Prof. Dr. Jawaid A. Mallick is working as a Clinical Oncologists in Ziauddin Hospital, Karachi since long a time. Muhammad Fareed, Publisher & Managing Editor, ‘Medical Review’ interviewed him in his hospital. Following are excerpts.
Q1 – Please tell us something about yourself.
Ans – I am Clinical Oncologist. I did my MBBS from Sindh Medical College in 1983. Then I started my house job. Here in Pakistan, we have two types of oncologists i.e. radiation oncologist and medical oncologist. In Europe, there are clinical oncologists who are practicing both chemotherapy as well as radiation. They are called clinical oncologists. I am also practicing clinical oncology.
Q2 – What are the different cancers you encounter and which are more prevalent.
Ans – In Karachi, Breast Cancer is the most common cancer in females whereas lung cancer is quite common in males. In Pakistan, we don’t have data to categorize which cancer is most common and prevalent. In JPMC, we often see lung cancer in men and Breast cancer in women. If we combine both men and women, then oral, head and neck cancer will be more prevalent. About 1200 out of 3000 individuals have oral and neck cancer.
There are 3 types of cancers which are most common i.e. head and neck cancer, breast cancer and lung cancer. In Karachi, occurrence of esophageal and liver cancer is showing an increasing trend day by day.
Q3 – What is the incidence of breast cancer. Is there institutional record to know more about the incidence.
Ans – It is not possible to tell the exact numbers as in Pakistan, there is no record of official data and so we cannot rely on results to quote.
Q4 – What is the level of treatment of cancer and breast cancer. What further facilities are needed to improve treatment.
Ans – In Pakistan, cancer treatment is a big and very difficult problem. There are many hospitals who don’t have cancer treatment facility. In Karachi, There are 80% people who have belong to a very low monthly income group. The cancer treatment or tests are very costly.
The cost of treatment from diagnostic tests and biopsy etc to chemotherapy or radiotherapy is about Rupees 5 lacs which is not affordable by the common men. There are many people who cannot afford the cancer treatment cost.
The reason behind the enhanced occurrence of head and neck cancers is the lack of awareness of the related causes among the masses. Oral cancer is very common cancer which is mainly caused by pan and gutka. There is constant increase in the number of patients of oral cancer. Youngster are often seen chewing supari, gutka, betelnuts, tobacco. The cancers caused by these substances are untreatable.
Q5 – There is need to conduct awareness campaigns. In which areas and ways it can be arranged.
Ans – Here in Baitul Sukoon, we have established a breast cancer clinic in which ultrasound and mammography facility is also available. Screenings are also carried out in this breast cancer clinic. Since its inception, 6322 cancer patients have been treated at Bait-ul-Sukoon. 4291 have had chemotherapy, over 1203 have had radiotherapy and over 1050 have had surgeries. In Bait-ul-Sukoon, the consolidated OPD patients from January to December 2009 is 3150 whereas 102 patients expired.
In Karachi there is also a growing need to establish oral cancer clinics. At Bait-ul-Sukoon, our first project is breast cancer clinic and the second will be oral clinics.
In Third world countries, 30% of cancer is caused by some infection. Mass immunization is therefore necessary to cater a large number of liver cancer patients.
Small organizations cannot do much awareness program. Government should take up this challenge on a large scale. Use of Pan, Chalia and smoking of cigarette should also be banned or discouraged drastically.
Q7 – Have awareness been introduced among women for breast cancer.
Ans – We have started breast cancer clinic for the awareness among women. Government should also initiate a programme to create awareness.
Q8 – How is hormonal therapy effective in breast cancer. When is preference given to hormonal therapy for breast cancer treatment.
Ans – Certain hormones can attach to breast cancer cells and affect their ability to multiply. Estrogen and progesterone can promote the growth of some breast cancers. In these cases hormone treatment is given to block the body’s naturally occurring estrogen to fight the cancer’s growth. By hormonal therapy, 40 – 45% cancers could be controlled.
Q9 – Are the students in medical colleges getting sufficient teaching in the subject of Oncology. If not then what do you suggest in improving the teaching standard.
Ans – Oncology is very specialized field. There is need to give exposure to Oncology. MBBS students need more orientation about cancer diagnosis and treatment.
Q11 – Anything you wish to add.
Ans – In the country, there is being no political stability. True democratic system and also political will must be there for the betterment of the nation as a whole. The healthcare system can improve and work better if the budget allocation for healthcare is adequately enhanced. At present it is quite low and there is needed to increase funds for healthcare.