A recent report from Apollo Hospitals shed light on India's escalating health challenges, particularly regarding cancer and non-communicable diseases (NCDs), leading to the country being dubbed the 'cancer capital of the world.' The study, aimed at raising awareness about this 'silent epidemic,' reveals alarming statistics. The report predicts a sharp increase in cancer cases, especially among women, citing environmental, socioeconomic, and lifestyle factors like tobacco use and poor diet as major contributors.
Recent estimates from the World Health Organisation (WHO) also revealed similarly concerning stats. As per WHO, India recorded over 1.41 million new cancer cases and more than 910,000 cancer-related deaths in 2022, with breast cancer being the most prevalent. These trends signal the need for a unified effort to prioritise preventive measures, enhance healthcare infrastructure, and address health disparities nationwide.
In the light of this study, the OnlyMyHealth team spoke to five specialists about India's position in the race to cure cancer. The good news is, the experts were positive about India's position with respect to cancer treatment, and believed that if the advancements in cancer treatment continue this way, the Indian population is not far from achieving successful and afordable outcomes.
Immunotherapy: A Boon For Cancer Patients
Talking to the OnlyMyHealth team about breakthroughs in cancer treatment in India, Dr RK Chaudhary, Director & Head, Medical Oncology, Metro Hospital, Noida highlighted Immunotherapy.
"Earlier, people were terrified of getting cancer. However, in the last decade, cancer has almost become an acceptable word. The last ten years have been the era of Immunotherapy for treating cancer, which has proved to be a boon for cancer patients. A decade before, we could not even think that advanced stages of cancer, or the 3rd or 4th stage of the cancer could be treated or cured. But now, with Immunotherapy, even such advanced end-stage cancers are being successfully cured."
The National Cancer Institute (NCI) defines immunotherapy as a type of cancer treatment that aims to boost the body's natural immune response to fight cancer cells, by improving or restoring immune system function. However, significant research is still required to establish Immunotherapy as a mainstream treatment for cancer like radiotherapy, surgery, or chemotherapy. This is because Immunotherapy does pose a few challenges:
- There have been instances where a patient's immune system was resistant to Immunotherapy.
- Scientists are yet to find a way to predict which patients will respond positively to Immunotherapy.
- Immunotherapy can bolster the immune system to such an extent that it starts attacking the healthy tissues and cells of the body in addition to the cancer cells.
How Car T-cell Therapy Has Revolutionised Cancer Treatment
Highlighting a specific type of Immunotherapy that has been making the waves in cancer treatment, Dr Esha Kaul, Haematology, Haemat-Oncology & BMT, Max Super Speciality Hospital, Vaishali and Max Multi Speciality Centre, told the OnlyMyHealth team about the benefits of CAR T-cell therapy.
"India's fight against cancer is bolstered by cutting-edge technology. CAR T-cell therapy, a revolutionary treatment that engineers a patient's immune system to attack cancer cells, is now available domestically. India's healthcare scene got a major boost with the introduction of homegrown CAR T-cell therapies which enhanced the affordability of cancer treatment significantly, as it costs only one-tenth of similar treatments available globally, making this powerful therapy more accessible to Indian patients. This is a big win in the fight against cancer!"
According to the American Society of Hematology (ASH), CAR-T cell therapy involves modifying a patient's T cells in the laboratory to express chimeric antigen receptors (CARs), which enable them to recognise and attack cancer cells. After genetic modification, the CAR-T cells are expanded and then infused back into the patient, where they initiate a potent immune response against cancer cells bearing the targeted antigen.
This therapy has shown significant success in treating certain blood cancers but requires careful patient monitoring due to potential side effects. As per a study mentioned by the ASH which assessed patients of blood cancer, 76% of patients undergoing CAR-T cell therapy achieved remission, while 33% experienced immune effector cell-associated neurotoxicity syndrome (a common side effect of this therapy).
"This, alongside advancements in genomics and diagnostics, offers more targeted therapies and earlier detection. While a single cure remains elusive, these breakthroughs are bringing us closer to a future with better outcomes for cancer patients."
Precision Medicine Driving Cancer Cure In India
The future of cancer cure is precision medicine. That is the agenda of the current wave of advancements in cancer treatment. Elaborating the same, Dr Dinesh Singh, Chairman Radiation Oncology, Andromeda Cancer Hospital, Sonipat spoke to the OnlyMyHealth team.
"We are inching closure to curing more and more cancer patients than we were able to cure earlier. Stage by stage cure rates in India are at par with the western world. Genomics or the details of cancer's genetic makeup guides us for heighly specific treatments is now more rapidly available and at a very economical cost as compared to the west (Rs 20000 vs 2-3 Lakhs). Indigenously developed CAR T Cell therapy is a boon to relapsed Leukemia and some other cancer patients. Cost has come down to 10 lacs from 2 crores in the west. These are the boons of percision medicine."
"Artificial Intelligence is playing a very big role in early and more precise diagnosis and treatment delivery. Precision treatment has increased cure rates by reducing side effects associated with traditional treatment modalities, and can be completed in as low as 1-5 sittings compared to the earlier 25-35 sittings."
Dr Singh further listed some breakthrough technologies being used to treat cancer in India that are also paving the way for better and faster cancer diagnosis and treatment:
- Robotics: Robotics is being increasingly used both in surgery and in radiotherapy. It increases our reach to inaccessible sites with very high precision thus increasing cure rates and reducing side effects.
- Targeted Therapies: Some cancer cells have specific targets. Medicines have been developed to identify them and act upon them to kill cancer. These medicines have much lower side effects as compared to chemotherapy.
- Liquid Biopsies: It’s a big development in which blood test can tell about presence of cancer and its burden.
- Nanotechnology: Nanoparticles deliver drugs directly to cancer cells and enable accurate diagnosis.
- Radiotherapy Innovations: Technologies like Proton therapy, Carbon Ion therapy, Boron Neutron Capture therapy have also led to significant advancements in cancer treatment.
Advancements In Cancer Treatment Paving The Way For Early Detection, Timely Intervention
Dr Vikas Goswami, Director, Medical Oncology, Max Hospital, Vaishali told the OnlyMyHealth team that early detection and timely intervention are the ultimate goals in cancer management.
"The landscape of cancer treatment has changed dramatically, encompassing precision medicine, genetic profiling, targeted treatments, and immunotherapies. Furthermore, advances in liquid biopsies and sophisticated imaging technology have transformed early detection approaches and transformed the diagnosis of cancer, allowing for prompt intervention and customised treatment regimens. Even though these developments represent significant progress, the search for a permanent cancer cure is still ongoing and is being fueled by the unwavering pursuit of scientific knowledge and cooperative efforts on a global scale."
"While a single 'cure' for all cancers remains elusive, India is making strides in treatment and diagnosis. New advancements like immunotherapy and gene editing offer a brighter future for patients. Early detection through improved screening methods is also crucial. This one-two punch of better treatments and earlier diagnoses is bringing us closer to winning the fight against cancer."
Roadblocks On The Road To Cancer Cure
Dr Harish Verma, Senior Consultant Surgical Oncology, Marengo Asia Hospitals, Gurgaon, explained the difference between cancer cure and cancer remission to the OnlyMyHealth team.
"Today, cancers that respond to treatment are not considered outright cured because there is always a potential they could come back. Instead, they are referred to as being in complete remission or evaluated as having no evidence of disease (NED), meaning there is no detectable cancer in the body. In terms of what the future holds for curing cancer altogether, some experts believe evolving treatments may, one day, make that a reality. Others think the ability to control cancer as a chronic disease is more achievable. Even if a cancer cannot be considered 100% eradicated today, many can be effectively 'cured' if detected early."
He also spoke about the gaps in cancer treatment in India which acts as a roadblock in India's journey to curing cancer or providing much more effective treatments"
- "Incidence of cancer is increasing worldwide. Despite the advancement in diagnosis and treatment modalities, there is a lot of gap in Indian society as most of the patients present late to the medical facility."
- "A big part of why cancer cannot be completely cured right now is that cancer is not one thing. Even when two cancers are the same tissue type, subtype, and stage, they may still have significant molecular differences that play a role in treatment options and outcomes."
- "Aside from the fact that cancer is not one thing, the continually changing nature of cancer, resistance to treatments, and other challenges continue to be roadblocks on the road to a cancer cure."
Dr Chaudhary also highlighted another major roadblock for India. He said, "A big problem for India's cancer sphere is that there are not enough cancer centeres in the country, most of which lie only in metropolitans or big cities. If we talk about Tier 2 or 3 cities, only one or two cancer specialists are available."
The experts concluded that the future of cancer treatment in India is a promising one. Evolving research and treatment modalities like immunotherapy, targeted therapy drugs, organ preservation and robotic surgery continues to deliver more personalised care and can potentially drive the Indian healthcare delivery to finding highly effective remission from cancer. New understanding about cancer and its treatment already informs cancer care and offers options that weren't possible even a few years ago.
However, the doctors also encouraged people to get routine checkups as the fight against cancer equally involves us regular people as much as the medical community. Whether a person's cancer will be cured or not is largely determined by the stage at which a cancer is detected in a patient. If it is caught at stage 1 or 2, or even stage 3, then there are chances that it could be cured. But at stage 4, the chances of a cure reduce making it difficult for healthcare providers to provide effective treatment. So, if you notice any symptoms that are remotely close to cancer symptoms, get yourself tested without delay.