Cancer Dwindling the Population Dividend of India

With the billion plus population, India is one of the youngest country in the world with 65% population in the working age. However, this promising population dividend is also suffering from malignant life style related health issues which is silently hollowing the India’s pillar of strength, it young people. The diseases like diabetes, cardiovascular problems and lately cancer has started appearing in the young men and women of this country as early as in late thirties or early forties.

Surprisingly, the cancer has become a significant menace and concern of personal, social and economic life of our people and severely impacting the socio-economic scenario of India. According to a study, in 2004 total cancer patients were over eight lacs, which in 2014, just after a decade, has more than doubled to 18 lacs. Every year a million (10 lacs) people are being diagnosed with cancer and nearly 6-7 lacs die of it annually, while the number of oncologists and specialists to treat these patients has not increased as much in these years.

According to an estimate an average cancer therapy for an individual with lung cancer comes around Rs. 6.5 lacs which is much more than average income (Rs. 5 Lacs) of middle class family. One can imagine how a poor family would remain untreated and left to die an untimely death. Thousands of the patients who receive the costly therapy are pushed deep into poverty.

What can be done?

The individual effort to stay healthy is necessary to beat the menace of cancer and live cancer free. The balanced and simple diet, active life style, daily exercise, routine check-up to catch the disease early are a few step an individual can adopt in order to lead a healthy life.

To increase the awareness of the cancer disease the government and private corporates under their social responsibility should run awareness campaign about the cancer using the social media, television and print media to have wide reach. The campaign may include awareness for early diagnosis, annual check-ups of the prone people such as 40 year plus individuals or those having the disease in close family, promoting healthy life style, especially in urban areas.

The state governments should provide for a clear policy for the patient’s treatment and cap the cost of cancer treatment so that private hospitals or care providers do not charge the patients unreasonable and catastrophic amounts for the treatments including the surgery, chemotherapy, radiotherapy or palliative care. The cost of treatment needs to be made realistic and affordable for the average citizen. Privately funded health insurance or publicly funded health initiatives help the people in western country to meet the excessive treatments cost, while in India insurance remains limited to middle class or upper middle class families, that most of the times not realistic to meet the cost of cancer treatments. The government initiative and funding is meagre and the majority of the people remain unaware of such schemes. Efforts and policy are urgently needed to plug these gaps so that cancer care become economically accessible.  

Enhancing the infrastructure and ensuring the availability of specialist doctors is major bottleneck in the current cancer treatments. A country of 1.25 billion population has only 27 dedicated cancer hospitals and only 1000 trained cancer specialists. These numbers suggest that situation is really serious. Sample this, India has one oncologist for nearly 2000 cancer patients while the USA has one doctor for every 100 patients. Therefore, a policy should be adopted to open more speciality care centres in the area where cancer incidence is more such as in the north-eastern states, West Bengal, Bihar, Uttar Pradesh and some areas of Punjab. 

Obesity causes lung dysfunction and breathing troubles by increased cysteinyl leukotrienes pathway

Increased body weight is a chronic health problem which has emanated from the globalized food market and dietary habit. This has led to the different types of ailments which occur in obese individual simultaneously and referred to as metabolic disorders. Metabolic syndrome includes conditions such as obesity, insulin-resistance, diabetes, hypertension, cardiovascular, and some forms of cancers. Lung dysfunction is also associated with increased body weight in which obese persons feel difficulty in breathing and could develop asthma like symptoms if not treated timely. Many studies have shown that such patients are difficult to treat with the regular asthma medicines, which suggests that probably breathing problem in obese people is caused by different mechanism and is different than allergic asthma. 

Elevated levels of cysteinyl leukotrienes (CysLTs) in the urine of obese asthma patients indicate elevated levels of biochemical pathway that forms this compound. CysLTs are responsible for the inflammation and swelling and can change the cell’s behavior by modifying their structure and function. In fact, LTs are known to cause lung problems in asthma and COPD in non-obese people and inhibitors of LTs receptors or of enzymes that make LTs are used as drug to treat such patients.

In the obese individual the fat deposits in the special cells called adipocytes which grows in number and size upon energy rich diet consumption. The adipocytes secret certain chemicals which attract macrophages, the policing cells in body which fight with pathogens and infectious agents and also some of the body’s own molecules and materials and removes them. In excessive accumulation of adipocytes, more macrophages get attracted to adipose tissue, get overactive and secrete molecules like cytokines, chemokines and also CysLTs which are released in blood and can cause inflammation in other body parts.

When it reaches to the lungs, CysLTs can activate the lung cells which can also secret the inflammation causing molecules and attract immune cells to the lungs. This scenario is similar to the early stage of development of asthma. Over the period of time these molecules can change the structure and function of lung cells including epithelial cells which can change into either mucous cells of fibrous cells and lung function may get severely affected. Mucous cells secret large amount of mucous which inhibit the gas exchange in the lung while fibrous cells affect the elasticity of the lung and lung cannot expand upon breathing.

How obesity causes these changes in the lungs is still not known and scientists are actively working to find answers. The mechanism once clear can help in treating such patients using the appropriate drugs.

Reference: Yadav UC, Srivastava SK. Cysteinyl Leukotrienes (CysLTs): Role in Obesity-Induced Asthma. Curr Mol Med. 2015; 15(7): 598-605.

  

Health Rhymes

Being evolved from nomads, hunter and gatherers, humans aught to remain mobile, active and runners.

Being sedentary is not healthy, that is not us. Sitting and laying make us filthy and creates pus.

Fast or slow but run, jump, squat, stretch, skip twist, bend and turn. Let the blood flow unhindered from top to toe and calories burn.

All them together or subsequently, but must you do them daily.

Call it Exercise, Yoga or Pilates. Practice them and stay away from trouble of heart and diabetes.

To stay fit, healthy, and athlete you must leave the bed, and your seat.

Kill the diseases whether diabetes, obesity, or heart failure. Play and laugh like a kid, do not get stressed like a mature.

Increase in Measles cases in the USA

The recent new cases of measles in some of the regions in USA has sent a panic alarm and social debate has sprung up about vaccination of children against the common contagious diseases that are known to kill many children in other parts of the world. The only way to protect the precious life is by vaccination, a proven strategy against the contagious diseases. The USA had declared in the year 2000 that country was free of measles. However, occurrence of new cases and rapid spread has shown deficiency in the vaccination program.

Measles is a viral disease, highly contagious and can spread rapidly in a human settlement. The disease mostly affects children, and cause infection of the respiratory system, skin and the immune system. The disease develops in 1-2 weeks after the exposure to the virus and some of the initial symptoms include high fever, running nose, redness in eyes, loss of appetite and accompanied with body rashes. The body generally recuperates from the infection in couple of weeks provided no other complications develop.

Image source: http://www.clinicaspace.com/

Although majority of the patients recovers, in some patients complication may lead to pneumonia, and in some rare cases, 1 in 100,000, it may result in measles encephalitis which is fatal. Those who survive may develop mental illness and retardation.

According to a report in 2011, despite an increase in overall vaccination, 6.7 million children did not receive vaccination for measles in India leading to measles outbreak and 29,339 measles cases were registered that year. According to Center for disease control (CDC) an estimated 20 million people get measles Worldwide and nearly 146,000 people die from the disease each year—that equals about 440 deaths every day. Therefore, preventing the occurrence of viral infection by vaccination is one safe way of protection from the disease.

Many scientifically unsound correlation studies have claimed that vaccination likely results in the autism which has deterred many parents from vaccinating their wards. In many state of the USA the laws related to vaccination has been relaxed and option of vaccination has been left to choice. Scientists assert that link between autism and vaccination is only correlational and no causal link between two could stand the scientific scrutiny.  Dr. Sanjay Gupta, Chief medical correspondent of CNN argues that while the amount of vaccine used in single shot has declined over the years and the incidences of autism has increased over this duration nevertheless (see below). This suggests that there is no direct link between the vaccine and autism.  

image source: wfmz.com

CDC recommends that all the children should get two doses of MMR vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age.

As the age-old adage goes, “prevention is better than cure”, therefore vaccination should be considered seriously for preventing the precious life of unsuspecting children that are threatened by the deadly diseases.

Common Cold and Loss of Taste and Smell

While suffering from a seasonal flu, my biggest trouble is that I cannot get the taste of food that I eat, a condition referred to as ageusia. Sense of smell has also taken a break, the condition is called anosmia, and it is giving me a kind of mixed feeling. Those same food whose aroma and flavour used to fill the nostrils and induced craving apatite, they do not appealing any more.  Have you ever wondered why our taste and smell go awry during sickness, I did!

My bout of rationality returned with a likely reason that probably nature has designed it in this way that during sickness one does not get overindulgent. With likelihood of slowed digestive fire during sickness, eating heavy meals would complicate the body’s healing capacity. This is the reason that one suffering from such sickness is advised light meal and high amount of liquid diet. Although patients prefer to consume hot and spicy soup during mealtime or otherwise.

Image source: vocalcoach.hubpage.com

But what could be the science behind this. It appears that loss of taste and smell during sickness has to do with how mucous has occupied the taste buds and smell receptors. Actually, our taste buds located on the tongue help us in sensing only four types of flavours that is salty, sweet, bitter and sour. But, nearly 75% of our sense of taste comes from our sense of smell. It has been found that the tiny molecules of ‘odour’ when interact with ‘smell receptors’ in the nasal cavity that produces the perception of taste.

As we chew the food item the aerosol generated in mouth gets filled with odour particles and it goes to the top of the nasal cavity where smell receptors interact with these odour particles and generate the taste of the food.

During common cold, flu, bacterial sinus infection, and other condition when a thick mucus layer covers the smell receptors in the nasal cavity, our sense of smell ceases and so does our taste.

Besides the mucus, virus which directly infect the nasal epithelial cells, they take over the host cell machinery and starts synthesizing their own DNAs and proteins. In this 'coup', the synthesis of nasal epithelium’s own proteins including ‘smell receptors’ suffers and also the integrity of these cells is lost leading to apoptosis and cell death. This may be seen some times as ‘bloody’ nasal discharge. Due to these factors the smell capacity and thus sense of taste become deficient for the duration till mucus thickness is decreased and the new epithelium with odour receptors replaces the dead cells.

The remedy? Steam may help loosen the mucus. Soup with herbal mix including ginger, garlic, mint and other healthy concoction with soothe the nasal passage and give some respite.

So, here comes my cup of soup, Cheers to taste buds, I know it’s not your fault.