Cancer: Better safe than sorry

KATHMANDU, June 8: British celebrity Jade Goody was diagnosed with cervical cancer in August 2008, eventually succumbing to the disease eight months later on March 22 at the age of 27. [break]

Although Goody had undergone prior screenings for cervical, ovarian and bowel cancer, she had not received any after 2006 until the diagnosis. But by this time it was too late. Being a celebrity and having the best of the medical facilities at her disposal could not help extend her life beyond eight months.

If Goody could not beat her cancer, there is little chance Nepali patients can. But we can succeed where she failed by taking regular screenings to receive an early diagnosis before it spreads. Prevention is better than cure.

“Screening is a must for cancer as it is the main tool for early diagnosis,” says Dr RP Baral, medical director and consultant clinical oncologist at Bhaktapur Cancer Hospital. “Early diagnosis may not always cure cancer, but it is the only option against cancer which is almost incurable at later stages,” Dr Baral adds.

There is no official data on cancer in Nepal, but experts believe there are approximately 60,000 patients suffering from cancer at any given time. Regular screening can help save many of these lives.

Cancer screening tests are inexpensive and are available at major hospitals in Kathmandu besides cancer hospitals. No tests exceed Rs 2,000 and most cost less than Rs 1,000. “Most of the screening tests are normal tests. It can be as simple as a chest x-ray for lung cancer,” Dr Baral says.

Colorectal, breast, ovarian, pancreatic, polio-carcinoma, liver and prostate cancers can be detected through different tumor markers found in blood. Pap smears can be taken to test for cervical cancer and mammograms test for breast cancer.

“The time period of each stage varies for different cancers, but early diagnosis is critical in every case,” Dr Baral explains. “Many cancer patients get cured in Nepal after early diagnosis, but there are significantly more who come late,” Dr Baral says, stressing the need for screening.

Cancer is not the only major disease whose damage can be limited by screening. Screening also plays an important role in preventing heart disease. Dr Bharat Rawat, consultant cardiologist and executive director at Norvic International Hospital, believes regular screening along with a healthy lifestyle goes a long way in avoiding heart disease.

Both non-modifiable and modifiable risk factors must be screened to ensure a heart is healthy. One has to be aware of non-modifiable risk factors, such as age (above 40 years), sex (male) and family (history of heart attack below the age of 65 years), and be extra careful if there is any risk pertaining to these factors. “We don´t know why, but females have a very low chance of heart attack, and many women under 45 years can only have an attack if she is diabetic and smokes,” Dr Rawat explains, attributing the disparity between male and female to nature.

Screening is more important in the case of modifiable risk factors, which include high blood pressure, high cholesterol, diabetes and tobacco addiction. “One has to regularly check blood pressure, and the level of cholesterol and glucose in the blood to prevent heart diseases,” Dr Rawat suggests. All three tests are cheap and can go a long way to help maintain a healthy, functioning heart.

Rate for screening tests

	Bhaktapur Cancer Hospital	B&B
Pap Smear Test	Rs 250	Rs 550
Chest X-ray	Rs 185	Rs 340
Mammography	N/A*	Rs 1,500 (double) Rs 1,000 (single)
Tumor Markers in blood	N/A*	Rs 1,200