On Tracks Of Hope and Despair Runs India’s Cancer Train

Every night at 9:30 PM, the Abohar Express, the Cancer train departs from Bhatinda station in Punjab, bound for Jodhpur. The twelve-coach train offers no air-conditioned coaches or reserved seating. Passengers travel on a first-come, first-serve basis. Most are cancer patients and their attendants, carrying little more than sheets of paper in plastic bags as their belongings, all heading to the Bikaner district of Rajasthan in search of affordable treatment.

1.4 million people had cancer in India in 2020. The expected rise in 2025 is 1.57million.

Treatment is available in Punjab, yet the final destination for most on this train is Acharya Tulsi Regional Cancer Hospital and Research Centre in Bikaner. 

Back home, the long queues and exorbitant cost of treatment drive them to distant locations.

The railways bear the cost of travel for cancer patients, while the food and lodging in Bikaner are more reasonable than in the affluent Punjab.

The cause of cancer is mutations or changes in the genetic material DNA of your cells. These genetic mutations can be inherited during birth or due to environmental factors. They are called carcinogens a few examples are

• Radiations and ultraviolet light.

• Chemicals like cigarettes, smoke, asbestos, alcohol, air pollution, and contaminated food and drinking water.

• The biological carcinogens are bacteria, viruses, and parasites.

The reason for the spike in cancer cases is 

• Changes in food consumption patterns 

• Genetic predisposition to the disease, and 

• Negligence in medical attention at the start of cancer.

Normal cells grow, divide, age, and die in the body. Cancer develops because of the uncontrolled replication of cells, which leads to their accumulation. DNA in cells is like a code that runs within our cells. In a way similar to computer codes running a computer. DNA carries instructions for cells to function, grow, and divide. When mutations occur, the suppressor cells in our body correct it.

Sometimes, DNA gives erroneous instructions to cause changes within the cells. It is called a mutation, it results in.

• Rapid growth of cells produces new cells that have similar mutations.

• An uncontrolled growth of cells causes cells to pile up and cause cancer.

• The DNA repair gene cannot make corrections, and more cells duplicate that have cancer anomalies.

These mutations occur by exposure to chemicals.

The patients traveling on this train are small farmers from the southern districts of Punjab, namely Mansa, Sangrur, Faridkot, Bhatinda, Muktsar, Moga, Firozpur, and Sangrur all make up the Malwa region.

Malwa is Punjab's cotton belt. Farmers here use a large number of pesticides to grow crops. Punjab farmers use 923 grams/hectare of pesticides, way above the national average of 570 grams/hectare. Their use of pesticides and sprays is excessive. Using chemical fertilizers and pesticides has resulted in farmers and their families living with toxicity.

A deep search revealed that farmers used empty pesticide cans to store water and food that gets contaminated with heavy metals.

The high use of pesticides leads to their accumulation in groundwater, drinking water, food, and the human body.

Many farmers blamed the Green Revolution of the 1970s when they switched to using high-yield seeds, fertilizers, and pesticides, leaving behind their traditional farming methods.

For most farmers, there is no escape. The land they have tilled is a part of their lives, just like the disease. A few do not need to board the train, but many acquaintances do as their journey and suffering continues.

The hazards of using pesticides in agriculture are becoming known. Traces of pesticides in more than acceptable amounts are present in Cow’s milk from Punjab and heavy metals in groundwater of the Malwa region ring alarm bells. No wonder there is a shift in demand for organic food products.

'Cancer Train' stands as a stark reminder of the urgent need for accessible healthcare and environmental reforms to address the growing cancer in the nation."

1.     Parsa, N. “Environmental Factors Inducing Human Cancers.” Iranian Journal of Public Health 41, no. 11 (November 1, 2012): 1–9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3521879/.

 2.     Aktar, Md Wasim, Dwaipayan Sengupta, and Ashim Chowdhury. “Impact of Pesticides Use in Agriculture: Their Benefits and Hazards.” Interdisciplinary Toxicology 2, no. 1 (March 2009): 1. https://doi.org/10.2478/v10102-009-0001-7.

(Rehash/Dr. Swati Sharma/MSM)