New Delhi: A new study has emphatically ruled out the role ascribed to the ‘erosion of traditional Indian culture and westernisation’ by sections of popular media and the public when it comes to cancer.
The paper, titled ‘History of the Growing Burden of Cancer in India: From Antiquity to the 21st Century,’ charts the journey of the disease in the country through an expansive time span and concludes that cancer has been recognised in India for ages and it is not really a new phenomenon caused by western influence.
The paper was published in the Journal of Global Oncology and is written by Robert D. Smith of London’s Kings College and Mohandas K. Mallath from Tata Medical Centre, Kolkata.
The new paper by Smith and Mallath examines two broad ideas.
First, it says, “Ageing is the main risk factor for carcinogenesis in multicellular animal organisms, including humans.”
Mallath told Times of India that one of the reasons he wrote this paper is because he often got questions from patients on whether there was a cancer epidemic in India. “Why did I get cancer when I don’t smoke, drink or eat non-vegetarian food?” patients would ask him.
India used to struggle with a low life expectancy and premature deaths due to famines, infections and related diseases. Now that the situation has improved, there has been an “epidemiologic transition,” which explains the rise of cancers as well as other non-communicable diseases, notes the paper.
Secondly, the paper debunks the popular understanding of cancer as a ‘new phenomenon’ and a western import. For this the researchers have looked at literature and archival records and come to the conclusion that “cancer-like illnesses have been documented in the Indian subcontinent since antiquity.” The formal diagnosis of cancer, as we understand the disease now, began in the 19th century and by the 20th century, an increased cancer burden made its appearance.
An article on The Wire had also examined a similar angle while taking off from the westernisation myth. The piece noted that cancer is “the price of living longer.” In other words, because we now have longer life expectancies, our bodies experience irreparable “genetic wear and tear,” which is basically what cancer is.
The researchers say that paleopathology studies from the Indus Valley civilisation do not reveal evidence of malignancies. There is also “no word equivalent to cancer in any of the texts from the Vedic ages.” But texts like the Atharva Veda do refer to symptoms which are seen in some advanced cancers and prescribes rituals for cures. Diseases like cancer and remedies for it are mentioned in the classic texts of Ayurveda and Siddha.
By 1910, the Indian Medical Service had started publishing audits of cancer cases. “We found that although cancer has been recognised since the ancient Ayurvedic period, the routine diagnosis of cancer began in the 19th century, after Western medicine gained acceptance throughout India,” says the paper.
Some types of cancer have stopped showing up significantly in India. For example, one of the early modern studies on cancer was on how the use of the kangri pot was related to the disease. The kangri pot holds hot coal and is used by people in Jammu and Kashmir to keep themselves warm. In 1866, W.J. Elmslie published a study conducted on 30 patients about a cancer that could be related to their use of this pot.
Other kinds of cancer documented in early modern literature is ‘dhoti cancer’ (caused by the dhoti or loin cloth tied tightly around the waist), scalp cancer (related to frequent shaving of the head) or penile cancer (related to poor penile hygiene among uncircumcised men). Most of these cancers are not seen or documented any more.
Cheek and oral cancer continue to be seen in India even now, due to a persistent habit of chewing betel nut and tobacco.
India had an estimated 1.15 million new cancer patients in 2018. By 2040, this number is predicted to double. Cancer mortality has also doubled in the 26 years from 1990 to 2016.
Supply of cancer care has not met its demand, with public health care insufficient to treat India’s poorest while private care for cancer continues to become more expensive.