Cancer is a silent killer that is not much discussed except on designated days when the World Health Organisation instructs the national government to create awareness on this insidious malaise which is among the top five causes of death in Meghalaya. A report released in 2022 titled ‘Monitoring Survey of Cancer Risk Factors and Health System Response in Meghalaya, found that tobacco consumption in the state begins at 19.2 years. But some surveys have also found that boys in particular start smoking by age 14 and below. The survey report also highlighted the usage of betel products, observed to be the cause of oral submucous fibrosis, a pre-cancerous condition that can progress to oral cancer. Currently, the consumption of non-tobacco betel products among respondents is 72.7%, of which areca nut consumption is the highest. The survey also found that many people in the state start taking alcohol at 21 years and 10% of the respondents said they have been into heavy episodic drinking. More than 60% of the respondents said they consumed preserved or salt-curated and fermented products.The problem with many, especially those living below poverty line is that they are disinclined to go for regular check-ups. The survey found that health-seeking behaviour was very low and about 29.2% of the respondents never had their BP measured in life and only 16.4% of the respondents were aware of Cancer screening for the three common cancers – oral, breast and cervical.
The above survey was done in collaboration with the Indian Council of Medical Research-National Centre for Disease Informatics and Research (ICMR-NCDIR), Bengaluru. ICMR-NCDIR Director Prashant Mathur had urged for improving cancer screening and bringing cancer care centres closer to the people. He also emphasised the need to declare cancer as a notifiable disease in Meghalaya to understand its actual burden and for better collaboration between the government and the PBCR. Dr Caleb Harris, oncologist at NEIGRIHMS has been at the forefront in the campaign to create more awareness about the causes of Cancer particularly esophagal cancers in Meghalaya which is largely due to betel-nut and alcohol consumption and smoking. It must be noted with concern that women are most susceptible to breast, cervical Cancer and endometrial Cancers, yet many women don’t turn up for regular screening. Most come at a late stage when treatment is both difficult and expensive. Early detection could mean a difference between life and death yet people seem to put that off and live in denial.
It is also a fact that in Khasi society Cancer is not openly discussed. It’s a taboo and is called “bam-pong” in Khasi. This word means an illness that eats into the vitals of a person. When people come for treatment too late everyone suffers. The doctor’s prescriptions become heavy; the expenses are heavy too and the infrastructure in Meghalaya is not yet capable of addressing the large number of Cancer patients. Its time to demystify Cancer in Meghalaya. Oncologists, activists and educational institutions should join hands in this fight against Cancer.
