On A Mumbai Street, Aspiring Soldier Endures India’s Cancer-Care Crisis

A cancer patient resting on the divider under the monorail station near Tata Memorial Hospital, Parel, Mumbai. Many cancer patients--unable to afford a hotel or a dharmshala (rest house)--stay on the pavements around the hospital till their treatment is complete.

Mumbai: For the past four months--as his life turned from college student in Bihar to cancer patient on a Mumbai footpath--Arvind Kumar, 24, has been bothered by one question: How did I get oral cancer?

Kumar never smoked, chewed gutkha, paan (betel leaf) or tambaku (tobacco), the source of cancers in four of ten Indians so afflicted. His right eye eaten away by cells growing out of control, Kumar found it difficult to speak. So his brother-in-law explained how the Bachelor of Arts student from Bettiah district in western Bihar--and, as his family’s most educated member, their great hope--came to be here, after visiting seven doctors in five cities over five months, more than 1,866 km from home.

Sitting on a thin, plastic mat, Kumar--who is checked bi-weekly and gets chemotherapy and radiation once in three weeks--is one of about 50 patients who, on any given day, are spread across the footpath of Jerbai Wadia road at the front and rear of Tata Memorial Hospital’s Homi Bhabha Wing in central Mumbai. Either sitting or lying down on thin mats, they are usually accompanied by family members. Their medical files and medicines are placed in plastic bags hanging on a wall. A bag full of clothes is usually next to them. Some have a thin tarpaulin for a roof and a stove.

Run by the Department of Atomic Energy, the 76-year-old Tata Memorial Hospital--India’s leading tertiary referral centre--is ground zero of India’s unfolding cancer-care crisis. Although India’s incidence of cancer is still low compared to the West, it is spreading, and the lack of quality cancer care sets people like Kumar on trans-subcontinental journeys that end on the pavement of Jerbai Wadia road.

That is why this IndiaSpend’s three-part special report on cancer treatment is focussed on the Tata Memorial Hospital. In part one, we describe Kumar’s journey to Mumbai and the trauma his family endures. In part two, we calculate the economic and social cost of cancer through a survey of cancer patients living on Jerbai Wadia street’s pavements. In the third part, we investigate the government’s programmes for cancer care for its poorest patients.

Cancer is now known to strike at any age, as cells grow out of control due to multiple reasons: A flaw in your genes, toxins in the air and in your food, or consumption of tobacco or excess alcohol. Cancer’s changing characteristics are made worse by India’s inability to even gauge the disease’s spreading tentacles.

There were 1.45 million new cases of cancer and 736,000 deaths in India in 2016, expected to increase to 1.73 million in 2030, with 880,000 deaths by 2020.

India’s (man-made) cancer-care crisis

A million Indians are diagnosed with cancer every year, and 680,000 die from a disease once regarded as an affliction of the western world. India’s cancer burden is now expected to rise 70% over the next 18 years, from nearly 1 million new cases in 2012 to 1.7 million by 2035 according to GLOBOCAN, an international initiative on cancer data.

These may be underestimations because there were 1.45 million new cases of cancer and 736,000 deaths in India in 2016, expected to increase to 1.73 million in 2030, with 880,000 deaths by 2020, according to data from the National Cancer Registr