Cancer Care Crippled | Kashmir stuck with just 1 PET Scan machine for millions

Srinagar, Feb 16: Concern is growing among cancer patients in Kashmir as Positron Emission Tomography (PET) scans, crucial for accurate diagnosis and staging of cancers, remain unavailable at most government hospitals in Kashmir.

Apart from a single PET scan machine at the Sher-e-Kashmir Institute of Medical Sciences (SKIMS) in Srinagar, no other government facility in J&K has this important diagnostic imaging tool.

A senior radiologist at SKIMS, who spoke to Greater Kashmir on condition of anonymity, highlighted the heavy workload and infrastructural limitations.

“On average, 5 to 10 PET scans are scheduled per day at SKIMS as we have just one machine. The scans require a tracer called FDG that has to be imported daily from outside J&K. But there are sometimes delays or supply issues with procuring this critical reagent due to flight delays or payment problems. This further hampers our capacity," he said.

"Institutes like SKIMS cater to a huge population across J&K and Ladakh. We should have at least 2 to 3 PET scan machines to meet the demand. With rising cancer cases, a single operational machine means patients have to wait for months just to get this important scan done,” he said.

The radiologist urged the J&K administration to install additional PET scan machines at SKIMS and other key government hospitals.

“It is frustrating for doctors and detrimental for patients when lack of infrastructure comes in the way of essential diagnostics and care,” he said.

Shri Maharaja Hari Singh (SMHS) Hospital in Srinagar, another major government tertiary care hospital catering to the Kashmir division, does not have a PET scan facility despite having a robust radiology department.

“There have been several proposals over the years to install a PET scan machine at SMHS, but none have materialised so far due to lack of funds or bureaucratic hurdles. As a result, we have no choice but to refer patients to SKIMS, where there is already a long waiting period for scans, or to private facilities where costs are prohibitive for poorer patients,” said a doctor from SMHS’ Radiology Department on condition of anonymity.

The patients are forced to travel out of J&K to access this technology or pay over Rs 25,000 for a PET scan at a private diagnostic centre in Kashmir.

"My father was diagnosed with prostate cancer, and the doctors at SKIMS advised us to get a PSMA PET scan done, which is not available at the institute. Getting it done from a private sector facility in Kashmir would have cost us Rs 45,000. Eventually, we had to travel to Delhi where we managed to get the scan done for Rs 12,000," said Ajaz Ahmad, a Srinagar resident.

A Prostate-Specific Membrane Antigen (PSMA) PET scan is an imaging test that uses a radioactive substance to detect the spread of prostate cancer in the body.

Surgical Oncologist at a leading hospital Dr Zahoor said, “It is extremely unfortunate that cancer patients in Kashmir still need to travel outside the state to access PET scan facilities due to the lack of adequate infrastructure here.”

He said that PET scans were crucial for oncologists to determine the accurate stage and spread of cancers.

“The scan reports guide our entire line of treatment and decisions on surgery, chemotherapy or radiation therapy," Dr Zahoor said. “Having patients travel hundreds of kilometres just for a diagnostic scan results in unnecessary delays in starting treatment. It also adds substantial costs and hardship for families at an already difficult time when a loved one is battling cancer."

The data collected by Greater Kashmir reveals a concerning rise in cancer cases over the last decade.

According to the gathered data, SKIMS has documented a staggering 44,112 cancer cases from 2013 to 2023, indicating a profound health crisis unfolding in the Valley.

SMHS hospital has reported 6379 cases from 2017 to 2023, emphasising the magnitude of the issue.

A majority of cancer patients are seeking treatment in these two hospitals, shedding light on the escalating crisis in Kashmir.

The concentration of cancer patients seeking treatment in these hospitals underscores the severity of the issue and points towards a significant rise in cancer incidence in Kashmir.

A detailed breakdown of the SKIMS data exposes a concerning progression of cancer cases over the years.

In 2014, 3930 patients were diagnosed, with the numbers steadily increasing each year.

The data reveals 4417 cases in 2015, 4320 in 2016, 4352 in 2017, 4816 in 2018, 4337 in 2019, 3814 in 2020, 4727 in 2021, 5294 in 2022, and up to September 2023, 4095 cancer registrations.

This brings the total tally of cancer registrations at SKIMS from 2014 to September 2023 to a staggering 44,112.

SMHS Hospital has not escaped the alarming trend, recording 188 cancer-related patient deaths and 6379 cancer cases between 2017 and October 2023.

The Oncology Department's official statistics reveal a concerning escalation in cancer cases and fatalities.

In 2017, 491 patients were registered, with seven reported deaths.

The numbers surged in subsequent years: 1032 cases and 27 fatalities in 2018, 801 cases and 34 deaths in 2019, 649 cases and six deaths in 2020, 1010 cases and 20 deaths in 2021, and 1159 cases and 39 fatalities in 2022.

In the current year, until October 9, the hospital has already registered 1237 cases and reported 55 deaths.