Advanced Robotic Prostate Surgery in India

A boon for Prostate Cancer patients - Advanced Robotic Prostate Surgery is now preferred choice for Prostate Cancer patients due to following Unmatched advantages

• Minimal Bleeding
• Much quicker recovery
• Reduced hospital stay
• Lesser pain killer requirements
• Lower blood transfusion rates
• Improved preservation of physical appearance
• Three (3) D vision enables surgeon to perform Prostate excision with Cancer
• Control without risk of Post Surgery Continence (control over urinary and
• fecal discharge) and causing Impotency

What is Da Vinci master slave Robotic System?

Da Vinci master slave robotic system is used to completely eradicate cancer with minimal side effects for treating Prostate Cancer. Through this system a minimally invasive robot assisted radical prostatectomy technique has been developed in which doctors evolved a unique sequence of surgical steps.

The Da Vinci is a sophisticated master-slave robot that incorporates 3-D high definition visualization, scaling of movement, and wristed instrumentation. The operations with the Da Vinci System are performed 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.

 How it is  performed ?

Robotic Prostatectomy, also known as Robotic surgery for prostate cancer or da Vinci Prostatectomy is a minimally invasive surgery that is now the preferred approach for removal of the prostate in those diagnosed with organ-confined prostate cancer. The da Vinci Prostatectomy may be the most effective, least invasive prostate surgery performed today. Though any diagnosis of cancer can be traumatic, the good news is that if your doctor recommends prostate surgery, the cancer was probably caught early. And, with da Vinci Prostatectomy, the likelihood of a complete recovery from prostate cancer without long-term side effects is, for most patients, better than it has ever been.

The operation is performed using the daVinci Surgical system and 3-D endoscopic and wristed instruments inserted through 5-6 small incisions across the mid-abdomen

UnbeatableAdvantages of Robotic Prostate Surgery over the Conventional Prostate Cancer Surgery
1) Usually in conventional approach, surgeons make decisions using tactile and visual cues to identify a phenomenon, which is actually microscopic which is likely to damage nerves or to leave cancer behind. In the Advanced Robotic Technique (ART) surgeons uses a sophisticated mastr slave robot that incorporates 3-D high definition vision, scaling of movement and wristed instrumentation that gives him the ability to perform Prostate excision with minimal risk of leaving the cancer behind and also minimal bleeding and post operative risk of incontinence and impotence.

2) Neither clinical nor imaging tests are sensitive enough to capture a tumour at T3 stage where it has become locally advanced and a risk for spreading to other body parts. Sometimes it is difficult for surgeons to find a precise plane between the cancer and urinary sphincter or the nerves and err on the side of cancer safety leading to incontinence or Impotence Da vinci robot system minimizes side effects thereby greater control for the patient over urinary discharge i.e. continence and return to normal sexual function after the surgery.

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Low Cost Colon Cancer Treatment in India

Diagnostic tests for colorectalcancer are usually done when:

• 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 Colonoscopy 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. Positron emission tomography (PET) scan 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. For more information visit:          http://www.medworldindia.com                           https://www.facebook.com/medworld.india Please scan and email your medical reports  to us at care@medworldindia.com and we shall get you a Free Medical Opinion from India’s Best Doctors. Call Us : +91-9811058159 Mail Us : care@medworldindia.com

Advantages of Next Generation Technology over Conventional Neurosurgery to Remove Brain Tumor

MRI Guided Brain Tumor Surgery - Most Advanced Brain Tumor Surgery in IndiaA brain tumor is a group (mass) of abnormal cells that start in the brain. Primary brain tumors can arise from the brain cells, the membranes around the brain, nerves, or glands.
Tumors can directly destroy brain cells. They can also damage cells by producing inflammation, placing pressure on other parts of the brain, and increasing pressure within the skull. The cause of primary brain tumors is unknown. There are many possible risk factors that could play a role.
Advanced imaging technique now developed to enable Neurosurgeons with intra-operative MRI to aid in the removal of complex and hard-to-access brain tumors during surgery. This new technique relies on a powerful computer system, which assists the surgeon in precisely localizing a lesion, in planning each step of the procedure on the computer screen, and in calculating the ideal access to the tumour before the operation.
This is particularly useful in reaching a tumour located deep inside the brain, areas traditionally considered to be difficult to reach. During the procedure, the computer tracks instrument movement with an extremely high precision, providing the surgeon with total control inside the brain at all times using "real-time" imaging. The surgeon can also check if the tumor has been removed as planned. This improves the outlook for the patient.
“BRAIN SUITE” in India – Amongst very few such facilities worldwide
It is the most advanced Neuro-Surgical Operating Room with high field MR. This system permits the neurosurgeon to have an MRI study on the patient during surgery, and if tumor has remained which was hidden to the human eye, can be detected by special MRI sequences, and can be targeted using neuro navigation (which works on the same principle as the GPS system).
The Brain Suite has two main parts. There is a high-intensity MRI scanner integrated with an image-guided surgical system. The MRI scanner has a wide-bore opening allowing a patient to lie on his or her side. Previously, tumors that could only be accessed from the side of the skull were not easy to scan. This special MRI system lets doctors repeat scans during the operation to get more accurate information on the location, shape and size of the tumor. This minimizes problems associated with brain tumors shifting during excision.

Advantages of Next Generation Technology over Conventional Neurosurgery to Remove Brain Tumor:-

• The surgeon is guided during the surgery by live Advanced New Generation computer assisted MRI and thus knows exactly where tumor ends and normal brain begins.

• Enhanced ability of Neurosurgeon to excise the complete tumor. Less risk of post operative complications. Functional image guidance with MRI allows for accurate, non-invasive preoperative assessment and planning for brain tumor surgery.

• MRI guided Brain Tumor Surgery allows a more complete tumor removal with much less risk to surrounding brain tissue.

• "Inoperable" tumors (inoperable by conventional surgical techniques) can be resected with MRI Guided Brain Tumor Surgery. Frequently, these are deep seated-relatively benign tumors in children and young adults or elderly patients. Many of these tumors can be cured with this most advanced technology.

Why choose us for HIFU Prostate Cancer Treatment in India?

HIFU Treatment for Prostate Cancer

HIFU is a fundamentally changed new treatment for Prostate Cancer in its early stage wherein the cancer is still limited to the organ which is possible to be treated without radiations and without even having surgical incisions in the body. We have help many international patients to avail HIFU Treatment for Prostate Cancer at best Cancer Hospital India.

High Intensity Focused Ultrasound (HIFU) in India is the procedure of focusing high intensity sound waves for creation of heat at a specific point-the focal point. With advanced technology, HIFU is used to kill target tissues during the procedure separately customized for every separate patient’s state of prostate cancer. When HIFU rays are conveyed to the focal point, the malignant tissues are killed without harming the tissues outside the focal point. HIFU method is basically used to heat and kill cancer cell in the prostate gland by using high frequency ultrasound waves.

HIFU is relatively an advanced method of treating cancer over other methods as this method involves heating only the tumors with precisely focused ultrasound which implies that men can be treated without even staying overnight at the hospital and completely avoiding the discomforting side effects that are associated with existing therapies.

A study in UK has discovered that HIFU offers ‘perfect’ results with no major side effects and safe from cancer 12 months post treatment in nine out of ten cases. Conventional therapies or radiotherapy can only offer the perfect result in only half of the cases currently. Experts have specially mentioned that the results obtained due to HIFU are ‘very encouraging’ and are a ‘paradigm’ shift in the treatment of cancer.

HIFU therapy in India minimally tends to spread Prostate Cancer

HIFU does not involve admitting patients for nights and is a general procedure performed under local anesthesia that is entirely free from radiations. As HIFU is not surgical, there is absolutely no loss of blood or incisions and brings recovery quickly. If need be, it can be repeated also and can also be done to save spreading of prostate cancer if other therapies fail. As HIFU therapy is a highly sterile process, the ultrasound energy does not cause any harm to any of the tissue in the periphery of the targeted focal point.

Advantages of HIFU therapy:

• No loss of blood
• Recovery is quick
• It is a non surgical process
• Free from radiations
• No need of getting hospitalized
  

This is by far the most advanced technique which is highly apt for treating prostate cancer of low grade. It does not involve surgery, radiation-free, good control over cancer, minimal production of cancer. In fact, after HIFU therapy, the quality of life improves and some other advantages of HIFU therapy also includes quick resumption to erections and good control on urine.

Why choose us for HIFU Prostate Cancer Treatment in India?

• Helps patients to make informed treatment decisions
• Provide expert multiple opinions on each case to arrive at the accurate diagnosis
• Carefully select, highly qualified and experienced doctors with proven track record as per case requirements
• Carefully select accredited hospitals having latest technology and world class infrastructure
• Close monitoring and control of the entire treatment process.
• Professional and comprehensive management of each case through case management to achieve best treatment outcome and avoid errors
• Professional qualified and experienced case manager assigned to each patient.
• Affordable & committed treatment cost estimates
  
  
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Risk Factors of Colon and Rectal Cancer

Causes and risk factors of colon and rectal cancer

Age : – About 90 percent of people diagnosed with colon cancer are older than 50. Colon cancer can occur in younger people, but it occurs much less frequently.

A personal history of colorectal cancer or polyps : – If you’ve already had colon cancer or adenomatous polyps, you have a greater risk of colon cancer in the future.

Inflammatory intestinal conditions : – Long-standing inflammatory diseases of the colon, such as ulcerative colitis and Crohn’s disease, can increase your risk of colon cancer.

Inherited disorders that affect the colon : – Genetic syndromes passed through generations of your family can increase your risk of colon cancer. These syndromes cause only about 5 percent of all colon cancers. One genetic syndrome called familial adenomatous polyposis (FAP) is a rare disorder that causes you to develop thousands of polyps in the lining of your colon and rectum.

When to seek medical advice

If you notice any symptoms of colon cancer, such as blood in your stool or a persistent change in bowel habits, see your doctor as soon as possible. Keep in mind that colorectal cancer can occur in younger as well as older people. If you’re at high risk, don’t wait until symptoms appear. See your doctor for regular screenings.

Talk to your doctor about when you should begin screening for colon cancer. Guidelines generally recommend colon cancer screenings begin at age 50. Your doctor may recommend more frequent or earlier screening if you have other risk factors, such as a family history of the disease.

Testsand diagnosis

Screening

Most colon cancers develop from adenomatous polyps. Screening can detect polyps before they become cancerous. Screening may also detect colon cancer in its early stages when there is a good chance for cure.

You may be embarrassed by the screening procedures, worried about discomfort or afraid of the results. Discuss your screening options and your concerns with your doctor. Most procedures are only moderately uncomfortable, and working with a doctor you like and trust can help ease your embarrassment…

Diagnosis 

If your doctor suspects you may have colon cancer based on your signs and symptoms, he or she may recommend colonoscopy to look for colon cancer. Colonoscopy allows your doctor to look for polyps or unusual areas in your colon. Your doctor can also remove a sample of tissue from your colon to look for cancer cells. In some cases, barium enema or flexible sigmoidoscopy may be used to diagnose colon cancer.

Treatments 

The type of treatment your doctor recommends will depend largely on the stage of your cancer. The three primary treatment options are: surgery, chemotherapy and radiation.

• Surgery :Surgery is the mainstay of treatment and involves in block removal of diseased segment with adequate margins, surrounding tissue and lymph nodes. The names given to such resections are right hemicolectomy, transverse colectomy, left hemicolectomy, sigmoid colectomy, and subtotal colectomy:
• Polypectomy : If the cancer is found in a polyp (a small piece of bulging tissue), the polyp is often removed during a colonoscopy.
• Local excision : If the cancer is found on the inside surface of the rectum and has not spread into the wall of the rectum, the cancer and a small amount of surrounding healthy tissue is removed.
• Resection : If the cancer has spread into the wall of the rectum, the section of the rectum with cancer and nearby healthy tissue is removed. Sometimes the tissue between the rectum and the abdominal wall is also removed. The lymph nodes near the rectum are removed and checked under a microscope for signs of cancer.
• Pelvic exenteration : If the cancer has spread to other organs near the rectum, the lower colon, rectum, and bladder are removed.

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Types of Bone Marrow and Stem Cell Transplants. Autologous. Autologous transplant uses your own stem cells

Types of Bone Marrow Transplants

• Germ Cell (Testicular) Cancer
• Lymphomas
• Multiple myeloma, and related diseases. Occasionally, this type of transplant is used for treatment of leukemia.
• Leukemias and bone marrow or immune system failure diseases.
• Reduced intensity or "mini"-transplant refers to a type of allogeneic transplant in which the pre-transplant

chemotherapy and/or radiation (called conditioning, see below) is less than maximally intensive. This type of transplant depends heavily on the anti-tumor effect of the donor cells for its therapeutic effect, so it generally requires that the disease either be in remission or very slow growing at the time of transplant. The immediate side effects of a reduced intensity transplant are less than those associated with a standard transplant, making it possible to offer transplant to a wider variety of people, including those who might otherwise not be transplant candidates because of age or other illnesses.

What the Donor Experiences
If stem cells are collected by bone marrow harvest (much less likely), the donor will go to the operating room and while asleep under anesthesia, a needle will be inserted into either the hip or the breastbone to take out some bone marrow. After awakening, he/she may feel some pain where the needle was inserted.

Autologous (self-transplant): This is the simplest form of transplant, and involves collection of the patient's own cells, which are counted, analyzed, and then frozen for later use. This type of transplant is most commonly performed for

• Hodgkin Disease

Bloodless Transfusions: For patients requiring a bloodless stem cell transplantation, our transplant center specializes in doing what is known as Bloodless Autologous transplants where patients do not receive any allogenic blood or blood products after the stem cell reinfusion. The period of cytopenias is managed with growth factors & other drugs to prevent bleeding.

Syngeneic (identical twin transplant): An identical twin is an ideal donor because of the genetic identity between the donor and recipient. It is like using one's own cells, except that the cells are not damaged from prior exposure to chemotherapy, and the risk to tumor cell contamination is eliminated.

Allogeneic (donor transplant): For this form of transplant, the stem cells are collected from a relative (usually a sibling), or other donor (volunteer unrelated donor or umbilical cord blood), whose tissue type matches closely with that of the patient. The chances of a brother or sister being a suitable match are about 1 in 4. The chances of any other family member being a match are much less, so we usually do not recommend extended family typing. Allogeneic transplants are most commonly done for

In most cases, a donation is made using circulating stem cells (PBSC) collected by apheresis. First, the donor receives injections for a few days of a medication that causes stem cells to move out of the bone marrow and into the blood. For the stem cell collection, the donor is connected to a machine by a needle inserted in the vein (like for blood donation). Blood is taken from the vein, filtered by the machine to collect the stem cells, then returned back to the donor through a needle in the other arm. There is almost no need for a recovery time with this procedure.

A bone marrow transplant is a difficult procedure to go through. Usually the person receives high doses of chemotherapy and/or radiation to eliminate whatever bone marrow he/she has left to make room for the new marrow transplant. Once this is done, the new stem cells are put into the person intravenously, similar to a blood transfusion. The stem cells then find their way to the bone and start to grow and produce more cells (called engraftment).

Most Advanced Small Cell Lung Cancer Treatment in India

A Lung Cancer is when out-of-control cell growth occurs in one or both lungs. The cancer can arise in any part of the lung, but majority of it arises in the epithelial cells, which are the lining of the Bronchi and bronchioles i.e. the larger and the smaller airways of the lungs. Lung cancer is predominantly a disease of the elderly almost 70% of people diagnosed with lung cancer are over 65 years of age.

Lung Cancer is largely classified into two main types based on the cancer's appearance under a microscope viz. Small Cell Carcinoma which accounts for only 20% of the total lung cancers and Non small Cell Lung Cancer (NSCLC) which accounts for 80% of lung cancers.

·         

   

 Small cell carcinoma : It generally starts in one of the larger breathing tubes, grows fairly rapidly, and is likely to be large by the time of diagnosis.

·         Non-small cell lung cancer (NSCLC) :It is further classified into the following:

o       Epidermoid carcinoma or Squamous cell carcinoma: It forms in the lining of the bronchial tubes and it usually starts from one of the larger breathing tubes and grows relatively slowly.

o    Adenocarcinoma: It starts forming in the mucus-producing glands of the lungs. It is most common type of lung cancer that occurs in Women’s and Non-smokers.

o    Large cell caracinoma: This kind of NSCLC initiates near the surface of the lung and it grows rapidly.

There are usually no signs or symptoms in lung cancer. 

The main symptoms of lung cancer are listed below:

·         A cough that doesn’t go away after two or three weeks

·         A long-standing cough that gets worse

·         Persistent chest infections

·         Coughing up blood

·         Persistent breathlessness

·         Loss of appetite or unexplained weight loss

Surgery, radiotherapy and chemotherapy are all used to treat lung cancer. They can each be used alone or together. Your doctor will plan the best treatment for you. Some people with advanced non small cell lung cancer may have biological therapy.

Treatmentand type of lung cancer

The treatment for non small cell lung cancer is different from the treatment for small cell lung cancer.

Small cell lung cancer is mostly treated with chemotherapy. Surgery is only suitable if there is no sign that the cancer has spread to the lymph glands in the centre of the chest (the mediastinal lymph glands) and this is rare with small cell lung cancer. It has usually spread at the time of diagnosis. So chemotherapy is usually the main treatment. You may also have radiotherapy to treat this type of lung cancer. 

Non small cell lung cancer can be treated with surgery, chemotherapy, radiotherapy or a combination of these, depending on the stage when the cancer is diagnosed. Some people with advanced lung cancer may have biological therapy. 

Treatment by stage for small cell lung cancer

If you have early stage small cell lung cancer you are most likely to have chemotherapy and then radiotherapy to the lung. People who are fairly fit may have chemotherapy and radiotherapy at the same time (chemoradiation). It is quite common for this type of cancer to spread to the brain. So doctors often recommend radiotherapy to the brain for people whose lung cancer shrinks with chemotherapy treatment. You usually have radiotherapy to the brain at the end of the chemotherapy treatment. It aims to try to kill any cancer cells that may have already spread to the brain but are too small to show up on scans. Doctors call this prophylactic cranial irradiation or PCI.

For very early stage small cell lung cancer that has not spread to the lymph nodes in the centre of the chest (the mediastinal lymph nodes), you may have surgery to remove the part of the lung containing the tumour . The surgery is followed by chemotherapy and sometimes radiotherapy. But usually the cancer has already spread at the time of diagnosis and surgery is not then possible.

If you have small cell cancer that has spread to lymph nodes or other areas of the body you may have chemotherapy, radiotherapy or treatment to relieve symptoms. If chemotherapy works well to shrink the lung tumour down and you are fairly fit you may also have radiotherapy to the brain to kill any cancer cells that may have already spread there.

• Chemoembolization:Strong chemicals are used in chemotherapy that interferes with cell division process and damages DNA or proteins. The aim of these treatments is to rapidly divide the cells. The normal cells can be recovered from any chemical-induced damage whereas cancer cells cannot be recovered. The medicines in chemotherapy travel in a systematic way by passing from the complete body and destroying the original tumor cells that have spread in the whole body. Usually many therapies are combined that also includes many types of chemotherapy.

• Radiation Therapy :Radiation therapy may be employed as a treatment for both NSCLC and SCLC. Radiation therapy uses high-energy X-rays or other types of radiation to kill dividing cancer cells. Radiation therapy may be given as curative therapy, palliative therapy (using lower doses of radiation than with curative therapy), or as adjuvant therapy in combination with surgery or chemotherapy. Radiation therapy generally only shrinks a tumor or limits its growth when given as a sole therapy, yet in 10%-15% of people it leads to long-term remission and palliation of the cancer. Combining radiation therapy with chemotherapy can further prolong survival when chemotherapy is administered. External radiation therapy can generally be carried out on an outpatient basis, while internal radiation therapy requires a brief hospitalization.

• Targeted Therapy :Targeted therapy drugs more specifically target cancer cells, resulting in less damage to normal cells than general chemotherapeutic agents. Erlotinib and gefitinib target a protein called the epidermal growth factor receptor (EGFR) that is important in promoting the division of cells. This protein is found at abnormally high levels on the surface of some types of cancer cells, including many cases of non-small cell lung cancer.

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