In Terminal State

On August 1, 2017, India’s Health and Family Welfare Minister, JP Nadda informed Rajya Sabha that the ‘Estimated Incidence of cancer cases’ in Nagaland from 2014-2016 was 3882. The Minister was replying to a starred question regarding the rise of cancer patients in the country.


The Population Based Cancer Registry (PBCR) of the Naga Hospital Authority Kohima (NHAK) said that at least 600 new cases of cancer are detected every year in Nagaland. The registry was established in June 2009 under the National Cancer Registry Programme (NCRP) of the Indian Council of Medical Research (ICMR) with the main objective to provide baseline information for identifying cancer cases from all over the state, carry out epidemiological research on cancer and generate reliable morbidity and mortality data on cancer in the state.


According to the registry, from 2010-2014, a total of 3161 cancer cases were registered in Nagaland. The top 3 cancers among men are Nasopharynx, Stomach, and Oesophagus, and among females they are Cervix, Stomach, and Breast.


Despite this telling data, however, an unspoken “terminal state of affairs in cancer treatment exists in Nagaland” and it is intensifying each year. For instance, a single Radiation Therapy (radiotherapy) machine to the state, an integral equipment to treat most cancer, which was installed in Mokokchung district hospital years back, now outdated, is still lying non-functional. At present, Eden Medical Centre- a private hospital in Dimapur, inaugurated in 2016 has the only functional radiotherapy treatment facility, The Morung Express reported last April.


A doctor at NHAK then said that the lack of radiotherapy treatment facility was one of the biggest drawbacks to provide treatment to cancer patients in Nagaland. Besides, the State is deficient in awareness, screening methods and diagnostic centres.


The PBCR Nagaland Report has highlighted these deficiencies. A good number of cases especially from the rural areas are not reported to the offices of Registrar, Births & Deaths. Most of the cancer patients die at home and are left unregistered, it informed adding that, published obituaries in the various local newspapers are an “important source to identify cancer patients.”


Early detection and timely treatment are must for the survival rate as well as cure from the deadly disease, most experts agree. Globally, a study released last week revealed that despite the growing challenges, the five-year survival rates for most cancers have improved—sometimes significantly—since 2000.


The study released targeting the Cancer Day on February 4 noted that lack of access to treatment is leading to premature deaths which could have otherwise been prevented.


“Low- and middle-income countries face the brunt as millions of people die prematurely from cancer every year as a result of inequities in access to diagnosis,” an AFP report said commenting on The Lancet medical journal publication, where scientists analysed patient records from 322 cancer registries in 71 countries and territories, comparing five-year survival rates for 18 common cancers for more than 37.5 million adults and children.


This gap was most likely due to variations in the availability and quality of cancer diagnosis and treatment services, it noted.


In India, 80% of India’s cancer cases come to medical attention at an advanced stage, one reason why 68% of patients with cancer die of the disease in India, IndiaSpend reported last year.


While North East India is considered an epicenter for Non-communicable disease, especially cancer, Nagaland Government is yet to wake up to the phenomenon.


For instance, realizing the burden of cancer, Assam government had announced in 2016 that it would provide free medical treatment to all cancer patients and treatment would be made available in all the civil hospitals from January 2017 onwards. The 2010 Sikkim Policy of ‘Comprehensive Annual and Total Health Check-up’ (CATCH) could be a good starter. A first of its kind public healthcare initiative in the country, the Government through Health Department undertakes health check-up of each citizen annually at designated centres across the State under the programme. According to the evaluation, nearly 90% of the population was covered under CATCH by 2014 and the State’s citizens are considered “Healthiest” among the NE States.


In Nagaland, till February 4 evening, even awareness programmme from the health department was far and few in between, highlighting the terminal state of affairs.