Navigating women’s health complexities demands a multifaceted approach to addressing rising cancer rates
As we celebrate Women’s Day on March 8th, it is crucial to reflect on the unique healthcare challenges confronting women worldwide. Among these challenges, the rising prevalence of cancer stands as the number one threat to women’s health and well-being.
And hence it is important to delve into the details of this pressing issue, unraveling the trends, challenges, and innovations driving the fight against cancer in women.
Rising cases of cancer among women: Trends & insights
According to the 2020 Global Cancer Observatory registry, females constituted 47.8 per cent of the total 19,292,789 global incident cases, 44.5 per cent of the total 9,958,133 deaths, and 50.9 per cent of the total 50,550,287 5-year prevalent cases. This data suggests that globally, cancer in females may be slightly more curable with better outcomes than in males. However, studies and surveys have proven a disproportionate impact of cancer on the lives and livelihoods of women, especially those in low-income or middle-income countries. This disparity is predominantly due to factors such as lack of awareness, lower literacy rates, psycho-socio-cultural hindrances, and self-neglect.
Dr Kavita Munjal, Technical Operations Head (Madhya Pradesh), Metropolis Healthcare said, “They say, “Men Are from Mars, Women Are From Venus.” And when it comes to health and disease, this gender gap still exists due to both biological and gender-related differences between the two. Men often perceive themselves as the stronger sex, given their larger size, more muscular build, and physical strength compared to women. However, when it comes to health, it’s a different story – men are often considered the weaker sex.”
“Statistics consistently show that in terms of longevity and life expectancy, women continue to outpace men decade after decade, with this gap widening over time. While this may seemingly prove that women are the stronger species on this planet, studies and data reveal a different reality. So where does the lack lie? What creates the gap that makes women more vulnerable to diseases and cancer? The centuries-long societal hierarchy places women in a position where they deprioritise their health, considering their own needs less important than others. This results in long-unattended, neglected diseases, and advanced stages of cancers among women.”
According to Dr Samdapa Dessai, Consultant – Gynecological Cancer and Robotic Surgeon, P. D. Hinduja Hospital and Medical Research Centre, Mahim, “Recent years have witnessed the concerning uptick in cancer rates among women, driven by a multifaceted interplay of factors. While breast cancer continues to be a predominant concern, with rising incidence rates in India, there is a silver lining in the declining trend of cervical cancer. This positive shift can be attributed to improved awareness, screening programs, and vaccination initiatives. Beyond reproductive organs, cancers affecting organs like the gallbladder and thyroid are also witnessing a concerning rise. Exploring the intricate links between environmental exposures, genetic predispositions, and lifestyle choices is crucial for a holistic understanding of the evolving cancer landscape in women.
Sharing some numbers, Dr Karishma Kirti, Consultant, Breast Specialist & Oncoplastic surgeon- Jaslok Hospital & Research Centre, Mumbai mentions, “According to the GLOBOCAN 2020 data, breast cancer, cervical cancer, ovarian cancer, and uterine cancer rank among the top 10 most common cancers affecting females globally. Breast cancer remains the most prevalent cancer among women, followed closely by gynecological malignancies such as ovarian, cervical, and uterine cancers. Moreover, lung cancer, traditionally associated with smoking, is also on the rise among women, highlighting the need for comprehensive prevention and early detection strategies.”
Over the years, cancer has become increasingly treatable. Yet, every four minutes an Indian woman loses their life due to breast cancer, a preventable disease. The significant rise in the prevalence of cancer among Indian women threatens to engulf many lives. It has become increasingly vital to empower women with the knowledge and solutions to defeat the disease.
Mohan Jain, Managing Director, Naprod Life Sciences emphasises that, “Data from the International Agency for Research on Cancer (IARC), the cancer agency of the World Health Organization (WHO) paints a grim picture. The numbers indicate that the new incidences of cancer among the Indian population had a higher share of women compared to men. Women also had a higher risk of developing cancer.”
“This surge among women being diagnosed with cancer encompasses various types, including breast, cervical, ovarian, and lung cancers. Compared to developed nations where early detection and accessible treatment are commonplace, the disparity in India becomes even more striking, highlighting the urgent need for intervention. Multiple trends are contributing to the rise of cancer among women. Rising obesity, unhealthy diets, and physical inactivity are pushing cancer risks upwards. Limited access to screening and early detection, particularly in rural areas, results in diagnoses often occurring at advanced stages, making treatment more challenging. The persisting stigma and misinformation surrounding cancer also creates barriers to seeking help and treatment”, he added.
Innovations and advances in women-centric oncology care
In India’s dynamic healthcare landscape, multiple advancements and innovations have been made in advancing oncology care, particularly in addressing the needs of women facing cancer.
From groundbreaking technologies to personalised treatment approaches, and holistic support services, these advancements are reshaping the landscape of cancer care for women across the country.
Some of the technologies and innovations are:
- Precision medicine and targeted therapies
The emergence of precision medicine and targeted therapies tailored to individual patient profiles is one of the most promising developments in women-centric oncology care.
Through genetic testing, molecular profiling, and biomarker analysis, oncologists can now identify specific mutations and molecular pathways driving cancer growth in women. This enables the development of targeted therapies that are more effective and less toxic, leading to improved treatment outcomes and enhanced quality of life.
Explaining about the same, Dr Munjal shares, “Breast cancer, being biologically heterogeneous, often yields markedly different clinical outcomes among patients with similar diagnostic and clinical profiles. However, recent advances in diagnostics have revolutionised treatment approaches by allowing for the differentiation of breast cancer into distinct molecular subtypes. This enables the prescription of targeted therapies and prediction of treatment responses based on genetic and molecular characteristics.”
“A timely diagnosis facilitated by comprehensive radiological and pathological workups, including advanced molecular profiling of cancer tissue, is crucial in ensuring customised and effective therapy for patients.”
- Minimally invasive surgical techniques
The approach to cancer treatment is also being revolutionised by advancements in surgical techniques, offering women less invasive options with faster recovery times and reduced post-operative complications. Laparoscopic and robotic-assisted surgeries have become increasingly prevalent in the management of gynecological cancers such as ovarian, uterine, and cervical cancer, allowing for precise tumor removal while minimising trauma to surrounding healthy tissues.
Talking about robotic assisted surgery, Dr Urmila Soman- Lead Consultant, Minimally Invasive Gynaecology, Robotic & Laparoscopic Surgeon, Apollo Adlux Hospital, Angamali said, “When it comes to treatment modalities innovative treatment options such as robotic-assisted surgery, exemplified by the Da Vinci technology, offer promising avenues for effective cancer management. With its precision and ability to access deeper pelvic areas, robotic surgery ensures maximal removal of cancerous tissue, potentially improving patient outcomes and quality of life.”
- Digital health solutions
Digital health solutions like Artificial Intelligence (AI), big data and others have further expanded access to specialised oncology care for women in India, particularly those residing in remote or underserved areas. Through virtual consultations, remote monitoring, and tele-rehabilitation services, oncologists can provide timely and personalised care to women irrespective of geographical barriers.
Dr Meinal Chaudhry, Director-Radio Diagnosis and Intervention Radiology, Aakash Healthcare, New Delhi highlights that with the help of AI new fast more effective molecules are being produced and their phase trials outcomes generated very fast
She added, “With the boom in AI and newer technologies like genomics and radiomics the disease is picked up very easily. With the help of big data analytics and AI algorithms the evolution of precision medicine, which means medicine which is tailored to one specific patient is rapidly evolving. Various studies have shown that the cure rate of breast cancers have really gone up in the last decade and mortality due to breast cancer is very less now. But the key is to catch the disease early and have great compliance with the treatment protocols.”
Adding to it, Dr Pavithran K., Head of Department, Medical Oncology and Hematology, Amrita Hospital, Kochi said, “By harnessing the power of AI, healthcare providers can significantly enhance early cancer detection, bridge diagnostic gaps, and reshape treatment paradigms. AI algorithms can analyse complex datasets, identify subtle patterns indicative of cancerous growth, and provide clinicians with actionable insights, thus enabling more accurate and timely diagnosis. A study from the USA found a 23 per cent increase in cancer cases identified during breast cancer screening compared with scans assessed by a radiologist. This transformative shift towards AI-driven healthcare improves patient outcomes and optimises resource utilisation and healthcare delivery, ultimately contributing to more efficient and effective cancer management strategies.”
- Radiation therapies
Radiation therapy remains a cornerstone of cancer treatment, and recent innovations in radiation oncology have expanded treatment options for women with various types of cancer. From intensity-modulated radiation therapy (IMRT) to stereotactic body radiation therapy (SBRT), these advanced techniques deliver highly targeted doses of radiation to cancerous lesions while sparing adjacent organs and tissues. This precision helps minimise side effects and optimise therapeutic outcomes, particularly in cases where tumors are located near critical structures.
Dr Shriniwas Kulkarni, Consultant Medical Oncologist, Sahyadri Super speciality Hospital, Hadapsar, Pune opines that, “The rising cases of cancer among Indian women, particularly breast and uterine cervical cancers, underscore the need for a comprehensive understanding of risk factors and preventive measures. As we navigate the complexities of urbanisation, lifestyle changes, and socioeconomic factors, it is crucial to leverage advancements in medical, surgical, and radiation oncology to improve outcomes and enhance the overall well-being of individuals affected by cancer. The integration of preventive strategies, early detection, and cutting-edge treatments remains key in the ongoing battle against cancer in the female population.”
Explaining about CRISPR technology, Dr Pallavi Panse, Consultant – Gynaecology, Jupiter Hospital, Pune said, “This is a gene editing technology in which doctors can edit, delete or add some bits of DNA inside cells. This is a very revolutionary technology which is helpful in treating and preventing cancer.”
Dr Rooma Sinha, President- Association of Gynecological Robotic Surgeons of India, Senior Gynecologist, Robotic and laparoscopic surgeon, Apollo Hospitals, Hyderabad highlights, “Addressing the shortage of trained gynaecological surgeons proficient in such technologies necessitates a comprehensive approach involving collaboration between medical institutions, professional associations, and governmental bodies. By fostering partnerships with international institutions renowned for their expertise in surgical robotics training, India can leverage valuable resources and knowledge to expedite the development of skilled professionals in this specialised field. Additionally, investing in research and development to advance such technologies and make it more accessible and cost-effective will be instrumental in overcoming barriers to its widespread adoption.”
Challenges faced by women battling cancer and possible solution
Many women in India face barriers in accessing timely and quality healthcare services due to factors like geographical remoteness, financial constraints, and inadequate infrastructure in rural areas.
Delayed diagnosis is a common challenge, resulting from insufficient screening programs, low awareness about cancer symptoms, and cultural taboos surrounding women’s health issues, leading to advanced-stage diagnoses and poorer outcomes.
Seema Bhaskaran, Gender lead, Transform Rural India explains, “One of the contributing factors to India’s higher cancer mortality rate is likely delayed diagnoses, which may be explained by low cancer awareness and certain cultural norms surrounding healthcare. Low cancer awareness has also fuelled misconceptions and inappropriate beliefs that cancer is incurable, transmissible, and a form of divine punishment. Female-centered cancers of the breast and cervix are also often stigmatised particularly in rural communities where they manifest as forms of public humiliation, abuse, social isolation, loss of occupation, and marital issues. Around 87 per cent of all cancer cases were detected at advanced stages.”
According to Dr Aditya Manake, Oncosurgeon, Adhikari Lifeline Multispecialty Hospital, “Implementing door-to-door screening programs ensures convenience and encourages participation, ultimately facilitating early detection. The recent introduction of breast thermography as an alternative to conventional mammography marks a significant advancement in screening methodologies. Offering a non-invasive, doorstep solution, this innovation holds promise in enhancing accessibility to breast cancer screening.”
Cancer treatment can impose significant financial strain on women and their families, with costs encompassing diagnostics, surgery, chemotherapy, radiation therapy, medications, and supportive care, often leading to catastrophic healthcare expenditure and financial distress.
Emphasising on the gender disparity as one of the common issues, Bhaskaran said, “The deterring factor in seeking early care is the stigma of social embarrassment and isolation among women. Women not only fear death and contagion by cancer but also fear that their family’s reputation would suffer if people knew of their cancer diagnosis, including potential difficulties in their daughter’s wedding. It is also a widespread assumption that cancer, especially in the private parts (breast and genitals) is linked to “bad” and “immoral behaviour”.
“More than half of the women were observed to have a delay of more than 90 days in seeking care. The patient-related delay was observed to be 6.1 weeks, and the system-related delay was 24.6 weeks with a mean total delay of 29.4 weeks in treatment. This led to a poor prognosis. These delays may be attributed partly to the ever-increasing patient load on the healthcare system and competing priorities”, she added.
Dr Suresh Advani, Senior Consultant – Medical Oncology, S.L. Raheja Hospital Mahim mentions, “Gender disparities persist in access to healthcare services, particularly in developing countries and marginalised communities. Socioeconomic factors, cultural beliefs, and systemic barriers contribute to disparities in screening, diagnosis, treatment, and survivorship care. Women from disadvantaged backgrounds often face greater challenges in accessing timely and quality healthcare services, leading to disparities in cancer outcomes.”
Dr Vishesh Kasliwal, Founder & CEO, Medyseva also believes, “Addressing these disparities requires targeted interventions, including increasing healthcare infrastructure in underserved areas, implementing culturally sensitive outreach programs, and advocating for equitable healthcare policies.”
When women battle cancer, they navigate a unique set of challenges that extend beyond the physical aspects of the disease. Cancer has a different effect on women in the Indian social setting, where gender stereotypes are still prevalent. Unlike their male counterparts, many women contribute significantly to the family income and serve as the primary caregivers for multiple generations. When a woman is diagnosed with cancer, the effects on her family, friends, and economy are increased by her dual function.
Dr Mandeep Singh Malhotra, Director of Surgical Oncology at CK Birla Hospital (R), Delhi stresses, “For women, hair loss from chemotherapy carries special implications that result in social stigmas and a unique acceptance challenge. Beyond just physical changes, the problem has a significant impact on how society views women and their sense of self. Reproductive concerns add another layer of complexity to the challenges. While the impact of cancer treatments on male fertility is acknowledged, there is a notable dearth of conversation about the reproductive challenges women face. Women dealing with breast cancer, endometrial cancer, ovarian cancer, or cervical cancer often grapple with the loss of reproductive organs, impacting their identity and psychological well-being.”
Dr Shivali Ahlawat, Director – Technical Operations, Oncquest Laboratories Gurugram also said, “In the fight against cancer, women usually face multifaceted challenges that extend beyond the realms of physical and mental health. Cancer’s impact on women is a complex interplay of individual experiences, public mindset, and healthcare accessibility. Unique hurdles, such as heightened concerns about body image, especially post-breast cancer or cervical cancer-related surgery and treatment, mark the journey. The emotional toll is compounded by issues surrounding sexuality, fertility, and pregnancy after undergoing cancer treatment. These challenges often intertwine with broader issues of women’s rights as affected individuals navigate stigmas and confront barriers to accessing comprehensive healthcare services. The need for a holistic approach to address both the physical and psychological aspects of cancer becomes evident, emphasising the importance of support systems, awareness campaigns, and policy initiatives to create an environment conducive to the well-being of women battling this formidable adversary.”
Experts believe that addressing the challenges in cancer prevention involves a multi-faceted approach.
Dr Dessai stresses, “Early detection, facilitated through systematic screening for cancers such as cervical and breast cancer, is imperative for improved outcomes. The implementation of widespread HPV vaccination stands out as a key solution to significantly reduce cancers associated with the human papillomavirus. Ensuring easy access to healthcare facilities, coupled with the provision of high-quality healthcare services, is crucial in the broader strategy to reduce cancer rates.”
Dr Mridul Malhotra, Sr. Consultant & Head-Medical Oncology, Asian Hospital Faridabad opines that if stakeholders invest more in the healthcare industry then the treatment and awareness campaigns and research work can happen more effectively.
Explaining the importance of raising awareness, Sigal Atzmon, CEO, President & Founder, Medix Global said, “There is a lack of awareness amongst Indian women, especially in rural and underserved areas, about cancer risk factors, symptoms, and the importance of early detection and regular screenings for cancers like breast and cervical cancer. Cancer is treatable more than ever with advancements in treatment, but it’s still better to prevent it or at least diagnose it as early as possible. Entrenched cultural beliefs and misconceptions further exacerbate this issue of lack of awareness, leading to delayed diagnosis and treatment.”
“The government aims to encourage vaccination for girls aged 9 to 14 to prevent cervical cancer, and leveraging digital platforms and educational campaigns to educate women about cancer prevention, early detection, and the availability of government health schemes like the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY), which provides coverage for cancer treatment, is crucial. Additionally, personal prevention and case management can play a vital role in improving awareness among patients and their families by providing personalised education, counselling, and addressing cultural or social barriers that may hinder awareness and access to care, ultimately empowering Indian women to take proactive measures for their health, facilitating early detection and timely intervention, and improving outcomes in the fight against cancer”, she added.
Manisha Kumar, Regional Chief Operating Officer Karnataka, HealthCare Global Enterprises also mentions, “We have to understand that this is a close-knit system. On one hand healthcare providers are responsible for early detection, diagnosis, treatment, and follow-up care, and on other the research institutions drive scientific discoveries and innovation in cancer prevention, diagnosis, and treatment. Government and public health agencies play a critical role in shaping cancer control policies, allocating research funding, and implementing public health programs.”
Way forward
To effectively combat rising cases of cancer among women in India, it’s essential to adopt a comprehensive strategy that includes raising awareness, promoting vaccination, and ensuring accessible screening. By embracing these measures and also working on the enhancement of technologies and innovations in the ecosystem, India can substantially lessen the impact of these diseases on our society.
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