ICMR issues guidelines on ‘management of stomach, cervix and buccal mucosa cancers’
January 03, 2011, 0800 IST – Source : Pharmabiz News & http://icmr.nic.in/guide/cancer/Cancer%20Mgmt%20Guide.htm
Aiming to assist the oncologists in making the major clinical decisions encountered in managing their patients and also to enhance clinical decision-making capabilities of clinicians, Indian Council of Medical Research (ICMR) has issued guidelines on ‘management of cancer’ in the country. These guidelines may be used as framework for more focused and planned research programmes to carry forward the process.
The aim of the ICMR Guidelines is to assist oncologists in making major clinical decisions encountered in managing their patients, well realizing the fact that some patients may require treatment strategies other than that suggested in these guidelines, said ICMR director general Dr VK Katoch.
Dr Katoch said that the purpose of this ICMR project was to review the principles of cancer management guidelines and to assess if any differences in patients’ response to treatment exist under Indian circumstances, and suggest the best evidence based available strategies for treatment of cancer patients.
The issuance of guidelines by the ICMR is important as there is a feeling among the scientists that despite rapid advances in the field of oncology, the results of management of cancer are still not completely satisfactory. Clinicians often point out that Indian patients respond differently than cancer patients from developed countries with similar treatment. Several hypothesis have been suggested including, differences in stage presentation, differences in genetic makeup, certain specific presentation stages not often considered by Western guidelines, pathogenetic differences, etc.
The guidelines mainly cover three types of cancer that include the management of stomach cancer, the management of cervix cancer and the management of buccal mucosa cancer.
Carcinoma of the buccal mucosa is the commonest oral cavity cancer in India. Several international consensus guidelines are available for the management of oral cavity tumours, but none that addresses buccal mucosa cancers in particular. The possibility of formulating reliable international guidelines based on Western data is questionable given the fact that buccal mucosa tumors are quite rare in the developed countries. There is obviously an urgent need to formulate guidelines in the management of buccal mucosa cancer based on Indian data which would not only incorporate the most recent evidence available but would also be feasible to be practiced in the hospitals of India.
Gastric cancer which is currently the fourth most common type of cancer worldwide has remained an important malignant disease with significant geographical, ethnic, and socioeconomic differences in distribution.
In India, the incidence of gastric cancer is low, compared to the high risk areas. The rates vary from 13.56 per 100,000 (Chennai) and 4.6 per 100,000 (Bangalore) among females; among females, the rates vary from 6.68 (Chennai) to 3.42 (Mumbai). Although, very high rates from north east India (Aizawl, Mizoram), (57.3 among males and 33.6 among females) are reported, it is premature to comment on this since these are relatively recent registries.
Cervical cancer is the leading cancer in India, although breast is leading cancer site globally. It is estimated that in the year 2005, there were about 520,000 cervical cancer cases in the World, of which 443,000 are in the developing countries. It is the most common cancer in the developing countries. In India, it would increase from 0.11 million in the year 2000 to 0.16 million cervix cancer cases in 2010. The proportion ranges from 15 per cent to 55 per cent of females cancers from different parts of the country. Over 80 per cent of the cervical cancer present at a fairly advanced stage and around 80,000 deaths are reported due to cervical cancer in India.
For feedback please write to Dr. Kishore Chaudhry, firstname.lastname@example.org