A few days ago, Prime Minister Pushpa Kamal Dahal announced that the government would provide free treatment to women suffering from cervical and breast cancer.

Providing screening for cervical cancer by the state-run health facilities throughout the country and administering vaccines against human papillomavirus are among the measures the prime minister outlined for the future to minimise the deaths of women from preventable cancers.

Several oncologists the Post talked to said it would be best to prevent cancer from occuring, which can only be done with the help of free screening, awareness drives and administration of the vaccine against human papillomavirus.

“Symptoms of cervical cancer can be detected 10 to 12 years before, through screening,” said Dr Sandhya Chapagain, an oncologist at Bir Hospital. "But most patients come for treatment in the third or fourth stage of cancer when their condition already gets complicated. Commitments from the prime minister to reduce the deaths of women from preventable cancers is a positive initiative but attention should also be paid to screenings and awareness.”

Cervical and breast cancers are among the most common and most fatal types in women and a major cause of death among Nepali women. Experts say early treatment can prevent up to 80 percent of cervical cancer cases.

In the fiscal year 2021-2022 alone, 720 women were diagnosed with cervical cancer at the Chitwan-based BP Koirala Memorial Cancer Hospital. The hospital administration said that the number of people suffering from breast cancer was 702 in that fiscal year. Among them, 29 were male.

Doctors say the number of patients suffering from cancer could be far more, as several other state-run and private hospitals also provide treatment for cancer.

Breast cancer is the second leading cause of cancer in women in Nepal. But women in increasing numbers are succumbing to the disease due to a lack of early detection and subsequent treatment that makes complete recovery possible, say doctors.

Experts say breast cancer can be treated, if it is diagnosed in the early stages and patients can live a normal life.

“Even self-examinations of the breast can help detect cancer symptoms in the early stages,” said Chapagain. “But many people miss a better chance of recovery due to a lack of awareness and knowledge about self-examination.”

Doctors say self-examination of breasts and regular visits to a doctor to check for lumps in the chest are key to detecting cancer in initial stages. Women should immediately go to the hospital, if they find a lump or a hard knot in their breasts, and should look for signs of unusual change in breast size and shape, or discharge from the nipples.

Breast cancer doesn’t have an exact cause but an increase in the use of tobacco, alcohol and consumption of unhealthy foods and pesticides in vegetables and fruits are responsible for the rise of breast cancer in young women, according to doctors. Even very young women have been diagnosed with breast cancer.

“Awareness and free screening along with administration of vaccines against human papillomavirus could make a big difference,” said Dr Dej Kumar Gautam, director at BP Koirala Memorial Cancer Hospital. “If diagnosed early, the disease can be cured by spending a small amount of money.”

The hospital is administering a vaccine against the human papillomavirus (HPV) to 6,250 girls aged between 11 and 13 years, in Chitwan. Human papillomavirus is a viral infection that causes cervical cancer.

The hospital had purchased 12,500 doses of the vaccine from the money allocated by the government. Officials said that the hospital has already inoculated around 5,000 girls.

The Ministry of Health and Population in the past too had decided to start vaccination against human papillomavirus, but due to a funds crunch, the plan was not implemented.

The ministry plans to administer the vaccine to girls in nine districts in 2023, and a budget has been allocated to purchase 20,000 doses.

The World Health Organisation says HPV vaccination is recommended as part of a coordinated and comprehensive strategy to prevent cervical cancer and other diseases caused by the HPV.

Bhutan, Sri Lanka, Thailand and the Maldives have introduced HPV vaccination nationally, while India and Indonesia have introduced it in some regions.

Nepal is also among the countries that has committed to eliminating cervical cancer by 2030. For that, the country has to meet 90-70-90 targets, which means vaccinate 90 percent of the girls with HPV vaccine by the age of 15, perform screening on 70 percent of women using a high performance test by the age of 35 and again, by the age of 45 and provide treatment to 90 percent of women who are pre-cancer tested and manage 90 percent of the women with invasive cancer.

The health ministry had also decided to provide free screening for cervical cancer by the state-run health facilities across the country in the past but the services are not available in most places.