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The Rediff Interview/Dr Praful Desai

'Education is at the core of cancer control measures. I will fund such education with the money from this award'

Last fortnight, Dr Praful Desai, the renowned cancer surgeon, received the 1998 Mucio Athayde Cancer Prize in Rio, during the 17th OICC International Cancer Congress. The former director of the Tata Memorial Hospital, now its professor emeritus, is the first Indian to receive the prestigious international award which reaffirms the publicity-shy doctor's reputation as the reluctant guru of cancer control. He tells Pritish Nandy about his pet obsession: fighting the disease.

When did you receive news of the award? Who proposed your name?

I have no idea who specifically proposed my name. But I know that the award is on the basis of nominations. No one can solicit it. I think the recommendation may have come from the IUCC, who had asked for my bio-data a long time back.

What is the IUCC?

It is the single largest NGO in the world overseeing the cancer control effort. It is a French acronym. It stands for the international union of those working against cancer and is headquartered in Geneva. Many months ago, they wrote to me, asking for my bio-data and I sent it to them without knowing what it was for. And, quite honestly, I forgot all about it.

I was pleasantly surprised when I heard about the award in January.

Does it entail a cash award and, if so, what do you intend to do with it?

The Athaydes of Brazil, I am told, are one of the biggest and most respected industrial families of South America. Like the Tatas and Birlas out here. They have announced this award, which is given once in every three years, as an international prize to support the campaign against cancer. Apart from the citation and a medal, it gives 150,000 US dollars to the awardee, to continue his or her efforts against cancer.

I intend to use this money for educational purposes. To support and supplement research efforts in this country. India has given me so much. If I can give back even a twentieth of what I have received from the community where I have lived and worked, it will enrich me. It will earn me a definite sense of fulfilment. For it is my conviction that life is all about giving. Only if you give do you also receive. I want to give back to the community and the nation whatever I can, whatever I have learnt and experienced.

At this age, such giving alone can yield me fulfilment and satisfaction.

I believe, we can achieve nothing as individuals. Everything is team work, a community effort. Whatever I have achieved in life is thanks to the Tata Memorial, which could not have achieved what it did without the support of the Department of Atomic Energy which, in turn, depends on the support of the Government of India. People like Dr Chidambaram, who have been such a positive force. Without their support and back-up, we could have done nothing.

What exactly are the educational initiatives you intend to launch with the award money?

All over the world, Pritish, people are focussing on educating people about cancer. Diagnosis and treatment are just a small part of our work. Two-thirds of all cancers in India are the result of our habits and lifestyle. The rest are, of course, genetic. We can do enormous preventive work by focusing on education, by teaching people how to change and restyle their lives, how to alter their habits. This is the only way to reduce the number of cancer cases.

Soon genetic engineering will also make huge strides. But, till that happens, education will be the key to cancer control. We must teach people to stop smoking, not chew tobacco. In the US, the smoking rate has come down very dramatically in recent years -- primarily due to persistent, nagging education. It is this kind of education that I believe is at the core of cancer control measures worldwide. It is this kind of education that I would like to initiate, encourage, support, fund with the money from this award.

What have you been doing since you retired as director of Tata Memorial? Just treating patients?

Yes, I have been treating patients. But my main focus has been on education. I continue as professor emeritus in Tata Memorial but my main interest is in the new centre that is coming up in New Bombay. This centre, to be commissioned in 2000, will focus very strongly on cancer education and will act as a catalyst for change. It will be an R&D centre. Not for routine treatment, which will continue in Tata Memorial.

In the new centre we will work on research methodology in treatment. Finding new ways and means to combat all forms of cancer. Particularly Indian cancers, which are a by-product of the way we live our lives. Our habits, our behaviour patterns, our food, our lifestyle. These need to be carefully studied and altered through persuasive means. That is how cancer can be fought. Through greater knowledge. Through more sustained education. Meanwhile, doctors will continue diagnosis and treatment. That is the healing end. For which Tata Memorial will continue to be the hub.

What will you call the new centre in Navi Mumbai?

The Advanced Centre for Treatment, Research and Education in Cancer. ACTREC.

Will this also be a part of the Department of Atomic Energy?

Yes, without their support it is impossible to set up such a huge 16-acre facility.

Are you doing any clinical work?

Yes, at Bombay Hospital and Breach Candy. But my interests are now focussing more and more on preventive work and cancer education. Proper education alone can reduce the incidence of cancer and quick, effective diagnosis can help us to treat cancer better. That is why I am interested in these areas. They will help to control cancer, not merely to treat it -- as I have been doing for all my life.

As I said, I hope to set up a special school for cancer education with the award money.

Is cancer really galloping in India? Or is the fear seizing mindshare?

Unfortunately, it is actually galloping. In both apparent and real terms. The reason is simple: We are living longer. People are growing older and, as they grow older, their chances of getting cancer increase.

You mean wear and tear is the cause of cancer?

Very largely. A decade ago, the average Indian lived up to 53. Today, our life span has increased to 63 and this is growing every year. People are living longer, becoming older and that is why, among non-communicable diseases, cancer has emerged as the No 1 problem. We have not armed our infrastructure well enough to cope with its pace of growth and, unless we ready a millenium plan, India will find itself having to cope with a national health emergency.

A very large section of our 900 million population is aging and the knowledge explosion has made them aware of this danger. Diagnosis has also improved. That is why more and more cases are being recorded. It is a matter of simple demographics.

How do our cancer stats compare with the West, in terms of 100,000 of population?

We are much better off. They have a figure hovering around 250 per 100,000. Ours is in the region of 120. But you must remember the fact that they live longer out there. Their average life span is 75 to 80 years. So, naturally, their figures will be higher. We cannot take consolation in these numbers. We have to arm ourselves for the millenium and ensure that by the time the new century comes along, we are ready with an infrastructure that can cope. This will not be easy. But it is a task we must prepare ourselves for.

The Rediff Interviews