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A train offers hope to Punjab’s patients with cancer but it isn’t enough

BMJ 2014; 349 doi: (Published 08 July 2014) Cite this as: BMJ 2014;349:g4484
  1. Akhil Kapoor, resident, Department of Radiation Oncology, Acharya Tulsi Regional Cancer Treatment and Research Centre, Sardar Patel Medical College and Hospitals, Bikaner, Rajasthan 334003, India
  1. kapoorakhil1987{at}

Pesticides may be to blame for cancers among Punjab’s farmers. Indian Railways is helping farmers get the care they need, writes Akhil Kapoor, miles away at a cancer centre in the middle of a desert

The green revolution in India increased food production, but the agrochemicals it employed are now being blamed for cancer epidemics. India achieved self sufficiency in the production of food and cotton in the 1970s.1 The villages of the Malwa region in Punjab, once the hub of cotton production, now see thousands more cases of cancer than would be expected. The Muktsar district of this region has recorded 136 cancers for every 100 000 population, compared with the national average of 80.2

These villages are being called “cancer hubs.” Patients believe that the diagnosis of cancer alone is a death sentence. The whole family suffers, having …

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