Mary’s husband called me up at 2 am. She can’t even breathe, he said. I could hear her muffled cries. The 51-year-old woman has incurable cancer. She is in palliative care.
I was amazed by her calm demeanour though. People get used to death very fast. Where do they find the strength to overcome this? Is it from faith, conviction or love? I, however, find myself drained out every time I talk to my patients about death. Cancer physicians bear a cemetery in their heart. The burden of grief and loss grows year after year.
I recommended Mary’s hospitalisation. But I could not go back to sleep. We need a strong therapy to fight cancer. Are we progressing on that front? Will we find a cure for cancer in my lifetime?
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US President Barack Obama told Vice President Joe Biden to lead the efforts to tackle cancer, during his State of the Union address in mid-January. He invoked his predecessor John F. Kennedy’s famous “moonshot” declaration in 1961 to power the cancer research. The phrase denotes achieving the impossible, as proved by the landing on moon within eight years of Kennedy’s declaration.
For Biden, this fight is personal. He lost his 46-year-old son to cancer six months ago. The mission, however, is perhaps more difficult than conquering the moon.
Biden launched the global war against cancer at the World Economic Forum in Davos.
The entire world has to sit up and listen. Cancer is pervading the world, affecting the rich and the poor alike. We need a collective effort to fight the disease. The US-led mission will help the entire world. Everyone will benefit from the outcome of the research, like India launched its own Chandrayaan on the footsteps of the first lunar mission.
This move has a special relevance for Kerala. The state has always led the rest of India in health and social sectors. Kerala has become a global model with lower infant mortality, total literacy and other social achievements.
Kerala is also under the grip of non-communicable diseases such as cancer. The state has a duty to lead the initiative to fight the diseases.
The key to the fight against cancer is prevention. Almost 90 percent of cancer cases are caused by smoking, drinking and unhealthy lifestyles. I feel proud of the Kerala government’s decision to lock down bars in the state. Let it be hailed as a historic decision in the health sector.
Three points have to be noted in cancer treatment
The shift in approach: Kerala has many hospitals with modern facilities. But we have to change the way we approach cancer. The patient has to be treated by a team of doctors, pathologists, nurses, pharmacist and social worker, led by an expert doctor. Just like a football team that works together to score. The treatment should be personalised. Everyone may not need to go through a PET scan or be on the most expensive medication.
Education: India has very few cancer doctors. We have to mould specialists in the area. All kinds of doctors will have to face cancer in the line of their work. Special cancer programmes have to be organised in medical colleges. New treatment methods have to be taught. Promising students should be groomed into experts. Continuing education should be provided to doctors as well. Many doctors in Kerala have to go to other places for training.
Research: Medical research is very backward in India. The government has to encourage drug trials. We have to chuck our misleading prejudgments. We get the medicines a long time after they have been tested and approved in other countries. We owe them to the people who volunteered to test them.
Let us revisit the key question: Can we find a cure for cancer?
For some cancers, there definitely can be a cure. Researchers are aiming to at least tame the others. Perhaps we could live with cancer by controlling it, just like we live with high blood pressure and diabetes. Let us be a part of the efforts.
Prevention, early detection and effective treatment can do wonders. Let the researches find a way to help out the people like Mary.
(The writer is the director of the Breast Oncology Programme at the Cleveland Clinic in the United States. He hails from Chapparappadavu in Kerala’s Kannur district.)
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