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The goal of cancer care has shifted from survival to a quality of life advantage: Dr Raj Nagarkar

We will be having the first hospital school in this country that will ensure that the kids during their treatment don?t miss their academic period.

In an interview with ETHealthworld, Dr Raj Nagarkar, MD & Chief Surgical Oncologist, , Nashik, talks about their initiative towards improving cancer care. Edited excerpts:

Cancer in semi-urban geographies

The incidence of cancer is increasing. There was a time when I use to see about 1 or 2 new cancer patients per day whereas today I see more than 20-25 new patients. The disturbing fact which has come about in the last couple of years is that the number of young patients is definitely increasing. Today many patients are 40 years of age and that definitely talks about the changing lifestyles and the changing scenario of cancer in this country.

Cancer care at HCG Manavata- Clinical protocols & technological innovations

In 2007 I tied up with HCG and we set up the Manavata Cancer Centre in Nashik. To begin with it is a 37 bedded surgical oncology nursing home but we had the 1st Uber accelerator radiation machine for Maharashtra after Mumbai and Pune. The idea was to give quality cancer care at the door step for semi-urban population in this part of the state. In the last 10 years we have treated almost 38,000 cancer care patients. We have eData available for each and every patient which helps us to asses the quality of results, to get a geographical as well as a population based data of the type of cancer patients which we are doing. It also helps to frame and design preventive programmes for the benefit of the society. About 2 years ago we launched this Aarogya Saheli Scheme with the help of a few NGOs from this part of the state. We realised that the incidence of cervical and breast cancer was very high in women but almost 90 percent of them were diagnosed in stage 3 and stage 4 so we started this screening initiative where a team of doctors, healthcare workers, nurses were actually going to the door step of women and training, advising and assessing them by breast examination, colposcopic & cervical evaluation. So in two years we have screened almost 15,000 ladies and we were able to diagnose 40 ladies in a primary stage because of this population based initiative.

Challenges in cancer care

The challenges are that we need to educate the masses, inculcate the trust in the society that cancer can definitely be prevented by following proper lifestyle. A decade earlier cancer also meant side effects, morbidity and quality of life as a concern however now with the advancement of technology in the form of surgical oncology tools, availability of robotic surgery, good reconstructive services available and chemotherapy radiation technologies, we have definitely been able to improve the quality of life of our patients. So survival is no longer the only goal, the goal has shifted from survival to a quality of life advantage.

Now globally, we have accepted and there is enough data to substantiate the fact that cancers in India tends to occur almost a decade earlier as compared to the western population, be it in the male population because of the higher prevalence of tobacco and its related hazards. Young victims of tobacco related oral cancers are increasing wherein we have to ensure that after surgical excision of the tumour, the reconstruction has to be such that the person should be able to go back to society and carry out a physically disease free lifestyle where he is able to take care of his family and social needs. Similary in case of women more and more are being diagnosed at a younger age group, where quite a few of them have not even started their families. We have to take care that they complete their treatment and further take care of their family needs as well.

HCG Manavata Cancer Center- A differentiator

While taking care of patients we have always set few goals for ourselves which are for self improvement which cannot happen without academics and research. Since last 5 years HCG Manavata Cancer Centre has been affiliated to the Maharashtra University of Health Sciences for post graduate training programme in various oncology fraternities. We have been involved in more than 200 multinational clinical trials right from phase 1 to phase 4 and the idea is to bring in newer technologies, newer modalities of treatment for patient care and definitely to make their life much better as compared to today.

One thing we have realised after treating more than 700 kids suffering from cancer is that one of the biggest pain that these kids have more than injections or the surgical scars is the pain of missing their school. Very few schools actually emphasise with them and these kids when they see their siblings or fellow colleagues actually promoting from one class to another while they happen to miss school almost for a year, that is a disturbing fact. We will be having the first hospital school in this country that will ensure that the kids during their treatment don?t miss their academic period. Everything is taken care in the hospital by trained educationalists and they can appear for their examination.

Future expansion plans

I feel these 275 beds dedicated to oncology make us probably one of the largest private cancer centre in this country. In the next couple of years we have another 3 projects lined up in rest of Maharashtra so by 2020 we intend to have at least 5 cancer centres running in Maharashtra under the banner of HCG Manavata Cancer Centre.