Closing the cancer care gap in Kashmir

By: Dr Fiaz Fazili

World Cancer Day is observed globally every year on February 4. It is a day dedicated to raising awareness about cancer, encouraging its prevention, early detection, and treatment, and advocating for greater access to care. However, the theme of World Cancer Day should not be confined to a single calendar date. Cancer control must remain a year-round focus to reduce the devastating impact of the disease on individuals and communities.

This raises important questions: Are our public institutions equipped to deal with a disease as complex as cancer? Why do so many people in Jammu and Kashmir still seek treatment outside the Union Territory? Why are even educated individuals often diagnosed at late stages when the disease is already advanced? These questions have always troubled me, especially in light of the growing number of cancer patients seeking care outside the region.

I do not entirely agree with the notion that people prefer to go outside for treatment simply because they want to hide their illness or because the affluent can afford it. Seeking treatment outside the community involves many additional expenses—travel, accommodation, long waiting periods, and the high cost of actual treatment. These costs can be overwhelming and make treatment inaccessible for many, particularly in low- and middle-income communities like ours.

Cancer management has made remarkable progress. In many cases, near-complete cures are possible. It is crucial to understand that cancer is not a single disease—it encompasses more than 200 subtypes, each requiring a distinct treatment approach. We are now in an era of precision cancer treatment, where advanced tools such as genomic testing, targeted therapies, and immunotherapy have revolutionized care. These advances demand a multidisciplinary approach, involving experienced and compassionate teams of medical, surgical, and radiation oncologists, counsellors, and support professionals. A coordinated team under one roof is essential for selecting the most effective, personalized treatment options.

Access to the best cancer care is a fundamental right. From choosing the right specialists to getting the correct tests done in a timely manner, ideally under one roof, every aspect of treatment contributes to better outcomes. While we do have good oncologists, we still lack a critical mass of highly experienced professionals. For instance, the Regional Cancer Centre at SKIMS struggles to manage the increasing burden of cancer cases, despite government efforts to expand cancer facilities to district hospitals.

This is why many patients still opt for renowned institutions like Tata Memorial Hospital in Mumbai or Rajiv Gandhi Cancer Institute in Delhi. Their decisions are influenced by several factors. These hospitals offer specialized expertise, with seasoned professionals experienced in treating diverse cancer types. They also provide access to cutting-edge technologies and treatment options not yet available in smaller or less specialized facilities.

Comprehensive cancer care—including surgery, chemotherapy, radiation, counselling, and support—is often centralized and better coordinated in these institutions. Their reputation for excellence and high success rates further instill trust in patients. Moreover, such hospitals are more likely to be involved in clinical trials, offering patients access to experimental treatments that could offer new hope. Many also provide holistic care, with support services like nutrition counselling and patient support groups.

Unfortunately, in Kashmir, we face numerous challenges. Infrastructure is limited. We lack specialized cancer centers, diagnostic labs, and a trained healthcare workforce. These deficiencies delay care and reduce the chances of effective treatment. Economic constraints add another layer of difficulty, as many cannot afford treatment or must delay it due to financial stress. Cancer has pushed countless families below the poverty line, draining them emotionally and financially. Every day, we see crowdfunding appeals on social media for cancer treatment.

Awareness is also low. Many in our communities still do not recognize the early signs of cancer or understand the importance of timely screenings. Late-stage diagnoses remain common. The region’s challenging terrain and harsh weather only add to these issues, making it difficult for patients in remote areas to reach treatment centers.

What can be done? We need urgent investment in cancer infrastructure, with state-of-the-art equipment and skilled professionals. Partnerships with national and international institutions can help facilitate knowledge sharing and improve services. Financial assistance programs and subsidized treatment schemes are essential to make care affordable. Awareness campaigns—through schools, local leaders, and media—can help spread vital information about prevention and early detection.

Telemedicine can play a transformative role by connecting patients in remote areas to specialist consultations and follow-ups without requiring long-distance travel. A holistic approach to care is also essential. Beyond medical treatment, we must address the emotional and psychological needs of patients through counselling, survivor support programs, and family assistance.

The cancer burden in Kashmir is overwhelming. But there is hope. The establishment of state-of-the-art charitable cancer hospitals can bring high-quality care within reach of all, regardless of socioeconomic status. Such institutions can bridge the gap between the privileged and underprivileged and reduce disparities in outcomes. These hospitals must be driven by sensitive and committed civil society members, engineers, philanthropists, campaigners, and medical professionals.

As someone who promotes cancer awareness and prevention, I, along with my team and associated NGOs, call upon you—wherever you are—to play your part in creating a cancer-free world. Join us. Support the cause. Participate, engage, and contribute. Together, we can build a future where cancer no longer defines lives, but where care, equity, and hope lead the way.

The author is a healthcare policy analyst and onco-surgeon leading the campaign for a not-for-profit, state-of-the-art cancer hospital in Kashmir.