjun Singh, Research Fellow at Tata Memorial Hospital and the lead author of the study said that the unit cost of treating advanced stages (Rs 2,02,892) was found to be 42 per cent greater than early stages (Rs 1,17,135).
At the same time, there was an average reduction of 11 per cent in the unit costs, as socioeconomic status increased.
Medical equipment accounted for 97.8 per cent of capital costs, with the highest contributor being the radiology services that included CT, MRI and PET scan.
Variable costs that included consumables for surgery in advanced stages were 1.4 times higher than early stages, said the study, adding "with the addition of additional chemo and radiotherapy to surgery, the average cost of treatment increased by 44.6 per cent."
"About 60-80 per cent of the cases of oral cancer visit their specialist oncologists at advanced stages."
With the onset of the COVID-19 pandemic last year and now its resurgence in the second wave we have been left unprepared in true sense to fight this biggest threat to human race in recent times. There are different aspects that need to be seen which in general can help us understand and plan better for future as this disease is here to stay and may not be gone so soon.
Issues with COVID Pandemic
COVID infection has posed a recent threat to mankind especially considering its intensity of spread and also severity and increased mortality in cases with comorbidities or older age. The best of the countries too have failed in providing adequate attention to ailing cases because of a simple reason of sudden rise in total number of cases in society surpassing limits that healthcare infrastructure can accommodate at any given time. Secondly, being totally new viral disease, assured and complete treatment and prevention will take time to develop by researchers. So to limit the spread and halt the rate of spread is the best way forward as of date.
COVID and Cancer
In the last one year, we have seen COVID infecting mostly older age group, but now even the young and children are getting infected in the second wave probably due to the new mutant variant. Although complications can arise in almost any case, mostly people with co-morbidities and immune-compromised state have been found to be infected earlier and also have more complicated clinical course with mortalities. Cancer being a known immuno-compromised state thus poses a risk factor. Moreover, issue with cancer is unawareness, late presentation and lack of timely treatment which has made cancer as one of the most dreaded diseases. With COVID scare in public - restrictions due to lockdown and prevention protocols, it has posed as a major roadblock in active management in needy cancer patients. This has left common public and also the care giver confused about the right approach in cancer care in this pandemic era.
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Effect of Covid on Cancer Management
Cancer is a disease that is known of stage progression if left untreated. Also, cure from cancer treatment largely depends on the stage that the patient presents. Thus cancer is a disease where we cannot hold treatment fearing a possible infection which may or may not affect the individual depending on exposure risk and on the contrary may also not be symptomatic or life threating even if infected, in all cases. At the same time in an already infected case, individual's capacity to fight infection in immune-compromised state created with cancer therapy and the risk of cancer progression outcome on survival if treatment delayed , is something that has to be weighed with caution.
Effect on Infrastructure and Care Givers
Apart from effect of COVID on individuals, the effect on infrastructure and care givers also decides the management in cancer cases. With sudden rise of Covid cases, as per government policies a big share of infrastructure (beds, ICUs, oxygen, medications, staff) is being diverted to COVID emergencies, which is logical too. However, this poses a serious threat to our capabilities of providing adequate care to non Covid oncological emergencies and timely intervention in needy patients. Although the priority between a COVID or an oncological malignancy is something that cannot be decided so easily, at least treatment related known morbidities and emergencies in cancer cases ï¿½is something that really needs to be looked into.
Lessons Learnt and Precautions for Future
To summarise, it should be known that COVID is here to stay. State, care givers and individuals in public have their own important role to play. First and the foremost role is of an individual to take all steps to avoid spread of Covid infection by social distancing, face masks and frequent hand-washing. Specific to cancer patients do understand that cancer growth will not stop so we cannot neglect this disease, be it a pandemic or no pandemic. Timely detection of symptoms, consultation by specialists be it physical with all Covid precautions or better by a virtual mode can atleast help detect urgency, stage and then prioritize treatment to see if it can be delayed or needs urgent start. Once diagnosed, care givers take all due precaution to decide appropriate treatments where routine management can be slightly modified with non invasive and less toxic therapies given priority.
Truncated iso-effective therapies needing lesser visits and monitoring if possible are preferred. More emphasis of preparing the patient for treatment with adequate nutrition, timely immunization prevention and preventive treatments to spare cases landing into severe treatment related complications and admission are advocated. Understanding limited resources especially as seen in this second wave, it will be prudent to choose alternatives where chances of medical emergencies and need of special care like oxygen and ICUs are reduced as far as possible.
Lastly there is a huge demand and need for the authorities from state health departments to understand the ardent need of expansion of our health care system, timely pre-planning of improving infrastructure and establish disaster management protocols where we are well prepared to fight such unpredicted emergencies and we have ample preparedness to support our ailing population in the time of need and none of them suffer due to lack of healthcare facilities at least. It's a ongoing battle, which we sure are going to win with patience, understanding, cooperation and collaboration.
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New Delhi, June 14 (IANS) The Union Ministry of Science & Technology said on Monday that a study conducted by Indian scientists have recently found that cancer-causing Epstein-Barr Virus (EBV) affects the glial cells or the non-neural cells in the central nervous system (CNS) and alters molecules like phospho-inositols (PIP) when the virus infects the brain cells.
The findings could pave the way towards understanding the probable role of the virus in neurodegenerative pathologies, especially given the fact that the virus has been detected in the brain tissue of the patients suffering from neurological disorders such as Alzheimer's, Parkinson's disease and multiple Sclerosis.
The EBV can cause cancers like nasopharyngeal carcinoma (a type of head and neck cancer), B-cell (a type of white blood cells) cancer, stomach cancer, Burkett's lymphoma, Hodgkin's lymphoma, post-transplant lymphoid disorders, and so on.
However, the infection is mostly asymptomatic, and very little is known about the factors which trigger the development of such a disease. It was the detection of the virus in patients with neurodegenerative diseases that triggered the search for the mechanism of propagation of the virus.
Scientists' teams from the Departments of Physics nd Biosciences and Biomedical Engineering at IIT Indore along with their collaborator, Fouzia Siraj, at the National Institute of Pathology (ICMR), New Delhi, used the Raman Spectroscopy System supported by the Fund for Improvement of S&T Infrastructure (FIST), a scheme of the Department of Science and Technology, to trace the propagation mechanism of the virus.
The study, based on spatial and temporal changes in the Raman signal, was helpful in advancing the application of Raman Scattering as a technique for rapid and non-invasive detection of virus infection in clinical settings.