(This news article is in two parts. Part-I is published today.)
ANANTNAG: Aggressive cancers, particularly brain and digestive tract tumors, are striking down orchard workers and farmers at alarming rates across Jammu and Kashmir. For over a decade, doctors have watched this devastating pattern emerge.
A 2010 study from the Sher-i-Kashmir Institute of Medical Sciences (SKIMS) revealed that orchard workers exposed to pesticides were over ten times more likely to develop malignant brain tumors than unexposed people.
At Government Medical College in Anantnag, located in the heart of Kashmir's agricultural belt, oncologists witness this grim reality daily while studying patients with unique symptoms filling the hospital.
The hospital registered over 730 new cancer cases in 2025 alone, pushing its total past 3,500 since 2022, an overwhelming burden for a facility only a few years old.
Young farmers arrive at hospitals with persistent and drilling headaches. Fathers collapse with seizures in their fields. Children suddenly can't walk straight and amble along with unsteady gaits. After months of dismissing these symptoms as related to stress or minor ailments, they arrive and leave with brain scans that reveal the horrifying truth of healthy tissues replaced by malignant tumors.
Across the Valley and the rest of Jammu and Kashmir, the findings from hospitals are similarly alarming.
The 2010 SKIMS study found pesticide-exposed orchard workers had a Relative Risk of 10.6 and an Odds Ratio exceeding 10 for brain tumors. In epidemiological terms, they're alarm bells, and not just statistical anomalies.
The Alarming Scale
Based on the comprehensive data provided from major healthcare institutions across Jammu and Kashmir, a clear and concerning surge in cancer incidence in the region is evident over the past decade.
SKIMS, Srinagar: Cases rose from 3,940 in 2014 to over 5,200 by 2024, with a notable peak in 2022 at 5,271 cases. Overall, a 32% increase was registered in the last decade. Unofficial 2025 figures show over 5,000 registered cases.
SMHS Hospital, Srinagar: A sharp rise was witnessed in its cancer patient load, from 491 cases in 2017 to 1,640 in 2023, with 2024 registering approximately 1,520 new cases by late November. The daily influx at SMHS is reported to be between 4 to 5 new patients, underscoring a sustained high volume of diagnoses.
GMC Jammu: A Hospital-Based Cancer Registry recorded 9,630 patients over the five years from 2018 to 2022, while a separate report covering 2020 to 2024 logged 9,427 cases. The recent data is particularly striking, with around 1,670 new cancer cases registered at the associated Cancer Institute in just the nine months between April and December 2024.
The compiled statistics from SKIMS, SMHS, SMGS, and other newly established health institutions collectively paint a picture of a growing public health challenge, indicating an increasing cancer burden in Jammu & Kashmir that necessitates continued monitoring, resource allocation, and enhanced diagnostic and treatment infrastructure.
The overwhelming wards bear testimony to this crisis as it unfolds, not only in the major institutes but also in the district hospitals.
The relatively new centre at GMC Anantnag alone registered over 730 new cancer cases in 2025, taking its total registry past 3,500, since 2022, indicative of a wave it is struggling to manage.
However, doctors at the facility are a bit hesitant to speak about it.
“We see such cases regularly – patients in their 30s or 40s, sometimes younger, from an apple-growing district like Shopian, Kulgam or Anantnag,” a neurosurgeon at GMC Anantnag, who spoke on condition of anonymity, finally revealed. “They often suffer symptoms of raised intracranial pressure like headaches, vomiting, and visual disturbances. The MRI reveals a high-grade glioma.”
An onco-surgeon at SMHS, Srinagar elaborated on a “concerning cluster” of cases among orchard farmers. While comprehensive, published epidemiological studies are still in their nascent stages in Jammu and Kashmir, internal audits and patient registries echo the older SKIMS findings with unnerving consistency, even at SMHS Hospital.
Small-scale, ongoing reviews of patient histories consistently flag prolonged pesticide exposure as a common denominator, particularly among patients with glioblastoma multiforme, the most aggressive and lethal form of brain cancer, he revealed.
“What is striking is the exposure history,” the surgeon explains, the weight of witness in his voice. “It’s not a matter of years; it’s decades. It begins in adolescence for many. And it’s not just the sprayer. We have cases of family members, including women and children who live within the orchards. The concept of ‘bystander exposure’ is very real here.”
The story of toxicity in Kashmir’s idyllic landscapes is not confined to the apple orchards, nor is its clinical manifestation limited to brain tumours.
Dr Mir Mujtaba, a Gastrointestinal Oncological Surgeon at GMC Anantnag, points to another, parallel epidemic emerging from the waterlogged paddy fields that quilt parts of the valley in emerald green.
“In the areas of Middle and Lower Brengi, and in parts of the Lidder Valley, Dachnipora, Khoveripora besides Shahabad, Larkipora, and Home Shali Bugh in Anantnag district, a different chemical horror unfolds every June and July,” Dr Mir Mujtaba states with clinical directness, referring to the already available literature.
“To kill weeds emerging during the paddy broadcasting season, a highly toxic herbicide, paraquat, is applied liberally. This chemical doesn’t just stay in the fields. It directly percolates into the mainstream rivers and streams that feed our waterways and, eventually, our drinking water sources.”
The consequence, he observes, is etched in the pathology reports of patients on his operating table.
“We are seeing a significantly higher incidence of adenocarcinomas, particularly of the gastrointestinal tract, in these populations compared to others. The timing, the geography, and the known toxicity of these chemicals form a pattern that is impossible for a clinician to ignore. The water is poisoning them,” he says with urgency.
However, Dr Mir notes that cancers are at a primordial stage and can be analysed at a molecular level. “While institutions like Kashmir University and SKIMS have done some excellent case studies, ours can be the hypothesis and the cases are to be correlated with the latest findings.”
He further adds that widespread use of fungicides and pesticides affect human health primarily through the processes of bioaccumulation and biomagnification, where these toxic residues move up the food chain from the grass to livestock (sheep, cows, buffaloes, poultry) and finally to humans who consume their milk and meat products, and that the prevalence of such cases also needs to be documented.
This expands the crisis from a neurosurgical specialty to a broader oncological catastrophe, implicating the very waterways of Kashmir as potential vectors of chronic disease.
The Chemical Landscape and Exposure
Kashmir's small-scale farming is an industrial chemical operation. Nearly 200,000 hectares of orchards are treated with thousands of tonnes of chemicals each season. Official figures report over 7,500 metric tons of fungicides and 3,100 metric tons of insecticides used annually. These are likely to be significant underestimates due to unlicensed and counterfeit products.
Farmers are told to spray up to 10 times per season. In reality, fearing crop loss and pushed by aggressive marketing, many spray 20 times or more.
The chemicals being used include:
Chlorpyrifos: An organophosphate insecticide that disrupts brain development in children at sub-poisoning levels. The EU banned it in 2020.
Mancozeb & Captan: Widely used fungicides classified as suspected carcinogens. Mancozeb breaks down into ethylene thiourea (ETU), definitively linked to cancer and thyroid disruption in animal studies.
Paraquat: A herbicide used in paddy fields. A single sip can be fatal with no antidote. Banned in over 50 countries including the EU and UK. Chronic exposure is linked to lung damage, Parkinson's disease, and suspected cancer risk.
People are exposed in various ways. During spraying, men work in dense chemical clouds without masks, gloves, or protective clothing. The mist settles on skin, enters lungs, clings to hair and work clothes, and is ingested with food and water.
Exposure seeps into homes. Many houses sit within or beside orchards and paddy fields. Chemical drift blows through windows. Contaminated dust enters on tools and shoes. Runoff seeps into kitchen gardens and water sources.
The 2010 study documented 31 pediatric brain tumor cases linked to orchard living, including tragic clusters. Three sisters in one family developed different brain tumors. A mother and her 10-year-old daughter were both afflicted. Exposure begins in the womb and continues through contaminated water, dust, and possibly breast milk.
It also flows through the waterways. Wells, streams, and rivers in agricultural areas become toxic reservoirs. The SKIMS study identified this as "a persistent source of pesticide exposure for all ages and sexes." Paraquat runoff during the paddy season threatens communal water supplies.
(To be Concluded)
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