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Dr. Ram Prabhu
M.B.B.S, M.D. (General Medicine), DM Medical Oncology (AIIMS)
Consultant Medical Oncologist, MIOT Hospitals. |
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MIOT Centre for Oncological Sciences provides
comprehensive cancer care with a multi disciplinary
super speciality treatment approach to all types of
cancer (solid tumours and blood cancers). Medical /
Haemato - Oncology, Surgical Oncology, Radiation
Oncology, Orthopaedic Oncology, Preventive Oncology,
etc… are some of the super speciality treatment services
offered by this department.
Medical oncology is the treatment of cancer using
chemotherapeutic drugs. When cancer is diagnosed at an
early stage, chemotherapy supplements the benefits
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surgery and radiotherapy. In advanced stages it improves
quality of life and prolongs survival. In some cancers,
chemotherapy plays a curative role these include
lymphomas, leukemia and germ cell tumours.
Chemotherapy drugs normally
cause side effects as they do not discriminate between
cancer cells and normal cells. At MICC these
side-effects are anticipated and managed with
pre-medications. Our trained and empathetic chemo nurses
use their expertise and the latest chemo delivery
devices to make treatment easier. This helps patients
complete planned drug cycles and prepares them for the
next line of treatment, putting them on the path to
recovery. The drugs are prepared under an infection-free
Laminar hood which maintains effectiveness. Our
experienced oncologists are abreast with the latest
drugs, oral and injections – including new drugs that
target and cure specific cancers.
Here treatment for cancer is provided using Medicine: -
a) Injection and b) Tablets. The treatment is given once
in 3 weeks and approximately for 6 months, depending
upon the nature of cancer and patients health condition.
All chemotherapy drugs are administered here. Side
effects: Nausea and Vomiting for 1 or 2 days. The
pioneering Department of Interventional Radiology is
practised in the technique of infusing chemotherapy
drugs through the artery. Monoclonal Antibodies and
Thyrosine Kinase Inhibitors are available for the target
therapy of cancers.
Monoclonal antibody therapy: It is the use of monoclonal
antibodies (or mAb) to specifically target cells. The
main objective is stimulating the patient's immune
system to attack the malignant tumour cells and the
prevention of tumour growth by blocking specific cell
receptors.
We also provide: a) pain management, b) colony
stimulating factors for improvement of WBC, haemoglobin
and platelets. Blood bank is available to assist
transfusion.
FAQs
1. What is cancer
2. Causes of cancer
3. Symptoms of cancer
4. Organs affected by cancer
5. Spread of cancer
6. Treatment of cancer
1. What is cancer?
Cancer is the name given to a group of diseases, which
have one feature in common: “uncontrolled growth of
cells”, which is of no use to the body. Normally
cell growth is balanced by death of equal numbers of
cells - a process called apoptosis or programmed cell
death. When this process is disrupted, a mass of cells
is produced - commonly known as a ‘tumour’.
Tumour:
Tumours may be benign or malignant:
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Benign: Here
tumour growth is slow and spread does not occur to other
parts of the body. |
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Malignant: A
malignant tumour on the other hand, can destroy organs
locally and spread to other parts of the body, such as
lungs, liver and bones-a unique ability, called metastasis. |
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Cancers are
of different types, depending on the tissue from which
they arise: Broadly, 4 types are recognized;
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Carcinomas -
which arise from the layers that cover the body[skin] or
line the body-mucosa of nose, throat, lungs, food pipe,
stomach, intestine etc, |
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Sarcomas - which
arise from soft tissues such as muscle, fat, blood vessels
or from bones, |
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Leukaemia’s -
which arise from the bone marrow and spread into the blood
and |
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Lymphomas -
which originate from the lymphnodes and spleen. |
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2. Causes of cancer
The cause of cancer is multifactorial - multiple agents
may act to produce cancer in a particular person. The
risk of developing cancer increases with age - 80% of
all cancers occur in those aged above 55 years. The
final common pathway is damage to the genetic component
of the cell (DNA), which leads to uncontrolled cell
growth.
The common causative factors may be:
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External: such
as dietary (high fat diet, alcohol), tobacco, excessive sun
exposure, viral infections like Hepatitis B, industrial
chemicals; or |
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Internal:
inherited defective genes (which explains how cancer ‘runs’
in some families), or |
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Reproductive
history (late age at first child birth for breast cancer) |
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3. Symptoms of cancer
Cancer being a disease which affects any organ in the
body, the symptoms are varied, and there is no
particular symptom which can accurately predict the
presence of cancer. The exact symptoms depend on the
location of the cancer, which part of the organ is
affected, how fast the cancer is growing and whether it
has spread to other parts. Cancer occurring in outer
parts of the body, such as skin, breast, limbs,
testicles or nose and mouth, may present with a visible
swelling or ulcer, and may be diagnosed earlier.
There are certain warning signs of cancer, which should
be further investigated:
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Unexplained
weight loss |
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Loss of appetite |
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Lump in the
breast or bleeding from the nipple |
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Recent change of
bowel habits |
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Vaginal bleeding
after menopause |
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Change in
shape/size or bleeding from a mole |
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Chronic cough |
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4. Organs
affected by cancer
Cancer can
affect every organ and cell type in the body, though
some organs such as the eye and heart are rarely
affected. Some of the common cancers are:
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Mouth and tongue
cancers |
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Throat and voice
box (larynx) cancers |
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Lung cancer |
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Esophageal and
stomach cancer |
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Liver cancer |
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Pancreatic
cancer |
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Colon and rectal
(Large intestine) cancer |
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Kidney and
bladder cancer |
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Prostate cancer |
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Ovarian, uterine
and cervix cancers |
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Breast cancer |
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Bone cancers |
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Blood cancer (Leukemias) |
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5. Spread of cancer
The hall mark of cancer and what makes it a deadly
disease, is its ability to destroy surrounding organs
and spread [metastasize] to far away organs. Cancer
which has spread to a far away organ is called stage IV
cancer, and is generally not curable. It is treated with
medicines, called chemotherapy. The common organs to
which spread occurs are those with rich blood flow, like
lung, liver and bone. Each cancer has a preference for
certain organs; eg. Stomach cancer spreads to the liver,
bone cancer to the lungs.
Once cancer spreads, it causes the patient’s condition
to rapidly worsen - weakness sets in, appetite goes down
and respiratory or liver failure sets in. Survival after
metastases are found is usually less than a year.
6. Treatment of cancer
The aim of cancer treatment is to relieve symptoms, cure
the patient and prolong or save life. All these aims may
not be met in every case. When cancer is detected early,
treatment is very effective and patients are usually
cured.
In patients who present with advanced disease, complete
cure may not be possible, and treatment aims to control
the disease, improve quality of life and to keep the
patient normal and comfortable as long as possible. The
treatment of each patient is designed to suit an
individual and depends on the age of the patient,
general condition, type of cancer and stage of disease.
There may be only one treatment or combination of
treatments.
There are
five main modalities of treatment for cancer:
Surgery
Surgery is the most important part of the cancer
treatment. Surgery removes cancer cells from the body by
cutting away the tumour and any tissues surrounding it
which may contain cancer cells, including the lymphnodes.
It is a simple, safe and effective method when cancer is
small and confined to the site of origin. It is best
suited for certain cancers like breast cancer, head and
neck cancers, early cancers of the cervix and lung, many
skin cancers, soft tissue cancers and gastrointestinal,
liver and pancreatic cancers. Surgery may also be used
in advanced cases to relieve symptoms such as bleeding
and blockage of the food pipe, intestine or urinary
passage.
Radiotherapy
Radiotherapy is a form of treatment which uses
radiation, a special kind of energy carried by waves or
a stream of particles originating from radioactive
substances and delivered by special machines. These
radioactive x-rays or gamma rays can penetrate the cell
wall and damage the nucleus of the cell which prevents
growth and division of cells. This also affects the
normal cells but these cells recover more fully than
cancer cells. Radiotherapy is required in 50% to 70% of
patients, usually before surgery to shrink large tumours,
or after surgery to destroy cells left behind after
surgery at the site of tumour origin. Radiation is also
used in patients with metastases, to relieve pain,
bleeding or pressure symptoms; eg to relieve paralysis
caused by a tumour pressing on the spinal cord.
Modern radiotherapy is very safe, and is technology
driven. Recent advances include Intensity Modulated
Radiation Therapy [IMRT] which is the delivery of
radiation with high precision, so as to spare normal
tissues, and reduce side effects. Improvements in
radiotherapy equipment, technique and applications, have
led to an increasing role both in local treatment and
also in its use as a whole-body treatment, as part of
bone marrow transplantation techniques for leukaemia’s
and lymphomas.
Chemotherapy
Chemotherapy uses drugs which interfere with the growth
and division of malignant cells. Once the drugs are
administered, they circulate throughout the body. It is
advantageous over surgery & radiation for treating
cancer that is systemic (spread throughout the body).
Chemotherapy is the main modality for cancers like
leukemia (blood cancer), lymphomas, certain lung cancers
and paediatric cancers. Chemotherapy may be used before
surgery to shrink large tumours, and make surgery
easier, in breast, esophageal, rectal and bone cancers.
Chemotherapy is also used after surgery to treat cells
shed in the blood, so as to prevent reappearance of
tumours.
The side-effects of the chemotherapy include nausea,
vomiting, hair loss, diarrhoea, weakness etc. which are
temporary and completely reversible. Modern chemotherapy
is very safe and well tolerated and is often given on an
outpatient basis.
Hormonetherapy
Hormonetherapy has limited use in cancer treatment since
only minority of tumours are hormone sensitive e.g.
breast and prostate cancer. This therapy provides
systemic means of treatment, i.e. to the whole body, but
without the side effects of chemotherapy.
Immunotherapy
Immunotherapy is a form of treatment which stimulates
the body’s immune system to destroy cancer cells. It is
expensive, and useful only in a few tumours such as
melanomas (type of skin cancer) and renal cancers.