Delay in Cancer diagnosis means poor survival

In the era of advanced technology two-thirds of cancer cases still get diagnosed at an advanced stage
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National cancer awareness day is observed every year on 7th November in remembrance of Marie Currie’s birth. She was born in 1867 and was a Noble Prize winner for her brilliant work, leading to the development of nuclear energy and Radiation therapy for the treatment of cancer.

The day is celebrated with the aim to highlight the significance of increased awareness about cancer prevention, and early detection for the general public.

Unfortunately in the era of advanced technology, two-thirds of cancer cases still, get diagnosed at an advanced stage, reducing Patients chances of survival.

In India, the late diagnosis is possibly because of lack of awareness about the fact that cancer is a treatable disease and even can be cured if detected at an early stage. The patients also present late because of the myths that still exist in our community like getting diagnosed with cancer means a Death warrant, or an offence.

Patients hide their symptoms particularly, breast cancer patients because they feel ashamed, humiliated, as they have a fear of being blamed for the diagnosis and fear of being left by a loved one. One of the more common myth in our community is that the cancer treatment hurts more than it cures.

Some people also believe that the treatments are useless in curing cancer and only end up creating severe discomfort before the cancer results in death whereas the fact is that if the cancer is detected at an early stage (Stage I-II) the cure rate is above 80% in most of the cases and even crosses 90% in some cases.

However the delay in the diagnosis is the main cause for poor out come in cancer. The delay may occur throughout the diagnostic path way, firstly, starting with the delay by patient, as the patient fails to recognize and act on suspicious cancer symptoms.

Poor public awareness for early symptoms of cancer is considered to be the predominant reason for late presentation, hence late diagnosis. Secondly, the delay occurs at the level of Primary Physician in the recognition, investigations, and the referral for symptoms suspicious of cancer, to the expert specialist.

Primary Physician is a doctor to whom patient presents first time with their symptoms. Primary care physicians are expected to identify patients with possible cancer at an early stage, they should be able to differentiate the minority of patients who need urgent attention from the majority of the patients, they see at their clinics whether in Govt or Private setup.

In some countries like U.K., there are policy guidelines for referring a patient from a primary physician to the specialist within one to two weeks, in order to shorten the time for diagnosis and treatment, hence improve cancer prognosis, which means improved chances of cure. Finally at the hospital level, there is again delay in establishing the final diagnosis and in starting treatment.

The delay is due to some investigations, for which patient has to undergo some invasive procedures like bronchoscopy or endoscopic biopsy, that take 7-10 days to have a report.

It takes more than 10 days if the Patients Immunohistochemistry markers (IHC) etc., are to be done and then patient has to remain in a queue for starting treatment as the minimum waiting time is more than 2 weeks in every oncology department. In short, the delay in the diagnosis at several levels is the main cause for the poor survival in cancer patients.

The best solution to overcome the delay in Cancer diagnosis and treatment is possible by conducting public awareness programs for educating the community about the early signs and symptoms of the cancer.

More important is making public aware about the importance of seeking medical consultation in time. It is also the duty of primary physician to make prompt referrals, of the patients suspicious of cancer to the specialist.

The electronic, print and social media should also play their role in making public aware about the importance of early presentation and early detection of their disease. Reducing the delay in the diagnosis means improving survival.

Dr. Nazir Ahmad Khan Professor Deptt. Of Radiation Oncology SKIMS Srinagar.

DISCLAIMER: The views and opinions expressed in this article are the personal opinions of the author.

The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK.

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