Feature story

Life beyond lumps

A unique approach to encourage screening for breast cancer cooks up interest in a manner far from medical

Meeta Sharma (name changed), a 38-year-old mother of three, found a knotty growth in her breast last year and got so anxious she did not know what to do. “I was scared; I wanted to get it checked by a doctor but I was feeling really awkward,” she says. Then  a cancer screening camp near her village provided the path to relief.

Called ‘Gaanth Pe Dhyaan’ (attention on lumps), the camp was part of a cancer detection programme nurtured by the Tata Trusts. Held in Ranchi in Jharkhand, just a few kilometres from her home in Chauri Basti, it enabled Ms Sharma to get a free screening session and a meeting with a doctor. The diagnosis revealed a non-malignant growth, reason enough for her to be relieved but there was more to it. “I’m so thankful I attended the camp, or I would have continued to worry,” she adds.

Gaanth Pe Dhyaan (GPD) is a unique on-ground social experiment by the Trusts that puts the spotlight on breast cancer, which affects an estimated 192,000-plus women in India every year — it kills more than 90,000 — making it the leading cause of the disease in the country.

Each GPD event starts with a cooking demonstration, which is followed by a screening camp, and covers 300-400 individuals. To make the programme more interesting, local chefs are invited to cook a regional dish that is prone to forming lumps if not prepared right. A few participants taste the dish and when they point out that the lumps mar the offering, the narrative shifts to breast cancer. The question then arises: if we take care not to have lumps in food, why don’t we check for these in our bodies?

The message being driven home is that women must not ignore their health, that they have to, as a first step, be responsible for conducting regular self-examinations to check for breast lumps.

Getting started

The first GPD event was held in October 2023, to coincide with breast cancer awareness month, at the Ranchi Cancer Hospital and Research Centre, a unit of Tata Trusts Cancer Care Foundation. A leading Jamshedpur chef and entrepreneur, Priya Gupta, was at the event and drew an all-women audience from local communities. Ms Gupta conducted a live cooking session on stage to make dhuska dhokla, a local savoury that tends to get lumpy if not prepared right.

The link between lumps in food and the importance of self-examination of breasts for lumps (which could be a symptom of cancer) was made clear to women in the audience, who were then encouraged to go in for a clinical breast examination. The Ranchi event turned out to be a tasty success, with around 400 women signing up for cancer screening.

“Screening-related activities, that too for cancers, are always tricky as we are reaching out to apparently healthy populations and hence there is no strong felt need to undergo screenings,” says Dr Vikram Sahane, lead, public health at the Tata Cancer Care Foundation, an initiative of the Tata Trusts. "An event like this takes a creative approach to generate interest in the community.”

GPD’s correlation with the community has been encouragingly positive. Over 90% of the attendees go for screening and that makes the investment in equipment, screening personnel and other resources for the event worthwhile.

The Ranchi response encouraged the Trusts to take the initiative further. Live events have since been held in Tirupati (Andhra Pradesh), Dibrugarh (Assam) and Kolkata (West Bengal). Devoid of medical jargon, the ‘lumps in food’ metaphor has worked well at all the locations where it has been staged.

In Kolkata the team tied up with chef and food author Ananya Banerjee, who cooked a local delicacy called rosopuli pitha. In Tirupati, chef Sailaja Aechuri, who runs a YouTube cooking channel, made tomato baath. She was joined by chef Varaprasad Karthyaeni (from the Taj Group of Hotels in Tirupati), who made pineapple kesari. In Dibrugarh, well-known chef Santa Sarmah came on board to cook a local favourite, narakhinha soup, in lumpy style.

In each of these GPD shows, hundreds of women signed up for cancer screening. The events are backed by the Trusts’ cancer care ecosystem, which works with the regional chapters of the Indian government’s National Health Mission and trains local frontline workers to help with the screenings.

The GPD programme has blossomed well enough to take the shape of a movement. Multiple hospitals are replicating the idea and more than a 100 media stories have highlighted the power of the idea.

The audience at the Gaanth Pe Dhyaan event in Kolkata

Fear of the unknown

Dr Sahane says this programme could not have come at a better time, considering the ever-rising cases of breast cancer in India. “This cancer is curable in most cases if detected early,” he says. “Unfortunately, women are either not aware that they may have it or are afraid to find out.”

The Trusts have long been committed to driving cancer-care interventions. Their comprehensive cancer care programme, launched in 2017, rests on the four pillars of better access; enhanced quality of care; affordability; and awareness, detection and palliative care.

Powerful communication has been critical in increasing awareness. In addition to the cooking demo events, the Trusts have made three short films that speak about watching out for symptoms and taking them seriously. What makes GPD vital for India is that over 50% of breast cancer cases in the country are diagnosed in the late stages, leading to preventable fatalities.

“Early detection is the key to survival,” says P Arun, director of the Tata Medical Center (Kolkata) and a senior oncology consultant. “People allow cancers to grow by avoiding regular checkups. Screening is scary but cancer is scarier. By the time the pain manifests itself, it’s nearly always late.”

Another supporter of the GPD initiative is Kailash Sharma, who joined the Tata Trusts cancer care programme in 2019 after a successful stint of three decades at the Tata Memorial Hospital, Mumbai. He is responsible for staffing the Tata cancer hospitals and centres coming up in India. “It’s good that we are getting these state-of-the-art facilities in India, but my heart sinks when I see advanced cases of cancer that could have been stopped in their tracks with early detection,” he says.

The GPD programme was the culmination of intensive research in the catchment areas of key Tata cancer hospitals. The core of the idea lies in addressing the fear and the multitude of questions that the disease brings for patients and their caregivers.

“Captured creatively in ‘kaise ka cancer’, a campaign that garnered more than 20 million views, the Trusts felt reassured that large-scale awareness campaigns can effectively change perceptions and reduce the stigma and the fear, nudging people to take action with the belief that every ‘question’ does have an ‘answer’,” says Deepshikha Surendran, head of communications at the Trusts.

The multimedia, multi-language campaign reflected a comprehensive segment approach. “We expected the GPD idea to gain immediate traction because of its core insight, the simple metaphor employed and the ease of action,” adds Ms Surendran. “Every hospital we did this in, the staff were amazed at how simple the concept was and how we were able to engage the community.”

What keeps the initiative going is the impact, of course, as well as the responses from participants. “It’s wonderful to see villagers, teachers, doctors, college students and others all come together for a common cause,” says Kumud Jha, president of Ranchi-based NGO Divyam Dream Foundation.

The chefs who participate are also completely on board, happy that they can use their skill and talent to make a difference. They contribute ideas on recipes and dishes and even share their personal stories. Laeba Ashraf, a chef from Taj Vivanta in Bhubaneswar (Odisha), attended the Ranchi event and related her story of how her grandmother survived breast cancer due to early detection.

At the Kolkata event, one of the participants was a woman from Bangladesh, attending along with her family. She had been diagnosed with leukaemia and had found out that the diagnosis was incorrect. After the cooking demo, she made sure she was among the first to register for the breast cancer screening, telling the other participants, “I understand the trauma that we go through if we are told that we have cancer. Better to get yourself properly checked.”

The launch of Gaanth Pe Dhyaan (in Ranchi, Jharkhand, in October last year) had more than 300 women in attendance