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HEALTH

Need for expanding affordable cancer treatment to rural areas
Tribune News Service

New Delhi, May 2
Despite the recent decision of the Union Health Ministry to allow expensive Linac technology for treatment of cancer in government hospitals, experts claim that Cobalt 60 continues to be the best and the most affordable treatment for cancer patients. The need is to expand affordable cancer treatment facilities to the rural areas, contend experts

In India there are 2.5 million cancer cases diagnosed every year on an average and the task of imparting significant affordable treatment still remains an overwhelming goal, especially in the far-flung rural settings. The gap of have and have-nots in cancer treatment is steadily widening here with a need of 1,000 radio therapy units as contrasted to a supply of mere 300 units. Ironically, even within this crunch, there are at least 30-40 machines that need urgent replacement where only about a handful of 12 new machines are added annually.

At the present rate of supply India may not be able to meet the demand of cancer treatment even in the coming 50 years.

There is a dire need to expand cheap and affordable cancer treatment facilities to the rural areas. Unfortunately, the focus and funds of the government have predominantly been centered on a few select major hospitals such as AIIMS and the CNCI, Kolkata.

Recently, the Union Health Ministry’s decision to help all major government hospitals to induct the expensive linear accelerator (Linac) technology for cancer treatment has drawn flak from cancer specialists. Experts say that the need of the hour in India is not to ape the Western countries by purchasing a few costlier machines but to increase the number of cheaper machines like the Cobalt-60 technique so that more and more patients can benefit from these, especially since the output from the two methods is same and comparable.

The World Health Organisation reports, too, indicate that either Cobalt 60 or Linacs do not alter the final prognosis of the cancer being treated. In other words the expensive Linacs, a product of complex computerisation and high investment, do little to improve the ultimate outcome in the treatment of the disease.

Says Chandigarh-based Dr B.D. Gupta, former Professor and Head, Department Of Radiotherapy and Oncology, PGIMER, “In India, there are almost 200 Cobalt units functioning efficiently and providing valuable treatment aid to cancer patients. Moreover, the Cobalt units are fairly maintenance–free, having a work capacity of up to 25-30 years with the replacement of the radioactive source performed in every seven to 10 years.” Dr Gupta, who has written extensively on the prevailing misconceptions in the medical community pertaining to the use of Cobalt therapy in cancer, further asserts, “Cobalt machines do not have a half-life of five years as previously believed. It is in fact the Cobalt source that has a half-life of five years that can be used for two half lives or for a duration of straight 10 years.”

The WHO National Cancer Control Programme Policies and Managerial Guidelines, 2nd edition, WHO 2002, observes, “Accelerators are more expensive and require sophisticated maintenance and frequent calibration. The requirement for stable electrical power and water supplies are high. In the absence of a service contract the breakdown of major components may incur significant emergency funding.” WHO further affirms that relatively inexpensive Cobalt machines are quite easy to maintain and can provide adequate therapy or palliation for most patients, thus making it unnecessary to invest in expensive linear accelerators and other high-energy machines requiring sophisticated maintenance and frequent calibration.

Ludhiana-based doctors Kamlesh Passi, Lalit Mohan and Harpreet Singh of the Mohan Dai Oswal Cancer Treatment and Research Foundation in their book titled “Performance of 10MV Linear Accelerator: 10 Year Experience”, categorically state, “Even in good working conditions the frequency of breakdowns in case of linear accelerators is at a rate of approximately 10-30 annually with approximately 12 service calls made per year”.

Radiotherapy with Cobalt 60, on the other hand, is being widely used in India. This is because Cobalt 60 falls under the bracket of affordability besides imparting optimum treatment results.

Treatment with Cobalt 60 is an affordable choice, particularly in developing countries such as India where sophisticated maintenance and frequent calibration required for Linacs cannot occupy the time needed to treat lakhs of waiting cancer patients. This situation is even dire in rural settings where cancer patients usually approach their physicians mostly in the late stages of the disease and in such situations either do not have the time or the financial resources to undertake complex Linacs treatment.

Therefore, analysing this key factor of affordability in rural areas the government should refrain from imposing high- end treatment profile in a low-end setting, suggest experts.

According to these experts, Linacs requires a complex system of maintenance, regular supervision by qualified physicists and a thorough check of calibration and symmetry of the radioactive beam especially in areas subjected to frequent power cuts or power fluctuations.

Radiotherapy with Cobalt 60 has been found to be better for target volumes that are close to the skin surface such as the head and neck, breast and brain besides having a lower risk of uncertain dose delivery.

Cancer is a time-sensitive disease where early treatment becomes imperative.

There should be a general consensus among the governing authorities and institutions to tailor their individual treatment of cancer and to invest in economical and reliable units dedicated to providing early and effective treatment. 
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SPORTS

Najafgarh Academy move up in under-12 tourney
Our Sports Reporter

New Delhi, May 2
Deadly bowling by Harshit Sharma (4 for 10) and Tanuj Sehrawat (3 for 19) and an unbeaten half century by Vijay Sehrawat helped Najafgarh Cricket Academy defeat U K World by ten wickets in the Capt. Dharam Pal Under-12 Cricket Tournament on the Haryana cricket ground at Dhasha. Harshit Sharma was named the man of the match.

Scores: U K World: 108 all out in 33 overs (Akash Yadav 33, Nial Dabral 21, Arshit Sharma 4 for 10, Tanuj Sehrawat 3 for 19). Najafgarh: 109 for no loss in 21 overs (Digvijay Sehrawat 51 n o, Rahul Tyagi 36 n o).

Max New York Life win

Max New York Life beat Xansa by 28 runs in the CallC Cup Cricket Tournament.

Scores: Max New York Life: 204 for 9 in 25 overs (Nitin Aggarwal 49, Salim 42, Sushant Kalra 42, Kapil Chouhan 4 for 34). Xansa: 176 for 8 in 25 overs (Vikas Keer 81 n o, Gaurav Bhatia 4 for 26, Sushant Kalra 2 for 37).

Five-a-side soccer final

Mount St. Mary’s School, Delhi Cantt. will take on International School, Geetanjali in the final of the five-a-side Ambuja Cup Football Tournament at the Ambedkar Stadium at 4 p m on Monday. Food Corporation of India will clash against Employees State Insurance Corporation in the final of the institutional category at 3.15 p m.

Chetan, Deepanshu star

A strokeful half century by Chetan Bisht (58, 8x4, 2x6, 40b) and deadly bowling by Deepanshu Kumar (5 for 11) enabled Poorvi Delhi Academy defeat Pramila Bai Chauhan Vidyalaya by 117 runs in a league match of the Sushila Devi Tiwari Under-17 Cricket Tournament on the Yamuna ground.Chetan Bisht was named the man of the match.

Scores: Pramila Bai: 165 for 5 in 20 overs (Chetan Bisht 58, Abhilash Kumar 37, Rishi Bhardwaj 30, Devender Kumar 3 for 24). Poorvi Delhi: 48 all out in 13.4 overs (Dipanshu Kumar 5for 11, Vihans Gupta 3 for 6).

Cricket coaching camp

West Delhi Cricket Academy will organise a 30-day cricket coaching camp for boys in the 10-18 age group at the Saviour Convent School, Paschim Vihar from May 6 to June 5. Details can be had from Phone No. 9810030964.
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Bachendri’s team scale Mt. Island Peak
Our Sports Reporter

New Delhi, May 2
A ten-woman team, led by former Everest queen Bachendri Pal, successfully completed an expedition to the 20,300-feet Mt. Island Peak in Nepal. The expedition was conducted to commemorate the 100th birth anniversary of JRD Tata and the 20th anniversary of the first all-woman Indian conquest of Mt. Everest.

The team commenced their arduous expedition from Lukla on April 3, with a brief stop-over at Kathmandu. Lukla is at 7,000 ft, which is another place for commencing the approach march for Everest expeditions. The team first reached Namche Bazar after a gruelling climb on the up and down mountain trails. The bazar is one of the highest trading points at 10,000 ft, with barter systems still existing.

The expedition was divided into two phases. The first phase was for acclimatisation, in which the team weathered the vagaries of the terrain and environment, and climbed upto Kala Pathar at 18,200 ft and reached the Everest base camp at 18,000 ft. In the second phase, the team reached the base camp at 17,000 ft. The base camp is quite an inhospitable place, with narrow valley full of boulders. There is always a danger of rock fall from either side of the mountain faces.

Strong wind and snow slowed down the expedition a bit on subsequent days and a new strategy was devised with a group comprising Seema Tolia, G Anita Devi, Chaula Jagirdar and Prem Lata Aggarwal sitting up one more camp at 18,000 ft.

This four-member team set out early morning on April 17 for the Island summit, and keeping up a steady climbing pace, and fighting against the elements, they finally reached the summit at 7.30 am. But team leader Bachendri Pal was not satisfied. With only four women managing to reach the goal, she wanted some more women to go up. Hence, the next day, Chetna Sahoo and Sushma Bissa tried again, and reached IMJATSE. On reaching the summit, the Indian National Flag, the Tata flag and the Indian Airlines flag were unfurled.

After returning to the Capital, the team were felicitated by Prime Minister Atal Behari Vajapee and Delhi Chief Minister Sheila Dikshit. Bachendri Pal explained the route map to the Prime Minister and introduced the team members.

The PM appreciated the brave efforts of the women, and hailed their feat.
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Rajat, Sandeep guide IA into final
Our Sports Reporter

New Delhi, May 2
An all-round display by Rajat Bhatia (3 for 18) and crafty bowling by leg-spinner Sandeep Sawal helped Indian Airlines defeat Air Sahara by seven wickets and enter the final of the fifth All-India Jubilant Cup Cricket Tournament on the Gajraula ground.

Rajat Bhatia, who was named the man of the match, was presented a cash prize of Rs 1,000.

Due to a damp wicket, the match was reduced to 22 overs a side.

Scores: Air Sahara: 95 for 9 in 22 overs (Kapil Mehta 35, Umesh Choudhary 26, Rajat Bhatia 3 for 14, Sandeep Sawal 3 for 18). Indian Airlines: 96 for 3 in 19.4 overs (Rajat Bhatia 31n o, Safiq Khan 31 n o).

KLM Cargo enter semis

KLM Cargo beat Touchtel by 11 runs in the Reebok Cricket Tournament.

Scores: KLM Cargo: 182 for 8 in 25 overs (Mahesh Sharma 49, Sameer Sharma 33, Anil Bhagat 32, Vishesh Khanna 2 for 24, Sandeep Chawla 2 for 37).

Touchtel: 171 for 9 in 25 overs (Ashish Khurana 55, Nakul Verma 33, Nitin Sharma 31, Mahesh Sharma 3 for 18, Anil Bhagat 2 for 23).
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SG Sports record handsome victory
Our Sports Reporter

New Delhi, May 2
SG Sports, Meerut, recorded a handsome six-wicket victory against Collage Sports Management and entered the semi-final of the Davinder Singh Memorial Cricket Tournament.

SG Sports won the toss and put Collage into bat. They made 168 for 9 in 35 overs, but in reply, SG Sports werepushed to the wall when they lost four wickets for 54 runs.

But an unbeaten 115-run fifth-wicket partnership betweenParvinder and Rahat Elahi bailed them out from the tightspot, and guided them to victory.

SG Sports will take on Lal Bahadur Shastri Club in the semi-final on the Central Secretariat ground, Vinay Marg.Parvinder Singh, who scored an unbeaten 74, was adjudged the man of the match.

Scores: Collage Group: 168 for 9 in 35 overs (Sachin Chaudhary 74, 5x4; Surya Azad 30, Hemant Dogra 28, Farman Ahmad 3 for 41, Rajeev Uniyal 2 for 23, Rajeev Rathore 2 for 37). SG Sports: 169 for 4 in 33.3 overs (Parvinder Singh 73 no, Rahat Elahi 44 n o, Rajeev Uniyal 30, Anuj Kumar 3 for 20).
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