Past, present, and future of molecular oncology in India

Abstract

Cancer has become an important public health issue in India as ICMR in its latest report on cancer status (summarized in Figure 1), has projected that the total number of new cases would be around 14.5 lakhs in 2016 and the figure is likely to reach 17.3 lakhs by the year 2020. Molecular oncology, a multidisciplinary specialty involving extensive use of genomics, computational biology, and tumor imaging, is the "backbone technology" for the management of the disease. In the modern day India, the growing significance of molecular genetics and cytogenetics in diagnosis as well as management of various cancers has also led to expansion of genetic diagnostic and counseling services. However, skewed geographical distribution, lack of awareness about the disease, symptoms, and diagnostic practices further augments the challenge of treating cancers in India. Lack of adequate infrastructure and absence of mass screening programs are key barriers to timely and accurate diagnosis in India. Key themes that may help in effective management of cancer include cost-effective, early diagnosis and screening; national planning based on robust and granular cancer registry; public-private partnerships to decentralize cancer care delivery and nurture centers of excellence.

Oncology Gold Standard™ consensus statement on counseling patients for molecular testing and personalized cancer care

“…At present, available molecular technology helps us understand this in a manner that has the capacity to help improve patient care. [1,[10][11][12]20] The knowledge existing in and about human body is stored in DNA. This is the human genome code.…”

“…If however, this change is not repaired and gets passed on to daughter cells, it becomes known as a mutation. [1,10,11,21,23] When mutations occur at specific sites on the genome, they may lead to change in the behavior of cells (before and after they become cancerous). Such mutations are called driver mutations.…”

“…Advances in molecular oncology technology and their application to personalized cancer care have evolved very rapidly over the past 5 years. [1] At the same time, there are a lot of conflicting and often misleading statements available on the world wide web. [2] This results in confusion and misunderstanding among cancer patients and their wellwishers.…”

“…The most important advances made in the last few years in the field of cancer include molecular diagnostics and immune mechanisms of treatment. [1,10] A. Molecular diagnostics refers to the use of modern techniques to detect changes at the molecular level that help us understand cancer better. It helps us identify if a person has: i.…”

“…This is due to better techniques of diagnosis, availability of better health-care facilities, higher number of qualified oncologists as well as the use of modern drugs to treat patients. [1,[10][11][12][13] Molecular genetics and its application for ascertaining the risk of cancer, its early detection, its accurate diagnosis, in selecting the right treatment and dose as well as helping assess the status at follow-up or recurrence are very important additional tools in the fight against cancer. [10][11][12][13][14]…”