On the special visit to Lahore, Muhammad Fareed, Publisher & Managing Editor, Medical Review interviewed a well-known Professor of Clinical Oncology in Pakistan, Prof. Dr. Shaharyar, who is the Chairman, Department of Clinical Oncology, King Edward Medical University, Lahore. Following are the excerpts of the Interview.
Q – Please tell us something about yourself.
Ans – I am Prof. Dr. Shaharyar, Chairman Department of Clinical Oncology, King Edward Medical University, Lahore – Pakistan and it has been 25 years of my passion in Oncology. I am the one who has opted for this specialty. It is my first choice and my first love. I feel very happy in treating cancer patients and trying to do cancer research.
Q – What are the different cancers you encounter and which are more prevalent.
Ans – Breast cancer is commonest cancer countrywide. Lymphoma in Punjab and Lung cancer in Karachi are the 2nd most common cancers. Head & neck cancer, cancer of ovaries and colorectal cancers are also common. Lung cancer is preventable, whereas breast cancer is not. Breast cancer is curable in early stages if detected early. Early detection is with mammography. In Pakistan, we cannot offer mammography to every women. Pakistan Society of Clinical Oncology recommends that women above 40 years of age with high risks should undergo mammography every year.
Q – What is the incidence of Breast Cancer. What is the level of treatment of Cancer and Breast Cancer. What further facilities are needed to improve treatment.
Ans – Breast cancer occurs in 56 women out of every 100,000 women in a year. It constitutes 33% of all female cancers. This tantamount to some 40,000 new cases every year. Each centre treats 300 to 400 new breast cancer patients every year. This is a small number and equal numbers of patients or even more never go to these treatment centres. Public awareness is required but that cannot be done without general awareness of health related issues.
Q – What is the role of Pharma companies in creating awareness.
Ans – Pharmaceuticals companies work on behalf of multi-national companies in Pakistan and therefore as such they lack commitment for our public. Local and National pharmaceutical companies are more concerned and are always ready to cooperate.
Q – How is Hormonal Therapy effective in Breast Cancer.
Ans – Hormonal Therapy is very effective in breast cancer, but only in women with hormone dependent breast cancer. In older women, majority of women has hormone dependent breast cancer and in younger women less than half have hormone dependent breast cancer. In these women, hormonal therapy is the main treatment.
Surgery and therapy give about 70% of the benefit. 20% of the benefit comes from chemotherapy and 10% by anti-cancer anti-bodies.
Q – Are the students is medical colleges are getting sufficient teaching in the subject of Oncology. If not then what do you suggest in improving the teaching standard.
Ans – Undergraduates curriculum is not having sufficient educational material and needs to be revised. Pakistan Medical and Dental Council (PMDC) has already been asked and they have started taking necessary steps in this regard.
Q – There is need of awareness campaigns. In which areas and ways it can be arranged.
Ans – Yes, there is need of awareness campaigns. There are two levels of creating awareness. One is for the patients and general public and the second level of awareness is for General Practitioners (GPs). There is need to create awareness on these two level. TV Program and radio should be used for awareness of patients and general public and for GPs, CME programs should be used.
Q – Have awareness been introduced among women for breast cancer.
Ans – We must have some awareness campaign about common cancers especially about Breast Cancer. Awareness is much needed in women about breast cancer. A campaign could be launched in a local community for prevention and early detection of Breast Cancer by arranging Workshop, lectures, Seminars, CME etc at district level. There should be different awareness programs for women. Medical camps should be setup in Urban for the awareness and for their checkups.
Q – The GPs have the role of referring cases to cancer hospitals when patients come to them. It is general impression this they do not effective follow this practice. Do you agree and what can we do about it.
Ans – The role of GPS in referring cases is very important. It is necessary for GPs to refer the cases to cancer hospitals timely.