“The current Indian population is 1,270,272,105 (1.27 billion). The incidence of cancer in India is 70-90 per 100,000 population. And cancer prevalence is established to be around 2,500,000 (2.5 million) with over 800,000 new cases and 5,50,000 deaths occurring each year. More than 70% of the cases present in advanced stage accounting for poor survival and high mortality. About 6% of all deaths in India are due to cancers which contribute to 8% of global cancer mortality” – Department of Surgical Oncology, Asian Institute of Oncology, 2014.
The news clippings show an increase in numbers, but what about the awareness rate?
ICMR’s 2016 report stated, ‘India is likely to have over 17.3 lakh new cases of cancer and over 8.8 lakh deaths due to the disease by 2020 with cancers of breast, lung, and cervix topping the list, a premier medical research body said today. In its projection, the Indian Council of Medical Research (ICMR) said in 2016 the total number of new cancer cases is expected to be around 14.5 lakh and the figure is likely to reach nearly 17.3 lakh new cases in 2020.”
The new generation is more likely to face this disease, how are we preparing for it?
Personalized medicine has brought a revolution in the healthcare sector. A significant proportion of cancer cases is due to gene variations (mutations) which could be inherited or acquired. For optimal patient care, medical practitioners and oncologists seek root-cause analysis through molecular diagnosis or DNA testing. This would help reduce the burden of multiple trial-and-error cycles of chemo. An added benefit would be the implementation of effective screening protocols to identify family members at risk, before they develop the disease.
How does that specifically help in Cancer-related conditions only?
The risk assessment strategies offered by genomics companies are multidisciplinary. Preventive screening for cancer is performed by checking for the presence or absence of specific changes in the genetic material (DNA) and mapping it to a reference database. In certain cases, if multiple genes are to be screened, the individual’s exome (complete sequence of protein-coding DNA) can be tested. However, a clinical confirmation for hereditary cancer syndromes would require a test with targeted and high-precision analysis. This is done by analyzing the tumour tissue (biopsy) for mutations which occur during the course of cancerous cell multiplication. Known as somatic mutation testing, this method helps tailor chemotherapy for patients. The cells which express such mutations can be killed by specific antineoplastic compounds.
Are there any issues in the field? What should the “common man” be aware of?
Some of the current challenges in this field include the availability of genetic counselors, and most importantly, access to testing options. While the former can be addressed by a radical change in the education patterns for geneticists, genomics companies are fast emerging in the latter. Their key focus is to provide end-to-end solutions to cancer-affected families which include clinical translation of genetic data. Given the complex nature of cancer genetics, a proper understanding of the requirements of every cancer patient is essential. The biological manifestation of tumour in a patient changes rapidly and constantly, to the extent wherein the roadmap to therapy becomes an uphill task. This is where personalized genomics can help, by facilitating the timely detection of cellular changes, the degree of progression and scope for survival.
And…what about the present scenario in India? Is it time to panic…
Cancer mortality has dramatically increased in India. Over two decades, our country has witnessed a 42% increase in a number of cancer-related deaths. Families grapple with tremendous pain and the road to recovery is a long (and sometimes, uncertain) one. Genomic science can be more than a mere light at the end of the tunnel, by serving as a beacon of hope right from the beginning, via early prognosis and management. By finding the right space for DNA testing in the healthcare paradigm, a radical change can be witnessed in cancer management.
What are the small bits that one can look out for?
Maintain a healthy body weight!
Avoid Binge drinking of alcohol
Say NO to Smoking
Conduct self breast and testicular exam.
How does Mapmygenome fit in this picture? How are we contributing …
Genomepatri Onco is a unique, purely predictive DNA-based test to assess your genetic predisposition to 17+ cancers, physiological traits that can contribute to the risk of developing cancer. The test covers risk assessment for Colorectal cancer, Lung Cancer, Prostate Cancer, Pancreatic cancer, Breast cancer, Bladder cancer, Melanoma, Renal cell carcinoma, Ovarian cancer, Basal cell carcinoma, Follicular lymphoma, Chronic Lymphocytic Leukemia, Thyroid cancer, Hodgkins Lymphoma, Testicular cancer, Non-Melanoma skin cancer, Alcohol Flush Reaction, Prostate Specific Antigen (PSA). Post the test, our team of board-certified genetic counselors peruse through it and collate it with your health history, family history, current medical conditions/clinical parameters, and existing lifestyle, to better assess your overall risk quotient. The counselor then explains the primary report and offers advice, answers query on key issues, during an extensive one on one session, and this information is then provided to as a secondary recommendations report. As can be seen, combined with genetic counseling and/or nutritional counseling, these tests have the potential to change your lifestyle, save on healthcare expenses and help you plan for proactive living at work.
Is there a test specifically for Breast Cancer?
Mapmygenome’s BRCAMap test covers both BRCA1 and BRCA2 genes (Full sequence analysis for coding regions). The blood specimen is collected from the individual for DNA extraction and analysis (Next Generation Sequencing). Validation by Sanger sequencing for pathogenic variants found (if any).
This test is offered to people with personal or family history, or those who have specific types of cancers in their family and these people are more likely to inherit these mutations. A positive result implies a pathogenic mutation in one of the breast cancer genes; the likelihood of developing breast cancer or ovarian cancer is higher when compared against the normal population. However, the positive result does not really mean that one will develop cancer. By detecting these mutations early, one will have access to preventative measures and proactive treatment – leading to an overall better prognosis.
We also have an advanced test which analyzes all the genes(non BRCA) relevant to breast cancer as well.
Are we the only ones worried – trying to create awareness? Apparently not…..
4 February is observed as “World Cancer Day”
People around the globe are making an effort in their own small way. Families teaching their kids, educational institutions via presentations, some people even through bake sales and donating hair! Scientists are making breakthroughs every year, giving people a shot at the best treatment possible. One has to simply learn from the tumour sometimes – we simply cannot give up. We will and CAN CERtainly beat it!
About the Authors
Dr. Pallavi Jain is part of the Scientific Team at Mapmygenome. She has a Bachelors Degree in Biochemistry with Genetics and a PhD in Molecular Medicine (UK). She recently completed an intensive course in IVF from Origio, Mumbai. She enjoys swimming and reading.
Rasika is the product specialist and scientific liaison for Mapmygenome’s personal genomics portfolio. With eight years of experience in sequencing, molecular biology, genetic data analysis and reporting, she currently works in the product team at Mapmygenome. Her key responsibilities include genomics product development, data curation, scientific content creation and management, data analysis and technical support for business development. Her key strength is a robust understanding of consumer genomics, including specialized areas such as pharmacogenomics, nutrigenomics and sports genomics. Rasika is also a certified group fitness trainer and Pilates (Balanced Body) Mat instructor.