Austin J Radiat Oncol & Cancer. 2015;1(2): 1007.
Renita Lorina Castelino*, Kumuda Rao and Subhas Babu G
Department of Oral Medicine and Radiology, Nitte University, India
*Corresponding author: Renita Lorina Castelino, Renita Lorina Castelino, A B Shetty Memorial Institute of Dental Sciences, Nitte University, Mangalore- 575008, India
Received: April 13, 2015; Accepted: April 20, 2015; Published: April 22, 2015
Oral cancer is considered as the eleventh most common cancer globally. Incidence of oral cancer has a wide geographical variation among approximately two-thirds of patients in the developing countries of Southeast Asia, Eastern Europe and Latin America . India has one of the highest incidences of oral cancer making it the most common cancer among men when compared to females with the ratio being 2:1. It also accounts for about 30% of all new cases annually . A recent survey of cancer mortality in India showed oral cancer as the leading cause of mortality in men and responsible for 22.9% of cancer-related deaths . The incidence is usually higher in the lower socioeconomic population of society due to the higher prevalence of risk factors such as use of tobacco and tobacco related products . Most cases of cancers are usually detected only in the advanced stages when they are untreatable. This is especially true in developing countries like India . Also the factors like long distances from homes, psychological shock and difficulties in arranging money for the treatment may lead to delay in the treatment decision by poor families . The age-standardized mortality rates have been stable despite improvements in diagnostic and management techniques .
The aetiology of oral cancer is mainly tobacco use either in smoked form or smokeless form followed by alcohol, HPV virus, malnutrition, vitamin deficiency, poor dental and oral hygiene which are the other predisposing factors for oral cancer [6,7]. The management modalities mainly include surgery, radiotherapy, chemotherapy, chemoradiotherapy etc.
The treatment for oral cancer is usually expensive draining the family completely financially. Most of the cancer patients in India succumb under the pressure of the enormous and huge cost of the treatment. The expensive treatment modalities usually are a cause for drain on the resources of families belonging to middle or lower income group. The mounting and the escalating cost of cancer care drives most families to the brink of bankruptcy . Although both the Central and State Governments provide free or subsidized treatment at the tertiary cancer centres, patients often use expensive and advanced level treatment to increase their survival chances.
As a low percentage of the population opt for health insurance, most of the money spent comes from the people themselves. Also emergence of new technologies and treatment protocols for cancer accompanied with a rapid rise in new cases of the disease signify that cancer care is rapidly becoming unaffordable to a majority of the population. The cancer treatment in private hospitals is expensive in India.
A web search on cancer treatment costs in India (http://india. gov.in/sectors/health_family/national_cancer.php) showed the price list of one corporate hospital charging between USD 1350- 2600 for radiotherapy course of 4-8 weeks exclusively, without taking into account the costs of other cancer treatments like surgery, chemotherapy, supportive medicines and indirect costs like transport, lodging and food borne by the patient. A study conducted by Nair K S et al. has clearly highlighted the financial burden faced by the cancer patients especially the underprivileged.
Cancer does not distinguish between the rich and the poor. The rich however when contracted with the disease can afford the best of the best treatment with ease, it is the underprivileged people who usually suffer due to the lack of resources to treat themselves. The central and the state governments should design and strengthen the existing policies available to treat cancer and make the treatment affordable or subsidized or completely free of cost to the masses.
Efforts and measures also have to be taken to prevent the disease itself through adequate public education and periodic screening by conducting community camps in collaboration with other non profitable organisations. In the Twelfth Five Year Plan (2012-2017), the Government of India has recognized the immensity of cancer in the country and drafted a package of policy interventions which include raising taxes on tobacco and tobacco related products, enforcing bans on tobacco consumption in electronic media, opening counselling centres for quitting tobacco abuse in any form along with screening for common and treatable cancers. Also evidence based strategies for cancer prevention and early detection of cancers should be implemented. To minimise the financial burden of the poor families, a good referral system and a mechanism to provide free diagnosis and treatment along with the travel expenses of the poor patients has to be set up . And last but not the least it should be the individual effort of every human being for not being a prey to the deadly disease by refraining themselves from tobacco and tobacco related products.
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