Tuesday, October 5, 2010

Marvellous Medicine

Have been puzzling over the treatment for cancer that is available for people who are visited by the disease. There is chemotherapy and there is radiation. and  if one is lucky, in a manner of speaking, chemotherapy and radiation are prescribed as adjuvant therapies. This means that one can have surgery and excise the cancer growth at any particular site, get rid of the existing cancer and then follow either or both methods to prevent the recurrence of cancer again in any threatening re-infestation.

The good thing about cancer is that if it is detected early, the chances of survival are strengthened. However, the therapies prescribed to help survivors of cancer who have had surgical intervention remain as scary as ever. Chemotherapy is intimidating  because the  very notion of  going in to attack the cancer cells with all guns blazing and bombing every living cell in the body is a terrifying and terrible project. Chemotherapy subjects living cells and marrow to a  blitzkreig and creates a collateral damage that is reminiscent of war by a superpower out to annihilate some small  voiceless nation which can only cower in fright. Not very surprising, if one were to recall that the protocol for cancer treatment really comes to us from the US and Europe.  Alternative treatments,  practised outside of the allopathic system, however varied, suffer from inadequate monitoring and documentation and are at best only seen as preventive strategies, never as curative options.

Yet even within  prescribed and valorised systems of  allopathic cure, grey areas persist. For instance you could have a small carcinoma of the breast and elect to have  a lumpectomy. If you have more than one tumor, this is termed multi-focal cancer and usually the total removal of breast is recommended as multifocal cancer indicates an aggressive cancer and normally, after a mastectomy, chemotherapy is prescribed.. There are a series of tests that the retrieved cancer tumor is subjected to. It is checked for IHC,  for HER-2 and then there is another test, the latest gold standard that is called the Onco type DX test. Examining tumor tissue at a molecular level, the OncoDX test predicts the likely benefit of chemotherapy and the possibility of the recurrence  in early stage cancers of both the breast and the colon.

 Cancer treatment is expensive and simple tests like the IHC and the more complex Her-2  are expensive. However, they are now available here in India. Unfortunately, facilities for  Onco DX  testing for tumors, the Medical Oracle for Chemical Oncologists, do not exist in India.  Samples have to be sent to America and some of  New Delhi's posh hospitals  offer such privileges. The costs of this test are so prohibitive that  79 out of the 80 people who are afflicted by cancer cannot even think of getting an Onco DX test done, which could accurately predict whether they actually require  chemotherapy or not.  Access to this test would allow them to escape the toxicity of chemotherapy and its attendant  traumas , as well as  bypass the unnecessary aggression that is waged upon the hapless body.
 For me, this is a significant discovery as i learnt recently that a multifocal tumor could have really low scores on an Onco- DX test. Chemical Oncologists in India and the US hastened to tell me that this was a unique occurence. One is too much a product of a scientific age to believe totally in miracles, but i wonder if the uniqueness of my case really lies in my access to this test?  What documentation do we have on multifocal  node free  breast cancers in our country which were subjected to the Onco-DX?

The test itself has only been around in  the last few years, but if we are working with Indian  demographics, the number of people who may have benefited  from this test could  have been  enormous. Given the fact that breast cancer is one of the more prevalent forms of cancer in our country today, we need to view Onco DX  analysis with far more seriousness. It is possible that if this technology had been  made available in India. we would  have a different set of readings and perhaps a new protocol for treatment based on a different  data bank. So a low Onco DX reading in a  node negative multifocal tumor might not be a unique case given a different set of statistics. For  something like this to happen, or to even move from being a mere  idea, we need this technology here and  now. We need it to be available, affordable and accessible! Our Medical Research Institutes and  Health Ministry Pundits need to do some urgent jugaad in the matter!