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Cancer treatment in India and its alternatives August 12, 2009

Posted by southasiamasala in : Doron, Assa, India , trackback

Assa Doron and Alex Broom

India is often viewed as a country where cancer is yet to take its hold. As part of the developing world, with relatively low rates of longevity and relatively high rates of communicable diseases, cancer was and often still is not seen as a priority. Lack of basic primary health care services, water-borne diseases and other infectious diseases remain the primary causes of death. But as India is stepping into the 21st century, with a burgeoning urban middle class, cancer is increasingly making its mark. Not only is cancer increasing amongst the affluent classes, who live longer under the auspices of India’s booming economy and consumer culture, cancer is also evident amongst the poor rural population who are now bearing the brunt for India of the much-lauded Green Revolution. More and more we hear reports of a sharp increase in cancer cases as a result of toxic material in the food of ordinary folk. The Indian Outlook magazine reports highly contaminated ground water in Punjab, a consequence of long term usage of fertilizers and pesticides. These dangerous chemicals infuse everything, from vegetables and up the food chain, causing a sharp increase in cancer and other physical and neurological deformities.

Ayrvedic hospital_assialexAyurvedic hospital

For many people in the rural areas identifying cancer and getting treatment is very difficult, which ultimately leads to late diagnosis and a much smaller chance of recovery. Around 80% of those diagnosed with cancer in India will die of the disease compared with 50% of those in most developed countries. In our recent study of cancer doctors and nurses in Delhi , a range of oncology practitioners expressed their frustrations at their inability to cure cancer for those who present late to hospital. The study found that the main reasons for presenting late were proximity to advanced healthcare, gender and economic means. Perhaps the most disturbing finding of the study was that Indian women may present late to hospital and conceal their tumours due to not wanting to be a burden on the family. Previous estimates have suggested that out of the million people diagnosed with cancer each year in India, 50% die within 12 months. Our recent study provides an indication as to why this may be.

old delhi_assialex
Old Delhi

Another frustration expressed by the clinicians that took part in the study was that patients often arrive at hospitals after having sought traditional or alternative medicines elsewhere – often in their home villages. The use of Ayurveda, Unani, Siddha and other practices, before presentation to hospital, was viewed as a major barrier to effective treatment of the disease. Patients regularly arrived at hospital with advanced stages of diseases, leading one clinician to lament “we are all palliative care physicians in India”. The use of traditional practices was thus viewed as one key reason among others (including gender and class-based inequalities) for the lack of success in treatment and curing patients from urban and rural areas of India. However, behind the ‘lure of alternatives’ and what many regard as the ‘erroneous claims of efficacy’ lies a much more fundamental challenge: how can the Indian State address and prevent further healthcare polarization and mitigate the emergent hierarchies of health. Lessons from the West tell us that biomedical technologies are not the silver bullet for eradicating cancer. While overall survival has increased for some cancers, rates continue to increase in the developed world. Indeed, traditional health practices may be a vital source of health knowledge in the 21st century as scientific medicine reaches it limits in terms of reducing the cancer burden. The task for India is to ensure that its people use treatments not because they are poor, female or geographically isolated, but because they work.

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