Special Feature

Cancer Treatment Comes of Age in West Bengal

Woeful lack of advanced cancer treatment facilities in Bengal, but also a complete lack of faith in the existing ones forced many to travel to distant cities for affordable and quality treatments till things changed for good

Dr Sourav Datta, Director, Medica Cancer Projects It was my dream to become a cancer specialist. Right from the time I was studying for my MBBS, I knew that treating cancer patients was my ultimate goal. As a student of MS at the Grant Medical College, Mumbai, I began visiting the Tata Memorial Centre, to spend time with the doctors there and learn from them. After passing out, I joined the centre as an observer and was later selected as a Fellow. During my visits, I was often surprised to hear a fair amount of Bengali being spoken around me. I realised that a large number of patients (around 25 per cent) getting treated here were from Bengal. The hospital had even set up a dedicated desk with Bengali-speaking guest relation executives to guide the patients from Bengal.

I began talking to these patients to find out why they felt compelled to travel to Mumbai for even the smallest of concerns. That is when I began understanding that the reason was not just the woeful lack of advanced cancer treatment facilities in Bengal, but also a complete lack of faith in the existing ones. This disturbed me, and when I discussed this with my mentor at Tata Memorial Prof Pankaj Chaturvedi, he told me that I should think of going back to Kolkata after a while and work towards improving the cancer care facility there. Rajarhat in Kolkata in 2011 was a giant leap in the region’s cancer treatment scenario. Though the hospital was not a unit of Mumbai’s Tata Memorial, the name Tata is associated with advanced cancer care the world over, and for patients in Kolkata, they finally had a facility in their backyard that they could trust.

In 2015, inspired by our teachers at Tata Memorial, a group of oncologists trained at the Centre, who belong to this part of the country decided to take the significant step of moving to Kolkata to set up a facility focussed on ‘organ-specific cancer care’, the modern method of treating the cancer patients.

Other metro cities like Mumbai, Delhi, Bengaluru, Chennai, started this organspecific cancer treatment long back, however, it was missing in Kolkata so far. Unfortunately, we failed to find any backers for this project among the big corporates in healthcare in the city initially. A relatively new cancer facility in Howrah finally agreed to our terms and our cancer care journey in this state began.

Coincidentally, around this time a gradual change was taking place in the city in the area of cancer treatment with various healthcare units in the corporate, trust and government sectors beginning to beef up their cancer care facilities. It was an encouraging trend, as not just new cancer centres

were coming up, but existing facilities were making significant additions to their facilities. As a result of this, the past few years have seen major developments in all areas of cancer treatment. The change has been seen across the entire healthcare spectrum in the city – in Corporate, Government and Trust facilities. New public-private partnerships have been formed.

Nowhere has this change been more visible than in the area of radiation oncology. Radiotherapy is an integral part of cancer treatment. A decade back, the city had only two advanced radiation therapy facilities (with linear accelerator), and that too was only in the corporate sector. Today there are 22, five of which are in government hospitals and seven in trust-run facilities (including two in Chittaranjan National Cancer Institute – a CentreState collaboration), and the rest in various corporate set-ups. Apart from this, there are four tele-cobalt machines. The availability of advanced radiation therapy in the city has significantly increased in the last five years.

Another important area in cancer treatment is medical oncology. Till about five years back there were only about five DM medical oncologists in the city. Now the number has increased significantly with at least 10 more specialists having joined various centres, thus giving the field of medical oncology a big boost in the city. Bone marrow transplant, a treatment modality that was barely available a few years back, is now being offered by multiple corporate, trust and govt hospitals in the city.

Nuclear medicine plays a major role in advanced cancer care. The city saw its first PET CT in 2013, the number has now gone up to 10.

Radioiodine therapy is an essential component in the treatment of thyroid cancer. Unfortunately, this facility was not available in either government or corporate set-ups a few years back. Only one trust hospital offered radio-iodine therapy through VECC (Variable Energy Cyclotron Centre). This meant long waiting periods for patients, leaving most with no option but to travel to other states for treatment. Today, five centres in the city are offering this treatment. Apart from this, one centre in the city now also offers advanced nuclear medicine therapies like Alpha and DOTA. These advancements have benefitted the patients immensely as the need to travel to other states and faraway centres have decreased, thus increasing both accessibility and affordability.

In the area of surgical oncology, Kolkata is gradually shifting its focus from general oncology to organspecific surgical care. This change is being seen in all sectors – among Trust hospitals at Tata Medical Centre, among Corporates at Medica Hospital and in the Government sector at Chittaranjan National Cancer Institute (new campus) and SSKM, have started this focused expertise-driven care. Advanced surgical procedures like HIPEC, microvascular free flap reconstruction, etc are routinely performed in various centres. In the area of robotic surgery, there have been significant leaps. The

city’s first robot was introduced in the city in 2012 but was used mainly for non-oncology cases. Now the city has five surgical robots of which three centres are using these robots exclusively for cancer surgeries.

An upsurge has also been seen in cancer-specific diagnostic facilities in the city with dedicated CT scans and MRI machines having been installed in multiple centres. Immunohistochemistry - an extremely important tool for cancer diagnosis - was barely available till a few years back. Now multiple hospitals are providing this facility regularly.

Apart from the massive developments in the private sector, what is most encouraging is that the treatment for cancer is the biggest thrust area in the state government’s book today. Chittaranjan National Cancer Research Institute has recently started a modern cancer care facility in Rajarhat with 600+ beds. Apart from this, in collaboration with Tata Memorial Centre, Mumbai the Government of West Bengal is in the process of setting up two state-of-theart cancer care facilities in Kolkata (with SSKM – IPGMER Hospital) and in North Bengal (with North Bengal Medical College), to cater to the economically backward sections of the society in urgent need of advanced care. Though the buildings are not yet ready, Tata Memorial alumni have already started treating patients in the existing facilities voluntarily.

Despite these significant advancements, there is still some lacuna that needs to be filled to enable the state to become a leader in cancer treatment not just in the country, but in the entire south-east Asian region, particularly given the high demand for such a facility in this region.

The upcoming Cancer Care facility at Medica Hospital is aiming to fill this gap. Our super advanced cancer hospital will have a high-end radiation facility, PET CT, therapeutic nuclear medicine and the first bone bank in this region, among other modern facilities. Medica is also setting up an advanced lab with the latest pathological test facilities like immunohistochemistry, molecular pathology, flow cytometry, among other high-end investigative tests.

In a first-of-its-kind endeavour in the country, Medica has recently announced a unique rehabilitation programme for cancer survivors. Medica group has decided to employ cancer survivors in the upcoming Medica Cancer Hospital, Kolkata as staff members in various areas of service delivery, a few already are on board. This will set an example for the rest of the country in the need for spreading the ambit of care beyond clinical treatment for cancer patients.

The increasing number of facilities for the treatment of cancer in the state is a welcoming trend for cancer patients not just in West Bengal, but also people in the neighbouring states of Jharkhand, Bihar, Odisha and the North-east. This will also benefit our neighbouring countries like Bangladesh, Nepal and Bhutan immensely. One can confidently predict today that West Bengal is set to become a destination in advanced cancer care for the entire region and South East Asia in the next two years.