Ratna Parikh
Breach Candy Hospital , Mumbai, India
Title: Experiences in organisation of Breast cancer facilities in rural India
Biography
Biography: Ratna Parikh
Abstract
India has a population of almost 1.2 billion. Nearly 70% reside in rural and semi- urban areas. Multidisciplinary therapeutic approach is a challenge in these areas because of lack of facilities and socioeconomic constraints. The objective was to initiate facilities for early diagnosis and treatment of breast cancer in these areas. We started our project in a rural area, Barshi in Maharashtra. Mobile vans were designed to reach remote areas with facilities for clinical examination, imaging, lab studies and cytology. Education was imparted for early detection and treatment of breast cancer through charts, one to one talks and videos in their native language. Most women presented in stage 111 – 1V (70%). Nearly all women opted for a mastectomy when indicated. Patients requiring multidisciplinary therapeutic approach were referred to a comprehensive cancer centre, in Mumbai. 75% had socioeconomic issues (finances, family issues, distances to travel, stay in metropolitan cities and social taboo of hair loss, post chemotherapy treatment). 20% had disease and therapy related physiologic disability. 43% could not complete therapy. Long term follow-up was feasible only in 1/3rd of patients. Over the years, diagnostic and treatment facilities have significantly improved. The rural centre from a humble effort of a simple outpatient has grown into a sprawling community cancer centre. Breast cancer patients can now be managed in their local environment. Training and education at all levels has been at the core by manual and technology transfers through the comprehensive cancer centre to these rural areas. Women with breast cancer, now report early and most complete therapy in their own environment. This effort is easily replicable and can be created in similar terrains for not only breast cancer but also many other diseases in India and other countries. The final culmination and success of this effort is proven by the actual images and success in the rural area where such a transformation has been achieved.