SME WORLD Bureau
Positive Bioscience is India's leading clinical genomics company using big data and artificial intelligence to predict disease risk in healthy individuals and optimal treatment options in cancer patients. Positive Bioscience believes in providing world-class molecular genetic testing and provides Personal Genomics tests which are targeted to healthy individuals for predicting disease risk and preventing it and Cancer Genomics test which are targeted for guiding treatment in cancer patients.
Positive Bioscience's Cancer genomics product is the most comprehensive genomic test which helps identify the genetic alterations in a patient's tumor and match those alterations with relevant targeted therapies and clinical trials. Cancer Genomics test is available for all cancers like Lung Cancer, breast Cancer, Ovarian Cancer, Prostate Cancer, Sarcoma etc.
Positive Bioscience's Personal Genomics test is for healthy individuals who want to learn their disease risk and prevent it. Personal Genomics test is available for understanding the risk Hereditary Cancers, Heart Diseases, Neurological disorders etc. Personal Genomics reports provides personalised prevention plan as per person's genetic profile with genetic counseling. Positive Bioscience believes that preventing the disease is much easier and cost effective than treating it and thus give enormous focus on preventive strategies.
The company has presence in all major metros in India including Mumbai, Delhi, Bangalore, Hyderabad, Kolkata, Pune etc. and have capability to pick up and process samples from anywhere in India. All the tests are carried out in NABL/CAP/CLIA accredited laboratories in India, USA, China or Germany.
Started in October 2012 by Samarth Jain, Positive Bioscience launched India's first comprehensive cancer genomics test in 2014. It also opened India's first Personal Genomics clinic in Medanta, The Medicity in August 2014. Over next 3 years Positive Bioscience plans to expand aggressively and open 100+ Personal Genomics clinics in all leading cities.. For cancer genomics company is working very closely with oncologists to improve cancer outcomes in India by making its cutting edge genomics test more accessible to patients. It intends to sequence 2 in 10 cancer patients by 2018 a ratio which is prevalent in USA now for Genomics test. The company expects to reach a turnover of Rs 2000 crores by 2020.
SME WORLD in conversation with Samarth Jain, Founder, Positive Bioscience.
What is the general scenario of the incidence of cancer patients in India vis a vis other developing countries?
The global burden of cancer has seen an exponential growth in the developing world in the last few years. The incidence of cancer in India was 1.1 million in 2015 as reported by the World Health Organization and is estimated to reach 7.1 million by the year 2020. A similarity in situation can be seen in other developing nations like China, Mexico, Vietnam, African and Arab nations where the incidence of different types of cancer is on the rise. The age-standardized cancer incidence in India is estimated to be 150-200 per 100,000 people, which is higher than Africa and equivalent to China. Together China and India account for about 28% of newly diagnosed cancer cases in the world according to a study published by the pharmaceutical giant, Pfizer.
Speaking specifically about India, the real incidence of cancer is expected to be at least two times higher than that reported. This gap in the reported and the real statistics can be attributed to the under diagnosed state of affairs when it comes to cancer. The growth in cancer burden can be specifically targeted to a number of reasons:
Changes in the demographics: Breast and cervical cancers occupy the highest burden of incidence in women, while cancers of the head and neck, lung, gastrointestinal and liver are widely diagnosed in the male population, and accounts for 60% of the total incidence of cancer in the nation.
Exposure to risk factors: As a rapidly developing country, the population is succeeding in achieving lifestyles similar to those of developed economies—unhealthy eating habits, increase in sedentary work, consumption of alcohol, use of processed food products and other environmental factors are anticipated to lend a helping hand to the rising cancer incidence.
Who are most vulnerable to the growth of cancerous cells?
It is usually impossible to know why one person gets cancer while the other doesn't. However, scientifically evidenced research has shown that there are certain factors which can increase an individual's chances of developing cancer. Widely acknowledged as 'risk factors', these things range from a certain lifestyle, dietary habit, exposure to chemicals, use of cancer causing agents like tobacco or alcohol, age, sex, geneticsand family history.
Genetics and family history: The risk of certain cancers (breast, ovarian) may be highly increased if any of your family member was diagnosed with the same. Also, mutations in certain specific genes can increase your risk for developing a particular cancer. For eg: A mutation in BRCA1 gene can increase your risk for both breast and ovarian cancer.
Diet: An unhealthy diet dictates one of the main causes of cancer in India. About 70% of colorectal cancer cases in the country are believed to be due to imbalanced diet. However, the impact of diet is different in different types of cancers. Heavy consumption of dietary fat and processed red meat have been positively linked to the gastrointestinal, breast, and even oral cancers. Consumption of large amounts of red chilies and food at very high temperatures have also been known to cause cancer.
Tobacco: Use of tobacco accounts for about 65% of the current cancer incidence in both men and women respectively. Cancers of the lungs, oral cavity, esophagus, pharynx, larynx and urinary bladder are mainly caused by tobacco and its products. Smoking is the most notorious factor for the causation of lung cancer.
Alcohol: Annually, about 9.4% new colorectal cancer cases are attributed to the consumption of alcohol, globally. Chronic alcohol consumption has been found to be a risk factor for the cancers of the upper respiratory and digestive tracts, including oral cavity, hypopharynx, larynx and esophagus as well as liver, pancreas, mouth and breast cancers.
Chemicals: Scientists suggest that about 90% of the cancer cases can be owed to environmental contaminants. The risk of lung cancers is increased by a number of outdoor pollutants such as poly aromatic hydrocarbons.Indoor environmental pollutants such as volatile organic compounds and pesticides increase the risk of leukemia and lymphoma, and brain tumors.
What are the prime reasons and spell out basic prevention elements?
There are several factors which can increase the risk of developing cancer. However, not all people who are exposed to these factors or have other risk factors develop cancer. Some of the risk factors are:
Family history and genetic factors: Mutations in certain genes can increase your risk for developing cancer which may also present a hereditary threat. For eg: A mutation in the BRCA1 gene can significantly increase the risk of both breast and ovarian cancer in women.
Tobacco use: Use of tobacco or its products substantially increases the risk of developing cancers of the mouth, lungs, throat, esophagus etc. Tobacco use is infact, the single largest contributor to cancer mortality.
Infectious agents: The three leading types of cancer causing infections are hepatitis B and C virus: liver cancer, human papilloma (HPV) virus: cervical cancer and Helicobacter pylori: stomach cancer.
Environmental factors: Exposure to certain chemicals present in the environment around us (pollutants, industrial chemicals, occupational exposure to chemicals) can alter your DNA which can initiate the formation of cancer in the body.
Diet and body weight: What you eat has a significant impact on your risk for developing cancer. This along with your body weight seems to act in a complex manner to either promote or mitigate the risk of cancer. For instance, a diet high in unsaturated fat, and obesity by itself, has been linked to an increased risk of colon, breast, and possibly prostate cancer.
The risk of cancer can be reduced by controlling several lifestyle habits:
Do not use tobacco or its products.
Avoid excessive intake of alcohol.
Make sure to use appropriate sun protection before stepping out in the sun.
Limit your intake of high fat, processed foods, particularly from animal sources (processed meats, whole fat dairy products).
Increase intake of high fiber, whole grain and fresh fruits and vegetables.
Keep a healthy weight and be physically active.
Get regular health checkups especially if you're above 50 years of age. Early diagnosis can aid treatment.
Are all cancer treatable?
Early detection is often the key to surviving cancer. If found in early stages, most cancers can be treated with the right drugs and lifestyle interventions.
To what extent timely detection can help overcome cancer?
Every year about 1 million new cases of cancer are diagnosed in India, but unfortunately, more than half of them are in either stage III or IV where the chances of survival are very poor. Even with the most effective medicines available to treat a particular type of cancer, the stage at which the cancer is diagnosed is very important for effective treatment. If a cancerous tumor is detected in the first or second stages of the disease, it can be successfully treated in 95% of the cases.
Since Positive Bioscience test is for healthy individuals, can a common man afford it?
The cost of genetic testing has seen a significant concavity in the last few years. The cost of DNA testing was a few thousand dollars about few years back. However, new DNA technologies that have been developed in the decade that has passed and which we use have helped to drive this cost to affordable levels. Today, one can get his or her entire genome sequenced for less than a thousand dollars. Genetic tests can also be customized to a specific disease panel further reduces the cost of the test. In the coming years, the prices will reduce further wherein an entire genome could be sequenced at less than $400. So while the affordability factor will soon be accounted for it's the accessibility of these tests that we need to focus on.
Diagnostics is one branch which is perfect. Thanks to the advancement in medical science. In India, advance diagnostics is yet unaffordable whereas almost 70% of India lives in rural areas. How can we make diagnostics within the reach of the common man?
Today we have an arsenal of different diagnostics tools for detecting various types of diseases in early stages. Yes, early detection is the key for defining the success of a treatment plan and its effectiveness. However in a developing country like India where a huge part of our population lives below the poverty line with meager healthcare knowledge and allowances, the situation does look grim.
The immediate step that can be taken to mend the diagnosis gap in rural India is spreading awareness. Arranging talks in regional languages which are easy to understand, educating people of the symptoms, the importance of timely diagnosis and the various treatments available can have a big impact. Rural India reports the highest use of tobacco which is known to increase cancer risk. Field level health workers need to be trained to produce awareness about the ill effects of such habits. It is also important to build collaborative networks with diagnostic centers in the urban areas who can help improve the availability of such tests in rural parts of the country. Networking with local hospitals in the rural parts and arranging swift sample pick is another initiative we need to focus on. One of the biggest challenges of the healthcare model in rural areas is lack of trained medical personnel—who can serve as big influencers in informing the residents about the various diagnostic tests as well as source in efficient ties with the government and industry to expedite the situation. Educating clinicians and doctors who serve in the rural areas about the availability of genetic testing is also important.
What is your vision on the cancer scenario in the next five to 10 years?
Currently, cancer is highly under diagnosed in the country. Our vision is to change this situation where we want to begin by informing people of their risk to start with and then move on to guide their treatment plan suited specifically for them. Genetic testing can both asses the risk of cancer and recommend a prevention plan as well as guide a cancer treatment plan specific to the individual depending on his or her genetics. If we look at the Western world, about 1 in every 10 cancer patients are already benefitting from genetic testing. Sadly in our country this number is as low as 1 in 10, 000. Our company wants to expand the cancer genomics space in India and sequence about 2 in 10 cancer patients in the next three years.
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