Cancer assist

India reports over 80,000 cervical cancer cases every year and many of these would not have arisen, if HPV vaccine had been administered to girls in the age group of 9 to 14 years.

Cervical cancer vaccines of GSK and Merck are available in India at a cost of Rs 4,000 per dose these vaccines are out of reach of average Indians.

The need of the hour is to include the vaccine in the national immunisation programme so that the vaccine becomes available free of cost. Further, a vaccine costing far less would make it easier for the Government to include the same in the programme.

It appears that these twin objectives can be achieved with the development of HPV vaccine by SII. Presently, India’s drug regulator is reviewing trial data of the vaccine submitted by SII. If the vaccine is approved, as is likely, the country’s apex immunisation body (NTAGI) would most probably include the vaccine in national immunisation programme.

That should pave the way for a drastic reduction after a few years of cervical cancer deaths, which today are a third of global cervical cancer deaths.

Cancer treatment being expensive is practically unaffordable to India’s underprivileged poor. Yet many of them end up getting treated in private hospitals and to bear the high costs, families of patients sell land holdings and exhaust their savings. When symptoms of cancer first appear, patients consult their family doctors who are general practitioners. The family doctor refers them to the private hospital known to him/her in the particular town/city. Once treatment begins at the private hospital, the patient has no option but to continue with them and costs begin piling up.

It doesn’t have to be such a bleak scenario for the underprivileged cancer patient. Serving them with free or subsidized treatment are Regional Cancer Centres (RCCs) of Government of India, Tata Memorial Centre’s hospitals and certain private hospitals. These are listed here.

27 Regional Cancer Centres (RCCs) have been set up in various States by Govt of India. These RCCs with highly qualified Oncologists and world-class facilities, provide excellent treatment options for various kinds of cancers. Every RCC is intended to treat patients from that particular State in which it is located. Any State which does not have an RCC has been assigned an RCC located in an adjoining State. Some of the popular RCCs are Kidwai Memorial Institute of Oncology (Bangalore), Regional Cancer Institute – WIA (Chennai), RCC Trivandrum, Chittaranjan National Cancer Institute (Kolkata) etc.

Tata Memorial Centre’s (TMC’s) acclaimed hospitals are in Mumbai, Guwahati, Sangrur, Varanasi and Visakhapatnam. Other private hospitals offering affordable treatment are HCG Foundation, Muthoot Hospitals, Shree Shankara Cancer Hospital. Delhi State Cancer Hospital etc, all of whom can be found here.

Cancer patients, being immuno-compromised, are at a high risk of contracting Covid-19 and protection through vaccination is absolutely essential. In this context, Vydehi Cancer Center of Bangalore has indicated the following guidelines:

1. Cancer survivors aged more than 18 years (treated and cured of malignancy and who are on follow up) should be considered for Covid vaccine.

2. Cancer patients (solid malignancies) who are on chemotherapy (conventional chemotherapy and high dose chemotherapy) should be considered for Covid vaccine preferably before the start of next cycle when blood count is normal

3. Newly diagnosed cancer patients not planned for transplant/CAR-T cell therapy/high dose chemotherapy should be considered for Covid vaccine preferably before initiating chemotherapy

4. Patients who have undergone Stem Cell Transplant / CAR- T cell therapy should not be considered for Covid vaccine for at least 3 months after procedure

5. Acute Leukemia patients planned for induction or who are on treatment should not be considered for Covid vaccine

6. Cancer patient aged >18 years, being considered for surgery should be vaccinated after a minimum gap of 1 week after surgery

7. Cancer patients >18 years on radiotherapy should be considered for Covid vaccine.

Most of the cancer treatments, particularly of children, are done on outpatient visits. This involves regular visits to hospital treatments like chemotherapy, radiation etc. Outstation patients and their care-taking family members need to find places to stay in big cities, where the top cancer hospitals are based. This is a big challenge for underprivileged people for whom rents in metros are simply unaffordable.

For lack of any alternative, the poor patients and their care-takers end up living in ramshackle shacks erected on footpaths in the hospital vicinity. A visit to Mumbai’s Parel area will reveal the miserable living conditions that such people have to put up with. Further, such a situation doesn’t help in the fight against cancer since that requires an infection-free hygienic and cheerful environment.

Having realized the gravity of the situation, over the years many cancer hospitals as well as charitable organisations have set up accommodation facilities in big cities for the economically disadvantaged cancer patients. The stay as well as food are either free or involve nominal charges. Often transport facilities are also made available from the accommodation to hospital and back so that the patients can attend chemotherapy and radiotherapy sessions etc.

Summarised list of various kinds of accommodation available in cities of India is listed below. Addresses, phone numbers, email IDs and website URLs can be found on www.cancerassist.in/accommodation-for-patients-and-kin

Accommodation provided by hospitals: (a) Bangalore: Dharmashala of Kidwai Memorial Institute of Oncology (b) Chennai: Rajasthani Dharmasala of Adyar Cancer Institute (c) Delhi: ‘Ashray’ guest house of Rajiv Gandhi Cancer Institute (d) Kolkata: Premashraya of Tata Medical Center (e) Pondicherry: ‘Shine’ Home of JIPMER

Accommodation provided by charities, trusts and foundations: (a) Delhi: Manav Ashray (b) Kolkata: Oncolink India (c) Mumbai: (i) Access Life (ii) Arogya Bhavans of Deepsikha (iii) Assam Bhavan (iv) Bombay Mother & Child welfare Society (v) Brahmaputra Cancer Care Society(vi) Chandramohan Foundation (vii) Gopal Mansion (viii) Jacaf Helping Hands (xi) Mangalam Charitable (x) Nana Palkar Smriti Samiti (xi) Shraddha Foundation (d) Surat: Pathikashram (d) Trivandrum: (i) DePaul (ii) Karunya (iii) Mar Thoma (iv) Visram Sanketh

Accommodation in childcare shelters & palliative care centres: (a) Delhi, Hyderabad, Jaipur, Kolkata, Mumbai: St Jude Childcare Centres (b) Jaipur: K D Avedna Ashram (c) Mumbai: Dr Earnest Borges Memorial Home

Accommodation in private Dharamshalas: (a) Indore: By Lions Club of Indore Mahanagar (b) Mumbai: (i) Ahuja Dharamshala (ii) Sant Gadge Maharaj (iii) Shree Kumavat Seva Trust