Why go outside for cancer treatment? A question that has always baffled me. Do we lack good doctors, or are we falling short of equipment; Is our state run institution inept to deal with A disease like cancer?
Personally, I don’t fully subscribe to the reason that people still want to go outside for treatment that they don’t want people to know they are suffering from cancer, or in the case of affluent class they do it because they can afford it. An emergent pattern frequently seen in our community as opined by DAK president Dr.Suhail Naik ,”as soon as local doctors break news that a patient is suffering from some type of cancer, the next immediate step resourceful family takes is that they book tickets for treatment outside.’ Knowing that it will burn all their savings, or in some cases family may fall into medical debt to treat dear near ones, leading to desperate appeals in print or social media ,or through PAS system mounted on three-wheelers, seeking financial assistance for getting cancer treatment outside. From choosing the right doctors to getting the right tests done at right place at right time, how you manage your health care makes a big difference in your long-term wellbeing.
Here’s what you need to know to be a smart patient and a strong self-advocate. Diagnosing and treating cancer is not what it was two decades before. Cancer management has advanced too much, in many cases almost cure has been achieved. It’s crucial to remember that cancer is not one disease – it’s more than 200. All different, unique diseases, which require different approaches, for treatment. The era of precision cancer treatment is bringing cancer care to a cellular level. New and developing tools, such as advanced genomic testing, targeted therapy and immunotherapy, cancer management often need the multidisciplinary approach by experienced, compassionate team of medical, surgical, radiation oncologists and other skilled supporting professionals having expertise in selecting the best treatment options and individualized care for a patient. To treat cancer various subspecialties have now emerged providing patients with the information required to make informed decisions utilizing sophisticated diagnostic resources, collaborative case review; comprehensive care by distinguished specialists and opinion leaders; infusion services, genetic counseling-; access to promising cutting-edge treatments like gamma knife ,psychosocial and palliative support end of life care, community outreach programs, cancer registry , and improved cancer prevention and screening programs—this all happens under one roof when you have a state of art cancer center. To get treated at the best available facility is patient’s right.
There’s a marked increase in the number of cancer cases in Kashmir valley and the only dedicated Regional Cancer Center at SKIMS is always seen busy in treating patients from across valley. But sadly it has just one faculty member (till my last information) often finding it difficult to cater to all patients. The cancer services in the state run hospitals do not meet international standards, many of my colleagues expressed to me in private that lack of highly skilled professional health care workforce trained in cancer sub specialties, limited access to modern diagnostic and therapeutic facilities, long waiting time, wrong diagnoses, wrong interpretation of tests / biopsies, effectiveness and availability of costly cancer medicine, mode of administering medicines, lack of inter personal skills, and end of life under one modern cancer unit care to provide psychosocial, and spiritual services figured in other reasons and maybe because of that, when people can afford to they go out. Agreeably there is marked difference when a general surgeon or surgical oncologist operates on cancer patient, the importance I could not appreciate much till I worked in a specialized breast and thyroid cancer unit. A general surgeon may do a range of cancer surgeries along with non-cancer-related procedures, while a surgical oncologist in each oncology division has completed additional training in the treatment of cancer patients and concentrates his or her clinical practice specifically on the management of only one or two types of cancer surgeries ensuring patients receive a high degree of specialization and expertise.
Cancer is a complex disease patients need caring, personalized service from the start, superior clinical care, requiring patients to navigate myriad doctors’ appointments, treatment visits, medications and other needs, access to best modern techniques for healing, advanced diagnostic and treatment and a complete continuum of care. Multidisciplinary team evaluation provides patients with the benefit of receiving input from multiple onco-specilaists during a single clinic appointment. As a result centers working under a multidisciplinary structure obtain more successful results in the treatment and follow-up of cancer. At cancer centers, patients discover the value of integrated coordinated cancer care, survival also tends to be longer If cancer is found early, before it spreads, it can be easier to treat, which need community level initiatives and tests called cancer”screening tests”. I don’t think currently there is any community level cancer screening programme running in the valley.
Addressing the leadership gap in healthcare, the best way to predict future is to plan new institution’s needed for future roles and challenges. As we look over the past 15 to 20 years in healthcare, there are several core management mistakes we see repeating themselves, like letting one great facility unsupported, a hyper-successful establishment without a requisite support is struggling to satisfy it vision and mission. Cancer centers -approved in 2013, continue to remain on paper. Going by the statistics, J&K has witnessed an 87 per cent rise in the cancer cases in the last seven years. The work on setting up the state of art cancer center should begin on a war footing. Cancer treatment nowadays is technology-driven, so the state government must make adequate allocations to acquire the best technologies.
Dr. Fiaz Fazili is a surgeon and Consultant on Health Care policy planning and quality improvement
fiazmfazili@yahoo.com