India's vast and diverse population presents a complex landscape for cancer control and treatment. Each region within the country possesses its own set of risk factors, genetic predispositions, and socio-cultural influences that significantly impact cancer incidence, progression, and response to treatment. Therefore, a one-size-fits-all approach to cancer research and management is not adequate. Furthermore, lifestyle factors such as diet, physical activity levels, tobacco use, and environmental exposures vary significantly across the county. These factors play a crucial role in developing cancer and its progression.
Why There Is A Need For Research
“Research is very important to drive patient care. Every treatment modality we use today in the clinic is based on decades of research and patient participation. Currently, cancer research is heavily focused on high-income countries, often overlooking the needs of low and middle-income countries. There is a need to rebalance research efforts to address the unique challenges faced by the latter,” said Dr Bhawna Sirohi, Medical Director at Vedanta’s BALCO Medical Centre.
“To prioritise and promote regionally relevant research, it is important to identify the common cancers and complexities of their treatment in a specific country and then carry out research based on that. Standard protocols need to be made through dialogue and research for treating specific country-based cancers,” she added.
Is There Any Difference Between Cancer In India and In Western Countries?
“Cancer in India differs from that in the Western countries. We observe a higher proportion of young patients developing advanced colorectal and gallbladder cancer, particularly in rural India. Similarly, tobacco-related cancers are uniquely different in India as compared to western countries mainly due to differences in the form it is consumed. Even the pattern of cancers in rural India is different compared to those in the urban parts, suggesting a different policy or approach specific to the region,” said Dr Sirohi.
“The most common cancers in our country are head and neck, cervix, gastrointestinal, and breast cancers. Majority of cases are still diagnosed or present at advanced stages, resulting in increased treatment costs and unfavourable outcomes. Late diagnosis can also occur because we often misread the symptoms while the disease is still at its nascent stage. Local research can contribute to identifying region-specific risk factors, genetic drivers, treatment responses and ways to prevent the development of such cancers, eventually facilitating more accessible, specific, and cost-efficient treatment options,” Dr Sirohi added.
Need Of The Hour
“The need of the hour is to establish uniform cancer registries in each state and develop a prospective database of outcomes to accurately estimate the burden of the disease and create benchmarks for common cancers. Efforts need to be directed towards investigating the causes of these cancers, their epidemiology, and potential treatments to improve outcomes for cancer patients,” said Dr Sirohi. According to Dr Sirohi, this necessitates the establishment of a research agenda followed by clinical screening. Building research capacity is essential, which includes establishing a central research secretariat and an ethics committee to start with. Secondly, prevention and early detection should be prioritised, and screening and diagnosis efforts specific to the region need to be strengthened.
“India has an exceptional opportunity to answer important questions in cancer research that could help control cancer worldwide. Research doesn’t always have to be complex but answering simple questions, which then transforms into improving patient care is important. To succeed, everyone— government, academic institutions, policymakers, industry, political leaders, researchers, patients and the public— needs to work together and stay committed,” Dr Sirohi said.
To prioritize evidence-based practice, BMC is actively working to generate regional data on cancer incidences, assessing the magnitude of the disease in the region. Additionally, the organisation is focusing on establishing a research centre tailored to India's needs for cancer and its treatment, and training and development of the best oncology professionals.
Colorectal cancer is rapidly increasing in India, particularly among younger individuals, with reasons still unclear. To address this, BMC along with teams from across the globe had applied for the Cancer Grand Challenges (CGC) funded by National Cancer Institute and Cancer Research UK to understand why so many young people are developing early-onset colorectal cancer (EOCRC) and to investigate factors such as the stool microbiome and metabolomics. BMC along with the teams from Harvard, King’s college London, Gustave Roussy, Paris were one of the teams to be funded by CGC to research this.
“The grant will accelerate global cancer research, specifically targeting the rise in EOCRC and developing prevention strategies globally. The study will further integrate colorectal cancer screening with a stool-based test, along with screening that is already being done for breast, cervix, and head & neck cancers via a Mobile Cancer Detection Van. Local research will be a turning point in cancer treatment and is likely to have global implications,” Dr Sirohi concluded.