High quality cancer treatment in the country is set to see more investment from private sector entrepreneurs as the number of cancer patients is going up every year while quality treatment stays out of reach for most.

Some of these privately-led initiatives are focused on critical areas of cancer care.

The National Institute of Cancer Research and Hospital (NICRH), the country's only full-fledged government-run cancer hospital established in 1991, has limited facilities.

Currently, the number of people opting to go abroad for cancer treatment is only increasing due to few treatment facilities and patients' lack of confidence in the hospitals.

Now, private sector entrepreneurs have entered the sector to change all that – envisioning a complete cancer care infrastructure inside the country.

Doctors say cancer treatment in the country is gradually becoming more advanced. A number of modern treatments including robotic surgery and targeted therapy are now available. Several private hospitals are equipping  up to provide these advanced treatments.

"Facilities for cancer treatment in government hospitals are inadequate. So we need private hospitals," Cancer Epidemiologist Dr Habibullah Talukder Ruskin told The Business Standard.

Acknowledging high treatment costs in private hospitals, he suggested that the government should step in to control the cost and make cancer treatment more affordable.

Dr Ruskin also urged owners of large enterprises to consider setting up cancer hospitals.

"We have big businessmen, who are investing thousands of crores in massive projects. The number of cancer patients is increasing in the country. Many are becoming bankrupt from the expensive treatment abroad. If the treatment were available in the country, it would have been much cheaper," he said.

Dr Ruskin also pointed out that those who can afford it, go abroad for cancer treatment because they do not trust the quality of treatment available here.

"We have to focus on gaining the confidence of patients," he stressed.

Success of cardiac treatment
Some two decades ago, a large number of people used to go abroad for treatment of heart disease. At the same time, however, several dedicated private cardiac care hospitals have been established. Most importantly, these hospitals have also gained people's trust by providing advanced treatment for heart diseases.

With the private sectors stepping in, the quality of heart treatments has also improved in government hospitals. Besides, the initiatives created more job opportunities and with time a skilled manpower has developed in heart treatment.

Prime Minister Sheikh Hasina, at a conference of the Bangladesh Cardiovascular Research Foundation on February 24, said Bangladesh now has 95-98% treatment capacity for heart diseases.

"The country is now equipped with skilled manpower, modern technology and necessary equipment to provide cardiovascular treatment," added the premier.

Initiatives for cancer treatment
In 1991, the government established the country's first dedicated cancer hospital, the National Institute of Cancer Research & Hospital (NICRH). In 2001, dedicated private sector cancer hospital Ahsania Mission Cancer Hospital was established followed by Khwaja Yunus Ali Medical College Hospital in 2004.  Later Delta Hospital introduced cancer treatment from 2007. The Labaid Cancer Hospital and Super Specialty Center became operational in 2020.

Labaid is set to establish another cancer hospital in the capital with an investment of some Tk1,000 crore.

Besides, several private hospitals – United Hospital, Evercare, Square and BRB Hospital – are providing cancer treatment through their own cancer centres. These hospitals provide cancer treatment for all three stages – surgery, chemotherapy and radiotherapy.

Apart from the government-owned cancer institute, the government medical colleges of the country provide cancer treatment, but on a limited scale.

The government is also set to establish cancer centres in eight divisions of the country at a cost of some Tk50 crores each.

A M Shamim, managing director of the Labaid Group told The Business Standard, "In the last three months, five people I know were diagnosed with cancer. Three of them went to Singapore while two went to India. They have spent several crores there. The same treatment was possible in my hospital for half a crore taka."

He also pointed out that cancer treatment is usually a lengthy one that lasts for three months to a year.

"For many it is not viable to avail the treatment abroad for a long time. So we are working to gain people's trust in cancer treatment. We have already been able to do it in cardiology," he said.

"Our home-grown pharmaceutical companies are already making cancer treatment drugs," he said, adding that a full-fledged lab to get accurate test results will be built by 2023.

Dr Arif Mahmud, head of Evercare Hospital Medical Services, said while increasing cancer treatment facilities are important, it is more important to train more oncologists, doctors, technologists and physicists.

It is key to encourage people to get cancer treatment at home, according to the doctor.

He also recommended that cancer treatment should not remain capital centric rather be available in all divisions in the country.

Evercare is set to open a cancer centre in their hospital in Chattogram next month making it the first private cancer care centre in the port city.

Dr Arif Mahmud also said that Bone Marrow Transplant at their hospital costs Tk12-15 lakh while in India it costs Tk50 lakh.

"There is a need for awareness about cancer and investors need to come forward," he added.

State of cancer diagnosis and treatment in govt facilities
According to the Bangladesh Cancer Society, there are approximately 13 to 15 lakh cancer patients in the country.

Some 1.56 lakh new cancer patients are diagnosed in Bangladesh each year while 1.08 lakh people die from cancer, according to the Globocan 2020 data.

The cancer institute, which is the only dedicated public cancer hospital, is under equipped to provide cancer care. Of the six radiotherapy machines, five are non-functional. Three of the four linear accelerator machines are out of service. The sole machine for brachytherapy and two cobalt-60 machines used for radiation therapy have been decommissioned and the facility is struggling to provide adequate treatment to cancer patients.

While the government medical college hospitals offer cancer treatment on a limited scale, they are also burdened with out-of-order machineries. Radiotherapy machines in five of the nine government medical college hospitals are not functional.

Besides chemotherapy is not given in all of these hospitals and patients often are unhappy with diagnosis and treatment.

Dr Golam Mohiuddin Faruque, president of the Bangladesh Cancer Society told TBS, "Many patients go abroad because of non-functional machines in government hospitals and inadequate diagnosis capabilities.

"I believe the number of patients going abroad will decrease if high-quality diagnosis and treatment are provided at the private level, he added.

Medical expenditures per year
Some seven lakh Bangladeshis go abroad for medical treatment every year. Although there is no specific information on how many patients go abroad for cancer treatment in particular, experts say most of the patients who go abroad for treatment are cancer patients.

India tops the list of medical tourism destinations, followed by other countries such as Singapore, Thailand, Malaysia and the United Arab Emirates.

According to the Bangladesh Bank data, Bangladeshis spent $2.2 million in fiscal year 2019 for medical treatment abroad. The amount for both 2020, 2021 fiscal years were $1.6 million while in fiscal year 2022, it was $2.3 million. In the current fiscal year 2023 Bangladeshis have spent $1.1 million as of February.