Recently, PGIMER received the best lung cancer care award at the World Lung Cancer Conference in Barcelona, Spain. Prof D Behera, one of the pioneers of lung cancer care in the country, is credited for the setting up of the lung cancer care programme at PGI in 1982. Paranjaya Mehra speaks to him about lung cancer treatment in India.
How common is lung cancer in India?
Lung cancer in India is the most common cancer in males. It is on a rise among females too. The main reason for the same is smoking and indoor and outdoor air pollution. Indoor air pollution is because of the fuel used for cooking. Over the years there is a change in the pattern of lung cancer in India. In about 80-90 per cent of the cases, by the time diagnosis is done, it is stage three or stage four of cancer. We are able to diagnose it only at the later stages. If we are able to diagnose it at an early stage, then we can remove it by surgery as well. In India, by the time a patient comes to a doctor and the diagnosis is done, it is late and the patient has to go for drug treatment.
What preventive measures can be taken?
Do not take to smoking. To protect yourself from indoor pollution, use clean fuel. Make sure there are proper windows in the house and a chimney should be there too. Smoke should not get stuck in the house. Law should be put in place to stop outdoor pollution, besides that one should use the surgical mask or N 95 mask. But, practically, this is not the solution. Masks are costly and one cannot wear them for long hours.
What is the latest development in the field?
Targeted therapy is the latest development that has come about in India in the last five-to-ten years. Life span of the patients have improved because of therapy. Better drugs are available as well. Back in 1982, patients used to die in maximum three-to-four months, since the drug available for treatment was not that strong and helpful in increasing the life span. Today, if the patient gets drug treatment in time then they can survive for three-to-four years easily. In some cases the patients are cured too. There is also immuno therapy, which strengthens the immunity of the patient through drugs. The only problem is that these drugs are expensive and cannot be easily afforded by a common man. No generic drugs are available for the same yet. With time, that will also change and more people will be able to afford it.
PGI is equipped with the latest technology for lung cancer treatment. Is the institution making efforts to make it more accessible to people across the country?
A society named, Indian Society for Study of Lung Cancer, was formed in 2004. Every one working in the field of lung cancer treatment, including general physicians, research scientists, clinicians, radiologists, surgeons and radio therapists, is a part of the society. We conduct annual meetings, organise awareness programmes at different cities to spread awareness about lung cancer, benefits of not smoking and symptoms of lung cancer, among other things. We also engage doctors in CME (Continuous Medical Education). I am the founder president of the society
Compared to the rising number of lung cancer cases in India, do we have ample doctors?
No. There are few medical oncologists in the country. Radio therapy machines are also less, compared to the quantity needed in India. Radio therapy machines are less across the globe, not just in India. We do have the machinery in PGI but the patient load is a lot, resulting in sparse slots for radio therapy treatment. The situation is adverse for quick recovery of the patients. If the machinery is made available across India, there will be shorter time duration between the radio therapy sessions of the patients.
What is your vision about the future of this field?
The aim will be early diagnosis and to try to make the treatment more affordable. Funding for providing treatment to economically backward patients should also be looked into. Patients can be helped through government’s medical schemes. People need to be educated about the symptoms of lung cancer, so that they come and get the X-Ray and required scans done in time. The symptoms are basic, like weight loss, chest pain, an unusually coarse voice and coughing.