Key Takeaways:

1.  India's cancer control strategy should include taxation on tobacco, promotion of physical activity, and evidence-based healthcare.

2. There is a pressing need for a unified, three-tier approach to cancer care, reducing disparities between urban and rural regions.

Summary of the session:

The 6th Professor Prakash Shetty Public Lecture, held in memory of the late polymath, was hosted at the Pope Paul VI Auditorium, St. John’s National Academy of Health Sciences on September 24, 2024. This event, organized by St. John’s Research Institute, saw esteemed guests, doctors, and scholars gather to commemorate the legacy of Professor Prakash Shetty, a distinguished figure known for his contributions to medical sciences, philosophy, literature, politics, Indian culture, and the arts. The keynote speaker for the event was Dr. Rajendra A. Badwe, a Padma Shri awardee, Professor Emeritus, and former Director of the Tata Memorial Centre.

The event began with a warm welcome address by Fr. Jesudoss Rajamanickam, who opened the session with reflections on Professor Prakash Shetty’s profound impact across various disciplines. The address celebrated Professor Shetty’s unique ability to blend science with philosophy, culture, and the arts, making his contributions stand out both in India and on the global stage. The event was structured as a public lecture to continue the academic legacy of Professor Shetty, who was a beloved teacher, researcher, and a thought leader in the history of medicine.

Recorded Message by Dr. Sumitra

One of the key segments of the event was a recorded message by Dr. Sumitra, a close colleague of Professor Shetty. In her message, Dr. Sumitra highlighted the significance of the Nutrition Department, which Professor Shetty helped establish. She credited him for laying the foundations of a modern nutrition curriculum, emphasizing its role in improving public health, particularly in India. She expressed deep gratitude, reminiscing about how his influence still reverberates within the walls of the department and beyond. Her words reflected the deep respect and admiration held for Professor Shetty, not just as a professional but also as a compassionate individual.

Introduction of Dr. Rajendra Badwe

Following Dr. Sumitra’s message, Dr. Hari Menon took the stage to introduce the keynote speaker, Dr. Rajendra Badwe. Dr. Menon spoke highly of Dr. Badwe’s warm demeanor and his consistent focus on supporting and uplifting his colleagues. He shared personal anecdotes illustrating Dr. Badwe’s humility and dedication to cancer care. Dr. Menon emphasized that no one else could better address the topic of “Indian Society & Cancer,” especially given Dr. Badwe’s extensive experience in oncology and healthcare management.

Keynote Lecture by Dr. Rajendra Badwe: "Indian Society & Cancer"

Dr. Rajendra Badwe’s lecture was a profound exploration of the state of cancer in Indian society, the socio-economic factors affecting cancer care, and the challenges posed by lifestyle changes. Dr. Badwe began by discussing the concept of lateral movement and the loss of horizontal vision. He explained that this metaphor referred to how society’s focus on short-term goals and segmented approaches had caused a loss of comprehensive, long-term vision in the healthcare sector. This lack of a unified approach, he argued, had created disparities in cancer care across urban and rural areas in India.

The Three-Tier System: Dr. Badwe introduced the concept of a three-tier system in cancer care, explaining how cancer cases differ based on geographical location—cities, towns, and rural areas. In cities, cancer detection and treatment rates are relatively higher due to better infrastructure, while towns and rural areas struggle with early detection and effective treatment. Dr. Badwe shared results from a house-to-house cancer survey conducted in rural areas, where no undiagnosed cancer cases were found, suggesting the need for more systematic efforts in such regions.

Diet and Cancer: Dr. Badwe highlighted the role of diet in cancer prevention, particularly in India. He noted that colon cancer rates have remained relatively low in India due to traditional dietary habits, such as millets, including the consumption of spicy foods and a reduced intake of non-vegetarian meals. However, he warned that the increase in tobacco consumption was causing a rise in colon cancer cases. Tobacco remains one of the major contributors to cancer in India, with 1 million tobacco-related deaths per year during the 2010s. Dr. Badwe advocated for a cancer control strategy centered around taxing tobacco products—what he referred to as a “triple tax system.” He argued that tripling taxes on tobacco could halve its consumption while simultaneously doubling government revenue.

Breast and Cervical Cancer Trends: Turning to specific cancer types, Dr. Badwe discussed the increase in breast cancer rates in India, particularly among urban women. He attributed this rise to lifestyle changes, including delayed childbearing and reduced breastfeeding. In contrast, cervical cancer rates are declining, thanks to increased awareness and improved screening practices.

Obesity and Childhood Lifestyle Changes

Dr. Badwe also raised concerns about the growing rates of childhood obesity in India. He pointed out that modern children no longer experience hunger in the way previous generations did, due to the easy availability of food. Combined with a lack of physical activity, this has resulted in rising obesity rates, which are closely linked to an increase in cancer cases. He stressed the importance of creating “walking cities” where people are encouraged to walk more as a way to combat the sedentary lifestyle that contributes to cancer.

Hub and Spoke Model of Cancer Care

Dr. Badwe then elaborated on the Hub and Spoke Model of cancer care, which has been successfully implemented at the Tata Memorial Centre (TMC). In this model, major cancer centers serve as hubs, while smaller centers in towns and rural areas act as spokes, enabling wider access to care. He emphasized the importance of uniform care and advocated for the national cancer grid, which aims to eliminate disparities in cancer treatment across different regions.

Addressing Financial and Emotional Support

Dr. Badwe didn’t shy away from discussing the financial and emotional challenges (financial toxicity) faced by cancer patients. He pointed out that many patients struggle with the cost of treatment, finding accommodation near cancer centers, and understanding the complexities of their disease. He stressed the need for better financial support systems, increased patient awareness, and improved emotional support services for both patients and their families.

Conclusion and Key Takeaways

Dr. Badwe concluded his lecture by urging for continuous research and improvements in healthcare delivery. He emphasized that healthcare providers must strive to “do better than yesterday” and that addressing lifestyle changes, improving cancer care infrastructure, and implementing robust preventive measures are crucial steps toward reducing cancer cases in India. He closed his talk by warning against the commercialization of cancer care, stating, “It is good to come to terms with reality, but it is bad to sell cancer.”

Closing Session and Vote of Thanks

Following the insightful lecture, a Q&A session was held, where audience members posed thoughtful questions, which Dr. Badwe answered with precision and clarity. The event ended with a token of appreciation presented to Dr. Badwe by Dr. Charles, and a vote of thanks delivered by Dr. Tony Raj, Dean of St. John's, who expressed gratitude to all participants for their contributions.

This session was a fitting tribute to Professor Prakash Shetty, celebrating his legacy by continuing the conversation on public health and cancer care in India. Dr. Rajendra Badwe’s lecture left the audience with much to reflect upon, particularly concerning the future of cancer treatment and prevention in the country.

Feedback analysis, from the students of St.John’s Medical College and Christ University.

The students shared a positive feedback about the event. Many appreciated the depth of knowledge presented by Dr. Rajendra Badwe, particularly his insights into the socio-economic factors affecting cancer care in India. His ability to explain complex medical concepts in an understandable manner made the lecture both engaging and educational for students from diverse academic backgrounds.

Several students mentioned that Dr. Badwe's focus on the lateral movement and loss of horizontal vision highlighted the importance of a holistic approach in healthcare—a concept they found crucial not only for cancer care but also for general public health policies. The idea of a three-tier system in addressing cancer disparities between rural and urban areas was seen as practical and actionable, and students were inspired by the Hub and Spoke model used at the Tata Memorial Centre.

The session also encouraged students to reflect on lifestyle changes, particularly regarding the increasing rates of childhood obesity. Many expressed that they gained valuable awareness about the importance of preventive measures, such as promoting active lifestyles and addressing tobacco use. Overall, the event fostered a deeper understanding of healthcare challenges in India and inspired students to think critically about future solutions.