SHILLONG, Jan 5: Cancer care in Meghalaya is not just a medical issue but a social and cultural challenge, according to a qualitative study conducted by researchers from the Indian Institute of Public Health (IIPH) Shillong, the Department of Radiation Oncology at Civil Hospital Shillong, and the Department of Health and Family Welfare.
The study, published in the Indian Journal of Medical Research, was led by Barilin Dkhar, Carmenia Khongwir, Uniqueky Gratis Mawrie, Fellicita Pohsnem, Redolen Rose Dhar, Anisha Mawlong, Rajiv Sarkar, Melari Shisha Nongrum and Sandra Albert.
The study calls for a more integrated approach to address the barriers to effective cancer care in the state.
India accounts for 7 per cent of the global cancer burden, and the Northeastern region, including Meghalaya, has the highest cancer incidence in the country.
Cancer is among the top five causes of death in Meghalaya, with oesophageal cancer being the most common among both genders. In men, hypopharyngeal cancer is the second most common, while in women, it is oral cancer.
The study points to cultural beliefs as a significant factor delaying cancer diagnosis and treatment. Many Khasis attribute illness to concepts like bih (poison) and skai (the evil eye), framing cancer as a result of fate or ill intent rather than medical causes.
“It is my fate to suffer,” one respondent told researchers, reflecting a sentiment that discourages seeking biomedical care.
Many patients reportedly turned to traditional healers first, delaying critical medical interventions.
While traditional medicine remains accessible and culturally familiar, the study notes that it often pushes patients to seek hospital care only as a last resort.
Further, stigma continues to be a major issue in Meghalaya. Patients are reluctant to share their diagnosis due to fear of judgement. This stigma is particularly severe for women with breast or cervical cancer.
One case highlighted a woman who concealed her mastectomy scars due to fear of gossip. Caregivers also reported facing societal pressure and negative attitudes while supporting patients.
Economic challenges further complicate cancer treatment in the state. The hilly terrain and limited healthcare infrastructure lead to additional costs for transportation and care.
While schemes like the Meghalaya Health Insurance Scheme (MHIS) offer some financial relief, the study found that coverage gaps often leave families relying on loans or community donations. Delays in starting treatment due to financial stress were also noted in the study.
The healthcare system’s limitations compound the problem. Misdiagnosis is frequent, with several patients initially treated for unrelated conditions such as tuberculosis or gastritis. Many only receive a cancer diagnosis when the disease has reached an advanced stage.
The lack of diagnostic facilities and specialised counselors means patients often have to seek treatment outside the state, which is not always feasible. Poor road connectivity and long waiting times were cited as additional barriers. The COVID-19 pandemic worsened the situation, disrupting follow-ups and treatment schedules.
The study suggests that bridging cultural beliefs and modern medicine is key to improving cancer care in Meghalaya. Training traditional healers to recognise early symptoms and refer patients for medical care could help address delays in diagnosis.
Community awareness campaigns are needed to counter stigma and promote understanding of cancer. Strengthening healthcare infrastructure by improving diagnostic facilities, recruiting healthcare workers, and expanding insurance coverage is also essential.
The researchers emphasised the importance of including mental health support through counselors and support groups for patients and their families.
The study concludes that addressing these challenges with a culturally informed and system-driven approach is critical to improving cancer care outcomes in the state.
