7 lakh Indians died of cancer last year: WHO


Download the report: http://www.iarc.fr/en/publications/pdfs-online/wcr/2008/wcr_2008.pdf

LONDON: Nearly seven lakh Indians die ofcancer every year, while over 10 lakh are newly diagnosed with some form of the disease.

According to the latest World Cancer Report from the World Health Organisation (WHO), more women in India are being newly diagnosed with cancer annually. As against 4.77 lakh men, 5.37 lakh women were diagnosed with cancer in India in 2012.

In terms of cancer deaths, the mortality rate among men and women in India is almost the same. While 3.56 lakh men died of cancer in 2012 in India, the corresponding number for women was 3.26 lakh.

One in every 10 Indians runs the risk of getting cancer before 75 years of age, while seven in every 100 runs the risk of dying from cancer before their 75th birthday.

Cancer of lip and oral cavity has emerged as the deadliest among Indian men while for women, it is breast cancer.

The top five cancers in men are lip/oral cavity, lung, stomach, colorectum and pharynx, while among women they are breast, cervix, colorectum, ovary and lip/oral cavity.

The global cancer burden jumped to 14.1 million new cases in 2012, with WHO saying the marked increase in breast cancers must be addressed.

The International Agency for Research on Cancer (IARC), WHO’s specialized cancer agency, has released the latest data on cancer incidence, mortality and prevalence worldwide.

The new version of IARC’s GLOBOCAN 2012 provides the most recent estimates for 28 types of cancer in 184 countries and offers a comprehensive overview of the global cancer burden. It reveals striking patterns of cancer in women and highlights that priority should be given to cancer prevention and control measures for breast and cervical cancers globally.

According to GLOBOCAN 2012, an estimated 14.1 million new cancer cases and 8.2 million cancer-related deaths occurred in 2012, compared with 12.7 million and 7.6 million, respectively, in 2008.

Prevalence estimates for 2012 show there were 32.6 million people (over the age of 15 years) alivewho had had a cancer diagnosed in the previous five years.

The most commonly diagnosed cancers worldwide were those of the lung (1.8 million, 13% of the total), breast (1.7 million, 11.9%), and colorectum (1.4 million, 9.7%). The most common causes of cancer death were cancers of the lung (1.6 million, 19.4% of the total), liver (0.8 million, 9.1%), and stomach (0.7 million, 8.8%).

Projections based on GLOBOCAN 2012 estimates predict a substantive increase to 19.3 million new cancer cases per year by 2025, due to growth and ageing of the global population. More than half of all cancers (56.8%) and cancer deaths (64.9%) in 2012 occurred in less developed regions of the world, and these proportions will increase further by 2025.

In 2012, 1.7 million women were diagnosed with breast cancer and there were 6.3 million womenalive who had been diagnosed with breast cancer in the previous five years. Since the 2008 estimates, breast cancer incidence has increased by more than 20%, while mortality has increased by 14%.

Breast cancer is also the most common cause of cancer death among women (522,000 deaths in 2012) and the most frequently diagnosed cancer among women in 140 of 184 countries. It now represents one in four of all cancers in women.

“Breast cancer is also a leading cause of cancer death in the less developed countries of the world,” says Dr David Forman, head of the IARC Section of Cancer Information, the group that compiles the global cancer data. “This is partly because a shift in lifestyles is causing an increase in incidence, and partly because clinical advances to combat the disease are not reaching women living in these regions.”

How Roundup weedkiller can promote cancer, new study from India reveals

1. How Roundup weedkiller can promote cancer, new study reveals
Sayer Ji
GreenMedInfo, 11 Nov 2013
[Links to sources and graphics included at weblink above]

Roundup herbicide (glyphosate) is in our air, rain, groundwater, soil and most food in the U.S., and an increasing body of research reveals it has cancer-promoting properties.

Researchers from the Indian Institute of Toxicology Research have recently confirmed the carcinogenic potential of Roundup herbicide using human skin cells (HaCaT) exposed to extremely low concentrations of the world’s best selling herbicide.

The researchers previously reported on glyphosate’s tumor promoting potential in a two-stage mouse skin carcinogenesis model[i] through its disruption of proteins that regulate calcium (Ca2+- ) signaling and oxidative stress (SOD 1), but were unable in these investigations to identify the exact molecular mechanisms behind how glyphosate contributes to tumor promotion.

The new study, published in the peer-reviewed journal ISRN Dermatology,[ii] sought out to clarify the exact mode of tumorigenic action, finding the likely mechanism behind glyphosate’s cancer promoting properties is through the downregulation of mitochondrial apoptotic (self-destructive) signaling pathways, as well as through the disruption of a wide range of cell signaling and regulatory components. Cell proliferative effects were induced by concentrations lower than .1 mM, and as low as 0.01 mM, which is four orders of magnitude lower than concentrations commonly used in GM agricultural applications (e.g. 50 mM). The fact that lower concentrations were more effective at inducing proliferation than higher concentrations (which suppressed cell growth), indicates that Roundup is a potent endocrine disrupter, and further highlights why conventional toxicological risk assessments are inadequate because they do not account for the fact that as concentrations are reduced certain types of toxicity — e.g. endocrine disruption — actually increase.

The researchers used the product Roundup Original (glyphosate 41%, polyethoxethyleneamine (POEA) ≅15%—Monsanto Company, St. Louis, MO, USA), and observed the following changes to human skin cells induced through exposure to this chemical mixture:

*Significant increases in cell proliferation (via disruption of CA2+ levels, i.e. decreased levels)
Increases oxidative stress, as measured by levels of ROS (reactive oxygen species)
*Cell-cycle dysregulation, marked by an accumulation of cells in S-phase (hallmark feature of cancer)
*Increased proliferating cell nuclear antigen (PCNA), a marker for increased cell proliferation
*Increased Bromodeoxyuridin (BrdU), a marker for increased cell proliferation
*Decreases in the level of the protein IP3R1, an indication of resistance to cell death
*Increases in Bcl-2 protein, a tumor promoter gene product
*Decreases in Bax proteins, a tumor suppressor gene product
*Caspase suppression (associated with prevention of cell death)
*Changes in the expression of the Ca2+- binding family of proteins (S100 family) S100A6/S100A9, associated with various cancers.

It is important to emphasize that while the researchers observed cell proliferation-associated changes in the expression of the Ca2+- binding proteins S100A6/A9 following glyphosate exposure to human skin cells, the implications of these findings reach beyond the skin cell lineage. They explained that related modifications of the expression pattern of S100A6/A9 protein have also been found in “hepatocellular carcinoma [15], lung cancer [16], colorectal cancer [17], and melanoma [18].”

The study included a diagram (shown below) representing graphically the multiple ways in which glyphosate disrupts cellular structure/function to contribute to uncontrolled cell proliferation.

The researchers summarized their findings as follows:

“In conclusion, in this study, we demonstrated that glyphosate may possibly exert proliferative effect in HaCaT cells by activating Ca2+ binding proteins to promote the imbalance of intracellular Ca2+ homeostasis and lessen SOD1 to increase ROS generation. This effect was partially reversed by treatment with antioxidant NAC indicating connections between oxidative stress and hypocalcaemia. Reduced Ca2+ levels enhance Bcl-2 and decrease Bax, subsequently leading to decrease in cytochrome c to stimulate further decrease of caspase 3 via the downregulation of IP3R1 level, thus halting apoptosis. The present study for the first time provides insight into the mechanism of glyphosate-induced neoplastic potential in mammalian skin system.”

It should be noted that their observation that the carcinogenicity of Roundup may be suppressed by the antioxidant n-acetyl-cysteine (NAC), which is a precursor to the cellular detoxifier and antioxidant known as glutathione and a readily available dietary supplement, has important implications, owing to how widespread exposure to Roundup herbicide has become, both through environmental exposures in air, soil, rain and groundwater, as well as in the tens of thousands of unlabeled products containing GM ingredients contaminated with physiologically significant levels of this chemical.

2. Emptying of Intracellular Calcium Pool and Oxidative Stress Imbalance Are Associated with the Glyphosate-Induced Proliferation in Human Skin Keratinocytes HaCaT Cells
Jasmine George and Yogeshwer Shukla
ISRN Dermatology
Volume 2013 (2013), Article ID 825180, 12 pages
Full text available free at:

Proteomics Laboratory, Indian Institute of Toxicology Research (CSIR), Mahatma Gandhi Marg, Lucknow, Uttar Pradesh 226001, India


We demonstrated that glyphosate possesses tumor promoting potential in mouse skin carcinogenesis and SOD 1, calcyclin (S100A6), and calgranulin B (S100A9) have been associated with this potential, although the mechanism is unclear. We aimed to clarify whether imbalance in between  levels and oxidative stress is associated with glyphosate-induced proliferation in human keratinocytes HaCaT cells. The  levels, ROS generation, and expressions of G1/S cyclins, IP3R1, S100A6, S100A9, and SOD 1, and apoptosis-related proteins were investigated upon glyphosate exposure in HaCaT cells. Glyphosate (0.1 mM) significantly induced proliferation, decreases , and increases ROS generation in HaCaT cells, whereas antioxidant N-acetyl-L-cysteine (NAC) pretreatment reverts these effects which directly indicated that glyphosate induced cell proliferation by lowering  levels via ROS generation. Glyphosate also enhanced the expression of G1/S cyclins associated with a sharp decrease in G0/G1 and a corresponding increase in S-phases. Additionally, glyphosate also triggers S100A6/S100A9 expression and decreases IP3R1 and SOD 1 expressions in HaCaT cells. Notably, Ca2+ suppression also prevented apoptotic related events including Bax/Bcl-2 ratio and caspases activation. This study highlights that glyphosate promotes proliferation in HaCaT cells probably by disrupting the balance in between  levels and oxidative stress which in turn facilitated the downregulation of mitochondrial apoptotic signaling pathways.

18 die of cancer in Punjab everyday

18 die of cancer in Punjab everyday
33,318 deaths reported in last five years, says first state-wide survey

Tribune News Service

Punjab State Report on Cancer Awareness and Symptom based Early Detection Campaign

Chandigarh, January 28
The first ever state-wide survey of cancer victims in Punjab has revealed high incidence of cancer in the Malwa belt, even as the cancer cases in the state are only a little more than the national average.

The survey has also reported average cancer prevalence of 216 cases per lakh population and suspected cancer cases of 319 per lakh population. If these two figures are taken into account, it seems a large number of cancer cases have been going undetected till now and that cancer incidence figures in Punjab could be much more than have been reported even in this survey. This was confirmed by Secretary, Health Vini Mahajan.

According to the survey, the overall figure of 90 cases per lakh population is only slightly more than the national average of 80 cases per lakh population. The situation, however, is grim in the Malwa region. The Malwa region has reported 107 cancer cases per lakh population as compared to 88 cases per lakh in the Doaba region and 64 cases per lakh population in Majha.

The report, which was released by Health Minister Madan Mohan Mittal today, states that the Muktsar district in the Malwa region has witnessed 136 cancer cases per lakh population – the highest in the state. Mansa comes a close second with 134.8 cases per lakh population, Bathinda third with 125.8 cases and Ferozepur fourth with 114 cases per lakh population. The survey has taken into record cancer cases reported to state health department workers who carried out a door-to-door campaign.

In Doaba, the cancer incidence is highest in Kapurthala district, which has reported 99 cases per lakh population. The Majha belt has least number of cancer cases. Tarn Taran has the least number of cases (41).

The Health Minister said a total of 23,874 cancer cases had been reported in the survey. As many as 33,318 cancer deaths have occurred in the state in the last five years (the break up comes out to be 18 deaths per day.) The survey data reveals that there are 84,453 persons in the state who have cancer-like symptoms.



Keeping cancer alive: State of Punjab


Author(s): Sonal Matharu
Date: Jul 15, 2012

Punjab has been in the grip of cancer for over a decade but the government has ignored the threat. Sonal Matharu reports with photographer Sayantoni Palchoudhuri from the state

image“If you want to live go to Bikaner,” neighbours told Raj Rani, who suffers from breast cancer

It all started with a knot in her left breast. Within no time it grew to the size of a tennis ball. In pain, 40-year-old Raj Rani went to the doctor in her village in Punjab’s Ferozepur district. Finding no relief, she started doing the rounds of government hospitals in Ludhiana and Faridkot and then a private hospital in Bathinda. Shelling out money at hospitals was not easy with a non-earning husband and sons bringing home little as small-time mechanics. By this time, a year had lapsed and Raj Rani’s health started deteriorating; she had stopped eating and had no hope of surviving.

Mukhtair Kaur of Jhajjar village in Bathinda thinks she got breast cancer because she beat her chest too much when her brother died. She has been a patient for the past 15 years Mukhtair Kaur of Jhajjar village in Bathinda thinks she got breast cancer because she beat her chest too much when her brother died. She has been a patient for the past 15 years“If you want to live, go to the hospital in Bikaner,” told her neighbours. With no option, she undertook a 10-hour road journey to Bathinda to board the train to Bikaner in Rajasthan, another nine-hour journey.

Doctors at Acharya Tulsi Regional Cancer Treatment and Research Center (RCC) removed her left breast and gave her chemotherapy. Three years later, Raj Rani sits patiently at the door of the hospital’s cancer out patient department for further check-ups.

“Correct treatment has kept me alive,” she says. Every district in Punjab is brimming with cancer cases. The Malwa region of Punjab, a cotton-growing belt, has the highest incidence of cancer in India, admitted Montek Singh Ahluwalia, deputy chairperson of the Planning Commission while releasing the plan for states for 2012-13.

Malwa region comprises the southern districts of Bathinda, Faridkot, Moga, Mukhtasar, Ferozepur, Sangrur and Mansa.

72-year-old Jaswant Kaur found she has breast cancer at a screening camp in Faridkot. Treatment will cost `2 lakh, doctors told her. She has resorted to taking unani medicine72-year-old Jaswant Kaur found she has breast cancer at a screening camp in Faridkot. Treatment will cost Rs 2 lakh, doctors told her. She has resorted to taking unani medicineAbsence of reasonable and quality treatment in Punjab forces hundreds of cancer patients to travel from faraway places to make a beeline for RCC, one of the 18 regional cancer research centres in the country.

In 2005, Down To Earth had reported the inadequate and expensive treatment for cancer in Punjab (‘Cancer train’, June 1-15) when Delhi non-profit Centre for Science and Environment (CSE) tested the blood samples of people living in Bathinda and found unacceptable levels of pesticides in them (‘Residue of a revolution’, Down To Earth, June 1-15, 2005).

Seven years later, government has done little to make treatment for cancer available in the state. Patients like Raj Rani still rely on the distant Bikaner hospital.

Patients wait outside the doctor’s room at RCCPatients wait outside the doctor’s room at Acharya Tulsi Regional Cancer CentreOptions too few

Bathinda, the hub of cancer in Punjab, has no facility to treat the disease in its civil hospital.

Patients have to choose between small private hospitals and the super-specialty Max Hospital. The hospital was built in November 2011 on government land through public-private partnership after government understood the cancer threat in the state.

But the hospital is run privately. It has the latest technology and equipment and the treatment bill can shoot up to lakhs of rupees.

“One chemotherapy session costs Rs 1.25 lakh. Treatment for pancreatic cancer can cost Rs 3.5 lakh,” says Manjinder Sidhu, oncologist at the hospital.

Both Karnail Singh and his wife Balbir Kaur of Jhajjar village in Bathinda are cancer patientsBoth Karnail Singh and his wife Balbir Kaur of Jhajjar village in Bathinda are cancer patientsPatients in the state decide against the Centrally-run Postgraduate Institute of Medical Education and Research in Chandigarh because it takes months to get admission there.

Eighty-year-old Karnail Singh and his wife Balbir Kaur, both cancer patients from Jhajjar village in Bathinda, opted for RCC. “Doctors in Bathinda robbed me,” says Singh. They kept getting the same tests done.

Each time it cost Rs 1,400. A farmer, he took loans for the initial treatment of his wife’s uterus cancer and his stomach cancer. Treatment at RCC added extra years to their lives. Balbir’s surgery and Karnail’s radiotherapy were done for free.

Medicines were also free. Investigations are cheap—Rs 50 each for biopsy and x-ray and CT scan. MRI costs about Rs 1,200.

Pappu Mamman, 50, awaits his chemotherapy session. He suffers from cancer in the oesophagusPappu Mamman, 50, awaits his chemotherapy session. He suffers from cancer in the oesophagusThe state government counters people’s allegations of poor facilities with a list—a brachytherapy machine at Government Medical College and Hospital in Patiala, a radiotherapy machine at Sri Guru Gobind Singh Medical College in Faridkot and a cobalt source machine at Sri Guru Ram Das Institute of Medical Sciences and Research Centre in Amritsar. But these are not enough.

The number of new cases from Punjab remains high, says Ajay Sharma, director, RCC. There has been no decline in the number of follow-up cases either.

In 2009, the hospital received 6,138 new cases and 45,357 follow-ups. In 2010, there were 6,295 new cases and 45,189 follow-ups. In 2011, new cases reduced to 5,787 and follow-up cases to 43,189.

However, the percentage of new cases that come from Punjab remains the same—60 to 70 per cent, says Sharma.

Government’s baby steps

To generate data on the magnitude and pattern of the disease, the Indian Council of Medical Research (ICMR) set up the national cancer registry programme in 1981 with centres at Mumbai, Bengaluru and Chennai.

Mamman being taken for chemotherapyMamman being taken for chemotherapyBut the programme failed to yield results. After high incidence of cancer cases were reported in Punjab, in 2010 the Centre asked the state to maintain a separate registry.

It was only in November 2011 that Punjab started maintaining such data. The drawback in the programme was that cancer cases that came only in government hospitals were to be reported.

On October 18, 2011, the state government made it mandatory for all public and private hospitals, pathological, clinical and radiological labs and medical institutions imparting medical education and providing diagnostic or treatment facility for cancer, to report all cancer cases to the pathology department of Government Medical College in Patiala. The college sends the data to ICMR for compilation.

Now, threat from uranium

While Punjab government is still trying to reach a conclusion on the link between pesticides and cancer, in 2009 a German laboratory tested hair samples of autistic children in Bathinda and found uranium, a carcinogen, in them.

A team from Bhabha Atomic Research Centre (BARC) carried out further tests and found that of nine water samples from Faridkot and Amritsar, three exceeded the Atomic Energy Regulatory Board’s (AERB) limit for uranium in drinking water of 60 µg/l (microgram per litre). Till 2011, BARC along with Guru Nanak Dev University had analysed 996 samples for uranium. Their report says, “Uranium concentration in water in a large number of samples is above the AERB specified limit of 60 µg/l in drinking water, the highest being 644 µg/l .”

Uranium concentration in 520 water samples from Bathinda, Mansa, Faridkot and Ferozepur ranged from 2.1 µg/l to 644 µg/l. In 92 water samples from remaining 13 districts—Taran Taran, Moga, Barnala, Sangrur, Ludhiana, Fatehgarh Sahib, Mohali, Ropar, Nawanshehar, Hoshiarpur, Gurdaspur, Amritsar and Pathankot—uranium content was between 0.1 µg/l and 153 µg/l.

However, the studies could not link the presence of uranium in Punjab water to high incidence of cancer. Epidemiological studies are required for the purpose.

According to the new registry, between December 2011 and June 2012, Patiala recorded 1,131 cases—highest in the state—and 74 deaths. The highest mortality was in Bathinda with 99 patients dying within six months.

But the numbers give just a fraction of the disease burden in the state. “In Patiala the number of cases is highest because the registry is located here,” says Manjit Singh Bal, professor and head of pathology department in Government Medical College, Patiala.

He also heads the registry programme. Doctors at faraway places do not bother to send data, he says. “They find filling forms a waste of time,” he adds.

Ailing state

Taking suo motu cognizance of media reports on rising cancer cases, in August 2011 the National Human Rights Commission (NHRC) asked the Punjab government what steps it had taken to check the problem.

The state government submitted two reports—on September 20, 2011, and February 27, 2012—saying it had banned 20 pesticides in Malwa and withdrawn their registrations. But it did not mention the names of the pesticides or the crops on which they were used. Pesticide suppliers do not even know of the ban.

“There is no government ban on pesticides,” says Chaitar Singh, a pesticide supplier in Chaina Bazar, Faridkot.

In the second report to NHRC, principal secretary, health and family welfare department, accepted that use of pesticides “was on the higher side in Malwa region on account of growing of cotton crop. But in the last four to five years, its use has reduced because farmers have switched to Bt cotton which requires 20 per cent of the pesticides used for earlier cotton varieties”.

State government data contradicts the statement. Reduction in pesticide use has been negligible in the past few years—from 5,975 tonnes in 2006-07, it came down to 5,690 tonnes in 2010-11.

Jarnail Singh, a farmer since 1970 in Bathinda, says between 1992 and 2004 pesticides were extensively used on cotton crop. When Bt cotton was introduced in 2004, there were no pests in the first two years. But new pests started attacking soon and farmers resorted to extensive pesticide spraying.

Offering lip service

In July 2011, the Punjab government entitled all cancer patients to get Rs 1.5 lakh for treatment from the chief minister’s fund. Till May 2012, it has spent over Rs 30 crore to treat 3,329 patients.

imageTreatment at the super-specialty Max Hospital in Bathinda is too expensiveBut the scheme is of little help because the amount goes directly to the hospital where the patients get treated. “We have to purchase all the medicines,” says Amarjit Singh. He buys injections for his younger brother who has stomach cancer. “One injection costs Rs 25,000,” he says as he waits at the Bathinda platform to take the train to Bikaner.

Max Hospital has treated 90 patients for cancer ever since the hospital started. Of these, 40 applied for money under the scheme, but only 24 could avail the privilege. Four of them passed away during treatment.

Doctors at Punjab seem to have left treatment to godsDoctors at Punjab seem to have left treatment to godsPromises made by political parties carry little meaning. In January, the state government announced it would set up a cancer hospital in Bathinda.

The four main parties in the state—Congress, Shiromani Akali Dal, Bharatiya Janata Party and People’s Party of Punjab—for the first time included the issue of high cancer incidence in their election manifestoes.

But residents are not convinced. “These were hollow promises just to win votes,” says Amarjit Singh.

“Waiting for people to get the disease and then offering them treatment is not the answer,” says G P I Singh, dean of Adesh Institute of Medical Sciences and Research in Bathinda and convener of Environmental Health Action Group, a non-profit. “We need to map the entire state to find out why the fatal disease is occurring,” he says.