Tuesday, March 13, 2012

The Role Of Oncology Centres In Making Sophisticated Cancer Treatment Affordable and Realistic

India with its present growth rate is on the threshold of becoming a developed country in the coming decades. With development comes rise in all lifestyle related diseases. According to WHO, cardiac diseases and cancers will be the most common killer diseases the developed nations would have to cope with.

Incidences of cancers are being diagnosed and reported more frequently all across India in recent decades. Increased longevity, better diagnostic facilities and increased awareness have contributed to the apparent increase in the incidence. While more patients now search for treatment of this grave disease, lack of specialized oncology centres across regions has contributed significantly to the shortcomings in management of these patients. Most of the cancer patients would require a combination of surgery, radiation and chemotherapy. The need to integrate more than two treatments for a single disease puts tremendous logistical and financial pressure on the patients as well as the treating physicians, who struggle to optimize the treatment approach.

Many potential curative patients withdraw from treatment due to a combination of reasons, financial pressures account for the most dropouts. Says Ms. Kalpaja, Director of Vydehi Institute of Oncology, which has commissioned a 300 bedded Oncology Centre in Bangalore, “we have realized that it is not enough to provide the state-of-the-art facilities for treating cancer patients. It is imperative for an Oncology Centre to seriously consider the cost of such treatment and make it affordable to its patients. For many Institutions it becomes an issue of recovering the investment made on the costly equipment, especially the radiation machines, which govern the pricing. For example equipment like Image Guided Radiation Therapy (IGRT) which is employed for the first time in India at Vydehi Institute of Oncology at Whitefield, Bangalore, costs 10 crores upwards. Usage of such equipments puts pressure on the Institutions to overcharge their patients. Fortunately our policy has been different and we being a Teaching Medical College Hospital and research institution are relying on patient numbers to keep the cost low and affordable an as such have kept the treatment charges lowest among all comparable cancer centers. Aiming at large patient volumes is the only realistic answer to curtail the spiraling treatment cost for cancer patients.”
While more number of patients treated on a machine would keep the cost low for radiation treatment, other viable approaches do exist that could help patients afford their treatment in totality. One is to limit the hospital stay and optimize the treatment approach. For example the cost of treating a breast cancer patient through surgery would be 20% more than normal, if the hospital stay is not properly planned. Says Dr. M. S. Ganesh, Head, Department of Surgical Oncology at the centre “Most breast cancer surgeries require the patient to stay for only a day in the hospital. This is possible by proper pre-operative planning and assessment.” If one analyses other causes for discontinuation of treatment for cancer, the fact comes to light that poor understanding of the disease and its treatment and improper guidance regarding which treatment modality to start first contribute significantly. A patient with a large oral cancer may not be operable in the first instance and would do well to be treated with radiation therapy first and later considered for a surgery, which could be less extensive and cheaper. Personal interests of treating physicians and lack of Institutional guidelines play spoilsport on most occasions. To overcome this bias Institutions like Vydehi has started a Tumor Board for all patients who commence their treatment. If a proper treatment approach is planned by all 3 concerned doctors, i.e. radiation, medical and surgical oncologist from day one of the patient landing at a cancer centre, a reduction in the expenditure to the tune of 30% can easily be achieved.
More importantly every cancer centre should constantly work towards a goal of making the cancer treatment reach the lowest rung of society at the most nominal cost possible.
Dr. M. S. Ganesh
Head of Oncology Service 
Vydehi Institute of Oncology 
oncology@vimsmail.com / msganeshl965@gmail.com    

1 comment:

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