Health

Cancer is deadly, no doubt. The reason for this is not farfetched: late detection makes it very debilitating, as such chances of anyone surviving the ordeal after the disease has literally run its full circle is very slim. Thankfully, all hope is not lost, according to Dr. Lohith Reddy, a Radiation Oncologist with India’s largest Cancer care center, Healthcare Global Enterprises Ltd (HCG). He shares his thoughts with Adedayo Adejobi

What is Cancer and Why does it kill?

The human body is made up of trillions of cells that over your lifetime normally grow and divide as needed. When cells are abnormal or get old, they usually die. Cancer starts when something goes wrong in this process and your cells keep making new cells and the old or abnormal ones don’t die when they should. As the cancer cells grow out of control, they can crowd out normal cells. This makes it hard for your body to work the way it should. Cancer can develop anywhere in the body and is named for the part of the body where it started. For instance, breast cancer that starts in the breast is still called breast cancer even if it spreads to other parts of the body.

Even though cancer can lead to death, it’s not necessarily cancer that causes someone to die. Causes of cancer deaths can include: organ failure due to the size and stress of a tumor, complications during surgery, organ rupture due to tumor size, and infection due to the immune system’s inability to fight off illness while on cancer treatment. Since all the organs in our body connect one way or another, all it takes is for one to begin shutting down, and the rest may start to follow suit. In the end, the person with cancer passes away. Depending on the type of cancer, the cause of death can vary.

As a specialist who has dealt with many cases, you are there to give a diagnosis that, more often than not, will alter someone’s life forever. How do you deal with a patient’s reaction upon being diagnosed with cancer, knowing that an average patient sees cancer diagnosis as a death sentence, the fear of a cancer death, of pain and the lack of dignity?

There is no formula for telling a patient that he or she has cancer. The diagnosis is still perceived, for the most part, as a death sentence, and a patient’s reaction is usually a combination of fear, despair, and anger. How a physician delivers the news about the diagnosis, however, and his or her empathy for the patient’s situation has a profound effect on the patient’s emotional well-being. Patients rely on their doctor to give clear and helpful information that will guide them through making decisions about their care.

And the doctor relies on the patient to be open and honest, and to trust them. In this way, you and your doctor are collaborators – a team working together to make sure you get the best care possible. Encouraging the patients to be a partner by taking the active role in cancer treatment can help to get the best care from the team of doctors, nurses, and other health care providers taking care of the patient. They can try to fully understand their cancer, their treatments, and what they can expect. The doctor can answer their questions, support you and your family, and help you feel that you have the information you need to make the decisions that are right for the patient. Also, the cancer care team members can help them find people and places near them that can give you more help, if needed.However, one of the most important techniques, effective listening, is often overlooked.

HCG is reputed to be the biggest and most advanced cancer hospital in India; can you give use insight into this?

Healthcare Global Enterprises Ltd (HCG), India’s largest provider of cancer care is at the forefront of the battle against cancer. Through its network of 19 comprehensive cancer centers spread across India, HCG has brought advanced cancer care to the doorstep of millions of people. For years, HCG has been defining the future of cancer care in India by designing, building and managing cancer centres with a steadfast vision: To transform the cancer care environment by bringing core clinical services to one central place. Our intent is to help patients live longer, better lives – and to improve cancer care one centre at a time. At HCG, each centre is a model of excellence, a place where physicians can achieve professional fulfillment and accomplish breakthroughs in patient care. HCG has grown rapidly and is now a leader in cancer care, managing a network of 19 cancer care centres pan India. Each centre is provided with a business system, management expertise and capital resources to bring patient-focused, state-of-the art cancer care to new regions.

An area of such intensity requires innovative treatments and methods, and the introduction of industry-changing technologies, for the overall benefit of both the medical expert and the patient. Cancer research is an area that requires more serious work and HCG aims to rise up to that challenge. In all its years of working in this field, HCG has led the march against cancer and set benchmarks in the industry, by introducing many new technologies, highly useful in increasing the accuracy and saving time. Cancer surgery is an important area of medicine and we aim to lead with our strong framework and technology infrastructure.Ultimately, our patients are the beneficiaries of these achievements – every accomplishment brings us one step closer to our ultimate goal of longer, better lives for cancer patients and their families.

In recent years, HCG has become a preferred destination for Nigerians seeking cancer treatment abroad, what do you think is responsible for this?

The main reasons for the growing popularity of medical tourism in India include the long waiting lists in the developed countries; low cost of medical treatments in India as compared to other developed countries. According to reports, Nigerians annually spend US$200 million on medical tourism to India. The attraction of Nigerians to Indian hospitals is to seek quality and cost-effective healthcare services. India has emerged as a major health care provider because of its ability to offer ‘first-class treatment at Third World prices’. India is a major player in global medical tourism and has become the destination of choice for afflicted Nigerians who can afford to, or are compelled by fate of ill-health, to seek medical attention in that country. According to the Indian High Commission in Nigeria, 47 per cent of Nigerians that visited India in the year 2012 did so to seek medical attention. The Nigerian medical tourists to India expended N41.6 billion (US$260 million) in foreign exchange in the process (Daily Independent Newspaper, June 6, 2014, p.3).

The trend resulted from the inequality in access to healthcare and dearth of specialised medical facilities, which have remained a critical challenge to Nigeria’s healthcare provision. At HCG, it has been our venture to redefine the future of healthcare through specialising in cancer care and advanced diagnosis. About 275 specialists work with HCG – The specialists in Cancer care. We have engaged in a constant endeavor to mold the future of healthcare in India by designing, building and managing healthcare centres with a steadfast vision of bringing core clinical services under one roof. Our intent is to help patients achieve a longer and better life. With a network of 20 cancer centres across India, HCG makes advanced cancer care accessible to millions of people.

HCG is striving to transform the healthcare environment of the country ensuring it brings together quality, expertise and knowledge. Besides this, it is also extending its footprint to international markets. We have established cancer centers in Tanzania and Kenya as of now and hope to expand further to other countries in the near future. At HCG, we offer all modalities of Cancer treatment with the most advanced state-of- art technologies under a single roof. The concepts like Precision Oncology which is integral part of HCG practice can be one of the factors. We strive to support our patients in all the possible ways; we have started Tele consultation also for International patients amid this pandemic.

According to available data, cancer leads to over 70,000 deaths per annum in Nigeria. What can be done to bring this mortality figure down?

Our Mantra we follow at HCG is “The right treatment at the right time”. Tobacco use, alcohol use, unhealthy diet, physical inactivity and air pollution are risk factors for cancer (and other noncommunicable diseases). Some chronic infections are risk factors for cancer; this is a particular issue in low- and middle-income countries. Approximately 13% of cancers diagnosed in 2018 globally were attributed to carcinogenic infections, including Helicobacter pylori, human papillomavirus (HPV), hepatitis B virus, hepatitis C virus, and Epstein-Barr virus. Hepatitis B and C viruses and some types of HPV increase the risk for liver and cervical cancer, respectively. Infection with HIV substantially increases the risk of cancers such as cervical cancer. Strategies to help people quit smoking, eat healthy, and get more physical activity can help reduce deaths from different types of cancer. Vaccines, screening procedures, and new treatments can also help reduce cancer deaths. Early detection, early diagnosis, screening and treatment are advised.

The estimated incidence for the top five commonest types of cancer in Nigeria are: breast cancer (25.7%), cervix uteri (14.6%), prostate (12.8%), non-Hodgkin lymphoma (5.3%) and liver (5.0). While estimated mortality rates are: breast cancer is 18.6%. What do you think is responsible for the high incidence of breast cancer and what can be done about it?

Approximately half of breast cancers develop in women who have no identifiable breast cancer risk factor other than gender (female) and age (over 40 years). Certain factors increase the risk of breast cancer, including increasing age, obesity, harmful use of alcohol, family history of breast cancer, history of radiation exposure, reproductive history (such as age that menstrual periods began and age at first pregnancy), tobacco use and postmenopausal hormone therapy. Behavioural choices and related interventions that reduce the risk of breast cancer include: prolonged breastfeeding; regular physical activity; weight control; avoidance of harmful use of alcohol; avoidance of exposure to tobacco smoke; avoidance of prolonged use of hormones; and avoidance of excessive radiation exposure.

Family history of breast cancer increases the risk of breast cancer, but the majority of women diagnosed with breast cancer do not have a known family history of the disease. Lack of a known family history does not necessarily mean that a woman is at reduced risk. Certain inherited “high penetrance” gene mutations greatly increase breast cancer risk, the most dominant being mutations in the genes BRCA1, BRCA2 and PALB-2. The three pillars toward achieving these objectives are: health promotion for early detection; timely diagnosis; and comprehensive breast cancer management.