Poor diet and self-prescribed dieting, smoking and drinking, chewing tobacco and betel nuts, and lack of exercise, are the leading risk factors for increasing cancer cases and, according to doctors, it’s affecting the country’s poorest the most.

Nepal’s two big cancer centres, BP Koirala Memorial Cancer Hospital (BPKMCH) in Bharatpur, Chitwan and Bhaktapur Cancer Hospital (BCH) in Kathmandu Valley, recorded a total of 19,433 new cases in 2017.

“The government should focus on upgrading and adding new infrastructure as patients, mostly from the lower class, are increasing,” Executive Chairman of BCH Lokendra Kumar Shrestha told the Post.

BCH, with its capacity of 150 beds, has been receiving patients from India, too, as the treatment is cheaper and better in Nepal, Shrestha said. But the scarcity of beds is affecting a lot of patients, he added.

Following a rise in the number of cancer patients, BPKMCH, which started with 100 beds in 2000, recently added 34 new beds, bringing the total number of beds to 228.

“There will be system upgrades and more beds added in the future,” Greehi Narayan Mahat, administrative officer at the hospital told the Post.

In 2003, Nepal Health Research Council (NHRC) recorded a total of 3,251 cancer cases. In 2012, a total of 7,212 cases were recorded, indicating a two-fold increase.

As per NHRC’s 2014 records, Kathmandu topped the list of the top 10 cancer-affected districts, followed by Sunsari, Morang, Chitwan, Jhapa, Lalitpur, Rupandehi, Kaski, Nawalparasi and Bhaktapur.

Lung cancer is the most prevalent cancer among Nepalis, followed by cervix and uteri, breast, stomach, gallbladder, ovary, oesophagus, urinary bladder and thyroid.

In recent years, breast cancer among women and ENT (ear, nose and throat) cancer among men have alarmingly increased, according to oncologists.

“The influence of western lifestyle, junk food and beverages, self-prescribed dieting culture are the major reasons behind the increasing number of breast cases,” Breast Oncoplastic surgeon at Nepal Cancer Hospital Dr Prafulla Shakya said.

“Women under age group of 40-50 are the most vulnerable.”

Among men, smoking and drinking from an early age and chewing tobacco and betel nuts are attributed as the major contributors of ENT cancer.

Both indoor and outdoor pollution are also significant factors affecting people who work in those conditions the most.

“Even those who’ve just begun smoking or drinking and people with poor oral hygiene, ill-fitting denture or sharp tooth can also suffer from ENT cancer,” Head and Neck Surgeon at Nepal Cancer Hospital Dr Prabhat Chandra Thakur told the Post.

Thakur, who has also practised at BPKMCH and BCH said the number of ENT cancer cases is increasing in all hospitals, and that the government should strictly regulate the sale of tobacco and alcohol.

The World Health Organisation estimates that new cases of cancer, which is responsible for one among six global deaths, could increase by 70 percent worldwide within the next 20 years.

The NHRC estimates that there are 30,000-40,000 cancer cases every year in Nepal and oncologists advise regular health check-up for the general public, as cancer shows no visible symptom in its early stage.