Catch it young : Efforts to improve early diagnosis of cancer in India

Here’s a proactive measure to address a big problem in cancer treatment in India – cancer detected too late to be cured.  The ministry of health is collaborating with PromOTE India, a non-profit initiative, to take practical oncology training and education to hundreds of medical colleges all over the country.

The idea is to train under-graduates in medicine (M.B.B.S students) and post-graduates  in the many practical aspects of cancer detection, treatment, follow-up, and care as also focus on the most common cancers afflicting Indians.

Short for Promotion for Oncology Education and Training in India, PromOTE was started by oncologists of the Indian Co-operative Oncology Network (ICON) which, in turn, is an autonomous body of the Indian Society of Medical and Paediatric Oncology (ISMPO).

In their practice, these doctors observed time and again that cancer patients were walking in through the door too late for all the scientific advance made in cancer treatment to be of much use. “They came in at such a bad stage,” says Purvish Parikh, president of the ISMPO and former head of medical oncology at Tata Memorial Hospital who is now managing director of NGO Americares in India.  “We couldn’t use our knowledge to treat them.” He estimates that while 50 per cent of all patients detected with cancer are cured in the developed world,  that number is just a little over 30 per cent in developing countries.

Thus was born PromOTE where leading oncologists go around the country training doctors with a view to ultimately help improve early detection as also follow-up care. PromOTE began with training general physicians (GPs) who  are best-placed to spot early signs and symptoms and should rightly be on the frontline of the war against any disease.

A typical seminar would help GPs answer important questions such as when to suspect cancer, when to advice screening, what sorts of tests specifically ought to be written,  understanding side-effects of cancer drugs and supportive care – which is a very important aspect given the serious side-effects associated with cancer treatment.

It also advised them on counselling newly-detected patients and their families and so on.

Before and after the end of the day-long seminar, attendees answered multiple-choice questions to test knowledge gained. They are also asked for feedback. They were not charged for participation.

After conducting 130 programmes since 2006 (participation from about 13,000 doctors, says Dr Parikh), PromOTE will now target 336 government and medical colleges in collaboration with the health ministry’s directorate general of health services. The two sides will work together on curriculum,  programme rollout and evaluating programme usefulness.

Dr Parikh says three pilots have been held in colleges and a brainstorming session is planned soon to refine the template and make it appropriate to the target audience i.e. medical students.

Cancer – whose signs and symptoms may not always present distinctly or can be confused with something else and which has such dread and stigma attached to it – is not the first thing that most patients or doctors suspect or even look for.  As a result, patients might go to any number of doctors before they finally reach an oncologist losing valuable time during which treatment could’ve been initiated.

In its latest World Health Statistics report published this week, the World Health Organisation named cancer as one of the clutch of chronic diseases that are taking more lives in developing countries as a result of greater life expectancy and lifestyle changes.

Which is why a ProMOTE-like initiative is timely. Even better that it has the support of the MoH.  After the bad odour that’s been emanating from the MoH lately with regards to drug regulation, this news is a breath of fresh air.


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