Cancer treatment: Big concerns and big costs

An 8-year old girl of a day labourer has been suffering from blood cancer for three years. Her father had to sell whatever little land the family owned in order to meet her treatment costs at a private hospital in Rangpur.

It is near impossible for him to pay the installments of the loans he has taken from some local NGOs to pay from the treatment.

A physician is providing free treatment for the girl, but various tests and medicines cost around Tk 15,000 every month. Overburdened with these towering expenditures, the girl's treatment now seems very uncertain.

Like this Rangpur family, there are many insolvent families who stop cancer treatment midway due to the huge financial burden.

Professor Syed Md Akram Hossain, head oncologist of Square Hospital in Dhaka, tells Prothom Alo that cancer care is a long procedure that requires a huge amount of financial support.

This is a huge burden even for the middle income families while the poor, in most of the cases, are deprived of complete care, he said.

Researchers at the Institute of Health Economics under Dhaka University and National Cancer Research Institute say that the treatment of a single cancer patient needs approximately Tk 639,000 annually.

The costs include charges for consultation, diagnosis, surgical or therapeutic procedures, drugs and injections, transport and accommodation for the patient and attendants.

Professor at the Institute of Health Economics, Syed Abdul Hamid, says that additional costs of cancer care are more expensive than the core treatment.

People need to go to various places for diagnosis and related tests. Many of them fall prey to unscrupulous 'agents' or dalals. They have to pay extra money at every step.

According to Global Cancer Observatory estimates, Bangladesh had 156,000 new cancer patients in 2020. And around 109,000 cancer patients died that year.

The health department data says 67 per cent of deaths in Bangladesh are caused by non-communicable disease like cancer, cardiovascular diseases, diabetes, high blood pressure, chronic kidney and breathing problems.

In this context, public hospitals are observing the World Cancer Day today, 4 February, with various programmes.

Recently, researchers have estimated cancer treatment costs at Bangabandhu Sheikh Mujib Medical University, National Cancer Research Institute, Dhaka Medical College and Hospital and Ahsania Cancer and General Hospital.

They interviewed 262 respondents and analysed data of 30 patients from each hospital.

On January 12, the International Journal of Social and Administrative Science published the research findings in a study titled Financing Cancer Care in Bangladesh: An Alternative Route.

The study finds cost variables in cancer treatment. According to the study, the annual cost of cervical cancer treatment takes Tk 492,000 and Tk 810,000 for colon cancer treatment. These include both direct medical costs and non-medical costs. However, the respondents could not report direct medical and non-medical cost separately.

Researchers say that cancer treatment in Bangladesh follow three modalities commonly–surgical procedures, chemotherapy and radiotherapy.

All of the oncologists who attended the consultation meeting under the study said that cost of cancer treatment in a public setting in Bangladesh require Tk 25,000 for a radiotherapy session, Tk 20,000 for a chemotherapy session, and Tk 60,000 for a surgical procedure.

The experts said that about 50 per cent of cancer patients, irrespective of the types, require all three treatment modalities while 20 per cent need any two modalities and a single modality is required for the remaining 30 percent.

There is no low cost solution for cancer care in Bangladesh. However, experts believe that well-planned and coordinated initiatives can make cancer treatment accessible to common people.

They recommend that cancer treatment be under insurance mechanism, along with massive awareness building.

Square Hospital’s head of oncology department, Professor Akram suggests producing cancer drugs at government-owned pharmaceuticals.

Moreover, waiving tax on import of modern equipment for cancer treatment would benefit the patients, he says.

*This report appeared in Prothom Alo print and online edition, and has been rewritten in English by Sadiqur Rahman