World Cancer Day

The history of World Cancer Day dates back to 1933 when Union for International Cancer Control (UICC) first observed the significance of this day at Geneva, Switzerland. It was an initiative of UICC to unite the entire world in order to reduce the global cancer burden, to promote greater equity, and to integrate cancer control into the world health and development agenda. World Cancer

Day is celebrated annually on 4^th of February all over the globe and aims to save millions of preventable deaths each year by raising awareness and educating about cancer, and pressing governments and individuals across the world to take action against the disease. In 2014 it has been focused on Target 5 of the World Cancer Declaration: Reduce stigma and dispel myths about cancer, under the tagline “Debunk the myths”. According to UICC its importance lies in preventing the inevitable global cancer epidemic by raising awareness against the deadly disease.

Currently, 7.6 million people die from cancer worldwide every year, out of which, 4 million people die prematurely (aged 30 to 69 years). Therefore the need of the hour is to raise awareness about the disease and to develop practical strategies to address cancer. By the year 2025, premature cancer deaths are projected to increase to 6 million per year. The estimate of 1.5 million lives which are at threat due to cancer could be saved per year if strategies are adapted to achieve the World Health Organization’s (WHO) ‘25 by 25’ target to reduce premature deaths due to non-communicable diseases (NCDs) by 25% by 2025.

Cancer Control in India

World Cancer Day is an important date where organizations and individuals are encouraged to project the day for a concerted ‘advocacy push’, calling on governments to live up to the new and ambitious commitments in the emerging NCD framework, and ensure that cancer interventions, prevention, early detection, treatment and palliation, are adequately addressed in the global health platform. There is now a need for a worldwide commitment which would aid advancements in policy and encourage implementation of comprehensive National Cancer Control Plans.

India is one of the few developing countries that have a National Cancer Control Program organized by the Ministry of Health and Family Welfare. Its primary objectives include prevention of tobacco related cancers and other prevalent forms like cancer of uterine cervix, mouth and breast as well as extension and strengthening of therapeutic services including pain relief on a national scale through regional cancer centers and medical colleges (including dental colleges). The current program envisages- Recognition of new Regional Cancer Centers (RCCs); Strengthening of existing RCCs; Development of oncology wings in medical colleges; District Cancer Control Program; Decentralized NGO Scheme which together would aid the concerted network of cancer control.

Cancer Research in India

Cancer control program is perfectly complemented with current trends in cancer research in India which aims to unravel the diverse molecular and biological changes underlying cancer development and progression. The research on cancer is more oriented towards understanding the tumour micro environment, mechanisms that restrain tumorigenesis and translating novel findings towards cancer diagnosis, prognosis and therapies. The new era science is more concerned with personalized treatment strategies with targeted agents that are directed specifically to the molecular abnormalities that are driving specific tumours.

Chittaranjan National Cancer Institute (CNCI), Kolkata

Chittaranjan National Cancer Institute, an autonomous organization under the Ministry of Health and Family Welfare, was formed by amalgamation of Chittaranjan Cancer Hospital and Chittaranjan National Cancer Research Centre on 1^st April 1987 and was recognized as the Regional Cancer Center (RCC). Government of India also recognized CNCI as a Scientific and Industrial Research Organization (SIRO) in the year 1997. The main objectives of CNCI are:

To spread cancer awareness aiming prevention and control.
To promote cancer prevention, cutting edge diagnosis: modern treatment, research, training and education in oncology.
To impart post graduation and paramedical education in all branches of oncology.
To have collaboration with National and International organizations in prevention, control and cure of cancer.

The main focus of CNCI is in patient care and management. CNCI has undergone major changes with extensive reorganization and renovation of all the departments, wards, operation theatre complex and laboratories. The Surgical Oncology Department today handles complex procedures backed by a fresh team of well-trained competent surgeons, state-of-art equipments like Laparoscope, CUSA (Cutting Ultra Sonographic Aspiration), Operating Microscope, Argon Laser and many more. The entire patient care system is well supported by the Intensive Treatment Unit (ITU), equipped with all modern gadgets and round-the-clock laboratory back up under the supervision of Department of Anaesthesiology. Special Clinics like Mastectomy, Laryngectomy, Speech therapy clinics and Pain & Palliative Care clinics are now available for rehabilitation as well as improved supportive care. A fully functioning Endoscopy OT handles the routine diagnostic and therapeutic procedures with fibre-optics Endoscopy. The Pathology and Blood Bank departments now have modern and automated equipments. The Diagnostic Radiology Department is now equipped with Mammography, modern X–ray, Ultrasonography with color Doppler set. Procurement of a state-of-the-art CT Scan – 1.5 Tesla MRI machine has been planned. At present CNCI hospital is one of the best centers for radiotherapy with two Cobalt Machines, Computerized Treatment Planning System, integrated Low and High Dose Brachytherapy units, a fully Computerized Simulator and one State of the Art Dual Energy Linear Accelerator with IMRT & IGRT facilities.

CNCI is dedicated to all classes of the society and therefore imparts free treatment for economically challenged patients. Each year more than 500 patients belonging to BPL category get financial assistance from the Rashtriya Arogya Nidhi (RAN) Scheme of Government of India. A special endeavour was initiated with the inauguration of the colourful paediatric oncology ward with all modern treatment facilities. A new Day care unit, opened on 6^th March, 2009 by Shri Ghulam Nabi Azad, Union Minister of Health & Family Welfare and Chairman, CNCI Governing Body. This is beneficial for the cancer patients requiring chemotherapy, blood transfusion and small procedures. For the benefit of patients and their companions who hail from remote and faraway places, a Night Shelter with 24 accommodations including toilet and drinking water facilities are available.

CNCI has endeavored in prevention of cancer, early detection and diagnosis through various programs. To meet the increasing need of health care services and to combat cancer efficiently many NGOs have come forward. A pilot survey was conducted at Chittaranjan National Cancer Institute, based on 900 respondents of the population of West Bengal to assess their levels of awareness regarding cancer with the aim of estimating associations between response variables (knowledge about cancer) and predictor variables (age, sex, level of education). The results have revealed a huge lack of cancer awareness in this part of India. Most of the respondents (68%) expressed desires for participating in cancer awareness programs. To overcome this situation, CNCI has taken initiatives to educate common people about all the facts of cancer prevention, early detection and treatment.

The research wing of CNCI has qualified and highly skilled scientists who earned their fame in their respective fields of cancer research. Scientists are focusing towards understanding the molecular mechanisms in the development of cancer, identification and modulation of molecular markers, targeted therapy, prevention of cancer, epidemiology, anticancer drug development and immuno regulation. There has been an impetus among the doctors of CNCI to do research work utilising the expertise of the scientists. Collaborative work has been initiated among the researchers and clinicians to establish potential biomolecules as tumor markers and also judging their therapeutic potentials in drug development. The Department of Translational Research undertakes “bench to bedside” research, blending the research and hospital units. Clinical and translational research in cancer relevant to the socio-economic needs of our country is going on. This department is equipped with modern, highly sophisticated equipment to perform highest quality research work. Clinical trials under various National and International collaborations have been undertaken at CNCI. Different multinational companies are approaching through their Indian counter parts to initiate clinical trials with potential anti cancer drugs. Clinical Trial Secretariat and subsequently Clinical Research Department was established in CNCI and presently this department is handling Phase II, III & IV trails. This Institute has got good infrastructure and trained personnel for Phase IB, II & III clinical trials. Some of the research activities have been patented by IPR. Every year a good number of summer students from various Universities and colleges are getting trained at CNCI. Good quality PhD work is carried out at CNCI. DNB course has been successfully launched at CNCI (hospital) and well qualified doctors have been enrolled for the course. It is a great honour that the Royal College of Surgeons of Edinburgh has selected CNCI to conduct the MRCS Part III examination for three consecutive terms.

Future Plans of Chittaranjan National Cancer Institute

CNCI is the only National Institute in the eastern region providing services to over 6500 new cancer patients every year along with 35,000-40,000 OPD patients for continued treatment and follow up. Due to lack of space and the overload of ever increasing cancer patients a new 500 bedded multi-disciplinary sophisticated cancer hospital has been planned at New Town, Rajarhat, Kolkata. Government of West Bengal has provided 10 acres (40,470 m²) of land at the Action Area 1D of New Town, Rajarhat, Kolkata.The broad objectives of CNCI which have been envisaged with the advent of the new campus at Rajarhat, Kolkata are - Development of a state of the art cancer therapy institute; setting up of preventive oncology service, cancer palliation, and training & human resource development in cancer diagnostics, cancer therapeutics and cancer control.

Therefore with the observation of World Cancer Day on the 4^th of February, 2014, CNCI along with the world wide cancer combating community continue to strengthen the fight against cancer as well as distributing the real message about dispelling the misconceptions regarding this dreadful disease and creating awareness for its prevention and control.