Monday 24 February 2014

Gamma Knife RadioSurgery in India – Most Advanced Treatment for Brain Tumors in India

Gamma knife is now the most accepted and widely used radio surgery treatment in the world for brain tumours. About half a million people have been treated with Gamma knife surgery, and it's the only Radiation Therapy System cleared by the FDA for irradiating brain metastases. Gamma knife surgery, despite the name, there is no blade or knife - it's called Gamma knife because radio surgery (one-session treatment) has such a dramatic and precise effect in the target zone that the changes are considered 'surgical.' So there's no incision or blood, and minimal risk of complications. 

The device aims gamma radiation through a target point in the patient's brain. The patient wears a specialized helmet that is surgically fixed to the skull, so that the brain tumor remains stationary at the target point of the gamma rays. An ablative dose of radiation is thereby sent through the tumor in one treatment session, while surrounding brain tissues are relatively spared.

 Radiosurgery uses high doses of radiation to kill cancer cells and shrink tumors, delivered precisely to avoid damaging healthy brain tissue. Gamma Knife radiosurgery is able to accurately focus many beams of high-intensity gamma radiation to converge on one or more tumors. Each individual beam is of relatively low intensity, so the radiation has little effect on intervening brain tissue and is concentrated only at the tumor itself.

Gamma Knife radiosurgery has proven effective for patients with benign or malignant brain tumors up to 4 centimeters in size, vascular malformations such as an arteriovenous malformation (AVM), pain or other functional problems.

The risks of gamma knife radiosurgery treatment are very low, and complications are related to the condition being treated. Gamma-Ray Stereotactic Treatment System. The Gamma Knife instrument put many gamma-ray beams from different angles and directions irradiate to body, making them all together to form the focus point. Since each dose of radiation beam is very small, it basically does not cause damage to human tissues which it through. As long as the ray focuses on the lesion, it can be as precise as a scalpel to destroy the lesion, with no trauma, no hemorrhage, no infection, no pain, and also reach rapid, safe, reliable magical effect.


What can Gamma Knife Radiosurgery Treat ?

 • Arteriovenous Malformations.
 • Functional disorders such as Trigeminal neuralgia and Epilepsy.
  • Meningioma
  • Neurinoma of Trigeminal and Either Cranial Nerves
• Pituitary Adenoma
• Single and multiple metastases of brain cancer



  • Gamma Knife is a neurosurgical tool designed exclusively for the treatment of brain disorders.
  • No incisions, No general anesthesia.
  • The lesion being treated receives a high dose of radiation with minimum risk to nearby tissue and structures..
  • The absence of an incision eliminates the risk of haemorrhage and infection.
  • A secure head frame ensures safety and accuracy within half a millimeter
  • Hospitalization is short, typically an overnight stay or an outpatient surgical procedure. Patients can immediately resume their previous activities.
  • Patients go home usually on the same day (time lost from employment is minimal)
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Saturday 22 February 2014

How colon and rectal cancers are diagnosed - Colon Cancer Treatment

  • the symptoms of colorectal cancer are present
  • the doctor suspects colorectal cancer after talking with a person about their health and completing a physical examination
  • screening tests suggest a problem with the colon or rectum


Many of the same tests used to initially diagnose cancer are also used to determine the stage (how far the cancer has progressed). Your doctor may also order other tests to check your general health and to help plan your treatment. Tests may include the following.

Medical history and physical examination

The medical history is a record of present symptoms, risk factors and all the medical events and problems a person has had in the past. The medical history of a person's family may also help the doctor to diagnose colorectal cancer.
In taking a medical history, the doctor will ask questions about:
  • a personal history of
    • polyps in the colon or rectum
    • inflammatory bowel disease
    • colorectal cancer
  • a family history of
    • colorectal cancer
    • familial adenomatous polyposis
    • hereditary non-polyposis colorectal carcinoma (also known as Lynch syndrome)
  • signs and symptoms

Tumour marker tests
Tumour markers are substances – usually proteins – in the blood that may indicate the presence of colorectal cancer. Tumour marker tests are used to check a person's response to cancer treatment, but they can also be used to diagnose colorectal cance

A colonoscopy is a procedure that lets the doctor look at the lining of the colon using a flexible tube with a light and lens on the end (an endoscope). A colonoscopy is preferred over a flexible sigmoidoscopy because the entire colon can be checked for polyps or abnormal areas.
A colonoscopy is done in a hospital on an outpatient basis. The doctor gently inserts the colonoscope (a type of endoscope) through the anus and slowly moves it into the rectum and colon. The colon is inflated with air to stretch out the lining so the doctor can look at the entire surface. This can be uncomfortable, so drugs are given to help the person relax during the procedure.

Biopsy

During a biopsy, tissues or cells are removed from the body so they can be tested in a laboratory. The pathology report from the laboratory will confirm whether or not cancer cells are present in the sample and may also identify the type of cancer.
A biopsy is the only definite way to diagnose colorectal cancer. Biopsies of polyps or abnormal areas are taken during a sigmoidoscopy or colonoscopy. A biopsy sample will allow the doctor to find out the type of colorectal cancer and the grade. Biopsy results may also show how far the cancer has grown through the wall of the colon or rectum.

Computed tomography (CT) scan

A CT scan uses special x-ray equipment to make 3-dimensional and cross-sectional images of organs, tissues, bones and blood vessels inside the body. A computer turns the images into detailed pictures. It is used to:
  • check if the cancer has spread to other organs in the abdomen or pelvis (small areas of spread [microscopic spread] may not be detected by CT scan)
  • check if the cancer has spread to the lymph nodes in the abdomen
  • check how far the tumour has grown into the wall of the colon or, especially, the rectum
CT-guided needle biopsy
  • CT scans may also be used to help guide a needle to perform a biopsy (CT-guided needle biopsy) to check for cancer cells in a tumour in the colon or a suspected area of metastasis (cancer spread outside of the colon or rectum).
Virtual colonoscopy
  • Virtual colonoscopy uses a CT scan to create images of the colon without having to insert an endoscope through the rectum. A virtual colonoscopy is less invasive and more comfortable than a regular colonoscopy. Studies are continuing to examine the effectiveness of this test.

 Ultrasound 
Ultrasound uses high-frequency sound waves to make images of structures in the body.
  • Endorectal ultrasound (EUS or ERUS) uses a special instrument (transducer) that is inserted into the rectum. It is used to see:
    • how far a tumour has grown into the rectal wall
    • if the tumour has spread to nearby organs or lymph nodes
  • Abdominal ultrasound may be done to see if the cancer has spread to other organs in the abdomen, such as the liver.
  • Pelvic ultrasound may be done if doctors suspect that the cancer has spread to the urinary tract.
  • An ultrasound may also be used during abdominal surgery. The surgeon can place the transducer directly on the liver to check for metastases.

A PET scan uses radioactive materials (radiopharmaceuticals) to detect changes in the metabolic activity of body tissues. A computer analyzes the radioactive patterns and makes 3-dimensional colour images of the area being scanned.
PET scans are not routinely used to diagnose colorectal cancer. They are more commonly used to help stage and check for recurrent disease if a person's CEA level starts to rise following treatment. PET scans are not readily available at all centres.


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Saturday 15 February 2014

Bladder Cancer treatment in India - surgery, radiotherapy and chemotherapy

The urinary bladder is a hollow sac like organ situated in the pelvis. Its major function is to store the
urine produced by the kidneys before finally emptying it. Uncontrolled proliferation of normal cells lining the bladder wall can lead to cancer.


Though the exact cause of bladder cancer is unknown, there are certain well recognized risk factors. Smoking is one of the most important risk factors, and smokers have twice the risk of developing bladder cancer than non-smokers. People exposed to certain chemicals like aromatic amines. which are especially used in dyeing, rubber, leather and textile industries are also at increased risk if proper precautions are not taken. Chronic irritation of the bladder wall due to any cause can also lead to bladder cancer.

Symptoms

Some of the common symptoms of bladder cancer are haematuria and recurrent urinary tract infection. However, it is important to realize that most of the early cancers may be totally asymptomatic. A patient with these symptoms should consult his doctor if the symptoms persist for more than two weeks.


The mainstay of diagnosis is a cystoscopy and biopsy where a long tubular instrument is inserted into the urinary bladder and the entire bladder lining is inspected. If any tumour is seen, the urologist tries to resect as much tumour as possible. Any abnormal looking tissue is taken for biopsy and sent to the pathologist for examination under a microscope. The pathologist will confirm any cancer if present, and the depth of penetration into the wall of the urinary bladder. Some of the other tests that the patient may have to undergo for diagnosis and staging are: urine for cytology, ultrasound, CT/MRI scan, and sometimes PET-CT and bone scan, if indicated.

The purpose of doing these tests is to find out the stage of the cancer as the prognosis and treatment depends upon the stage. Broadly speaking, there are four stages depending upon how deep the cancer has penetrated into the bladder wall, and whether it has spread into other structures outside the bladder like lymph nodes, bone, liver etc.

Treatment

There are three main modalities of treatment of treatment - surgery, radiotherapy, and chemotherapy, either alone or in combination. In very early bladder cancers limited to the superficial layer of the bladder wall, immunological therapy is used where the patient comes in for multiple sessions of a drug being instilled into the bladder.


* Surgery is one of the most widely used treatments. In most of the locally advanced tumours, the surgery is called radical cystectomy where the entire bladder and some adjoining structures are also removed. This operation requires some form of urinary diversion for the urine to come out through a new pathway. In certain less advanced tumours, a partial cystectomy may be sufficient where only a part of the bladder will be removed.


* Radiotherapy alone or in combination with chemotherapy is an alternative to surgery where the patient wants to conserve his bladder. Radiotherapy is the use of high energy X-rays which are focused on the area to be treated without affecting the tolerance of surrounding normal structures. Today, there are a number of sophisticated treatment techniques like IMRT, IGRT etc. To achieve this aim using state of art linear accelerators.

* Chemotherapy is the use of medicines given intravenously and is called systemic treatment as it can kill cancer cells anywhere in the body.

Appropriate treatment in a good multidisciplinary hospital can result in curing more than 50 per cent of patients. If the cancer is diagnosed at an early stage, the results are much better.


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Monday 10 February 2014

Low Cost Robotic prostatectomy for prostate in India

Da Vinci Robotic System is a boon for prostate cancer patients as it completely eradicates the prostate cancer with minimal side effects. Da Vinci is a highly advanced and sophisticated master-slave robot that incorporates 3-D high definition visualization, scaling of movement, and wristed instrumentation.

The surgeries with the Da Vinci System are done with no direct mechanical connection between the surgeon and the patient. The surgeon is working a few feet away from the operating table, while seated at a computer console with a three-dimensional view of the operating field.

The surgeon's fingers grasp the masters on the computer console and while viewing the surgical field through the da Vinci Systems, the surgeon manipulates and guides Da Vinci's computer- assisted robotic arms and instruments to perform complex surgery.

This advanced computer technology seamlessly translates the surgeon's movements at the computer console into precise, real-time movements of the surgical instruments inside the patient. While the surgeon's hands and fingers direct the surgery, the movements are translated by the computer to precise movement of the microsurgical instruments on the robotic arms inside the patient's body.

There are several things you may want to know about the procedure.
  • A robotic radical prostatectomy uses an advanced machine to mimic the movement of human hands, allowing surgeons to operate with extreme precision and care.
  • Robotic radical prostatectomy is classified as a minimally invasive surgery (MIS). MIS procedures make very small incisions compared with more invasive surgeries and allow your body to recover more quickly afterwards in addition to being less shocking on your body during the procedure.
  • The smaller incision used for robotic radical prostatectomy means that there will be less blood loss during surgery
Radical prostatectomy in India is performed by experienced, board-certified physicians in our network.

By electing to have radical prostatectomy in India, you will be able to appreciate many benefits over having the surgery in your home country. Some of these benefits are:
  • The cost of radical prostatectomy in India is a fraction of the cost in the US and other western countries. Free quotes are available online to see just how affordable it can be.
  • In addition to techniques like the Da Vinci prostatectomy in India, which uses robotics, other minimally invasive procedures are available. You can choose to have a laparoscopic prostatectomy in India instead, which is a more traditional minimally invasive procedure that is carried out without the use of a machine.
  • In India, you can expect to receive care from doctors who have handled a large number of cases and are very experienced.
  • It’s recommended that after prostate removal surgery you begin to walk leisurely as soon as possible to help your body recover. Having your prostate removal surgery in India means you can take in a unique and beautiful culture during your recovery.
·    The da Vinci system has revolutionized minimally invasive surgery in Urology . Most operations involve working in the pelvic cavity where the movements are very difficult even with the human wrist. The Robotic arms and endowrists have a greater freedom and seven degree of movement and thus allow precise surgery in these tight locations.

Radical prostatectomy for prostate : the entire prostate is removed and the urinary bladder and is joined to the urethra. The 3D vision helps in accurate surgery and in preserving the nerves so that the post surgery complications like incontinence and impotence are avoided.

Pyeloplasty: During this procedure, obstruction of the pelviureteric junction is removed and renal pelvis is joined back to healthy ureter. The robot helps in suturing and thus improving the overall results of the operation.

Partial Nephrectomy: this operation is done for removal of small renal tumors. This procedure also involves precise cutting and suturing of the kidney in minimal possible time which is greatly helped by the da Vinci system.

  • ·    Radical Cystectomy with Orthotropic Neobladder Or Ileal Conduit
  •     Pediatric Robotic-Assisted Antireflux Surgery
  •     Ureteroneocystostomy
  •     Adrenalectomy
  •     Nephroureterectomy
  •    Pediatric Robotic-Assisted Antireflux Surgery
  •    Ureterolysis In Retroperitoneal Fibrosis


Approximate Cost for Robotic Prostate Cancer Surgery in India at Best Cancer Hospitals in India

Approximate cost of  Laproscopic Radical Prostatectomy surgery at best hospitals in India is 7000 US dollars

Approximate cost of Robotic prostate cancer surgery at best hospitals in India is 9000 US dollars.

The above estimated costs include stay in a private room at the hospital, where a companion can stay with the patient, nursing care, surgeon fee, medicines and consumables, patient's food and airport pick up etc. Actual cost may vary to some extent depending on the patient's individual medical status.


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Wednesday 5 February 2014

To-Do List for Brain Tumor Patients - Brain Tumour Treatment

Brain tumours can be primary or secondary. a primary tumour is a tumour that starts in the brain. A secondary brain tumour is a tumour that has spread to the brain from somewhere else in the body.
The brain is contained within the skull and has a fixed amount of space. If a tumour grows in the brain it will often cause an increase in pressure within the skull, which can cause symptoms to develop. An increase of pressure in the skull is called raised intracranial pressure (ICP). The most common symptoms of raised pressure within the brain are headaches, feeling sick (nausea) and being sick (vomiting). Of course, many other things can cause headaches or feelings of sickness.

Nothing can prepare one for being diagnosed with a brain tumor. But there are some things that might help you cope with it. Following are some suggestions for dealing with your diagnosis:
  • Prepare a notebook
  • Get a second opinion
  • Keep a diary
  • Bring someone with you each time you see a physician
  • Take notes during meetings with physicians
  • Investigate clinical trials
  • Take it one day at a time

Prepare a Notebook

A three-ring binder with divider tabs can help you keep track of information, medications, schedules and personal notes. The sections in your notebook could be broken down like this:
  • Physician and consultant's business cards
  • Lab reports and scan results*
  • Miscellaneous correspondence
  • Medication schedules
  • Personal notes
The easiest way to get copies of your MRI films, MRI reports and pathology reports is to request them at the time the test is performed. Having these copies will help when you're seeking second or third opinions.

Get a Second Opinion

Multiple opinions will give you peace of mind and give you new choices about treatment options. And you'll want to confirm your diagnosis. The Department of Neurosurgery physicians will review your images and medical history information without you being present. This is called our "Educational Scan Review Program." It's also important for your treating physician to discuss your case with major brain tumor centers and other experts, especially if your physician is not a specialist.

Keep a Diary

If you choose to keep a diary, it can greatly assist in your care. It can also serve as a readily available source of information for you to refer to. We suggest keeping track of several different items. These include:
  • Symptoms
  • Drug side effects
  • List of doctors with whom you have consulted
  • Conversations with doctors
  • Treatments investigated
  • Treatments performed
It may also help you to keep track of your feelings. This is an emotional time, and you will have days when you're feeling despondent and hopeless. But you'll also have days when you feel hopeful and positive. Putting your thoughts down on paper allows you to express these feelings rather than hold them inside. And feeling at peace is an important part of the healing process.

Bring Someone with You Each Time You See a Physician

Your friends and family are a vital support system for you. Don't hesitate to count on them. They want to help.
If you've been diagnosed with a brain tumor, a visit to your physician can be a depressing experience. Chances are you'll go in to a meeting knowing that you'll be getting needed information, but you may not be able to think clearly. Having someone with you who can listen and who knows which questions to ask will make it much easier for you. It will also give you someone to talk to after the meeting, to help you make decisions and understand the information you've been given.

Take Notes during Meetings with Physicians

Taking detailed notes when you meet with your physician can help you. The information will help you if you forget a detail.

Investigate Clinical Trials

Your physician may recommend that you enroll in a clinical trial. Clinical trials are research studies for new treatments. These trials are helping to move us all closer to a cure for all types of brain tumors. The Department of Neurosurgery is continually developing clinical trials.

Take It One Day at a Time

Don't worry about next month or even next week. Take things one day at a time. It'll be easier for you in the long run.

Latest and Advanced Treatment options for Brain Tumor in India


Brain Tumor is no more a scary health condition as modern technology and advanced surgical modalities now offer near perfect clinical outcomes and the patients can soon return to normal life after surgery. 


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Monday 3 February 2014

Nonsurgical Treatments for Liver Cancer in India

Liver cancer or Hepatocellular carcinoma (HCC) is one of the commonest cancers in the world which have a high incidence of Hepatitis B infection. Apart from Hepatitis B, it may be caused by other diseases that lead to cirrhosis of the liver such as Hepatitis C infection, and alcohol abuse. 
Unfortunately, like many other cancers, liver cancer may go undetected until a late stage. It is often brought to attention by an ultrasound or CT scan done for pain in the upper abdomen or another unrelated symptom. Liver cancers are malignant tumors that grow on the surface or inside the liver. 
Typers of liver cancer are 

HepatocellularCarcinoma  , Cholangiocarcinoma , Hepatoblastoma and Angiosarcoma or Hemangiosarcoma

Liver cancer is usually diagnosed with a number of different tests, which may include:
§  Blood tests: To check your general health and check for a chemical usually found inincreased levels in people with primary liver cancer.
§  Ultrasound: A picture of the liver is taken using sound waves.
§  Computed Tomography (CT) Scan: A specialised x-ray taken from many different angles to build a three-dimensional (3-D) picture of the body.
§  Magnetic Resonance Imaging (MRI): Similar to a CT scan, but uses a powerful magnet and magnetic field instead of x-rays to build an image of the body.
§  Liver Biopsy: A small piece of liver tissue is removed with a needle and examined for cancer cells.
§  Laparoscopy: A small cut in the lower abdomen is made and this allows a thinmini-telescope (laparoscope) to be inserted to look at the liver and take a sample of liver tissue.
§  Needle Biopsy: Needle biopsy, also called image-guided biopsy, is usually performed using a (MR) to guide the procedure. In many cases, needle biopsies are performed with the aid of equipment that creates a computer-generated image and allows radiologists to see an area inside the body from various angles. This “stereotactic” equipment helps them pinpoint the exact location of the abnormal tissue.
§  Large Core Needle Biopsy: In this technique, a special needle is used that enables the radiologist to obtain a larger biopsy sample. This technique is often used to obtain tissue samples from lumps or other abnormalities in the breast that are detected by physical examination or on mammograms or other imaging scans. moving X-ray technique (fluoroscopy) computed tomography (CT), ultrasound or magnetic resonance.


Liver Cancer Treatment in India
§  Surgery: Procedure to remove a portion of the liver. Your doctor may recommend partial hepatectomy to remove the liver cancer and a small portion of healthy tissue that surrounds it if your tumor is small and your liver function is good.
§  Transplant Surgery: During liver transplant surgery, your diseased liver is removed and replaced with a healthy liver from a donor. Liver transplant surgery may be an option for people with early-stage liver cancer who also have cirrhosis.
§  Freezing Cancer Cells: Cryoablation uses extreme cold to destroy cancer cells. During the procedure, your doctor places the instrument (cryoprobe) containing liquid nitrogen directly onto liver tumor.
§  Heating Cancer Cells: In a procedure called radiofrequency ablation, electric current is used to heat and destroy cancer cells. It is also called hyperthermia cancer treatment.
§  Injecting Alcohol: During alcohol injection, pure alcohol is injected directly into tumors, either through the skin or during an operation. Alcohol dries out the cells of the tumor and eventually the cells die.
§  Chemoembolization: A type of chemotherapy treatment that supplies strong anti-cancer drugs directly to the liver. It is palliative and not curative treatment.
§  Radiation Therapy: This treatment uses high-powered energy beams to destroy cancer cells and shrink tumors.
§  Targeted Drug Therapy: Drugs designed to interfere with a tumor’s ability to generate new blood vessels.

Nonsurgical Treatments for Liver Cancer at World Class Hospitals in India
1) Chemoembolization: Chemoembolization is a minimally invasive treatment for liver cancer that can be used when there is too much tumor to treat with radiofrequency ablation (RFA), when the tumor is in a location that cannot be treated with RFA, or in combination with RFA or other treatments. In this the anticancer drug is given along with another substance that blocks the hepatic artery. (artery supplying the liver). Thus the anticancer drug is gets concentrated in the cancerous portion of the liver.2) Radiofrequency Ablation: For inoperable liver tumors, radiofrequency ablation (RFA) offers a nonsurgical, localized treatment that kills the tumor cells with heat, while sparing the healthy liver tissue. Thus, this treatment is much easier on the patient than systemic therapy.
3) Cryosurgery: It is a treatment that uses an instrument to freeze and destroy abnormal tissue, such as cancerous cells. This type of treatment is also called Cryotherapy. The doctor may use ultrasound to guide the instrument.
4) Drugs called radio-sensitizers may be given with the radiation therapy to make the cancer cells more sensitive to radiation therapy.
5) Percutaneous Ethanol Injection: Percutaneous ethanol injection is a cancer treatment in which a small needle is used to inject ethanol (alcohol) directly into a tumor to kill cancer cells. The procedure may be done once or twice a week. Usually local anesthesia is used, but if the patient has many tumors in the liver, general anesthesia may be needed.
6) Hyperthermia Therapy: Hyperthermia therapy is a type of treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs. Because some cancer cells are more sensitive to heat than normal cells are, the cancer cells die and the tumor shrinks.
7) Biologic Therapy: Biologic therapy is a treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
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