NIPPED IN THE BUD

In April 2019, the Preventive Oncology team embarked on a screening camp in an underprivileged community adopted by the RGCIRC (Rajiv Gandhi Cancer Institute & Research Centre). They visited Kamala Devi, a 42-year-old resident of the area. Little did they know the profound impact their visit would have on her life. The team collected her Pap-smear sample, which later revealed that she had screened positive for cervical high-grade lesions (HSIL), a precursor to cervical cancer. Dr. Rupinder Sekhon, the Head of the Gynaecology and Urology Department, recommended a hysterectomy to treat the disease.
Kamala underwent the surgery, which successfully eliminated the cancer without the need for chemotherapy. The key factor that contributed to her positive outcome was the early diagnosis of the disease. Reflecting on her journey, Kamala expresses her gratitude, saying, “If it weren’t for this screening camp, I wouldn’t have received treatment. And if I hadn’t undergone the screening, I wouldn’t have gotten better. Now, I can take care of my household chores and visit the hospital every three months with a smile on my face.”
This story of triumph over adversity began in March 2018 when the hospital made a strategic shift from opportunistic screening to organized, population-based screening in underserved localities. The aim was to reach out to communities beyond the hospital’s walls and provide comprehensive preventive care. The RGCIRC extended its services to approximately 9 million individuals living in 50 communities, including urban slums, semi-rural areas, and marginalized JJ clusters within a 10-kilometer radius.
The Department of Preventive Oncology played a pivotal role in this initiative. Starting in 2008, they began conducting screenings as part of routine health check-ups. They offered clinical examinations, Pap-smear tests, and visual examinations for breast, cervical, and oral cancers, respectively. The positive cases from these screenings were further investigated and offered follow-up tests and treatments free of charge if they met the eligibility criteria. The hospital also provided significant discounts on various screening procedures, such as mammography and low-dose CT scans, to promote early detection.
Over the past decade, more than 80,000 individuals have been screened, with nearly one-third of them through the hospital’s OPDs (Outpatient Departments) and the rest through community camps. This proactive approach has saved numerous lives by either preventing cancer or enabling early detection, which significantly improves the chances of successful treatment. The hospital’s Chairman, Rakesh Chopra, emphasizes the importance of prevention, stating, “An ounce of prevention is worth a pound of cure. We can cure nearly 80% of patients at stages one or two. But if cancer progresses to stages three or four, the cure rate drops to only 20%. Our focus is on expanding our preventive work to benefit the patients and the country.”
The transition from opportunistic screening to population-based screening presented a new set of challenges. It required not only identifying and testing individuals but also ensuring that those who screened positive received the necessary treatment and support. The hospital committed to providing comprehensive care to patients from underserved communities. This involved adopting patients and covering the expenses of investigations, treatments, and follow-up care. The initiative aimed to remove financial barriers and provide holistic support to individuals battling cancer.
However, the journey from awareness to treatment was not without obstacles. Creating awareness about cancer and the importance of early detection was a crucial but challenging task. Dr. Indu Aggarwal, Head of the Department of Preventive Oncology, highlights the significant knowledge gap and stigma surrounding cancer, especially in underprivileged areas. Many individuals in these communities lack awareness about screening procedures and risk factors.
Addressing these barriers requires sensitive communication, dispelling myths and misconceptions, and engaging with community leaders and local influencers to spread awareness about cancer prevention and the benefits of early detection. The hospital organized numerous awareness campaigns, community workshops, and interactive sessions to educate individuals about the signs and symptoms of different types of cancer, the importance of regular screenings, and the availability of free or discounted services.
To ensure access to treatment, the hospital collaborated with government health schemes and partnered with various NGOs to provide financial aid and support to patients in need. They established a dedicated team of social workers and patient navigators who guided patients through the healthcare system, helping them overcome logistical challenges and connecting them with resources for emotional and psychological support.
The success of the population-based screening program can be attributed to the combined efforts of a multidisciplinary team, including doctors, nurses, counselors, community health workers, and volunteers. The team worked tirelessly to build trust, establish relationships, and provide personalized care to each individual, addressing their specific needs and concerns.
The impact of the program extended beyond the detection and treatment of cancer. It empowered individuals with knowledge about their health and equipped them with preventive strategies to lead healthier lives. By emphasizing the importance of regular check-ups and adopting healthy lifestyle habits, the program aimed to reduce the burden of cancer in the long term.
The RGCIRC’s population-based screening program serves as a model for other healthcare institutions and organizations seeking to implement similar initiatives. It demonstrates the power of community engagement, early detection, and comprehensive care in combating cancer and saving lives. Through their unwavering commitment to preventive oncology, the hospital has made significant strides in reducing the burden of cancer in underserved communities and improving the overall health outcomes of individuals at risk.