Daily Times

KARACHI: Sindh government health department has failed to materialize the recommendations of Task Force on cancer treatment planning in the province.

Registry for cancer patients of Sindh: Cancer is extremely deadly diseases affecting thousands of people every year, according to committee.

Three months have passed since the recommendations have been provided but the Sindh health department has not yet taken any action due to lack of cancer data and expertise towards this ‘extremely deadly diseases affecting thousands of people every year’ in the province.

Then Sindh Governor Dr Ishratul Ebad Khan had formed this Task Force in April 2016 in order to provide cure on better grounds to cancer patients.

Sindh Governor constituted a three-member task force to find out the present status of facilities being provided to cancer patients in Sindh. A Committee was formed under Dr Noor Muhammad Soomro, Head of Oncology Civil Hospital Karachi as its convener and Dr Tariq Siddiqui, Head of Oncology, Ziauddin University Hospital Karachi and Dr Shemveyl Panjwani, Pediatric Oncologist as its members.

Terms of reference included to formulate document for establishment and improvement of cancer treatment facilities in Sindh based on available data.

According to the document available with Daily Times, The Task Force recommended immediate and intermediate measures. Under immediate measures, committee recommended to form a registry for cancer patients of Sindh, availability of morphine, dedicated oncology bed in government hospitals and also the availability of common chemotherapeutic agents.

In response of committees recommendations, Government’s response towards practical steps is ‘zero’, said Dr Soomro, Convener of Task Force while talking to Daily Times.

“Sindh Government possesses no cancer data. Officials should take up the issue seriously. What is visible though, that there is no vision for public health with in government ranks,” Dr Soomro added.

Based on the recently published data from a Lahore based private hospital cancer registry, it is estimated that with the current population of Sindh, about 25,000 new cases of cancer are diagnosed in entire Sindh every year.

Status of cancer, care in Sindh particularly outside Karachi is deplorable with poor access to treatment, lack of multi-disciplinary team, poor surgical oncology and no palliative services resulting in dismal survival. Cancer services in the province need to be improved.

Currently there are less than thirty fully trained medical oncologists practicing in entire country and most of the cancer patients might never see a medical oncologist throughout the course of their treatment. In Sindh, apart from Karachi there are hardly any formally trained medical oncologists in the entire province.

Pediatric oncology in Sindh is limited in Karachi; the rest of the province is devoid of a pediatric cancer facility and pediatric oncologist. Most children diagnosed with cancer in Sindh and Balochistan are referred to Karachi. Long distance from treatment centers has a lot of social and financial implications resulting in high rate of abandonment and poor survival.

“When we assess the burden of cancer in Sindh we must not forget Balochistan and lower Punjab where cancer treatment facility is minimal and substantial number of patients travels to Sindh for treatment,” Dr Soomro added.

Under the recommendations, committee suggested to create a registry of cancer patients for Sindh as there was no cancer registry in Pakistan.

Procurement of morphine in many institutions is a complex, complicated and cumbersome task. The morphine availability is a measure hurdle in effective pain control either result majority patients suffer or die of poorly controlled pain.

Committee has also recommended forming radiotherapy facility at Civil Hospital Karachi.

The Committee has strongly recommended the enforcement of legislation on ban on use of gutka. “Delay in diagnosis due to poor awareness and bad habits like using tobacco, pan, gutka and chalia can be prevented by creating awareness among general population.”

With exception of hematological malignancies, most patients are initially treated by the surgeons. Most of the surgeons have no surgical oncology training hence ontological surgical principals are not followed and many patients do not get standard treatment and often they are not referred to oncologists,” committee alarmed.

“Under intermediate measures, the committee has suggested the formation of cancer centers to cover entire Sindh, radiotherapy facility at civil Hospital Karachi and cancer awareness programme,” Dr Soomro added.