Rowshan Ara Khan, a coordinator at an English-medium school, got worried—and not just a bit surprised—the other day. “This is the third time I have heard that one of my near and dear ones (in two cases from my greater family) have been suffering from cancer.” “Is it just me, or is the number of cancer patients actually increasing in the country?" she said.
Khan is not alone in her apprehensions. These days, finding a cancer patient in anyone’s greater family or among close acquaintances has become a common phenomenon.
The estimates of the National Institute of Cancer Research and Hospital (NICRH), Bangladesh, also seem to agree with this claim. According to their data, the country now has approximately 1,500,000 cancer patients. This figure was just under 4,00,000 just a decade ago.
Alarmingly, each year, some 200,000 people develop cancer, while at least 150,000 die of the disease in the country. In the past decade, cancer has appeared as an important public health problem in Bangladesh. Owing to the dearth of a reporting system and under-diagnosis of cancer, the real situation is not yet known.
Lung and breast cancer are the most prevalent forms of cancers among male and female patients respectively in Bangladesh, with 28.39 per cent male cancer patients fighting lung cancer and 26 per cent female patients battling breast cancer.
As per the Hospital Cancer Registry Report for 2011–13, 46,110 new cases attended the outpatient department of NICRH. Among them, 27,281 were confirmed as cancer cases. Of these 27,281 patients, 56.1 per cent were male and 43.9 per cent were female.
The top five organs affected in both sexes were: lung (18.1 per cent), breast (11.7 per cent), cervix of uterus (9.3 per cent), oesophagus (4.9 per cent) and stomach (4.1 per cent).
In males, the five leading cancers were: lung (28.39 per cent), oesophagus (6.14 per cent), liver (3.98 per cent), larynx (3.01 per cent) and rectum (2.17 per cent). In females, the leading five cancers were: breast (26.0 per cent), cervix of uterus (21.1 per cent), lung (5 per cent), ovary (3.3 per cent) and oesophagus (3.3 per cent).
In patients aged 10 years or more, some 78.4 per cent of the male patients had been smokers during their lives and 63.9 per cent were current smokers. Among female patients, these rates were 3.5 per cent and 3.3 per cent respectively. Cancer specialist Dr Syed Mohammad Akram Hossain cited some reasons behind the increasing number of cancer patients in Bangladesh. According to him, the main reasons are tobacco, sexual and reproductive factors, and the diet in the country.
Tobacco smoke contains approximately 4,000 chemicals, of which at least 438 can cause cancer.  Dr Hossain said tobacco is the single most important modifiable risk factor (30 per cent) for cancer. Unfortunately, in Bangladesh, cigarette production has grown tremendously since 1980 and bidi production has grown even faster.
Dr Hossain said sexual and reproductive factors were associated with cancer of the uterine cervix and breast. Factors related to sexual behaviour, such as young age at the time of first sexual activity, multiple sexual partners and poor sexual hygiene, are associated with cancer of the uterine cervix, he added.
Dr Hoissain said changing dietary patterns would lead to increased contribution of diet to cancer causation in Bangladesh.
Again, with the spiralling number of cancer patients, the anti-cancer drug market in Bangladesh is growing at 20 per cent.
Locally-produced drugs are meeting 86 per cent of the country’s demand, while the remaining 14 per cent is met through imports, according to Intercontinental Marketing Services, an international research firm.  Beacon Pharmaceuticals, a Bangladeshi-owned company, is the market leader with a 31 per cent share, followed by Roche Bangladesh, the local arm of the Swiss healthcare company, at 24 per cent.
Dr NM Nuruzzaman, former director of the Directorate of Health, said treatment of cancer has improved over the past decade. “Still, it’s one of the most deadly diseases and complete cures still elude human grasp.” He said to stop the spread of cancer, prevention is always better than cure. “At least 40 per cent cancers can be prevented if tobacco usage in the country is reduced,” he added. Dr Nuruzzaman said that the government should also take appropriate steps to control food adulteration. “The chemicals that are being mixed in the foods are carcinogenic agents. These poisonous substances slowly infect our organs and cause cancer,” he added. Citing an example, Dr Nuruzzaman said the number of child cancer patients in the country is on the rise because of food adulteration, with blood cancer affecting the kids more than half of the total number. “If we can’t stop this, it will destroy our nation’s future,” he warned.