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In India, Dr Sarbani Ghosh Laskar is one of 14 radiation oncologists working at the Tata Memorial hospital in Mumbai. The hospital registers about 25,000 new cases of cancer each year, of which 75% are in advanced stages.
“We have a huge load of patients; we treat about 450 cases every day, with our radiotherapy facilities. It would seem to the onlooker that we'd go mad with the numbers but it's not frustrating because we do cure patients. The only frustrating thing is that patients do have to wait because the numbers are so huge. We treat about 60% of our patients for free.
“Of the patients we see each year, about 14,000 are in advanced stages of disease, some 30% are suitable for treatment, the remaining for palliation. We see about 5000 head and neck cancers a year, and a similar number of cervical cancers.
“India is a very big country and you'll find a lot of disparity in the resources you have across the country. Luckily for us we are a tertiary hospital supported by the Department of Atomic Energy, so as far as resources go, we aren't too strained. We've got everything that you can ask for in terms of equipment — three cobalt units, three linier accelerators a brachytherapy unit — but even so, it's less than the numbers you have to deal with.
“When cancer strikes women, it hits the family hard. The woman is not only the care giver in the family; she also is the breadwinner a lot of the times. Even in the rural setups. The patterns of cancer are very different in the city to the rural areas in India. In the metropolis like Bombay that's where you have breast cancers, where as in the rural areas uterine and cervical cancers are more common. In the rural areas women are often not aware of screening programmes, and multiple childbirths are common. Women are often a little shy to report to you, so won't show until they have advanced stages of cancer. There are still people who ask us if cancer is communicable.”
The Tata Memorial hospital where Dr Laskar works has adopted inventive ways to help women detect cancer early. The country cannot afford a pap-smear programme. So primary health care workers rely on their resourcefulness instead. They visit the cities slums to screen women for cervical cancer using makeshift lamps and conduct a visual inspection. This cheap method is making a real dent in detecting cancers earlier, when the disease is treatable and curable.
The IAEA, through PACT, supports the establishment of Regional Cancer Control Training Networks around the world. The Tata Memorial Centre will be integral to this model, with India well placed to be a leader in training cancer professionals from other developing nations.
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