KATHMANDU: Cancer, once regarded as a terrifying and incurable disease, is now increasingly viewed as a manageable condition, thanks to advancements in technology.
Recent innovations in treatment methods and research have significantly improved the accessibility and effectiveness of cancer care.
Doctors point out that the scope of cancer treatment has expanded over the years, leading to longer life expectancy for many patients.
However, for certain complex cancers, patients still have to seek treatment abroad, highlighting the need for increased government investment in the sector to make advanced treatment options available within Nepal.
Dr. Krishna Sagar Sharma, a specialist at BP Koirala Memorial Cancer Hospital in Bharatpur, Chitwan, shared his insights on the improvements in cancer treatment and the challenges that still remain.
How has cancer treatment changed compared to the past?
In the past, cancer was often seen as a hopeless and frightening disease, but that perception has changed.
While the treatment protocols have remained in line with international standards, the accessibility and availability of tests have improved.
Some advanced tests, such as genetic testing for blood cancers, karyotyping, and chromosome analysis, are still not available in Nepal, so patients must travel abroad for these procedures.
However, treatment for cancer is now more accessible, especially for childhood cancer, where Nepal ranks among the best in the world.
The government also provides free treatment for children under 14 years of age.
Is it true that cancer treatment, such as chemotherapy, surgery, and radiation therapy, is extremely painful?
There is a common misconception that cancer treatments are excessively painful, especially when it comes to surgery.
In the past, surgeries required large incisions, which caused significant pain, but modern advancements have made treatments much less painful.
Today, we use anesthesia, painkillers, and other medications that make these procedures far more manageable.
Cancer can be treated using three main methods: chemotherapy, radiotherapy, and surgery.
Chemotherapy, which was once thought to be ineffective for some cancers, now offers hope, with new drugs enabling even advanced cancers to be treated successfully.
Similarly, radiotherapy has advanced, with more machines and trained doctors available now than in the past.
Surgical procedures have also evolved; many surgeries can now be done through small incisions using laparoscopic techniques, allowing for faster recovery and less time spent in the hospital.
Overall, public awareness and the number of medical resources, including hospitals and trained professionals, have significantly improved over the years.
Despite these advancements, what challenges remain in cancer treatment in Nepal?
While there have been significant improvements, the situation is still not ideal.
The availability of machines, specialist doctors, and trained nurses remains limited. For some types of cancer, we still rely on India for diagnosis and treatment.
To fully meet the needs of cancer patients in Nepal, it is essential for the government to invest more in this sector, so that treatment can be provided locally without the need to send patients abroad.
Are there any discrepancies between government and private cancer treatment facilities?
Most government hospitals are equipped with the necessary facilities for cancer treatment, including chemotherapy, radiotherapy, and surgery.
However, the availability of these services is still insufficient and needs expansion. Private hospitals often advertise rare treatment services not available in Nepal, but this is often a marketing tactic meant to attract patients and create confusion about government hospitals’ capabilities.
The truth is that the services provided by government hospitals are just as capable, though they require further investment and improvement.
While government hospitals are equipped with essential resources, the state must take responsibility for increasing these resources.
Retired specialist doctors, who may be providing services not yet available in government hospitals, should be given opportunities to work in these hospitals.
The government should create an environment where experienced doctors can contribute to the healthcare system.
Private hospitals are growing rapidly, largely driven by the need to increase business.
This is natural, but the state must ensure awareness and increase resources in government health institutions to provide better services to the public.
How expensive is cancer treatment technology?
New technologies, medicines, and research have revolutionized the treatment of many diseases, including cancer.
While new drugs and methods emerge, they are often expensive at first. These high costs, however, do not necessarily mean that cancer treatment itself is inherently expensive.
Some of these new medications, while potentially life-saving, come with a hefty price tag. But as the treatment of diseases advances, there is hope that life can be saved with these newer treatments.
Unlike patients with chronic conditions such as high blood pressure, diabetes, and kidney disease—who need lifelong medication—cancer patients can sometimes recover with treatment, and this makes the cost of treatment seem more justifiable.
The government has also subsidized some medications and resources, and increasing these subsidies would help ease the financial burden on patients.
BP Koirala Memorial Cancer Hospital in Bharatpur, Chitwan, is regarded as one of the oldest and most reliable cancer treatment centers in Nepal.
It has been treating thousands of cancer patients annually. Initially, the hospital faced shortages of specialists, but now there are specialists in various fields of cancer treatment.
Originally, the hospital had only 100 beds, but it has since expanded to 500 beds.
However, even with this expansion, the hospital still struggles with inadequate bed availability. Additionally, modern treatment technologies, such as radiotherapy, chemotherapy, and surgery, have been upgraded.
These services, however, are still not enough to meet the growing demand. Given the current patient load, the hospital should have 1,000 beds instead of 500.
BP Koirala Memorial Cancer Hospital also plays a key role in education, producing additional medical personnel to address the national shortage of specialists.
The government needs to enhance its investment and policy support to produce more human resources across the country.
However, the government’s subsidy for the hospital has been decreasing, despite its expansion.
The state has not adjusted its investment to match the hospital’s growing needs. If the government continues to overlook health institutions like this one, private hospitals will continue to benefit, and patients will be forced to seek treatment at higher costs.
While the services provided by BP Koirala Memorial Cancer Hospital are on par with those in private hospitals, the number of resources remains limited.
The hospital has all the necessary technology and equipment for treatment, but more investment is needed to expand these facilities.
If the required improvements are made, patients would be able to receive cancer treatment in Nepal without needing to go abroad.
For some complex treatments, like bone marrow transplants, patients still have to seek care in countries like India. With the right infrastructure and expertise in Nepal, this need could be eliminated.
Hair loss and changes in skin color are common side effects of cancer treatment. Is there no technology available to prevent these issues?
Hair loss and skin changes are common side effects of chemotherapy and radiation therapy.
These side effects are not unique to Nepal; they occur globally. To help reduce hair loss, some new therapies like targeted therapy are being used.
However, not all patients can access this treatment, as it is expensive.
In developed countries, patients may have better access to these treatments and can afford artificial hair to cover hair loss.
But the reality is that no technology currently exists to fully prevent hair loss during cancer treatment. The treatment process is the same in Europe, America, and Nepal.
Which types of cancer are most commonly affecting patients right now?
In Nepal, the most common cancer among children is blood cancer, while lung cancer is the leading cancer among adults.
For women, cervical cancer is the most common, followed by breast cancer and lung cancer. Men are more likely to develop bowel and prostate cancers.
Globally, breast cancer is the most common among women, but cervical cancer has also been prevalent in Nepal.
To address this, the HPV vaccination campaign is being implemented to protect young girls from developing cervical cancer in the future.
While the benefits of this vaccination will not be immediate, it is expected that in 20 years, when the vaccinated girls reach the age of 35-40, the situation will improve.
As awareness and early detection of cancer increase globally, more cancer cases are being diagnosed in Nepal as well.
Many people on social media have suggested that cancer is on the rise due to the consumption of food products like oil and sugar, as well as pesticides in fruits and vegetables. How much truth is there in these claims, and how can we adjust our diet to prevent cancer?
Cancer is not caused by a single factor but is the result of a combination of many causes. It is true that pesticides used on fruits and vegetables can increase the risk of cancer, as confirmed by numerous studies and investigations.
These foods not only raise the risk of cancer but can also lead to other health issues.
Therefore, before such products enter the market, it’s crucial to assess the levels of pesticides they contain and ensure they are safe for consumption.
Other factors also contribute to cancer risk, such as light pollution, radiation, and chemicals in products like dyes and enamels. These should be used with caution.
In terms of diet, it’s important to focus on healthy foods. For example, eating fried meats with crispy, fatty skin can increase the risk of stomach cancer, so it’s best to avoid such foods whenever possible.
Additionally, smoking, air pollution, and dust are major contributors to lung cancer, so avoiding these is crucial.
Consuming fruits and green vegetables that are beneficial to the body, as well as exercising regularly, can help reduce the risk of cancer.
By staying proactive with regular health check-ups, we can prevent not only cancer but also a variety of other health problems.
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