No story about the Cancer Institute, Adyar, located in a sprawling 9-acre campus next to IIT, Madras, can be complete without a meeting with the living legend who heads the Institute, Dr. V. Shantha, the Magsaysay and Padma Bhushan awardee.

I met her at her small office in the old campus of the Institute in Gandhi Nagar. An 85-year-old diminutive woman looking a little frail, she continues to display a rare enthusiasm and energy that she is famous for when she talks about her favourite 'temple'. She says that she does not believe in going to temples, as she considers the Cancer Institute, where she has served for 60 years, as her temple. When I told her that for lakhs of cancer patients who come with hopes in their hearts to the hospital, she and her team of dedicated doctors are like Gods and their saviours, she smiled.

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Cancer Institute (WIA) was founded in 1952 as a charitable institute by Dr. Muthulakshmi Reddy, the first woman in South India to graduate in medicine. She was also the first woman to become a member and, subsequently, the Vice-President (Deputy Speaker) of the Madras Legislative Assembly. The loss of her younger sister to cancer affected her deeply and propelled her to institute a Cancer Relief Fund in 1949.

It was several years before she could translate her dream of establishing a speciality hospital for treatment of cancer to serve the growing number of those afflicted, particularly poor patients. Despite several obstacles in her way that the bureaucractic system placed, she was determined and started searching for land for the Institute she planned. Eventually she got a narrow stretch of 2-acre land abutting the Buckingham Canal in Gandhi Nagar, Adyar. With the support of the Women's India Association (WIA) of which she was President for 30 years, Muthulakshmi Reddy started on this site the first cancer hospital in South India. The foundation stone for the hospital building was laid by Pandit Jawaharlal Nehru in 1952 and the hospital was inaugurated on June 18, 1954 by the then Union Finance Minster, C.D. Deshmukh. The facility that was raised had just 12 beds in a small hut. It was run right from its inception by Dr. S. Krishnamoorthy (son of Dr. Muthulakshmi) who passed away in 2010, and Dr. V. Shantha (both of them were earlier at Government General Hospital), doubling themselves as doctors and assistants in the initial years.

After the death of Dr. Reddy in July 1968, both fought all odds to keep the facility going. According to Dr. Shantha, right from the beginning it has been a running battle between supportive and non-supportive governments. Since the hospital was totally dependent on donations, getting the money to run the Institute in the early years was itself a stupendous task. But thanks to the generosity of both corporate and individual donors and the dedicated team, the hospital made tremendous strides over the years and is celebrating its Diamond Jubilee this year.

The hospital, which in the first year opened a small single building space, with minimal diagnostic and therapeutic facilities, is today a Comprehensive Care Centre for cancer with 450 beds and a very active research laboratory apart from the Dr. Muthulakshmi College of Oncologic Sciences and a separate Division of Preventive Oncology.

The patients, mostly from poor sections of community across the country, come with fear in their minds but hope in their hearts. Every day, the Institute registers over 400 cases of which nearly 80 per cent are poor. The poor are given totally free or highly subsidised treatment.

The hospital treated over 1,40,000 patients in 2012, a jump of over 60 per cent from the figure of 85,000 patients it treated in 2000.

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The Research Centre is recognised as a Centre of Excellence by the Department of Science and Technology, Government of India. It has Molecular Oncology, Electron Microscopy and Immuno Hematology facilities and a tumour bank. Research is going on in the Institute to find a vaccine for the prevention of cancer. Another area of research is 'gene profiling' of the disease, literally creating a horoscope of the disease for each patient.

Dispelling the concept of miracles in cancer cure, Dr. Shantha says that all improvements in this area are a result of modern science, which today can provide 'targeted treatment' for different types of cancers, resulting in a much higher success rate. Today, the disease can be diagnosed even at the molecular stage (without any sort of growth/tumour or physical appearance). If diagnosed early, 65 per cent cancer cases can be treated and the patients can lead normal lives. It is no more a killer disease as it was thought to be in the past, because of the tremendous strides made in research in the field of Oncology.

The Institute introduced the concept of Oncology as a super-speciality as early as 1982 and started the first super speciality college in Oncology – the Dr. Muthulakshmi College of Oncologic Sciences – in 1984. The Institute, affiliated to Dr. MGR Medical University and Madras University, offers courses in Surgical Oncology, Medical Oncology and Radiation Oncology. Every year, eight students who study three specialised fields pass out of the College. The College also offers para-professional training, covering a wide variety of support services.

"Thanks to the efforts of the Institute in the area of education and professional training in cancer care, cancer hospitals across the country today have trained doctors and support staff," says Dr. Shantha. She refers to a Dr. Ravi Kumar, who moved from the Institute to start a new cancer speciality hospital in Silchar, Assam, to provide free or subsidised cancer care to poor patients there with support and guidance from the Cancer Institute, Adyar.

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A visit to the Paediatric Oncology unit, located in the old premises on the canal bank, will move anybody. This is the place where thousands of poor children from the villages of South India come for treatment of cancer – mostly lymphoblastic leukemia. From a dismal 20 per cent, the cure rate today at the state-of-the-art Mahesh Memorial Paediatric Ward is as high as 60 per cent. According to Dr. Shantha, this can be further increased if only patients come at an early stage of the disease.

The hospital was the first to establish a Paediatric Oncology unit in India, as early as 1960. In 2009, a Comprehensive Paediatric Oncology Centre, including a long-term survivor clinic, was established in the premises of the Mahesh Memorial Paediatric Ward, thanks to a generous donation from friends of Mahesh who himself was a patient at the Institute and survived for over 12 years after intensive care at the Institute.

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At every forum and at every meeting she addresses, Dr. Shantha is never tired of emphasising the importance of prevention of cancer through education. According to her, "Lung cancer is the top killer among men, mainly due to tobacco-related habits, whereas among women breast and cervix cancer are most common. These cancers can be detected early through simple check-ups. Apart from regular mammograms, it is a good idea for women to physically check for any lumps in their breasts regularly and also consult gynaecologists if they find any unusual discharge between two periods."

The Department of Preventive Oncology is a mission that reaches out to every nook and cranny of the State through seminars, lectures and screening camps conducted by specially trained Village Health Nurses (VHN) and multipurpose workers to help detect early cancer of the cervix, oral cavity and female breast.

The Tobacco Cell at the Institute is aggressively involved in anti-tobacco programmes.

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When I asked Dr. Shantha why patients are asked very detailed questions regarding not only symptoms but also a lot of personal and family details before they are registered, she said, "It is to help compile the Demographic Registry of the disease maintained by the hospital."

The Madras Metropolitan Town Registry is one of the oldest demographic registries in the country. It was established in 1984 and provides data on cancer incidence, mortality and long-term survival in all treated cases. The Institute is the only centre that provides lifetime follow-up of patients.

In 2012, the Institute launched a joint effort with the Department of Health and Family Welfare, Government of Tamil Nadu, to start the largest population-based Cancer Registry in the world, covering the 72 million people of Tamil Nadu. The information collected through such efforts is of immense help for researchers doing research on the subject. The initiative was inaugurated at the Diamond Jubilee celebrations.

(To be concluded next fortnight)

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