Concern over cancer: Early screening, treatment in initial stage can save life

Bangladesh sees some improvements in the health sector save specialised treatments for fatal diseases like cancer for shortage of specialists and technical advances in both public and private hospitals.

Also among the shortcomings are Dhaka-based centralised healthcare system, insufficient fund allocation in the national budget for the health sector and high out-of-pocket health expenditure.

These are the cardinal factors driving people to travel abroad for lifesaving advanced treatments.

A specialist view comes from Prof Dr Moarraf Hossen, a renowned physician and senior cancer specialist in the country. He is the former director of National Institute of Cancer Research and Hospital (NICRH), Dhaka.

Also having a Fellowship Training at Tata Memorial Hospital, Bombay, and National University Hospital, Singapore, Professor Hossen talks to the FE on the occasion of the World Cancer Day today (February 4).

He delves deep into the case of cancer infection and growing cancer deaths in Bangladesh. He says early detection and the beginning of treatment can save the lives of hundreds but so many people in the country come to hospital in the last stage when doctors are helpless.

"We are citizens of a poor country and people live in poverty. In the initial stage, they ignore the disease symptoms and then visit local unauthorised caregivers. When they reach the fourth stage of cancer-- the last stage of cancer to treat--they come to us. Specialists not only in Bangladesh but elsewhere could hardly save a patient in such a condition," he explains.

So, the first job is to ensure early detection of the disease. Early detection could reduce the death rate in cancer, he believes, suggesting strengthening the screening system as a precondition to this effect.

There are 114 people suffering from cancer per 100,000 in the country, according to the first population-based cancer registry conducted by the Department of Public Health and Informatics, BSMMU.

According to data published in the December edition of the global cancer-research journal Lancet Oncology, the number of cancer patients in the country is 1.5 million. So far, the number of deaths from this disease is more or less close to one million.

The number of cancer patients here is increasing the fastest compared to other countries. The death rate in this deadly disease in Bangladesh is 70 per cent.

In response to the question as to why so many people are visiting neighbouring India and other countries on treatment purpose despite development in the country's health sector, the physician, citing other countries' instances, including in the West and Europe, said, "Most of the patients who visit foreign countries on treatment purpose take treatment in private medical hospitals in those countries."

And the amount the wealthy people spend on treatment in some foreign countries, like Singapore, with this sum there could be established hundreds of cancer-specialist hospitals, Dr Hossen says, urging the authorities to stop the tendency of going abroad unnecessarily.

"Generally, people in Bangladesh are poor and can't bear the cost in private hospitals. So, apart from improving the condition of government hospitals, the well-off people in society should come forward to establish charitable cancer-care facilities," he suggests.

Meanwhile, the cancer centres outside Dhaka need to resume in full swing and the Dhaka-based healthcare system ought to be decentralized.

"Our people need to have a nearby centre and easy access to those to have prompt screening. If patients need to visit Dhaka for a test or detection of cancer, then it discourages them from coming under treatment. So, immediate access to screening and cancer detection is mandatory," he underlines.

Suggesting enhancing budget allocation, he says building public-private partnership can expand the treatment capacity and cut the treatment cost in the country.

Bangladesh has over 300 cancer specialists and global-standard treatment capacity, he claims, adding that willingness from all concerned could change the scenario.

In Bangladesh, environment pollution is among the major causes of cancer, certainly lung cancer, a malignant tumor that develops in the lungs when cells grow abnormally. And, smoking is the main cause of lung cancer.

"People are infected with lung cancer more in passive smoking than active smoking. So, it is unacceptable that one is dying because of another's curse. We need an awareness campaign to motivate people to stop smoking, and smoking in public places," Dr Hossen prescribes.

One of the biggest reasons for the increase in cancer patients in Bangladesh is environmental pollution. Environment and air pollution are also involved. Besides, most people in Bangladesh suffer from lung diseases owing to air pollution.

A study has found fine particulate air pollution (PM2.5) shortens average life expectancy by 6.8 years in Bangladesh. The World Bank research showed losses from air pollution in 2019 ranged from $11.5 billion to $13 billion, which was 3.9 per cent to 4.4 per cent of Bangladesh's GDP.

"Air pollution is the potential cause of developing cancer. Air pollution damages the immunity against diseases and the body's protection capability," says Dr Hossen.

Furthermore, growing uses of devices like mobile phones and home appliances like television and refrigerator release micro-ray which also could develop cancer.

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