National cancer control programme

ndia is one of the developing countries who have national cancer control programme (NCCP). We started way back in 1975 and the plan has been revised three times. The first revision was in 1984, second one in 1991 and third one 2004.

1. DR.ANJALATCHI MUTHUKUMARAN VICE PRINCIPAL ERA COLLEGE OF NURSING NATIONAL CANCER CONTROL PROGRAMME

2. Introduction Cancer is an important public health problem with 8 to 9 lakh cases occurring every year. At any point of time, it is estimated that there are nearly 25 lakh cases in the country. Every year about 4 lakh deaths occur due to cancer. 40% of the cancers in the country are related to tobacco use. Data from population based registries under the National Cancer Registry Programme indicate that the leading sites of cancer among men are cancer of oral cavity, lungs, oesophagus and stomach and among women are cancer of uterine cervix, breast and oral cavity. Cancers namely those of oral and lungs in males and cervix and breast in females account for over 50% of all cancer deaths in India

3. Established in National Cancer Control Programme is a centrally sponsored scheme by the Ministry of Health and Family welfare, Government of India, which was initiated in the year  1975 , with priorities given for equipping the premier cancer hospitals/institutions.

4. NCCP recognized by GOI How many national cancer control Programme has been Recognised by the Government of India? India is one of the developing countries who have national cancer control programme (NCCP). We started way back in 1975 and the plan has been revised  three times . The first revision was in 1984, second one in 1991 and third one 2004. Every time we have brought out a report.

5. National Cancer Registry Programme (NCRP): For data base of cancer cases, National Cancer Registry Programme (NCRP) was initiated in 1982 by ICMR, which gives a picture of the magnitude and patterns of cancer . There are two types of registries; Population Based Cancer Registry and Hospital Based Cancer Registries, which was started in January 1982.

6. Evolution of NCCP 1975-76 National Cancer Control Programme It was launched with priorities given for equipping the premier cancer hospital/institutions . Central assistance at the rate of Rs.2.50 lakhs was given to each institution for purchase of cobalt machines. 1984-85 The strategy was revised and stress was laid on primary prevention and early detection of cancer cases. 1990-91 District Cancer Control Programme was started in selected districts (near the medical college hospitals). 2000-01 Modified District Cancer Control programme initiated. 2004 Evaluation of NCCP was done by National Institute of Health & Family Welfare, New Delhi. 2005 The programme was further revised after evaluation.

7. GOALS & OBJECTIVES OF NCCP 1 . Primary prevention of cancers by health education specially regarding hazards of tobacco consumption and necessity of genital hygiene for prevention of cervical cancer . 2. Secondary prevention i.e. early detection and diagnosis of cancers, for example, cancer of cervix, breast and of the oro -pharyngeal cancer by screening methods and patients’ education on self examination methods. 3 . Strengthening of existing cancer treatment facilities, which are woefully inadequate . 4. Palliative care in terminal stage of the cancer.

8. basic step of national cancer control Programme ? But because of the wealth of available knowledge, all countries can, at some useful level, implement the four basic components of cancer control   prevention, early detection, diagnosis and treatment, and palliative care   and thus avoid and cure many cancers, as well as palliating the suffering.

9. Existing Schemes under National Cancer Control Programme (NCCP) as on 1st June 2008 1.Recognition of New Regional Cancer Centres (RCCs ): to enhance the cancer treatment facilities across the country and reduce the geographical gap in the country in the availability of cancer care facilities, New Regional Cancer centres are being recognized. A one-time grant of Rs. 5.00 crores is being provided for New RCC’s.

10. Continued 2. Strengthening of existing Regional Cancer Centres : A one-time grant of Rs.3.00 crores is provided to the existing Regional Cancer Centres to further strengthen the cancer care services.

11. Continued 3. Development of Oncology Wing: Government Hospitals & Government Medical Colleges are provided with a grant of Rs. 3.00 crores for the development of Oncology Wing.

12. Continued 4. District Cancer Control Programme : The DCCP will be implemented by a nodal agency, which may be a Regional Cancer Centre or Government Medical College or Government Hospital with radiotherapy facility. A cluster of 2-3 districts are taken up for prevention, early detection, minimal treatment and provision of supportive cancer care at district levels. A grant-in-aid of Rs. 90.00 lakhs spread over a period of 5 years is provided per DCCP proposal.

13. 5. Decentralized NGO Scheme: A grant of Rs. 8000/- per camp will be provided to the NGOs for IEC activities.The funds are released through a Nodal agency which could be a Regional Cancer Centre or Government Medical College or Governmenthospital with radiotherapy facilities.

14. Regional Cancer Centres : As of now, there are 27 Regional Cancer Centres , including 6 NGOs, providing comprehensive cancer care services. Outreach and research activities in prevention and treatment of cancers are carried out by these centres . (List of Regional Cancer Centres given in Annexure I)

15. National Cancer Registry Programme ? Welcome to National Cancer Registry Programme . The main objectives of the project are: ( i ) To obtain an overview of patterns of cancer in different parts of the country ; ( ii)  To calculate estimates of cancer incidence wherever feasible .

16. Oncology wing: Support has been given to 82 institutes in both Government Medical Colleges and Government Hospitals for development of Oncology wing. At present there are 246 institutions with radiotherapy facilities across the country, including the 27 Regional Cancer Centres .

17. District Cancer Control Programme : The District Cancer Control Programme , which has been developed to intiate awareness and early detection activities at the district level; are in place in 28 districts at present.

18. LIST OF REGIONAL CANCER CENTRES Govt RCCs 1. M.N.J.Institute of Oncology, Hyderabad, Andhra Pradesh 2 . Dr. B.Borooah Cancer Institute, Guwahati , Assam 3 . Indira Gandhi Institute of Medical Sciences, Patna, Bihar 4 . PGIMER, Chandigarh 5 . Pt.J.L.N Medical College, Raipur, Chattisgarh 6 . PGIMS, Rohtak , Haryana 7 . Indira Gandhi Medical College, Shimla , Himachal Pradesh 8. Sher-i-kashmir Instt ., Srinagar, Jammu & Kashmir 9 . Government Medical College, Jammu& Kashmir 10 . Kidwai Memorial Institute of Oncology, Bangalore, Karnataka

19. Continued 11. Regional Cancer Centre, Thiruvananthapuram , Kerala 12 . Regional Institute of Medical Sciences, Imphal , Manipur 13 . Civil Hospital,Aizwal Mizoram 14 . Dr.B.R.A . Institute Rotary Cancer Hospital, AIIMS,New Delhi 15 . Regional Cancer Centre, Cuttack, Orrissa 16 . JIPMER Puducherry 17 . S. P. Medical College, Bikaner, Rajasthan 18 . Arignar Anna Memorial Instt ., Kancheepuram , Tamil Nadu 19 . Civil Hospital, Agratala , Tripura 20 . SGPGI, Lucknow , Uttar Pradesh 21 . Chittaranjan National Cancer Institute, Calcutta, West Bengal

20. NGO RCCs 22 22. Gujarat Cancer Research Institute, Ahmedabad , Gujarat 23 . Cancer Hospital & Research Institute, Gwalior, Madhya Pradesh 24 . Rashtra Sant Tukdoji , Nagpur, Maharashtra 25. Tata Memorial Hospital, Bombay, Maharashtra 26 . Cancer Instt ., Chennai, Tamil Nadu 27 . Kamla Nehru Memorial Hospital, Allahabad, Uttar Prade

21. Budget Allocation Budget Allocation: The tentative budget for the 11th Five Year Plan is Rs.2400.00 crores . The budget allocation for 2007-08 is Rs. 140.00 crore .

22. National Cancer Awareness Day The birth anniversary of Nobel Laureate Madam Curie is being observed as National Cancer Awareness Day since 2001, to create more awareness about cancer. The theme for 2007 was “Detect Early, Save Life’. Some pictures related to National Cancer Awareness Day may be seen at: http://www.whoindia.org/EN/Section20/Section385_1353.htm

23. Why do we celebrate cancer Day? World Cancer Day is an international day marked on 4 February  to raise awareness of cancer and to encourage its prevention, detection, and treatment . World Cancer Day is led by the Union for International Cancer Control (UICC) to support the goals of the World Cancer Declaration, written in 2008.

24. IEC Activities: Health education is an important tool for prevention and early detection of cancers, which is given importance in every scheme under the National Cancer Control Programme . The programme supports activities of health magazine ‘ Kalyani ’ and telecast by Prasar Bharti targeting especially those living in the most populous States. It is an interactive programme which provides an interface to the people with experts on various health and social issues . Kalyani is telecast in 9 capital Doordarshan stations-Bhopal, Bhubaneshwar , Dehradun , Guwahati , Jaipur , Lucknow , Patna, Raipur, Ranchi and 12 sub regional stations i.e. Gorakhpur, Varanasi, Bariely , Mau, Allhabad , Indore, Gwalior, Jagdalpur , Daltonganj , Bhawanipatna , Sambalpur & Muzaffarpur . IEC materials in the form of audio-video spots, posters, leaflets, flipcharts etc. have been developed . Advertisements have been given in the leading dailies for creating awareness about cancer among the general masses.

25. Meaning of cancer Cancer  is the uncontrolled growth of abnormal cells anywhere in the body . These abnormal cells. are termed cancer cells, malignant cells, or tumor cells. These cells can infiltrate normal body

26. Warning Signs of Cancer Unexplained weight loss. Fatigue. Night sweats. Loss of appetite. New, persistent pain. Recurrent nausea or vomiting. Blood in urine. Blood in stool (either visible or detectable by special tests)

27. Frequently asked questions about cancer 1 . What is cancer? All cells in the body keep multiplying throughout life. Normal cells multiply under control. Cancer cells lose this control and start multiplying more than required. These cells can damage the organ where the cell multiplication is occurring and can also spread to other sites. 2 . In which part of my body can I get cancer ? Cancer can occur in any part of the body. They are usually painless and generally present as swellings or growths. They gradually increase in size and damage the surrounding tissue.

28. 3. Can Cancer spread from one person to another? Certainly not! Cancer is a non-communicable disease, which does not spread from one person to another. It occurs due to some changes in the cells due to which the cell multiplication becomes uncontrolled. Certain cancers may have a hereditary causation which means a person may be at higher risk of getting cancer if his/ her relatives have had that particular cancer. These cancers are breast, ovarian, colorectal, and other less common cancers 4. How does cancer spread? As Cancer grows, it invades the surrounding structures and causes damage. It spreads to the draining lymph nodes. Through the blood stream it spreads to the others parts of the body like lung, liver, bones, brain etc.

29. 5. What causes Cancer? Exact cause of cancer is not yet known. However, there are certain risk factors, which may lead to cancer. Among the common factors Tobacco is an important factor. Nearly half of the cancers in India are due to tobacco. Some common Risk factors for Cancer: Tobacco: Smoking: Cigarette, Bidi , Cigar, Hukka , others Smokeless: Zarda , Gutka , Khaini , Snuff, etc . Alcohol Infections (viruses, parasites, bacteria) Diet (dietary carcinogens) Reproductive hormones

30. What are the diagnosis method for cancer? Imaging tests used in diagnosing cancer may include a  computerized tomography (CT) scan, bone scan, magnetic resonance imaging (MRI) , positron emission tomography (PET) scan, ultrasound and X-ray, among others . Biopsy. During a biopsy, your doctor collects a sample of cells for testing in the laboratory.

31. 6. Is Cancer a preventable Disease? Yes , to a large extent. About 50% cancers are Tobacco related e.g. Lung Cancer, Cancer of Mouth, Cancer of the Voice box, Cancer of the Food pipe, etc. Avoiding intake of Tobacco can prevent these cancers. Certain cancers like the Cancers of the mouth, breast and cervix can be detected early and cured, if treated promptly. Therefore it is important to be aware of the early warning signals and consult a health professional

32. 7. What are the signs and symptoms of Cancer? Common symptoms of cancer are : 1. Lump or swelling 2 . A sore that doesn’t heal 3 . Recent change in a wart/mole 4 . Unusual bleeding or discharge 5 . Changes in bladder or bowel habits 6 . Nagging cough or hoarseness 7 . Difficulty in swallowing or dyspepsia 8 . Can cancer be cured? Yes , Cancer can be cured if detected early and treated promptly. Unfortunately in India, about 70% patients present in advanced stage diseases, which have poor chances of survival.

33. 9. How is cancer treated? Cancer can be treated through Surgery, Radiation and drugs . Treatment generally requires more than one type of treatment like surgery with radiation or drugs, etc. To decide on the best treatment for a given patient, initial testing is done to make the diagnosis and determine how far the disease has progressed. Based on this the treatment is planned. The response of disease to treatment is assessed from time to time. The treatment generally needs to be given over a period of time. Once the planned treatment is completed, cancer patients need regular follow-up.

34. 10. What can I do to prevent cancer? • Avoid tobacco and alcohol • Take healthy food • Indulge in physical activity • Be aware of your body so that you can detect any changes early • Be alert for the warning signs of cancer Contact a health professional immediately if you come across any suspicious symptom

35. diet to prevent

36. Color diet for cancer

37. Cancer fighting food

38. Dos and don’t food

39. GUIDELINESS Overview of NCCP  (91.66 KB)  Schemes  (967.71 KB)  Training Manuals 50 Years of Cancer Control in INDIA Achievements under NCCP  (2.94 MB)  FAQs  (86.6 KB)  Links  (79.42 KB) 

40. Thank you