3 P’s to Understand Cancer

By Dr. Sujay Prasad, Medical Director, Neuberg Diagnostics

Cancer is a serious health concern; medical management of the disease requires a combination of health strategies at both population and individual levels. There are 3 principles that can define cancer management in the current era of Healthcare called evidence-based medicine.

1. PREVENTION:
   “Prevention is better than cure”- is the foundation of this approach. It involves a two-pronged approach that can contribute significantly to a healthy population.
   a. Awareness- education about the causes of cancer, ways to self-diagnose and when to meet an expert on a large scale can create an aware population that can care of their own health and combat the disease.

For example, being aware of the CAUTION Signals of cancer
 Change in bowel or bladder habits.
 A sore that does not heal.
 Unusual bleeding or discharge.
 Thickening or lump in the breast or elsewhere.
 Indigestion or difficulty in swallowing.
 Obvious change in a wart or mole.
 Nagging cough or hoarseness

B. Screening- easy, cost-effective, and accessible tests that can help identifying high risk individual early.

The best example to understand this is PAP Testing a simple smear-based done periodically in women after 21 years of age to screen for cervical cancer.

“In women who undergo regular and routine screening the risk of developing Invasive Cervical Cancer is <1% approximately however, in women without routine screening the risk for cervical cancer is higher than 4%. Another example is the constant training of self-breast examination provided to women making
them responsible for their own health.

2. PRESICION TESTING:
   The exponential growth in technology, its accessibility and affordability have significantly modified cancer diagnostics and treatment. Advanced diagnostic techniques in- Radiology or imaging (PET-CT), Pathology (IHC) and Genetic testing (NGS) now define how a person is treated and monitored.

However, a major challenge is that science grows rapidly and for it to translate to medicine takes time, continuous updating of medical education and training of doctors is the need of the hour. We are now capable and predicting an individual’s risk of cancer by detecting genetic changes making them more susceptible to the disease and indicate what types of cancer can occur allowing of better health management. The case of Angelina Jolie getting tested for BRCA mutation is a great example to understand the impact of genetic testing of Individuals.

3. PERSONALIZED MEDICINE:
   We are now in the era of tailor-made medicine everyone is different and so is each cancer, so profiling of tumors using techniques like – IHC, Genetic sequencing, advanced imaging can help decide the best treatment for a person. This journey of targeted cancer therapy started from Imatinib (Magic Bullet) that has revolutionized treatment of blood cancers in terms of response to treatment and quality of life in comparison to conventional Chemo therapies.

A very important P in the Indian scenario is PRICE while the costs are reducing the only way to ensure best possible patient care is by innovative PARTNERSHIPS between all stakeholder’s government, institutions, hospitals, laboratories, and Pharmaceuticals. An open environment with clear priorities- where patient is first, science next and business follows is the way forward in combating Cancer.