The War Against Cancer

Cancer is currently the big bad wolf in our world. Director of the Tata Memorial Hospital in Mumbai, Dr. Anil D’Cruz, spoke to us about the facts and myths about cancer and where we stand in our fight against it.

Currently, there are about 14 million cases of cancer worldwide. Two-thirds of those cases are in the developed world and the remaining one-third, in the rest of the world. However, according to Dr. D’Cruz, the pendulum shall swing by the year 2030, flipping the statistics in disfavor of developing nations. He emphasised on the inequity of cancer treatment due to income, telling us Rotarians, “Where you live matters on how well you do with cancer [because those suffering from] cancer in high income groups has better [chances of] recovery than cancer in low income groups.”

The mortality to incidence ratio of cancer in developing countries is 0.69, which means that out of every three people diagnosed with cancer, two will die, compared to developed countries wherein two out of three people diagnosed will survive.

So where are we in the war against cancer? Dr. D’Cruz answered this question, reminding Rotarians about the efforts of the 37th President of the USA, Richard Nixon. Nixon began the legislation of the National Cancer Act of 1971, declaring that he would conquer cancer. The war still continues and was renewed recently by Joe Biden, the 47th Vice President of the USA. Each day, 1650 people die because of cancer worldwide.

We have conquered polio, tuberculosis, and HIV, but are still not able to conquer cancer because, as Dr. D’Cruz stated, “It is not one disease, it is a heterogeneous group of disorders; every cancer is different and everybody’s immunity responds differently to cancer.”

India sees a hundred cases of cancer out of a hundred thousand compared to developed countries which see three hundred cases of cancer.

There is an anticipated increase in the cases in India, especially considering the increase in life expectancy from fifty years in 1947 to eighty now, due to factors like rapid modernisation, change in lifestyle, and the modern diet.

On a slightly more positive note, Dr. D’Cruz informed Rotarians that the cases of cervical cancer are decreasing, owing to access to clean bathrooms for women. However, cases of lung cancer, breast cancer, and ovarian cancer are increasing. These numbers also vary across different parts of the country. For example, Mizoram has the highest incidence of cancer (more than two hundred per hundred thousand) because of the high amount of smoking, smoked and preserved food, and the ban on alcohol which leads to the consumption of low quality alcohol.

Reiterating the importance of a healthy lifestyle, Dr. D’Cruz said that 70% of cancers are lifestylerelated whereas only 30% are genetic (and caused by other factors). 40% of cancers that are lifestyle-related are due to tobacco consumption, 10% are related to diet and obesity, and 20% are infection-related. After cautioning Rotarians about the reality of cancer, Dr. D’Cruz spoke about the four factorsto take care of in order to beat cancer, prevention is always better than cure.

Firstly, with regards to tobacco, it is evident that merely banning it does not help. Whilst tobacco consumption was prominent among a quarter of Bhutan’s population despite a tobacco ban, France and South Africa observed a drastic decline in its consumption after introducing a tobacco tax. Therefore, Dr. D’Cruz urged Rotarians to consider policies that increase taxes on carcinogenic substances rather than just banning them.

Analysing the synergetic relationship of alcohol with tobacco, Dr. D’Cruz warned Rotarians that the effects are not simply additive but twenty-fold when both these products are regularly consumed. Though less harmful than smoking, alcohol consumption must be moderated.

Further, discussing the effects of a healthy diet, Dr. D’Cruz told Rotarians to go for as colourful a plate as possible to ensure consumption of vitamins A, C, and E. These vitamins are chemopreventive and are often found in colourful fruits and vegetables.

Lastly, talking about infections whilst referring to oro-pharyngeal and tonsillar cancers, Dr. D’Cruz informed Rotarians their causes: multiplicity of partners, abnormal sexual practices, and high practice of oral sex. These cancers are quickly becoming the most frequent in the world.

In conclusion, Dr. D’Cruz shed a new light on the status quo of cancer; not only did the talk urge our fellow Rotarians to make lifestyle changes, but also introduced them to ways to help make cancer prevention more equitable.