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February 3, 2019

Pakistan severely lacks diagnostic, treatment and palliative care facilities


February 3, 2019

Rawalpindi : Cancer that has emerged as a major health threat in Pakistan has never been given due attention by the concerned government authorities as the facilities of screening and early detection of cancers along with treatment and even palliative care are not available in public sector healthcare facilities almost all across the country.

Pakistan does not have National Cancer Registry in the absence of which it is hardly possible to assess the true nature of problem though according to estimates, well over 300,000 new individuals suffer from cancer every year in the country and the disease claims well over 50,000 lives every year. Data available at teaching hospitals show the existing pool of cancer patients is on the rise sharply.

The most alarming fact is that in Pakistan, only minority of cancer patients are able to get treatment and that too in five to eight major cities of the country while population in smaller cities and peripheries do not have any screening or treatment facilities.

It is also alarming that majority of cancer patients in the country are refused treatment due to limited capacity of cancer beds even in major cities and also there is a lack of facilities for even palliative care, the treatment to relieve symptoms and reduce pains caused by cancers.

According to health experts, palliative care is particularly required in places like Pakistan that has high proportion of patients with advanced stages with little chance of cure. There is a dire need to establish new cancer facilities in the country.

A large proportion of cancers present at an advanced stage mainly because of lack of awareness about cancers and if we want to combat cancer, there is a dire need of running awareness and education campaigns for masses, said Medical Superintendent at Benazir Bhutto Hospital Dr. Tariq Niazi while talking to ‘The News’ in connection with World Cancer Day being observed on February 4 around the globe with a three-year campaign ‘I Am and I Will’ from 2019 to 2021.

Cancer is the uncontrolled growth and spread of cells. It can affect almost any part of the body. The growth often invades surrounding tissues and can metastasize to distant sites. Lung, stomach, liver, colon and breast cancer cause the most cancer deaths each year.

Tobacco use, pan, chalia, alcohol use, physical inactivity, being overweight and obese, exposure to occupational for example asbestos carcinogens, radiation including ultraviolet and ionizing radiation, excessive X-Rays, low fruit and vegetable intake, excessive consumption of red and preserved meat, estrogens tablets, high fat diet, genetic factors, having unsafe sex, infections from hepatitis B, hepatitis C, HIV, human papiloma viruses, Helicobacter pylori, urban air pollution and indoor smoke from household use of solid fuels are major risk factors for cancer development, said Dr. Niazi.

According to WHO, cancer is the second leading cause of death globally and is estimated to account for 9.6 million deaths in 2018. Lung, prostate, colorectal, stomach and liver cancer are the most common types of cancer in men, while breast, colorectal, lung, cervix and thyroid cancer are the most common among women.

According to Deputy Director at Pakistan Institute of Medical Sciences, Dr. Wasim Khawaja, cancer’s seven warning signals are change in bowel or bladder habit, a sore that does not heal, unusual bleeding or discharge, thickening or lump in breast or elsewhere, indigestion or difficulty in swallowing, obvious change in wart or mole and nagging cough or hoarseness.

The four basic components of cancer control are prevention, early detection, diagnosis and treatment, and palliative care, he said.

According to WHO, between 30% and 50% of cancer deaths can be prevented by modifying or avoiding key risk factors, including avoiding tobacco products, reducing alcohol consumption, maintaining a healthy body weight, exercising regularly and addressing infection-related risk factors

Health experts say that dietary modification is another important approach to cancer control. Diets high in fruits, vegetables, whole grains, pistachios, peanuts, walnuts, soybean, tomatoes, beans, pulses and legumes and avoiding processed foods high in fat, salt and or sugar and sugary drinks, bakery items have a protective effect against many cancers.

Experts say that about one-third of the cancer burden could be decreased if cases were detected and treated early. Some of the most common cancers – including breast, colorectal and cervical cancer– are curable if detected early.

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