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Cancer in India: Prevention, Early Detection, and the Human Side of Oncology

Khushi Khandelwal — Wed, 01 Apr 2026 06:30:00 +0000

Brig. (Dr.) Arvind Kumar Tyagi is a senior surgical oncologist and Director of Surgical Oncology & Robotic Surgery at Yashoda superspeciality hospital & cancer institutes. He was interviewed by Dr. Soumya Singh, Creative Editor at InnoHEALTH m agazine on the importance of prevention, early diagnosis, and compassionate, patient-centric care in improving cancer outcomes across the country.

Cancer is increasingly recognized as a major public health challenge. How significant is its impact today?

Cancer has emerged as one of the leading causes of death worldwide and in India. In a country with a population exceeding 1.4 billion, the absolute number of cancer cases is substantial. What makes this burden particularly concerning is that many cancers are preventable or treatable if detected early. Late presentation, lack of awareness, and lifestyle-related risk factors continue to drive high mortality, making cancer not only a medical issue but a public health priority.

Your professional journey is unique, combining military service with medicine. How has that experience shaped your approach to cancer care?

Training and serving as a paratrooper instills discipline, resilience, and the ability to perform under extreme physical and mental pressure. Military medicine demands precision, teamwork, and rapid decision-making—qualities that translate directly into surgical oncology. Exposure to high-risk environments and leadership roles strengthens accountability and calmness, which are essential when dealing with complex cancer surgeries and emotionally challenging patient care. The soldier’s mindset reinforces the commitment to duty, perseverance, and service to humanity.

What exactly is cancer, and why can it develop in almost any part of the body?

Cancer originates from the body’s own cells when they lose normal regulatory control and begin to divide uncontrollably. These abnormal cells can invade nearby tissues or spread to distant organs. Since every organ in the body is composed of cells, cancer can arise virtually anywhere. This is why cancer is not a single disease but a diverse group of diseases, each with distinct behavior, prognosis, and treatment strategies.

What are the most common risk factors for cancer, especially in the Indian population?

Cancer is multifactorial. In India, tobacco use—both smoking and chewing—is one of the most significant contributors, particularly to oral, throat, and lung cancers. Alcohol consumption, air pollution, obesity, physical inactivity, and poor dietary habits also increase risk. Certain infections, such as Hepatitis B and C or Human Papillomavirus, are known causes of liver and cervical cancers respectively. Genetic predisposition plays a role in some cancers, but lifestyle and environmental factors remain dominant contributors.

Can lifestyle changes genuinely reduce the risk of developing cancer?

Yes, lifestyle modification can significantly reduce cancer risk. Avoiding tobacco and excessive alcohol, maintaining a healthy body weight, engaging in regular physical activity, eating a balanced diet, and ensuring adequate sleep all strengthen immunity and reduce cancer incidence. While genetic factors are beyond control, lifestyle choices are powerful tools for prevention and long-term health.

What early warning signs or symptoms should people be vigilant about?

Any unexplained bleeding—from the mouth, nose, urine, or stools—should never be ignored. Persistent lumps or swellings in the breast, neck, armpit, or groin require prompt evaluation. Sudden weight loss, loss of appetite, prolonged fatigue, or unexplained pain are also warning signs. Awareness of one’s own body and early medical consultation can lead to timely diagnosis and improved outcomes.

How important is early detection, and what screening tests are advisable?

Early detection dramatically improves survival rates. Cancers identified at early stages are often curable. Screening tests such as Pap smears for cervical cancer and mammography for breast cancer are particularly valuable. Ultrasound examinations can help detect certain abdominal cancers. Advanced imaging techniques like PET scans are primarily used for staging rather than routine screening due to cost and limited applicability.

There are many myths surrounding cancer. Which misconceptions need to be corrected?

A common myth is that sugar causes or “feeds” cancer. In reality, all cells—healthy and cancerous—require sugar for energy; sugar itself does not cause cancer. Another misconception is that only smokers develop cancer, whereas non-smokers can also develop cancer due to genetic, infectious, or environmental factors. Such myths can delay diagnosis and distract from genuine preventive measures.

How has cancer treatment evolved, particularly in surgical oncology and technology?

Advances in surgical techniques, including minimally invasive and robotic surgery, have improved precision and recovery in selected cases. However, these technologies are not suitable for all cancers, especially large or advanced tumors where open surgery remains essential. Artificial intelligence and advanced imaging assist in diagnosis and planning, but the surgeon’s expertise, judgment, and hands-on skill remain irreplaceable.

Can cancer be cured, and what is the most important message for the public?

Many cancers are curable when detected early. Early-stage cancers respond well to treatment, while advanced-stage cancers are often managed to prolong life and improve quality of life rather than cure. The most important message is prevention and awareness: avoid tobacco, limit alcohol, exercise regularly, maintain a healthy weight, eat a balanced diet, sleep adequately, and seek medical evaluation early. A disciplined lifestyle—much like military training—can be the strongest defense against cancer.

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Preventive Medicine: An Urgent Imperative

Khushi Khandelwal — Wed, 25 Dec 2024 10:30:00 +0000

Dr. Chandreshkumar Sudani

In the past decade of my clinical practice, I have encountered numerous patients brought to the hospital in life-threatening conditions. Among them were several young individuals who, despite having no prior medical history, required ICU admission due to major health issues such as heart attacks, strokes, kidney or liver dysfunction, and other serious conditions. During the assessment of their medical histories, no significant health issues were identified before hospitalization. Unfortunately, some of these young patients succumbed to their ailments. When questioned by the patients’ relatives about the preventability of these clinical conditions, doctors responded affirmatively, emphasizing that prior health check-ups might have detected abnormal parameters earlier.

The modern lifestyle, characterized by altered food habits and disrupted sleep patterns, underscores the importance of identifying minor health issues in their early stages to prevent major catastrophic events. While individuals invest significantly in health insurance to mitigate the financial impact of hospitalization, they often neglect preventive measures. Many diseases are preventable, and the progression of these conditions can be controlled or reduced with timely interventions. Therefore, preventive medicine warrants equal importance alongside therapeutic management. As the saying goes, it is better to build dams than to wait for the flood.

Preventive medicine involves promoting health measures to avert disease, a form of prophylaxis that reduces the risks of diseases, disabilities, and death. There are four levels of prevention:

Primordial prevention: Preventing the occurrence or development of risk factors.

Primary prevention: Preventing disease when a risk factor is present.

Secondary prevention: Preventing the complications of an existing disease.

Tertiary prevention: Preventing disability or death from an existing disease.

By the time individuals seek medical consultation, they often already have established diseases or risk factors. While doctors can provide medications for secondary or tertiary prevention, primordial and primary prevention are equally vital, emphasizing the proverb that prevention is better than cure.

Consider, for example, a young overweight individual presenting with persistent headaches and elevated blood pressure. Treating the high blood pressure with medications constitutes secondary prevention. However, had the same individual consulted a doctor a few years earlier when noticing weight gain, the doctor might have advised lifestyle modifications to control body weight, representing primary prevention. If attention had been given to healthy food, nutrition, and exercise before weight gain occurred, this health education would be considered primordial prevention.

Physicians can guide individuals in adopting preventive health measures, emphasizing that preventive measures extend beyond medications to include simple lifestyle modifications, exercises, nutrition, and health awareness. While abundant information on healthy living is available on the internet, individuals often struggle to discern when to consult a doctor in the absence of active health issues.

Even in the absence of symptoms, it is advisable for individuals to undergo routine health check-ups annually. Early detection of abnormal parameters is fundamental to preventive medicine. These check-ups should include blood investigations (complete blood picture, renal function test, liver function test, thyroid profile, random blood sugar, and lipid profile), ECG, 2D-ECHO, and abdominal ultrasonography. If all results fall within normal limits, primordial prevention—incorporating healthy food, nutrition, exercises, and discouraging alcohol, smoking, and drug use—is sufficient.

For individuals with deranged lipid profiles and elevated cholesterol levels, dietary and lifestyle modifications are recommended as cholesterol is a risk factor for sudden heart attacks. Similarly, individuals with higher blood sugar levels can implement lifestyle changes, exercise, and dietary modifications to maintain HbA1c below 5.7%, avoiding the need for medications.

Awareness about health-related issues can aid in identifying major health concerns early. By cultivating the habit of periodic health status checks, many diseases can be prevented. Even healthy individuals should consult a doctor annually to discuss health check- up reports, allowing for preventive measures. Further investigations may be necessary if preliminary reports are abnormal, requiring regular follow-up with a doctor.

Common preventive measures advised by doctors to healthy individuals include:

Periodic measurement of blood pressure.

Annual blood tests to identify diabetes, thyroid disorders, and dyslipidaemia.

Breast cancer screening for women over 40 years and colon cancer screening for men aged 50 to 75 years.
Smoking, alcohol, and drug cessation.

Avoidance of a sedentary lifestyle and maintenance of a healthy body weight.

Regular vaccination and immunization.

Hand and oral hygiene.

Preventive care investigations or tests may vary by age group, with cancer screening and bone density screening becoming more relevant to elderly people. Despite the absence of apparent health issues, everyone should prioritize preventive healthcare for several reasons:

Preventive healthcare identifies problems before symptoms manifest, facilitating early disease detection.
It prevents the progression of diseases, averting complications.
Regular health check-ups provide peace of mind, allowing individuals to discuss concerns with doctors and receive necessary support.
While health insurance covers treatment costs, preventive healthcare identifies major health issues before they become severe, potentially avoiding costly advanced treatments.
Those who care for others must prioritize their health to fulfill their role effectively.

Individuals are the heart and soul of their families, and it is crucial for them to prioritize their health through timely preventive care.

Author’s biography

Dr. Chandreshkumar Sudani has been working in the department of critical care as senior Intensivist. He has shown great contribution in public health by spreading awareness about preventive medicine.

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AI Engraving Footprints on Healthcare Transcontinental Canvas

InnoHEALTH Magazine — Fri, 21 Dec 2018 07:22:38 +0000

SIR ALEXANDER FLEMING, the discoverer of Penicillin, shared the Nobel Prize for Medicine in 1945. But when he arrived in Stockholm to receive the award he had a bad cold. Throughout the ceremony, he used his handkerchief repeatedly. Later when he was leaving, his eyes were still watery, and he was still sniffing. One of the officials shook his head sympathetically and said, “No good for colds”. EE Edgar January 1965.

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But, it was a stunning discovery that changed the course of history. The active ingredient, which Fleming named Penicillin, turned out to be an infection-fighting agent of enormous potency. When it was finally recognized for what it was, the most efficacious life-saving drug in the world, Penicillin altered forever the treatment of bacterial infections.

Now, it is turn of AI (Artificial Intelligence) that is making fast forays in a broad-spectrum of disciplines, and medical diagnostics and treatment field is paving way for intrusion of AI.

Across the world, race is underway to exploit AI for good of patients. Many say it is not much away from tipping point: those who will take timely advantage of it or those who are set to miss the opportunity at the initial moments.

In India, AI ball has started rolling in the wake of the huge potential of the healthcare network and an ever-burgeoning population of 130 crore people. A discussion paper on National Strategy for Artificial Intelligence prepared by NITI Aayog team which included, Arnab Kumar, Punit Shukla, Aalekh Sharan, and Tanay Mahindru, came up for discussions recently and moves are afoot to proceed further.

The paper delved at length on various dimensions of AI. It said NITI Aayog is working with Microsoft and Forus Health to roll out the technology for early detection of diabetic retinopathy as a pilot project. 3Nethra, developed by Forus Health, is a portable device that can screen for common eye problems. Integrating AI capabilities to this device using Microsoft’s retinal imaging APIs enables operators of 3Nethra device to get AI-powered insights even when they are working at eye checkup camps in remote areas with nil or intermittent connectivity to the cloud.

The resultant technology solution also solves for quality issues with image capture and systems checks in place to evaluate the usability of the image captured.

AI-based healthcare solutions can also help in making healthcare services more proactive – moving from “sick” care to true “health” care, with emphasis on preventive techniques.

AI solutions can augment the scarce personnel and lab facilities; help overcome the barriers to access and solve the accessibility problem; through early detection, diagnostic, decision-making and treatment, cater to a large part of India.

Cancer screening and treatment, the paper says, is an area where AI provides tremendous scope for targeted large-scale interventions. India sees an incidence of more than 1 million new cases of cancer every year, and early detection and management can be crucial in an optimum cancer treatment regimen across the country.

NITI Aayog is in the advanced stage for launching a programme to develop a national repository of annotated and curated, despite the obvious economic potential, the healthcare sector in India remains multi-layered and complex and is ripe for disruption from emerging technologies at multiple levels.

It is probably the most intuitive and obvious use case primed for intervention by AI-driven solutions, as evidenced by the increasing activity from large corporates and start-ups alike in developing AI focused healthcare solutions.

Researchers said the Adoption of AI for healthcare applications is expected to see an exponential increase in the next few years. The increased advances in technology and interest and activity from innovators provides an opportunity for India to solve some of its long-existing challenges in providing appropriate healthcare to a large section of its population. AI combined with robotics and Internet of Medical Things (IoMT) could potentially be the new nervous system for healthcare, presenting solutions to address healthcare problems and helping the government in meeting the above objective pathology images. Another related project under discussions is an Imaging Biobank for Cancer.

In US, Viz.ai, Inc., an applied artificial intelligence healthcare company a few months back announced that the U.S. Food and Drug Administration (FDA) has granted a De Novo request for the first-ever Computer-Aided Triage and Notification Platform to identify Large Vessel Occlusion (LVO) strokes in CTA imaging. This regulatory clearance compliments Viz.ai’s recent European CE Mark for the product in January 2018.

“The Viz.ai LVO Stroke Platform is the first example of applied artificial intelligence software that seeks to augment the diagnostic and treatment pathway of critically unwell stroke patients,” said Dr. Chris Mansi, Neurosurgeon and Chief Executive Officer. “We are thrilled to bring artificial intelligence to healthcare in a way that works alongside physicians and helps get the right patient, to the right doctor at the right time.”

Stroke is a serious and time-sensitive medical condition that requires emergency care and can cause lasting brain damage, long-term disability, and death. A stroke occurs if the flow of oxygen-rich blood to a portion of the brain is blocked. When this happens 2 million brain cells die every minute. “This software device could benefit patients by notifying a specialist earlier thereby decreasing the time to treatment. Faster treatment may lessen the extent or progression of a stroke,” said Robert Ochs, Ph.D., Acting Deputy Director for Radiological Health, Office of In Vitro Diagnostics and Radiological Health in the FDA’s Center for Devices and Radiological Health.

The Viz.ai LVO Stroke Platform was developed using deep learning, a revolutionary technique where algorithms learn how to identify patterns in data from millions of prior examples. The Viz.ai system connects to a hospital CT scanner and alerts the stroke specialist that a suspected LVO stroke has been identified, sending the radiological images directly to their smartphone.

In a 300-patient performance study, the Viz.ai LVO Stroke Platform obtained an AUC of 0.91, identifying LVOs and alerting the relevant specialist with 90% sensitivity and specificity and a median scan to notification time of under 6 minutes. In over 95% of cases, the automatic notifications demonstrated faster notification of the specialist, saving between 6 and 206 minutes, with an average time saving of 52 minutes.

“Timely LVO stroke identification and transfer to a specialist hospital that can perform mechanical thrombectomy is the top priority for LVO stroke patients,” said Dr. Raul Nogueira, Professor of Neurology, Neurosurgery and Radiology at Emory University and the Immediate-Past President, Society of Vascular & Interventional Neurology. “This software is designed to help identify appropriate patients earlier and more often, and enable faster transfer and treatment, which, ultimately may result in improved patient outcomes.

Noted Cardiologist ERC Topol, who is Professor of Genomics and holds the Scripps endowed chair in innovative medicine, has now written a book that calls for the “creative destruction” of the current medical paradigm, which he believes has failed to keep up with the digitized world of interactivity, social media, computers, apps, and advanced engineering and electronics.

In his book, he lambasts current day medicine as being archaic and wasteful, making his case with a compelling blend of statistics, anecdotes. Prof. Topol believes that consumers teaming up with innovators in the med-digital world are the key to forcing change, which is certainly true. But how exactly will this work?

The NITI Aayog discussion paper says AI is a constellation of technologies that enables machines to act with higher levels of intelligence and emulate the human capabilities of sense, comprehend and act. Thus, computer vision and audio processing can actively perceive the world around them by acquiring and processing images, sound and speech.

The natural language processing and inference engines can enable AI systems to analyze and understand the information collected. An AI system can also act through technologies such as expert systems and inference engines or undertake actions in the physical world. These human capabilities are augmented by the ability to learn from experience and keep adapting over time. AI systems are finding ever-wider application to supplement these capabilities across enterprises as they grow in sophistication. The paper says healthcare is one of the most dynamic, yet challenging, sectors in India, and is expected to grow to USD 280 billion by 2020, at a CAGR of upwards of 16%, from the current ~USD 100 billion.

Adoption of AI for healthcare applications is expected to see an exponential increase in the next few years. Technology disruptions like AI are once-in-generation phenomenon, and hence large-scale adoption strategies, especially national strategies, need to strike a balance between narrow definitions of financial impact and the greater good. NITI Aayog has decided to focus on five sectors that are envisioned to benefit the most from AI in solving societal needs: a) Healthcare: increased access and affordability of quality healthcare; b) Agriculture: enhanced farmers’ income, increased farm productivity and reduction of wastage; c) Education: improved access and quality of education; d) Smart Cities and Infrastructure: efficient connectivity for the burgeoning urban population; and e) Smart Mobility and Transportation: smarter and safer modes of transportation and better traffic and congestion problems.

Yet, it faces major challenges of quality, accessibility, and affordability for a large section of the population:

A: Shortage of qualified healthcare professionals and services like qualified doctors, nurses, technicians and infrastructure: as evidenced in 0.76 doctors and 2.09 nurses per 1,000 population (as compared to WHO recommendations of 1 doctor and 2.5 nurses per 1,000 population respectively) and 1.3 hospital beds per 1,000 population as compared to WHO recommended 3.5 hospital beds per 1,000 population.

B: Non-uniform accessibility to healthcare across the country with physical access continuing to be the major barrier to both preventive and curative health services, and glaring disparity between rural and urban India. With most of the private facilities concentrated in and around tier 1 and tier 2 cities, patients have to travel substantial distances for basic and advanced healthcare services.

The problem is further accentuated by lack of consistent quality in healthcare across India, most of the services provided are individually driven rather than institution driven, and less than 2% of hospitals in India are accredited.

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