By Dr Caleb Harris & Dr Shreya Paul
In a famous monologue, Shakespeare says, “sweet are the uses of adversity”. Though written in 1603, these words hold more truth today than they ever have. The past year has presented us with adversities that perhaps none of us would have believed possible. In the modern era of global connectivity and lifestyles of relentless motion, the world was brought to a screeching halt beyond our wildest nightmares. As the pandemic hit, and the most powerful nations fell like a pack of cards, quarantine emerged the Ace of Spades. Social gatherings were banned and social distancing became the new normal. We discovered ways of functioning from within the confines of four walls and masks became a daily staple.
The battle was against an invisible enemy which could only be held at bay with adequate knowledge and strict adherence to correct practices. Out of the many lessons that COVID taught us, the power of collective will was one. As there was no known cure to the disease and no treatment protocols were yet in place, the only option available was prevention. So booming economies shut down overnight and health was put above all else. Travel became a thing of the past, every possible measure, previously thought impossible, was put into place. With the introduction of the much-awaited vaccine, and a better understanding of the disease and its treatment, we are witnessing a slow reversal of ways. Lockdown and quarantine regulations are not as watertight as they used to be and we are looking forward to going back to our old normal.
Cancer, unlike COVID is not an unknown enemy. It has been studied extensively and cancer treatment modalities have been major areas of research over several decades. Though there are effective treatment modalities for several cancers and the quality of life for patients has improved over the years, as an oncologist, I would never want to undergo any cancer treatment for myself. As someone remarked, the ways of treating cancer involves butchery (surgery) or burning(radiotherapy) or poisoning(chemotherapy).
10 million people die each year from cancer, and by 2030 experts project cancer deaths to rise to 13 million. Today, 65% of cancer deaths are happening in the least developed parts of the world. Northeast India has a higher incidence of cancers as compared to the rest of the country, more than half of which are due to tobacco. While India has laws to curb the use of tobacco, unfortunately, the implementation is rather poor. Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 or COTPA, 2003 provides the legal basis for curbing the use of tobacco.
Tobacco, in any form, is the most important cause of cancer. The use of kwai (betel nut) can also independently (without the use of tobacco) cause cancers. Meghalaya has among the highest rates of esophageal (food pipe) cancer in the world. Tobacco, betel nut and alcohol are group 1 carcinogens, yet are abused by a majority of the population, including minors.
Let us entertain a scenario wherein cancer wasn’t this dreaded chronic illness, which was manageable at worst and cured at best. Let us imagine a world where there was no cure to look forward to, no survival rates to debate upon. Would we overlook the abuse of carcinogens? Would we tolerate smoking in public places even though it is banned? The answer is a resounding NO. So, why cannot we “deny services” to someone who smokes in a public place, while putting others at risk too, just like we refuse services to someone without a mask?
A considerable number of cancers and their overall risk can be held at bay by mere lifestyle changes alone. Changes which we as a society are unwilling to make, perhaps because we know there are treatment protocols in place. While stringent laws on curbing the sale and banning the use of said products might be in place, but at the end of the day it is the society which dictates the demand and use. In a world without cure, we would be left with no other option but to adapt to the times. Instead of depending upon drugs, radiation or surgeries, we can incorporate certain changes into the fabric of the society wherein carcinogens like alcohol and tobacco are no longer perceived as benign habits but of catastrophic consequence. Why spend millions of dollars and mourn over precious time lost with loved ones when all we could do is act now?
World cancer day, observed on February 4 annually, is an initiative of the Union for International Cancer Control (UICC). 2019 marked the launch of the 3-year ‘I Am and I Will’ campaign, an empowering call-to-action for personal commitment emphasising the power of individual action taken now to impact the future.
While Meghalaya (and India) has done its best to keep Covid-19 at bay, through strict vigilance at the border and use of masks, hand-washing and social distancing, we have failed in our efforts to curb the use of tobacco, betel nut and alcohol which cause most of the cancers here. If we could curb the use of these carcinogens and prevent the young and naïve from getting into this habit, we would sure be able to save several lives.
Views expressed are personal. Email: [email protected]