People as statistics
But why should this story of an individual cancer patient be of interest to anybody in a large and growing nation like India? Individuals are, after all, mere statistics. My case, however, is instructive because it represents today the scale of life-threatening and destructive processes that we are inflicting upon ourselves. My cancer, like most other cancers, is deeply related to environmental pollution — an issue, on which, ironically, I have written numerous articles and books, given lectures and made films to increase public awareness of the threats we face. Therefore, I feel a sense of moral responsibility for going on.

My cancer, like most cancers, is related to environmental pollution

The poor, naturally, suffer more than the rich from environmental degradation. However, at least the powerful urban middle and upper classes — we had thought — were intelligent and self-indulgent enough to try and protect themselves and moderate the impact of environmental destruction on their own lives. That theory has proved to be a total chimaera. The elite of our nation have failed to internalise the ecological principle that every poison we put out into environment comes right back to us in our air, water and food. These poisons slowly seep into our bodies and take years to show up as cancer, as immune system disorders, or as hormonal or reproductive system disorders — affecting even the foetus.

One of every 10-15 people living in metros are potential cancer victims

Is it, therefore, not imperative for a society to find a way that balances its urge for economic growth and material comforts with the requirements of its natural and human health? Isn’t this some thing that we owe to ourselves and to our children?

Cancer as statistics
Although cancer statistics in India — relatively poor — probably understate the extent of the disease, what they tell us is terrifying. There are six hospital-based cancer registries in India — five in Bangalore, Mumbai, Madras, Delhi and Bhopal and one in the rural area of Barsi near Pune — which give us an idea of urban and rural cancer incidence in India (see Table 1). The data shows that age-adjusted cancer incidence rate per 100,000 people in the five urban centres varied between 101.2 (Bhopal) to 143.6 (Delhi) for women in 1990, whereas for males it was between 107.5 (Bhopal) and 138.9 (Mumbai). This incidence was twice the incidence rate of 56.2 in Barsi, which shows that living in our polluted urban centres more than doubles our chances of developing cancer.

There is another way of looking at this data by asking the question: what is the chance that I will be affected by cancer during my lifetime? The answer is stunning. If you are living in one of the four metros — Bangalore, Mumbai, Madras or Delhi — the chance of your catching cancer during a lifetime is as high as seven-11 per cent. In other words, one out of every 10-15 people living in these cities is going to become a cancer victim during his/her lifetime. Or, assuming an average household size of five, it means every second to third household in these metros will have a member falling victim to the disease. However, if you were living in Barsi, the chances of cancer in a lifetime would go down by half — only one out of 20-36 persons will get cancer in their lifetime.

In industrialised nations like Britain or the us, the average lifetime cancer incidence rate in the late ’70s was one out of every six to eight persons. With environmental conditions rapidly worsening here, there is no reason why Indian cities will not get there very soon.

But while cancer is an issue that impinges on national consciousness in the West, it does not do so in India. Experts in us argue that what is occurring in their country is nothing short of a ‘cancer epidemic’. The concern for cancer shared by millions in the public has strongly fuelled environmental regulations for control of air and water pollution and toxic wastes. In India, cancer is still largely regarded as a relatively insignificant threat to public health. Yet one conservative estimate puts the total number of national cancer cases by the year 2001 at 806,000. This figure, of course, does not include people who probably cannot even reach hospitals and get diagnosed, especially amongst the vast population of rural and urban poor.

In India, cancer is still largely regarded as a relatively insignificant threat to public health

Let me look at statistics about the cancer I am suffering from Non Hodgkin’s Lymphoma. In 1990-91, nhl was listed amongst the eight most common forms of cancer in Delhi, Madras and Bangalore amongst males and in Delhi, amongst females, too. But there are less than 200 medically recorded cases worldwide where nhl has affected the eyes; I am probably the first case of ocular lymphoma diagnosed from India.