First Head and Neck Surgery Program in Madhesh State of Nepal at the Binaytara Foundation Cancer Center Impacting Community

Dr. Rubina Suwal performs successful head and neck surgery

Dr. Rubina Suwal, the head and neck cancer surgeon at the Binaytara Foundation Cancer Center (BTFCC) in Janakpur, Nepal, recently treated a cancer patient in the community. The 40-year-old female patient came to the hospital with non-healing ulcers on her tongue, which Dr. Suwal described as a sign of cancer.

“The good thing is [that] she came to us in an early stage, which was completely curative, and she, including her family, were motivated to cure the disease.”

Dr. Rubina Suwal

The treatment plan involved diagnosing with a biopsy and performing surgery on the patient’s tongue and neck to remove the cancer. Head and neck surgery usually consists of three parts: primary resection, neck dissection, and neck reconstruction. Because the patient had an early stage of cancer resulting in a smaller defect, she did not need reconstruction. Post-surgery analysis of the tissue confirmed that it was stage 1 cancer, which meant that the patient would not need further treatment or radiation.

Dr. Suwal reflected on how the patient and her successful treatment was impactful to her.

“She was a young patient, a mother…I feel good that I was able to help [this] patient have a better life and to get treated, as she is young and has her life ahead. It really motivated me, I feel satisfied that I could leave some impact on the life of the cancer patient.”

Challenges Faced in Providing Cancer Care

The Binaytara Foundation Cancer Center (BTFCC) is the only one of its kind in Province 2 (Madhesh) of Nepal. Previously, residents had to travel to the central province for treatment, but now they can have access to care in their community. As the center has grown, they have been able to offer more specialized doctors and departments, such as the head and neck oncology department, which opened six months ago and has already made an impact on the community.

“The main challenge of the patients for getting treated is that they are financially not capable of affording treatment, even if it’s a very small cost. We have been trying to do a minimum cost, the material cost, but they are still unable to afford it.” Suwal stated.

The Center addresses this challenge by first offering care at the lowest cost possible, and if the patient and their family cannot afford it, they donate the treatment at no cost.

Another challenge that the Cancer Center faces is how cancer and its treatment is viewed by the community.

“In our community, cancer is regarded as a very dangerous disease and when we try to help them, the people are scared because of the social stigma and lack of awareness.”

Dr. Suwal

To address this fear, Dr. Suwal is working to educate the people of Janakpur and surrounding cities on cancer, its prevention, and the availability of treatment.

Oral, or head and neck cancer, has become prevalent in Nepal and throughout South Asia because of the use of tobacco and tobacco related products.

“[Use of] tobacco and related products has led to greater incidences of cancer because it is one of the most dangerous carcinogenic products. It is one of the most widely used products that is causing cancers in the oral cavity in most of the population of South Asia.” Suwal explained.

She has worked on educating the community to create awareness of the dangers of tobacco use and how they can effectively prevent cancer.

Along with addressing the financial constraints and community mindset around cancer care, Dr. Suwal is also facilitating academic activities for local doctors and medical professionals to further their understanding of head and neck cancers and improve patient care.

Providing cancer care in a developing country comes with its challenges, but Dr. Suwal and the staff at the Binaytara Foundation Cancer Center (BTFCC) are working hard to overcome them, and they are confident that they will continue to make an impact.

“[There] are challenges but we are on our way to helping the local community as much as possible.” Dr. Suwal said.

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The Binaytara Foundation is a global cancer non-profit dedicated to improving access to cancer care in the United States and abroad through education and innovative program models that break down barriers and advance best practices in hematology and oncology. Binaytara Foundation’s major projects include hematology and oncology conferences, and the establishment of a cancer hospital in Nepal.