With a view to mapping incidence of breast cancer among women, the state government has tied up with the Yuvraj Singh Foundation and UE LifeSciences for screening of one lakh women. The Yuvraj Singh Foundation will fund the project as a part of its corporate social responsibility and UE LifeSciences will supply the high-tech portable iBreastExam device which will enable health workers to identify non-palpable breast lumps in just a few minutes, without pain or radiation. According to rough data, at least 200 cases of breast cancer are detected in the state every year, which is quite high for a state with a population of just over 15 lakh. About 23 per cent of all cancer cases detected in Goa were of breast cancer, which makes it the second highest type of cancer in the state. High incidence of breast cancer is attributed to late marriage and tendency among women to stop breastfeeding earlier than the desirable time. Screening would help detect breast cancer, making it better for a woman to start on treatment if the result in her case is positive. Cancer detected in an early stage can be expected to prevent complications.
The state government had set up a breast cancer detection facility in 2009 and two buses fitted with mammography machines were deployed in either district of the state, but with change in government in 2012 this surveillance was dropped and no one knows where those buses and equipment are. The government must not let the Yuvraj Singh Foundation-supported project lose its way after a grand start. Early detection of breast cancer cases is necessary. Also, a good surveillance system in the form of cancer registry is important for planning and evaluating cancer control activities. The state had set up a cancer registry almost a decade ago which is now defunct. Cancer registration and cancer surveillance system are required. The need for a full-fledged registry was highlighted over two years ago as the doctors treating cancer felt that an undeveloped cancer registry was creating obstacles for the local doctors in treatment of the disease. To ensure that the cancer cases are not only detected but also treated and the progress of treatment monitored, the government should give the responsibility of maintaining the registry to the oncology unit of the Goa Medical College Hospital which should serve as nodal centre for cancer cases in the state. There is no exact information about how many cases of cancer are detected in the Goa Medical College Hospital and other hospitals of the state per month. According to rough estimates, 900 persons have died annually on an average in the last three years. A cancer registry will help monitor the cases of cancer already detected and registered. There is need for coordinated approach in fighting and preventing cancer and the government should appoint a nodal officer to liaise with all the concerned hospitals and doctors for better management of cancer cases.
There is a need to remove the risk factors that lead to cancer. The government has to go beyond ineffective enforcement of ban/restrictions on all the known cancer causing substances, such as cigarettes, bidis, chewing tobacco, gutkha and alcohol. Though gutkha has been banned in the state it is being sold openly in many shops. For reasons unknown the Food and Drugs Administration (FDA) has not been acting strongly against those selling gutkha.
According to experts, the causes for around 60 per cent of cancer cases are still unknown. The Goa Cancer Society has called for the need for a ‘cohort study’ on cancer cases in Goa. Though cancer is said to be a lifestyle disease, the mystery behind the disease is still unresolved in many cases. There are cases that do not fit in the criteria linked to lifestyle which is known to cause cancer. The state government and the heads of government and private hospitals in the state must keep abreast of the latest researches on the causes and treatment of different types of cancer. Together with focus on early detection the government should direct its effort on prevention. The government must allocate special funds for encouraging research by local doctors into the causes of incidence of cancer in the state, so that preventive measures can be built into the state government’s public healthcare strategy. Non-government organizations such as the Yuvraj Singh Foundation can help the state government only to an extent. The main responsibility for prevention, treatment and cure of cancer lies with the state government.