As I absorb the news of Akshay Kumar's latest PSA-themed movie ‘PadMan’ being postponed from a Republic Day release to February 5th, I cannot help but brood over the powerful impact that it would have had on the current status of India's awareness about female hygiene, and the risks associated with a deadly disease that we're talking about this month - Cervical Cancer.
In a stark departure from thoroughfare entertainers, this movie touches upon a topic that is generally considered taboo in India. Based on a short story called The Sanitary Man Of The Sacred, PadMan is poised to create awareness and break social taboos concerning menstrual hygiene in India. Interestingly, the movie's planned release date was synced with January's ‘Cervical Cancer Awareness Month’ theme before being postponed.
As I saw the trailer, I recalled a four year old conversation, that I had with my college gang. Mind you, these were my salad days - days of wandering aimlessly and discussing themes with minimal intent to solve anything of real importance. That, and chai.
The Chai-time Cancer Scare
During one of these long and seemingly endless teatime rants, a girl told us that she was travelling home on account of her mother getting her uterus removed. That isn't something you hear in a regular conversation, so I became curious. She told that the decision to opt for surgery was triggered by the fear of developing 'Gyenac Cancer', owing to a family history of cancer down the maternal bloodline.
That got me thinking.
You see, even though I do not consider myself an expert on the subject of cancer, from what I understand of the disease, I have always thought of it as being similar to the kind of code we use in computers. Cancer, by definition, arises as a result of multiple genetic mutations. And operating on the 'If it ain't broke, don't fix it' principle, I wondered why someone would remove an organ from their body just out of fear! My friend somehow convinced me that I was being paranoid about the subject, so I shut my trap and returned to the aimless chai trolling.
Cut to 2018
Later, much later, I had the good fortune of working with an online cancer consultations firm, and in doing my part to build the virtual cancer hospital of the future. After being part of a lot of cancer related discussions, eventually I reflected on that long lost chai-time conversation. And then I found the stuff that adds sense to every confusing memory. Facts.
Digest this - apparently, one in every six women in India undergo procedures to get their uterus removed. So if you happen to work in a decently sized office that employs about 60 women, statistics dictate that about 10 of them will get an organ removed! Makes you think, right? So I went ahead with my investigation, and began observing a pattern.
When it comes to women and cancer, us 'first-world-aspirant' folks always think of Breast Cancer. Agreed, it is the most common cancer for women in metropolitan cities. But at the same time, thousands of women in rural India get affected with a much deadlier disease - Cervical Cancer.
And while India seems to have a good publicity game going on for itself on all matters related to women empowerment, I think we all agree that we really are not progressive or 'empowered' enough to fight Cervical Cancer.
According to the NCBI, every year, 122,844 Indian women are diagnosed with cervical cancer and 67,477 women die from the disease. I'd say that's pretty bad, wouldn't you?
Why Is This Happening?
This brings us back to #PadMan and to the reason why I felt compelled to thank Mr Akshay Kumar today.
You see, India has had a love-hate relationship with all things sexual since what is probably the beginning of time, and in the process of establishing taboos and social behavioral constructs, we have successfully lost sight of what is critical for sustaining life.
And till the time we do not get a public figure reminding us quite literally to our faces, we continue to ignore what is right in front of us. Without further ado, let me introduce the chain of thought that goes into indiscriminate organ removal from the fear of cancer.
Most Rural Indian Women Don't Know About The Types & Subtypes Of Cervical, Uterine & Ovarian Cancers.
As much as we hate to admit it, it's true. Since Indian households shy away from talking about sex, there is no scope for conversations surrounding sexual health or menstrual hygiene, for that matter. Most of such families just know the word 'Cancer' and the idea that all 'Cancers' will kill you.
These families believe that the Womb, or the Uterus, is at the core of their 'Cancer Curse'.
Driven partly by superstition, partly by lack of knowledge and partly by the history of cancer deaths in some families, most mother-in-laws encourage their daughter-in-laws to get their uterus removed after they have born a decent number of children (Also a deplorable fact: A lot of these families treat women as baby-machines, and the case in point is simple enough for them to take action on; Once the family heirs are in place, get rid of the uterus.)
Now, here's the really bizarre part.
Fact. India doesn't have a lot of trained, expert surgical oncologists on the field, in rural areas.
Hypothetically, even if a woman were to have a tumor removed surgically, in an ideal medical scenario she would need a surgical oncologist. Sadly, we don't have enough trained surgical oncologists on the field. So these families often approach underqualified doctors/practitioners of a completely unrelated specialization to get the surgery done.
This might seem funny or outrageous now, but it is a lot more scary to imagine that some families actually go to orthopaedic surgeons to get Uterus Removal Surgeries done!.
We cannot even begin to fathom the kind of risks associated with such an unsupervised procedure. First, and let's really establish this - The fear of cancer does not in any way, necessiate surgery, unless an oncologist explicitly prescribes it.
Next, if there is no tumor and if the candidate is unlikely to develop any cancer of the reproductive system, then the surgery is both unnecessary and potentially harmful.
Third (and this is the worst possible scenario) - If an undetected tumor is ruptured during such a surgery, it might lead to actual metastasis of cancer, and for all we know, could turn into the reason why a woman dies.
So, Should We Just Sit Still?
Absolutely not! We have moved way past the era of suffrage, and while being a hypochondriac is definitely not the go-to solution against any terminal disease, neither is blind ignorance.
In order to overcome the menace of Cervical Cancer, Indian women must strive to become aware of the real reasons why it manifests, and the kind of preventive measures available today.
Research shows that nearly 90% of all Cervical Cancer cases are a direct result of an infection caused by the Human Papillomavirus (HPV). This virus is transmitted both sexually, and due to non-maintenance of female hygiene, especially menstrual hygiene. The topic that #PadMan continuously touches upon, is that rural India still resorts to DIY (Do It Yourself) discourses (fondly called Jugaad-s), to avoid spending on basic hygiene. While metropolitan women find themselves coaxed with glamorous advertisements for sanitary napkins, Indian villagers still advocate the use of sub-standard, reusable cloth, or worse - soil.
Soil. Mud. That opens up the (unvaccinated) woman in concern, to a million possible infections. Using a WHO-validated menstual hygiene product can help bypass this risk multifold.
So thank you, Akshay Kumar and thank you, #PadMan!
Beyond #PadMan (Other Discourses)
This could be an epic movie, and might create a lot of buzz (as did Rang De Basanti, Toilet - Ek Prem Katha and other socially striking movies) and stay in the public memory for a long time. But will it do everything that is needed to get Indian women to stand up and take notice of the very real threat ahead of them?
Probably not. This is because an effective strategy against Cervical Cancer requires lot more than just a periodic reminder (no pun intended).
HPV Vaccinations are available in the market today, and availing this vaccination at the age of 11 to 15 (at the onset of puberty) can reduce the risks of developing Cervical Cancer at a later age for most women.
Many state-sponsored and private cancer screening camps are organized all year round, where PAP Smear Tests are used to detect any cancerous tissue/lesions in a swab drawn from the cervix. It is recommended that PAP Smears & HPV tests should be taken by women who are sexually active, every five years, beginning at the age of 21.
Women, and their love for hair has created a lot of negative buzz surrounding Chemotherapy and Hair Loss, while fact remains that Chemotherapy is not the only treatment modality against cervical cancer.
Thanks to the kind of research that is happening all around the world, treatment options for Cervical Cancer have now diversified to include radiation therapies, minimally invasive surgical procedures, and Immunotherapy. It is important to understand what procedure is going to work for someone with a confirmed diagnosis of Cervical Cancer before getting started on the treatment journey. I'm proud to remark that the organization I work for, can help in this regard!
In conclusion, I'd like to assert that it is okay to be not completely prepared against cancer. Nobody ever is. But the world of cancer care is evolving by the minute, and with the right vigilance, willpower and treatment, we can overcome the disease.
Always remember - We can have cancer, but we won’t let cancer have us.
If you choose to be so kind as to share this article, I'd like to end it with a beautiful pin I found recently, highlighting everything you need to know about Cervical Cancer.
This is an Employee Blog. The views expressed here belong solely to the author, and are not representative of the opinions of Onco.com as an organization.