Page 0145

REGIONAL INITIATIVES

144 CANCER CONTROL 2014

that from the public health standpoint, cancer prevention and

early detection are overwhelmingly more cost-effective than

diagnosis and treatment of cancer in late stages. It is

estimated that greater than 70% of cancers are related to

preventable or reducible environmental and behavioural

factors such as use of tobacco products, betel nut, grilled and

smoked meats and fish, chemical preservatives, pollution of air

and water, sexually transmitted diseases, obesity, etc. A

national long-term cancer control plan, which focuses on

cancer prevention, public education and early detection

through effective screening, should be a top priority for

government and the public health and oncology communities

in order to lower cancer incidence, morbidity and mortality

over the coming decades. American observers pointed out

that in the United States, major progress against cancer began

in 1974 with President Nixon's "War Against Cancer", then 40

years of progress, and that India is now in the early stages of

this process and can benefit from our experience, our extant

cancer information and educational materials and that India

can accelerate progress leveraging the advanced state of

India's information technology.

A second aspect of Indian oncopolitics relates to the

tensions among the oncologic specialists - medical, surgical

and radiation oncology - some of whom are still debating the

relative importance and merits of their specialty-specific

management of cancers. Several of the ICC sessions discussed

the importance of interdisciplinary team management of

cancers, but this approach is lacking in all but the most

advanced cancer centres such as Tata Memorial, the All India

Institute of Medical Sciences and several leading regional

cancer centres. Some sessions at ICC gave the impression of

an "intellectual chauvinism" regarding the relative

contributions of surgery, radiation oncology and medical

oncology to cancer care, rather than committing to the

interdisciplinary care model, where pathologists, diagnostic

and interventional radiologists, molecular geneticists,

oncopsychologists, palliative care specialists and other

therapists all play a role in developing individualized

treatment plans for patients, and then carrying out the plan

according to consensus guidelines. This interdisciplinary care

approach will require the ongoing development of Indiaspecific consensus guidelines for the management of each

cancer type and stage, such as those developed by the NCCN

in the United States. Access to such guidelines and supporting

evidence-based materials can be assisted via

oercindia.merlot.org, a programme developed by and for

the Indian oncology educational community. l

Dr Lawrence S Lessin, MD, MACP is the Medical Director of

Washington Hospital Center's Department of Continuing Medical

Education and Quality Training (DCMEQT) and former Medical

Director of The Washington Cancer Institute, from 1993-2007. He

is one of the founding members of OERC and serves as chair of its

Executive Committee. He received his Doctorate in Medicine in

1962 from the University of Chicago School of Medicine,

completed postgraduate training in haematology and oncology at

the University of Pennsylvania's Hospital. Dr Lessin was awarded a

special fellowship from the National Institutes of Health in the

Institute for Cell Pathology at the University of Paris for advanced

research training. He research interests include anemias,

leukemias, myelodysplastic syndromes and other aspects of

haematologic malignancies resulting in over 150 journal articles,

book chapters and monographs. His has also held distinguished

roles such as Professor, Division Head and Medical Director within

prominent hospitals including Duke University Medical Center

(Durham, NC), Veterans Administration Hospital (Durham, NC),

and The George Washington University Medical Center (GWUMC)

and its Cancer Center (Washington, DC).

Dr Madhavan V Pillai, MD, FACP is an adjunct Professor of

Oncology at Thomas Jefferson University, Philadelphia, USA. He is

currently the Chairman of Astermedcity Oncology Center of

Excellence, Kochi, India and also the Chairman of the OERC-India

Task Force. Triple-board certified in internal medicine,

haematology and medical oncology he has extensive experience in

community oncology, the USAF Medical Corps and academia. He

serves on several national and international committees dealing

with cancer care.

Dr Savitri Singh-Carlson is currently the Assistant Director,

Graduate Program and Associate Professor in Nursing, California

State University, Long Beach, USA. She is an advocate for

international oncology nursing and has been involved in projects

that advance oncology nursing education at a global level. Her field

of research is on quality of life, cancer survivorship, palliative care

with diverse immigrant groups' perceptions and experiences of

cancer prevention, diagnosis and treatment.

Professor Jeanne Sewell is a nursing professor at Georgia College in

Milledgeville, Georgia, USA. She is also the Editor of the Health

Sciences Editorial Board for MERLOT (Multimedia Educational

Resources for Learning and Online Teaching and serves on the

Open Educational Resources for Cancer (OERC) India Executive

Steering Committee. She has a special interest in OERC prevention,

treatment, and survivorship.

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