Nagaland is slowly reaching a state of silent emergency. As per the Population Based Cancer Registry of the Naga Hospital Authority Kohima (NHAK), at least 600 new cases of cancer are detected every year. Annually, from a population of one lakh, the incidence rate of cancer stands at 27, to say the least. It could be much more because the identifying data is only of patients registered in Nagaland. There are still countless others who go outside the State to avail better treatment without any reference from the doctors here.
Nagaland also has the country’s highest incidence of nasopharyngeal cancer in both the male and female population. Internationally, Nagaland is placed 3rd in male prevalence and 2nd in female prevalence of this type of cancer. According to the latest data from the cancer registry, the leading cancer in males is nasopharyngeal cancer at 19.27%, stomach cancer at 17.43%, esophageal cancer at 16.06% and hypopharyngeal carcinoma at 7.80%. In females, cervical cancer has the highest incidence rate at 19.09%, stomach cancer at 13.64%, breast cancer at 11.82% and nasopharyngeal cancer at 10.91%.
No Radiotherapy Treatment Facility
Distressingly, these facts and figures are still not convincing enough for the State Government to address this alarming health burden on a war footing, clearly evident from the fact that it has not even brought in a single radiotherapy machine to the State. The only machine, which was installed in Mokokchung district hospital years back, is now outdated and non-functional. At present, the Eden Medical Centre—a private hospital in Dimapur—has the only functional radiotherapy treatment facility.
‘The lack of a radiotherapy treatment facility is one of the biggest drawbacks in providing treatment to cancer patients which could save or prolong their lives, and decrease their pain and suffering,’ says Dr Tina Khamo, senior pathologist, NHAK. NHAK is the only government district hospital, which was conferred autonomous status in 2004 and is the referral centre for the whole State. While NHAK claims to have all facilities for cancer diagnosis and the requisite trained manpower, the lack of infrastructure, most importantly, the radiotherapy machine which is an integral equipment to treat most cancers is a deterrent to treatment. It is a known fact that at least 50 percent of cancer victims can benefit from radiation therapy (radiotherapy) that destroys cancerous tumours.
Even though the doctors at NHAK administer chemotherapy, cancer treatment is not confined to chemotherapy alone. ‘After surgery, some patients may need chemotherapy, some radiotherapy, immunotherapy, hormone therapy or it might be a combination of different therapies,’ she explains. ‘When someone is diagnosed with cancer, what happens? They have to go outside for treatment because we don’t have the treatment facilities here,’ Dr Tina rued.
Many Succumb to Treatable Cancers
Due to the lack of affordable and inclusive cancer treatment facility in the State, many patients continue to succumb even from treatable cancers. Many of the patients come from lower income groups and cannot afford to go outside the State for treatment. ‘In Nagaland, the patients who come from villages or far-flung areas face transportation problems due to poor road connectivity. In some places, there are no buses or taxis plying, whereas some roads are not even motorable. Some of the patients can’t afford the fare to come to Kohima to get themselves treated,’ Dr Tina elaborates on the numerous constraints faced by cancer patients.
‘For patients who do manage to travel outside the State for treatment, they further encounter problems such as: language, food and lodging, or waiting for weeks to avail treatment, while in the meantime, the cancer grows. And when the patient (s) return back, they are often too angry to meet us, the doctors, who have referred them there,’ the senior pathologist laments.
A Ray of Hope
At Eden Medical Centre, Dimapur, the first multispecialty cancer hospital in Nagaland, which was only formally inaugurated in 2016, hordes of cancer patients throng in for treatment. At least 336 cancer patients availed the radiotherapy treatment within a span of two years from April 2015 till date. The Director of Eden Medical Centre, Dr Lima Imchen who himself is a radiotherapist informed that there were 109 cases of treatment in 2015 while 190 cases were registered in 2016. These patients form the bulk of the new 400-cancer cases diagnosed at the Centre.
The Ministry of Health and Family Welfare, Government of India is stated to have released Rs. 13.23 crore for establishing a Tertiary Care Cancer Centre (TCCC) at District Hospital, Kohima during the financial year 2016-17, which was announced in the Lok Sabha by Anupriya Patel, the Minister of State (health and family welfare) recently. ‘We are hoping and praying that this fund is utilized properly for the establishment of a radiotherapy unit here at NHAK. If we can’t even start a radiotherapy treatment unit here or provide basic cancer treatment, we are criminals, we are killing people’, Dr Tina points out.
Words- Imti Longchar