Dr. V. Shanta: A cancer crusader with a mission of service above self

Dr. Viswanathan Shanta [Figure 1] was born on March 11, 1927, in Chennai (formerly Madras) to a distinguished family of academicians that included two Nobel Laureates, Sir C. V. Raman and S. Chandrasekhar. Resisting the conventional path that women in her era chose, Dr. Shanta opted for a full-time career in medicine and graduated with her MBBS in 1949, DGO in 1952, and MD in Obstetrics and Gynecology in 1955. In April 1955, Dr. Shanta joined the fledgling Cancer Institute, established on June 18, 1954, by the Womens' Indian Association (WIA) Cancer Relief Fund under the leadership of the legendary social reformer Dr. Muthulakshmi Reddy. Dr. Shanta initially joined the Cancer Institute (WIA) as a Resident Medical Officer in preference to the plum Governmental post of Assistant Surgeon in the Women and Children's Hospital, Madras. She held various positions at the Cancer Institute (WIA) including Director (1980–1997) and subsequently occupied the position of Chairperson, Cancer Institute (WIA) till her very last breath in the early hours of January 19, 2021. She dedicated her entire life to the mission of organizing care for the cancer patients, the study of the disease, its prevention and control, the generation of many specialists, (including M.Ch and DM in oncology for the very first time in India in 1984) scientists, nurses, technicians, technologists, and allied health workers in various domains of oncology. She was a member of the World Health Organization's Advisory Committee on Cancer till March 2005 and also represented several other national and international committees on cancer.Figure 1: Dr. Viswanathan Shanta (March 11, 1927 – January 19, 2021)The phenomenal growth of the nascent Cancer Institute (WIA) of 12 beds, housed in Sewagram type of huts to a world-class comprehensive cancer center of 617 beds as it stands today was primarily driven by a strong institute ethos and the unique and complementary efforts of the legendary duo of Dr. S. Krishnamurthi and Dr. V. Shanta. Dr. Krishnamurthi, Advisor as he is fondly remembered was a great visionary, a genuine all-rounder in the scientific aspects of oncology, a firebrand disciplinarian, and a master strategist. Dr. Shanta, a great visionary herself, remains the immensely popular face of the Cancer Institute (WIA), owing to her charismatic persona and her humanitarian and personalized approach toward cancer care. When Dr. Shanta initially joined the Cancer Institute (WIA), the field of medical oncology was not even born. Her mentor Dr. S Krishnamurthi had formal training in general surgery and had a special interest in radiobiology and tumor pathology. Dr. Shanta, being a qualified gynecologist herself, received formal training in radiotherapy from the Princess Margaret Hospital in Canada in 1956–1957 and later studied bone marrow transplantation from the United Kingdom in 1968. The legendary duo conceptualized and practiced the important tenet of multidisciplinary management of various cancers ever since. Further, with Advisor's mantra of “Today's Research, Tomorrow's Treatment” Dr. Shanta and Dr. Krishnamurthi were involved in the conduct of several collaborative kinds of research (including randomized controlled trials) in many cancers, especially cancers of the oral cavity, cervix, breast, and pediatric hematolymphoid cancers. They went on to publish their practice-changing results in leading national and international journals of repute. Over the years, Dr. Shanta was extremely concerned about the spiraling costs of specialized cancer care and was extremely anguished over the larger menace of commercialization of cancer care. The Cancer Institute (WIA), despite its severe financial challenges, remained true to its ethos of “Service To All.” The clinical services of the Cancer Institute (WIA) continue to remain free or subsidized to about 60% of its patients. Dr. Shanta tirelessly worked to raise donations from all quarters and toward procuring government subsidies for the lifesaving, anticancer drugs to make this mission of service possible. Her secretary recalls her dictating letters seeking donations from corporates even on the last day of her life, despite her age and frailty. Furthermore, Dr. Shanta worked with the Government of India to make rail and road travel concessions possible to cancer patients to facilitate regular follow-ups. It comes as no surprise that the internationally acclaimed Cancer Institute (WIA), Hospital-Based Cancer Registry (HBCR: since 1954) and the population-based Madras Metropolitan Tumor Registry (MMTR: since 1981) established under the leadership of Dr. Shanta, as a part of the National Cancer Registry Program of the Indian Council of Medical Research, Government of India are able to provide reliable data on cancer incidence and survival for the Chennai city. Further, Dr. Shanta's efforts in making cancer a notifiable disease in the state of Tamil Nadu (under Tamil Nadu Public Health Act 1939, Government order No. 66, dated 22.02.2018) has aided in better-capturing cancer epidemiological data from across the state under the aegis of the Tamil Nadu Cancer Registry project, the largest population covered (80 million people) by any cancer registry in the world. Dr. Shanta managed to dedicate a significant part of her time to cancer prevention, especially cancers of the cervix, breast, and oral cavity. Tobacco control and cessation were a major thrust area of her advocacy efforts. The preventive oncology division of the institute has been working in collaboration with various nongovernmental organizations to carry out cancer screening camps at the district level in various parts of the state. Dr. Shanta was also instrumental in setting up a separate research division of preventive oncology to further the cause of cancer prevention and cancer research. Dr. Shanta's missionary contributions to cancer care had won her several prestigious awards, including the Ramon Magsaysay Award for public service (2005), Padma Shri (1986), Padma Bhushan (2006), and Padma Vibhushan (2016), the second-highest civilian award given by the Government of India. Dr. Shanta, however, maintained that her greatest reward was to bring a smile on the face of suffering, cure patients with cancer where ever possible, and more importantly bring relief and comfort to them always. Although Dr. Shanta used to be in periodic touch with all the staff of the institute, I perceived her customary joint address to all the institute staff on New Year's Eve since 2010 to be very insightful and inspiring. Her words of wisdom would help us better understand and appreciate the myriad facets of the Cancer Institute and would help guide us forward. She would occasionally share inspirational quotes from great leaders such as Mahatma Gandhi, Swami Vivekananda, Rabindranath Tagore, Dr. Abdul Kalam, among others. Dr. Shanta would often nudge a few of us to dream big and explore much beyond the narrow domestic lanes of academics. Further, she encouraged us to fearlessly voice our opinions against social injustice in healthcare, against corruption, and in any domain wherein a change is needed. The fact that tributes have been continuously flowing in from several people worldwide, across varied walks of life, is another reflection of the many lives that Dr. Shanta managed to touch during her remarkable career spanning over six decades. We never lose special people that we love and admire so very much. Our lives are intertwined in such incredible ways that not even death can separate us. Dr. Shanta's life has left an indelible imprint in all our memories and I believe that her legacy will forever continue to live with all of us.

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