Cancer scenario in Northeast India

Dr Th Tomcha Singh *

Technological advances in recent past have drastically curtained most of the infection related diseases but the opposite is true in respect of cancer. The present day increase in life span coupled with modern life style and pollution culminated in a spurt of this dreaded disease.

In fact, there is gradual yet consistent increase in the incidence of cancer the world over. The present cancer burden is quite alarming at 25 millions globally and 2.5 millions for India. What is more alarming is that this figure is going to increase 50% by the year 2020 as predicted by World Health Organization.

Not only the same trend prevails in the Northeast India but certain types of cancers are relatively very high in the region compared to national figures. The incidence of stomach cancer is very high in Mizoram and is comparable to that of Japan, the highest in the world.

Why the incidence is so high is understandable from the fact that some people of Mizoram are in the habit of consuming water filtrate of tobacco which is even sold in the open market by the name of "Tuibur", popular habit of consuming smoked meat, higher drinking habits, high level of cigarette smoking etc.

In Manipur, the incidence of lung cancer is very high both in males as well as in females. This is owing to the habit of heavy tobacco use in the form of smoking, hookah etc by our elders (A pastime in the past) and smoke filled housing environments as prevalent before electricity was available in Manipur.

The incidence of Nasopharyngeal cancer is also relatively very high in Manipur mainly because of consumption of smoked meat or fish, salted fish, household burning of firewoods and other environmental factors. Paan eating habit with or without tobacco is a relatively newly acquired habit in Manipuri females in the last one decade or so.

Predictions are that there will be higher incidence of oropharyngeal cancers in Manipuri women in coming 15-20 years (Carcinogenesis roughly takes 20-25 years from start of exposure).

In Assam, oesophageal cancer, hypopharyngeal cancer and oral cancer are very common mainly due to the habit of consumption of betel-nut (Areca nut) and perhaps higher use of alkaline food.

In Nagaland, nasopharyngeal and stomach cancers are very high mainly because of high consumption of smoked meat and alcohol besides other factors. The trend in Meghalaya is very near to that of Assam and is high on oesophageal cancer and hypopharyngeal cancer because of the similar habit of betel-nut chewing.

Stomach cancer is also common in Arunachal Pradesh and Sikkim in males likely because of similar habits as in Mizoram (Except use of tuibur). So it is quite obvious that the food we eat, the life-style we follow and the environment we live in will predict what type of cancer we will suffer from.

Luckily though, cancer is a preventable disease by majority provided we take precautionary measures. The saying "Prevention is better than cure" equally holds true in respect of cancer and in fact, it remains the most desirable tool in the array of cancer management. Understanding this fact, Preventive Oncology has come up in a big way particularly in the western countries.

Cancer prevention is achievable by avoiding all the harmful carcinogenic agents like tobacco, strong chemicals, preserved, charred and infected foods, excessive ultraviolet rays etc and by consuming wholesome food mainly based on green leafy vegetables and fruits and by following an active life-style.

Next to prevention, early detection (Detection in stages of I and II) is the second best approach. If detected early, with proper treatment, a cure of almost 50% of the patients can be achieved, a contradiction to the common belief that cancer is incurable.

Early detection can be achieved by having regular health check-up, at least once yearly after 40 years age and by understanding the warning signals of cancer and reporting to the concerned doctors on earliest instance of having any of the suspicious signs and symptoms.

From the health administrators and health providers perspective, conducting regular screening programmes to susceptible subgroups of the populace also pays a long way in the early detection of cancer.

Three commonest cancers in last five years as treated in Radiotherapy Dept., RIMS, Imphal