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Cancer Care in India: An Interview with Past IDEA Recipient Dr. Navneet Singh

Mar 11, 2014

 Navneet Singh, MD, DM,
: Postgraduate
Institute of Medical
Education and Research,
in Chandigarh, India
Member since: 2008
Specialties: Thoracic
oncology, non-small cell lung cancer
ASCO Connection checks in with past 2008 Conquer Cancer Foundation of ASCO International Development and Education Award (IDEA) recipient Navneet Singh, MD, DM, FACP, FCCP, to see how this ASCO initiative aimed at expanding oncologists’ knowledge and skills through training and relationship-building has affected him professionally and helped to improve cancer care in India. Dr. Singh is a pulmonologist and a faculty member of the Department of Pulmonary Medicine at the Postgraduate Institute of Medical Education and Research (PGIMER), in Chandigarh, India.

: How would you describe the current state of cancer care in India?

Dr. Singh: Cancer incidence continues to increase in India and has become one of the most important non-communicable diseases, and, from a patient’s perspective, one of the most dreaded illnesses. The shortage of appropriately trained medical, surgical, and radiation oncologists to deal with the increasing disease burden is likely to be aggravated in the absence of a parallel increase in training of available health care professionals who can deal with the same.

AC: What led you to pursue oncology as a career?

Dr. Singh: I am primarily a pulmonologist with a focus on thoracic oncology. Lung cancer is one of the major causes of cancer-related morbidity and mortality both globally and within India. I work at PGIMER, a government-funded referral medical institute wherein patients are referred from primary-, secondary-, and tertiary-level health care facilities located in neighboring states. The department of Pulmonary Medicine here at PGIMER has been running a special clinic for lung cancer for two to three decades now. After completing my super-specialization (DM) in Pulmonary Medicine, I have continued to be a part of the department as a faculty member and currently along with my senior colleague am responsible for managing patients in this clinic at all stages of the disease (diagnosis, treatment, and follow up). In addition to taking care of the enormous load of lung cancer patients, I am involved in lung cancer research both clinical and translational.

AC: What impact did the IDEA have on your professional development and your ability to affect care in India?

Dr. Singh: Receiving the IDEA and subsequently attending the ASCO Annual Meeting, as well as visiting the Indiana University Cancer Center as part of this award, was probably the turning point in my professional career as a thoracic oncologist. The IDEA initiative by ASCO’s Conquer Cancer Foundation provides an unparalleled opportunity for clinical oncologists from high-burden and resource-constrained countries such as India to participate in an academic forum that is par excellence. The advanced cancer center visit gave me an insight into high-quality cancer care. Both of these put together allowed me to enhance my practice of clinical oncology on returning back to my institution. In my case, the benefits of receiving this award have continued well beyond the visit. In the past five years following the award, I have continued to remain in touch with my mentor and have communicated with him on guidance whenever I have felt the need to consult someone for a challenging case of lung cancer in the clinic.

AC: You are currently planning a Multidisciplinary Cancer Management Course (MCMC) in India. What are your goals for this course?

Dr. Singh:

  • Develop and establish a uniform management approach for lung cancer within India and in the long run, other thoracic tumors. Such an approach shall be evidence-based but would be appropriately modified and adapted to address the unique challenges encountered by treating physicians/surgeons in resource-constrained settings such as ours.
  • Train attendees to provide high-quality cancer care for lung cancer patients while keeping the costs of treatment affordable since most patients do not have access to medical reimbursement or medical insurance and thus pay for cost of treatment from their personal savings. For this purpose, treatment goals would include improving quality of life and symptom relief while simultaneously attempting to achieve reasonably good objective response rates and overall survival.

AC: How do you hope to use this educational opportunity to further the development of cancer care in India?

Dr. Singh: We hope that the immediate impact of this educational course is reflected by an improvement in management of lung cancer patients presenting to the course attendees. For a long-term impact, we also hope that we are able to promote course attendees (residents/fellows in-training/early-career professionals in academic centers) to identify potential areas for future research related to lung cancer management. This has the potential to address and ultimately remove lacunae/gaps which arise as a consequence of evidence generated from randomized trials conducted in non-Indian patient populations and the challenges in their applicability/generalizability to Indian patients.

AC: What do you see as the role for organizations such as ASCO to support career development and cancer care in your country and region?

Dr. Singh: ASCO can, and I anticipate will play, a progressively increasing role in enhancing cancer care in developing countries like India in the years to come. This is feasible because of two main factors: (1) ASCO has in its vast member database, a wide spectrum of oncology professionals including medical, surgical, and radiation oncologists, oncology nurses and palliative care physicians who can help in the transfer of expertise (disease-specific as well as that related to general oncological care); (2) ASCO enjoys an enviable position in its ability to provide funding and technological know-how that are needed to establish advanced oncology molecular diagnostic facilities in India. This will facilitate the practice of personalized cancer care at all health care institutes—private and public—in India that are involved in the diagnosis and treatment of cancer patients.

AC: Is there anything else that you would like to share?

Dr. Singh: I hope that subsequent to conclusion of the Lung MCMC that is scheduled for April 2014, ASCO will continue its initiative of holding multidisciplinary cancer management courses in India in the future and maybe have it on a regular basis (annually if there is general enthusiasm, and it is organizationally feasible).

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