CANCER AWARENESS IN INDIA

1. Breast Cancer Health
Awareness
PRESENTED BY :- RAJNISH KUMAR
(RESEARCH SCHOLOR, SOCIAL WORK,
(MGKVP, VARANASI)

2. Introduction
 Breast cancer ranks as the number one cancer among Indian females with rate as high
as 25.8 per 100,000 women and mortality of 12.7 per 100,000 women, according to
health ministry . India continues to have a low survival rate for breast cancer, with only
66.1% women diagnosed with the disease between 2010 and 2014 surviving, a Lancet
study found. According to estimates, at least 17,97,900 women in India may have
breast cancer by 2020.
 A cluster or group of cancer cells also called as malignant tumor in the
breast is called as “Breast Cancer“

3. Cause of less Awareness of BC
 1. lack of awareness include limited health education programs
especially for women living more rural areas.
 2. Inadequate health care infrastructure.
 3. Carelessness about own the Health.
 4. Lack of Government initiative at mass level.
 5. Not providing the Root cause information among peoples.
 6. Less involvement of schools and colleges regarding Cancer
Awareness.

4. Facts Findings
 A study on 7066 women aged 15– 70 years by A. Gupta , K. Shridhar & , P.K. Dhillon shows that
Awareness levels on the strongest risk factors related to age at menarche and age at menopause
varied from 1% to 21% while 13–58% reported family history as a risk factor for breast cancer .
Age at birth of first child and that of breast feeding were considered to be risk factors by 8–83%
and 17–88% of the women, respectively. Tobacco smoking was reported to be a risk factor in 20–
74% of women.
 Fotedar, (2013) Cross-sectional study which includes 434 women’s of average age 28yrs in
Shimla shows that awareness level of risk factor during Age at menarche 73.1% , Family history
93.9% , Diet 79.2% , Ionising radiation 71.9%.
 Rao in his study included 342 women (2005) and found that among Coastal Villages in Southern
India rural population the awareness level about the Risk factors of BC is only 9 %.

5. Continued ….
 A study on Breast Cancer Awareness at the Community Level among Women in Delhi, India by
Subhojit Dey, Arti Mishra(2015) which includes 2017 women's shows that Almost all women (90%)
were found to be aware of the importance of early detection of BC (Table 2). But this awareness was
lacking regarding the specifics related to early detection of BC. Only about half of the women
(49.9%) were aware of clinical breast examination (CBE).
 Knowledge of BC treatment - Majority of women (89.1%) being aware of BC being curable if detected
early and treated appropriately and adequately. On investigating specific areas of BC treatment
though majority (73.8%) of women believed that surgery/operation for BC means removal of entire
breast. 79.1% women also thought that alternative healthcare modalities like yoga/Ayurveda could
result in BC cure.
 Knowledge about BC symptoms -Although 84.5% of women were aware of BC usually presenting as
a lump, 73.9% women spuriously believed pain to be an initial sign of BC. Most women were also not
aware that BC can also present without a lump (62.9%).

6. Intervention
Because cancer treatments have become more aggressive during the last 20 years,
the need for new techniques to manage pain, nausea, and other aversive side effects
of such therapy has become apparent. Behavioral research and theory offer the
possibility of nonpharmacologic intervention methods.
 1. Behavioral intervention procedures are now among the most widely offered
psychosocial services at comprehensive cancer centers.
 2. At the World Health Consensus Conference on pediatric cancer pain
management, behavioral methods were identified as a primary treatment for side
effects with children undergoing repeated diagnostic and treatment procedures.

7. Continued…..
There are eight specific methods have been used in behavioral intervention to reduce aversive
side effects of cancer treatment:
 1) contingency management,
 2) cognitive/attentional distraction,
 3) hypnosis/distracting imagery,
 4) systematic desensitization,
 5) emotive imagery,
 6) relaxation training,
 7) cognitive restructuring, and
 8) modeling.

8. Psychological Intervention
Cognitive behavior therapy:- Cognitive Behavior Therapy are types of treatment that are based
firmly on research findings. These approaches aid people in achieving specific changes or goals.
Changes or goals might involve:
 A way of acting: like smoking less or being more outgoing;
 A way of feeling: like helping a person to be less scared, less depressed, or less anxious;
 A way of thinking: like learning to problem-solve or get rid of self-defeating thoughts;
 A way of dealing with physical or medical problems: like lessening back pain or helping a person
stick to a doctor’s suggestions.
Cognitive Behavior Therapists usually focus more on the current situation and its solution, rather than
the past. They concentrate on a person’s views and beliefs about their life, not on personality traits.

9. Awareness Interventions for the Future
 1. Government agencies, non government organizations and the media can play a major role in
increasing awareness about breast cancer among the general public. It should be ensured that
awareness campaigns are in regional languages to have a better penetration. Awareness about
breast feeding and its protective effects also needs to be imparted to decrease the risk of breast
cancer.
 2. There is also a need to strengthen the cancerrelated curriculum in medical schools, focusing
on breast awareness and screening methods. Also breast lump protocols made management will
go a long way in avoiding mismanagement of patients with cancer at primary and secondary
healthcare facilities.
 3) Public health workers can be trained in Clinical Breast Examination to reach out to the length
and width of this huge country.

10. Continued…
 4) Programmes should be devised for surgeons to train them in the appropriate surgical
management and referral. Continued medical education can help in training the general
surgeons in basic skills of breast surgery.
 5) Guidelines for breast cancer management have been developed for the developed
countries. India is a limited resource country and within the country also there are many
cultural, social and health infrastructure differences therefore we should form our own
management guidelines which are feasible and practical.
 6) Mobile mammography units to target women in the interior of the country, villages, hilly
areas etc.
 7) Research into genetic makeup of breast cancer in India is limited. If undertaken it may help
us understand the early onset of breast cancer in India.

11. Government scheme for Cancer Patients
 1. Health Minister’s Cancer Patient Fund :- The Ministry of Health & Family Welfare offers the Health
Minister’s Cancer Patient Fund (HMCPF) under Rashtriya Arogya Nidhi. This is available for patients
living below the poverty line.
 2. The Health Minister’s Discretionary Grants:- Also under The Ministry of Health & Family Welfare,
the HMDG offers up to a maximum of Rs. 50,000 to poor patients in cases where free medical facilities
are not available at government hospitals. Only those having an annual family income up to
Rs.1.25,000 and below are eligible for financial assistance of up to 70% of the total bill.
 3. National Health Protection Scheme:- An Ayushman Bharat initiative, the National Health Protection
Scheme provides coverage up to 5 lakh rupees per family per year for secondary and tertiary care
hospitalization.
 4. State Illness Assistance Fund:- States/UTs (with Legislature) have set up Illness Assistance Fund that
offers coverage up to Rs. 1 Lakh for cancer treatment at government hospitals within the state. While
some states do not have this scheme, Karnataka, Madhya Pradesh, Tripura, Andhra Pradesh, Tamil
Nadu, Himachal Pradesh, Jammu & Kashmir, Maharashtra, West Bengal, Kerala, Mizoram, Rajasthan,
Goa, Gujarat, Sikkim, Bihar, Chhatisgarh, Jharkhand, Haryana, Uttarakhand , Punjab and Uttar Pradesh
and the NCT of Delhi and Puducherry support it.

12. Programmes by Governments
National Cancer Control Programme launched in 1975 and revised its strategies in 1984-85
stressing on primary prevention and early detection of cancer which goals are:
 1. The primary prevention of tobacco related cancers
 2. Secondary prevention of cancer of the uterine cervix, mouth, breast etc.; and
 3. Tertiary prevention includes extension and strengthening of therapeutic services including
pain relief on a national scale through regional cancer centres and medical colleges (including
dental colleges).
National Cancer Registry Programme
 National Cancer Registry Programme was launched in 1982 by Indian Council of Medical
Research (ICMR) to provide true information on cancer prevalence and incidence.
Tobacco free Initiatives
 WHO established the Tobacco Free Initiatives (TFI) in 1998. Long term mission of TFI of WHO is
to reduce smoking prevalence and tobacco consumption in all countries and among all
groups, and thereby reduce the burden of disease caused by tobacco.

13. Organization working for Cancer Patients
 1. Charutar Arogya Mandal:- Charutar Arogya Mandal treats patients from weaker economic
groups. The center offers state-of-the-art multidisciplinary cancer care at affordable or no cost,
with experienced and compassionate experts in cancer. Several types of cancer in children have
survival rates of around 80% with proper treatment.
 2. St. Jude India’s Child Care Center:- Every year, hundreds of cancer-affected children travel to
Mumbai for treatment. With no place to stay, they usually end up staying on the streets. St. Jude
provides shelter to these families along with necessary nutritional and emotional support.
 3. Karunashraya:- First of its kind, Karunashraya is one of the best cancer care NGOs in India. It
provides free professional palliative care to 17,500 patients with advanced-stage cancer, who are
beyond cure. The treatment includes psychological and social support, rehabilitation therapies,
counseling, and practical and financial advice. It helps patients to live without pain and with peace
till their journey ends.
 4. Cuddles Foundation:- Cuddles Foundation provides nutritional support to 35,000 poor children
fighting cancer across India. They work with 22 government and charity cancer hospitals across 12
cities. The program includes a customized diet plan and nutritional supplements like protein
powder and feeding tubes.

14. Continued….
 5.Grace Cancer Foundation:- Grace Cancer Foundation was born in 2013 with a vision to reach
out to people who cannot afford treatment and to spread awareness. It organizes cancer
awareness programs in rural areas and conducts free tests to suggest the necessary
precautions to the people suffering from cancer. It has been honored with the Guinness Book
of World record for conducting cancer tests for 1,69,668 people in one day at Guntur in
Andhra Pradesh.
 6. CanKids…KidsCan :- Over the last 13 years, CanKids has worked in over 45 cancer centers in
18 cities and 14 states treating more than 1,3000 new cases of childhood cancer each year. It
also runs four homes in Delhi, Trivandrum, Kolkata, and Chennai.
 7. Sanjeevani Life Beyond Cancer:- It also motivates and encourages patients to keep a
positive outlook towards treatment and life. Founded in 2012, Sanjeevani has enriched the lives
of over 180000 patients till date.

15. List of Cancer Centers under Health Minister’s
Cancer Patient Fund scheme
 Kamala Nehru Memorial Hospital, Allahabad, Uttar Pradesh.
 Chittaranjan National Cancer Institute, Kolkata, West Bengal
 Kidwai Memorial Institute of Oncology, Bangalore, Karnataka.
 Regional Cancer Institute (WIA), Adyar, Chennai, Tamil Nadu.
 Acharya Harihar Regional Cancer, Centre for Cancer Research & Treatment, Cuttack, Orissa.
 Regional Cancer Control Society, Shimla, Himachal Pradesh.
 Cancer Hospital & Research Centre, Gwalior, Madhya Pradesh.
 Indian Rotary Cancer Institute, (AIIMS), New Delhi.
 R.S.T. Hospital & Research Centre, Nagpur, Maharashtra.
 Pt. J.N.M. Medical College, Raipur, Chhatisgarh.
 Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh.
 Sher-I- Kashmir Institute of Medical Sciences, Soura, Srinagar.

16. Continued…
 Regional Cancer Centre, Thiruvananthapuram, Kerala
 Gujarat Cancer Research Institute, Ahmadabad, Gujarat.
 MNJ Institute of Oncology, Hyderabad, Andhra Pradesh.
 Pondicherry Regional Cancer Society, JIPMER, Pondicherry.
 Dr. B.B. Cancer Institute, Guwahati, Assam.
 Tata Memorial Hospital, Mumbai, Maharashtra.
 Indira Gandhi Institute of Medical Sciences, Patna, Bihar.
 Acharya Tulsi Regional Cancer Trust & Research Institute (RCC), Bikaner, Rajasthan.
 Regional Cancer Centre, Pt. B.D.Sharma Post Graduate Institute of Medical Sciences, Rohtak,
Haryana.
 Civil Hospital, Aizawl, Mizoram.
 Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow.
 Government Arignar Anna Memorial Cancer Hospital, Kancheepuram, Tamil Nadu.
 Cancer Hospital, Tripura, Agartala.
 Regional Institute of Medical Sciences, Manipur, Imphal.
 Govt. Medical College & Associated Hospital, Bakshi Nagar, Jammu.

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