Nearly 40% of all cancer cases in the underdeveloped district of Gadchiroli are tobacco-related. A study of a population-based cancer registry in the region has revealed that the tribals have little access to basic facilities, but the availability of tobacco is easy. The results from the registry were released at Tata Memorial Hospital (TMH) on April 17.
“The main addiction in the region is kharra, a mixture of betel nut and scented tobacco, nus, a form of powdered tobacco that women use on their teeth and gudakhu, a paste of tobacco commonly used by men. One can find shops selling tobacco every few kilometres,” said Dr. Yogeshwar Kalkonde, a co-investigator of the study. The cancer registry is a collaboration of Society for Education, Action, and Research in Community Health (SEARCH), a non-governmental organisation working in the district and the Tata Memorial Centre. The study was based on the registry data from January 2015 to December 2016.
“Mouth was the leading cancer site among men, and the second leading site among women after the cervix and breast,” the study said. Tobacco control thus should be a priority in the district, it said.
According to Dr. Kalkonde, most patients opt for treatment at a very late stage due to lack of good healthcare facilities in general as well as cancer-specific facilities. “The villagers have to travel 200 km to Nagpur to access a fully-equipped healthcare facility,” he said. Dr. Pankaj Chaturvedi, head and neck surgeon from TMH, is working to start a basic cancer facility in the district hospital.
The study also highlights this. “Gadchiroli district has mostly secondary-level healthcare facilities. There was only one pathologist in the district until recently, now there are two. Due to poor availability of diagnostic and treatment facilities, lack of awareness, high costs of cancer diagnosis and the fatalistic attitude towards cancer, few patients had their diagnosis confirmed by microscopy,” the study said.
Dr. Chaturvedi termed the incidence of oral cancer in Gadchiroli as shockingly high. “This is compounded with a high incidence of alcohol use. All three etiologies (causes) have led to this alarming level of oral cancer in Gadchiroli. Poor health care services lead to most patients coming for treatment in advanced stages, and they die within a few months of diagnosis,” he said.