Coimbatore: On World Cancer Day, which is observed on February 4, a majority of city oncologists are worried about the increasing incidence of cancer. Though Coimbatore does not have a dedicated registry, data available with the Madras Metropolitan Registry shows that the number of paediatric cancer cases and incidence has gone up by 60% among both boys and girls.
However, doctors say the positive side of the story is that new forms of genetic testing, targeted molecule drugs, awareness and lessons learnt from the past have led to better cure rates.
Doctors say cure rates for low risk leukaemias are close to 90% now and is close to 80% for standard risk cancers too. They attribute the increase in cure rates to multiple factors like better knowledge and technological advancements to better drugs and early awareness.
"Due to newer technologies like genetic testing and molecular testing, which helps us identify cancer causing chromosomes, we can clearly categorise under low, standard or high risk," says director of Sri Ramakrishna Institute of Oncology and Research, Dr P Guhan. "Treatment is based on the category. The chemotherapy we administer is also more intensive followed by better supportive care," he added.
They say the discovery of newer drugs which act as targeted molecules and produce antibodies also have played a major role. "These new drugs act only on the cancer cells and are low in toxicity for the normal tissues," says Dr Sudhakar. "So the side effects of prescribing such strong drugs are not extreme on children and they remain strong enough to fight the disease."
A majority of childhood cancers are leukaemias, following lymphomas and brain cancer. "While we used to see around two to three new cases a day a decade ago, now we see four to five new cases a month," says consultant oncologist at Kovai Medical Centre and Hospital, Dr N Sudhakar.
Senior oncologist at New Delhi-based Sir Ganga Ram Hospital, Dr Shyam Aggarwal, says they see "at least 70 to 100 new cases of paediatric cancer a month compared to hardly 30 cases seen a decade ago".
"However, the increase is probably due to better diagnosis and awareness than an actual increase in cases," said. Dr Revathi Raj, consultant paediatric haematologist, at Chennai-based Apollo Specialty Hospital.
According to the Madras Metropolitan Tumour Registry, 285 boys were diagnosed with cancer between 1982-'86 contributing to an incidence of 10.7 per 1 lakh children. This number rose to 376 cases in 2007-'11 leading to a rise in incidence of 14.9 for every 1 lakh children. Among girls too, the number of cases has risen from 189 cases in 1982-86 to 263 cases between 2007-11. The trend also seems to be seen across the country. Data from the National Cancer Registry Programme which compiles data from 25 population based registries, like MMTR, across the country shows an increase in contribution of peadiatric cancer to the total number of cancer cases. It went up from 2.5% in 1998-2000 to 5.5% in 2007-2011.
Cancer screening centres and more awareness among doctors which leads to early detection also plays a role, say doctors. "Now most patients come in the early stages without other complications," says Dr Guhan. For example, a 14-year-old girl, Geetha Selvaraj, from Pollachi walked into a primary health centre thinking she just had a strange fever that kept returning every three days. She was diagnosed with lymphoblastic leukemia in the first stage. "However, cure rates in brain cancer and neuroblastoma is yet to increase beyond 50% to 60%," says Bindu Nair, founder of Aroh Foundation which works with cancer affected children.
According to medical doctors treating Covid-19 patients in India, the drug does help in reducing the viral replication however, they highlight that moderate to severe Covid-19 patients are being treated not only with Remdesivir but a combination of oxygen therapy, vitamin supplements, steroids and blood thinner at appropriate stages and that has been helping patients in recovering faster.