Most Advanced Treatment Options for Prostate Cancer : Prostate Cancer Treatment in India

Knowing the various treatments for prostate cancer available and what the risks associated with each are is the first step in being informed about what will be one of the most important decisions of your life. The potential side effects of some of the treatments are too life altering to leave this decision to chance.

Have a discussion with your doctor. Ask questions about any side effects you need to be aware of. While your treatment options become less viable if your cancer has progressed beyond your prostate gland, it is important to be aware of what to expect after the treatment has been completed.

Here are some of the options open to you.

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Prostate Cancer Treatment India | Prostate Cancer Surgery at Best Cancer Hospital India - MedWorldIndia

Surgery

Surgical options available are as follows.

A complete prostatectomy where your entire prostate gland is removed     A lymph node dissection where only the nodes surrounding the urethra are removed     A transurethral resection is done in which small pieces of your prostate are removed

Each of the above procedures requires a hospital stay and you would be anesthetized and put under. They are effective in most cases although cancers have been known to return weeks or months afterward. As well, side effects can include urinary incontinence, impotence and infertility.

Radiotherapy

There are 2 common approaches to radiation therapy in treating prostate cancer, external beam radiotherapy and brachytherapy.

External beam radiotherapy is a procedure where a high energy radioactive source is used to project a beam at your prostate from a short distance outside your pelvic area. There is no anesthesia required and it is done on an out-patient basis. It is typically done on 5 consecutive days over a period of about 5 to 7 weeks.

Brachytherapy is the usage of about 100 to 150 small radioactive pellets or seeds. They are placed directly into your prostate with a syringe a few at a time; it usually takes up to 40 injections to implant them all. This procedure is painful and requires a general anesthetic.

These two procedures use radioactivity to burn away cancerous cells. Side effects include impotence, inflammation of the bladder and rectum and cancers have been known to return.

Chemotherapy

Drugs known to be toxic to cancerous cells are introduced to your body. It is used to slow cancerous growths and relieve pain. It is not a cure but it can be used to help patients where cures through other means are not possible.

High Intensity Focused Ultrasound (HIFU)

HIFU is a procedure that uses sound waves to destroy cancerous cells. A focused ultrasound beam is aimed only at the regions of the prostate that are diseased with cancer. The cells targeted are destroyed using heat. Surrounding tissue is not affected by the beam and remains undamaged.

The entire prostate can be exposed to the ultrasound beam in about three hours. The procedure is done quickly and is effective in eradicating prostate cancer in over 90% of patients treated. Side effects are minimal resulting in urinary incontinence in only 5% of patients. Only 8% suffered urethral blockage and about 40% suffered sexual impotence. Impotence drops to 20% in patients whose cancer does not affect the prostate nerve.

These reasons alone make HIFU the choice you should make when thinking about prostate cancer treatment options.

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Major Factors that may increase your risk of Colon Cancer - Best Cancer Treatment in India

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.
  
  
  
  

What are the five major approaches to the treatment of leukemia (Blood Cancer)

Leukemia(Blood Cancer) 

Cancer can form in and attack any organ or organic system in the human body. When it comes down to blood cancer, it is found that cancerous cells multiply rapidly and violently attack different parts of the circulatory system, making it one of the, if not the most dangerous cancer that could possibly attack anyone. Apart from blood and the lymphatic system; bone marrow is prone to be affected by this kind of cancer.

There are three basic types of blood cancer, primarily. These are:

Leukemia – Because of the rapid increase of cancerous cells that are either affecting the marrow or the blood, the circulatory system loses its ability to produce and regulate blood effectively, hence severely impairing it.

Lymphoma – The cancer affecting lymphocytes is called lymphoma. Lymphocytes are one of the types of white blood corpuscles.

Myeloma – Myeloma affects plasma, another type of white blood corpuscles.

Treating blood cancer is determined by various factors, such as age, how fast the cancer is progressing, where the cancer has spread to, other health conditions, etc.

Leukemia is not a single disease. Instead, the term leukemia refers to a number of related cancers that start in the blood-forming cells of the bone marrow. There are both acute and chronic forms of leukemia, each with many subtypes that vary in their response to treatment. In addition, children with leukemia have special needs that are best met by care in pediatric cancer centers. 

Most Advanced Blood Cancer Care and Treatment in India

In general, there are five major approaches to the treatment of leukemia:

• Chemotherapy to kill leukemia cells using strong anti-cancer drugs
• Interferon therapy to slow the reproduction of leukemia cells and promote the immune system's anti-leukemia activity
• Radiation therapy to kill cancer cells by exposure to high-energy radiation
• Stem cell transplantation (SCT) to enable treatment with high doses of chemotherapy and radiation therapy and
• Surgery to remove an enlarged spleen or to install a venous access device (large plastic tube) to give medications and withdraw blood samples.

Stemcell transplantation

Younger patients that are at high risk for dying from CLL might consider hematopoietic stem cell transplantation (HSCT). Autologous stem cell transplantation, a lower-risk form of treatment using the patient's own blood cells, is not curative. Myeloablative (bone marrow killing) forms of allogeneic stem cell transplantation, a high-risk treatment using blood cells from a healthy donor, may be curative for some patients, but most patients cannot tolerate the treatment. An intermediate level, called reduced-intensity conditioning allogeneic stem cell transplantation, may be better tolerated by older or frail patients.

Biological Therapy : Biological therapy, also referred to as immunotherapy, involves the treatment with those substances that affect the ability of an immune system to kill cancer cells. Monoclonal antibodies and interferon are the two types of biological therapy. The purpose of monoclonal antibodies is to stick to cancer cells in order to draw the attention of the immune system to these cancer cells. On the other hand, interferon helps in stimulating the immune system so as to destroy the cancer cells. These two options are generally used for chronic leukemia instead of acute leukemia.

Radiotherapy : Radiotherapy, also known as radiation therapy, makes use of energy rays such as X-rays for stopping the growth and multiplication of the cancer cells. This energy is directed at any particular part of the body such as the spleen or also to the entire body.

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The CyberKnife Robotic Radiosurgery System improves on other radiosurgery techniques

How the CyberKnife System Treats Brain Cancer

The CyberKnife Robotic Radiosurgery System improves on other radiosurgery techniques by eliminating the need for stereotactic frames. As a result, the CyberKnife System enables doctors to achieve a high level of accuracy in a non-invasive manner and allows patients to be treated on an outpatient basis. The CyberKnife System can pinpoint a tumor’s exact location in real time using X-ray images taken during the brain cancer treatment that reference the unique bony structures of a patient’s head.

The CyberKnife System has a strong record of proven clinical effectiveness.  It is used either on a stand–alone basis or in combination with other brain cancer treatments, such as chemotherapy, surgery or whole brain radiation therapy.

CyberKnife brain cancer treatments involve a team approach, in which several specialists participate. The team may include:

1. ·         a radiation oncologist
2. ·         a neurosurgeon
3. ·         a medical physicist
4. ·         a radiation therapist
5. ·         other medical support staff

Once the team is in place, preparations begin for the CyberKnife treatment. Generally there are three steps involved:

1.     Set up and imaging

2.     Treatment planning

3.     CyberKnife treatment

Unlike other radiosurgery systems, the CyberKnife System does not require patients to be fitted with an invasive head frame. In the set-up stage, the radiation therapist will create a soft mesh mask that is custom-fitted to the patient’s face. This comfortable and non-invasive mask helps the patient keep his or her head and neck still during treatment. While wearing the mask, a CT scan will be performed. The CT data then will be used by the USC CyberKnife team to determine the exact size, shape and location of the tumor.

An MRI, PET scan or angiogram also may be necessary to fully visualize the tumor and nearby anatomy. Once the imaging is done, the face mask will be removed and stored until the CyberKnife treatment begins. Then a medical physicist and the patient’s doctor use the data to custom-design the patient’s treatment plan. The patient does not need to be present at this time.

During the CyberKnife treatment planning phase, the CT, MRI and/or PET scan data will be downloaded into the CyberKnife System’s treatment planning software. The medical team will determine the size of the area that must be targeted by radiation and the radiation dose. They also will identify critical structures where radiation should be minimized. Using this information, the CyberKnife System calculates the optimal radiation delivery plan to treat the tumor. The treatment plan will take full advantage of the CyberKnife System’s extreme maneuverability, allowing for a safer and more accurate treatment.

After the brain cancer treatment plan is developed, the patient will return to USC Norris Cancer Hospital for the CyberKnife treatment. The doctors may choose to deliver the treatment in one session, or stage it over several days. Typically, brain cancer treatments are completed within five days. For most patients, the CyberKnife treatment is a completely pain-free experience. Patients dress comfortably in their own clothes and may bring their own music CD's to listen to during the treatment. Patients also may want to bring something to read while they wait, and have a friend or family member with them to provide support before and after treatment.

When it is time for treatment, the patient lies on the table while their custom-fitted face mask is secured into place. The CyberKnife System’s computer-controlled robot will move around the patient’s body to the various locations from which it will deliver radiation to the tumor. Nothing will be required of the patient during the treatment, except to relax and lie as still as possible.

Once the CyberKnife treatment is complete, most patients quickly return to their daily routines with little interruption in their normal activities. If the treatment is being delivered in stages, the patient will need to return for additional treatments over the next several days, as recommended by their doctors. Side effects vary from patient to patient. Generally some patients experience minimal side effects from CyberKnife treatments, and these often go away within a week or two. Prior to treatment, the doctor will discuss with the patient all possible side effects they may experience. The doctor also may prescribe medication designed to control any side effects should they occur.

After completing CyberKnife radiosurgery treatment, it is important that the patient schedule and attend follow-up appointments. They also must keep in mind that their tumor will not suddenly disappear. Response to treatment varies from patient to patient. Clinical experience has shown that most patients respond very well to CyberKnife treatments. As follow-up, doctors will monitor the outcome in the months and years following a patient’s treatment, often using either CT scans and/or PET-CT scans.4

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Most Advanced Robotic Prostate Surgery in India

Robotic Prostate Surgery Service - where a minimally invasive robot assisted radical prostatectomy technique eradicates prostate cancer with minimal post surgery complications

The mission of “Minimally Invasive Robotic Prostate Surgery Program” is to leverage latest technology to and treat prostate disease through small incision and great precision resulting in:

·  Shorter hospital stay, Faster recovery and return to normal activities

· Less pain and scarring , Reduced blood loss and need for blood transfusion

·  Reduction in the use of pain medicines, Decreased postoperative pain

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 some cancer behind.  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

Highly trained Indian surgeons who have worked for decades at some of the global centres of excellence now use Advanced Robotic technique gives surgeon a sophisticated master slave robot that seamlessly translates the surgeon's movements at the computer console into precise, real-time movements of the surgical instruments inside the patient. This ensures that the Prostate is removed excellent outcomes and minimal chances of cancer left behind after the surgery.

If you're young and in good health, the short-term risks of this surgery are low. The hospital stay is usually 2 to 3 days, with the catheter left in place for 2 to 3 weeks. You're usually able to go back to work in about 1 month. You shouldn't have severe pain with this surgery. Most men regain bladder control a few weeks to several months after the surgery.

The main advantage of surgery is that it offers the most certain treatment. That is, if all of the cancer is removed during surgery, you are probably cured. Also, the surgery provides your doctor with accurate information about how advanced your cancer is, since the nearby lymph nodes are taken out along with the tumor.

 Surgery does have risks. The main risks of radical prostatectomy are incontinence (loss of bladder control) and impotence (loss of the ability to get or keep an erection long enough to have sex). Most bladder and impotence problems improve with time.

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Best Uterine Cancer Hospital in India : Advanced Radiation Cancer Treatment

Endometrial Cancer (Uterine Cancer)

The uterus (womb) is part of the female reproductive system. It is shaped like an upside-down pear and sits inside the pelvis. It is in the uterus that a fertilised egg grows into a baby.

Most of these women are over the age of 50 years. Cancer of the uterus is also known as cancer of the womb, uterine cancer, endometrial cancer and cancer of the lining of the womb.

Causes of uterine cancer

The exact cause of uterine cancer is not known. Some things seem to put women at more risk including:

• endometrial hyperplasia (an abnormal increase in the number of cells in the endometrium)
• menopause, never having children or being infertile
• being overweight
• high blood pressure and diabetes
• a family history of endometrial, breast or bowel cancer
• being on oestrogen hormone therapy without progesterone
• being on tamoxifen or anastrozole for treatment of breast cancer. if you are on either of these medications, you should discuss this risk with your doctor.

Uterine cancer is not caused by sexual activity and cannot be passed on this way. Remember, most women who have known risk factors do not get cancer of the uterus and many women who do get cancer of the uterus have none of these risk factors.

Types of Uterine Cancer :- 

Sarcoma: Sarcoma cancer grows in the supporting tissues of the uterine glands or in the myometrium. This cancer accounts for 2-4% of uterine cancers.

Adenocarcinoma: This cancer is considered as the main type of uterine cancer that grows from the cells in the uterus lining. Endometrial cancer is the other name of this cancer.

The Symptoms of Uterine Cancer include :

• Unusual Vaginal Bleeding or Discharge
• Trouble Urinating
• Pelvic Pain
• Pain during sexual intercourse
• Discomfort or pain in the lower abdomen

Diagnosis of Endometrial Cancer (Uterine Cancer)

A pelvic exam is performed by the doctors checking the vagina, uterus, ovaries, bladder, and rectum for Endometrial Cancer (Uterine Cancer). An instrument called a speculum is used to widen the vagina so the doctor can see the upper portion of the vagina and the cervix.

The Pap Smear test is often performed during a pelvic exam Endometrial Cancer (Uterine Cancer). The doctor uses a wooden scraper (spatula) or small brush to collect a sample of cells from the cervix and upper vagina. The cells are then sent to a medical laboratory to be checked for abnormal changes. Because uterine cancer begins inside the uterus, it may not show up on a Pap test, which examines cells from the cervix.

A biopsy may be needed for a definitive diagnosis where the doctor removes a sample of tissue from the uterine lining. In some cases, a woman may require a dilation and curettage (D&C), which is usually a day care procedure. During a D&C, the opening of the cervix is widened and the doctor scrapes tissue from the lining of the uterus. A pathologist examines the tissue to check for cancer cells, hyperplasia, or other conditions.

Common Endometrial Cancer (Uterine Cancer) Symptoms

•   Abnormal bleeding- heavy bleeding between periods, or heavy bleeding  during irregular periods
•    Pain during intercourse, pelvic pain or pain in the legs or back
•    Difficulty urinating or pain during urination
•    Enlarged uterus , Vaginal discharge and or unexplained weight loss

Surgical Treatment of EndometrialCancer (Uterine Cancer)

Surgery is the best option when Endometrial Cancer (Uterine Cancer) is diagnosed in its very early stages. At this time, the location and the stage of cancer make removal easy. Sometimes patients are treated with a combination of surgery and radiation therapy. Laparoscopy Assisted Vaginal Hysterectomy - involves the minimally invasive or open surgery to remove the uterus. If required teh surgeon may decide to remove both ovaries and the fallopian tubes if there is a risk of Endometrial cancer spread to the ovaries.

In most cases, uterine cancer is an Adenocarcinoma that metastasizes late, usually from the endometrium to the cervix, ovaries, fallopian tubes, and other peritoneal structures. It may spread to distant organs, such as the lungs and the brain, through the blood or the lymphatic system. In such cases advanced tratement post Hystrectomy like Chemotherapy and Radiation are advised

Chemotherapy 

Involves modern cancer drugs that are administered intravenously or orally to kill cancer cells and to reduce the chances of the tumour returning elsewhere in the body.


Radiation therapy 

India's leading Cancer hospitals now have some of the world's moset advanced radiation equipment like Linac, Novelis, Gamma Knife and Cyberknife for treating Colon rectal Cancers. High technology radiation is used to kill cancer cells without affecting the healthy tissues. Radiation may be used to reduce the tumor prior to surgery or to obviate the symptoms of colorectal cancer such as pain, bleeding, or blockage.

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Radiation Oncology that holds great promise in the diagnosis and treatment of many diseases, particularly cancer.

PET (Positron Emission Tomography) scan
Positron Emission Tomography (PET) is a powerful imaging technique in Radiation Oncology that holds great promise in the diagnosis and treatment of many diseases, particularly cancer. A non-invasive test, PET scans accurately image the cellular function of the human body. In a single PET scan your physician can examine your entire body. PET scanning provides a more complete picture, making it easier for your doctor to diagnose problems, determine the extent of disease, prescribe treatment, and track progress.

PET (Positron Emission Tomography) and CT (Computed Tomography) scans are advanced imaging techniques that physicians use to locate and pinpoint disease states in the body. A PET scan shows the biological function of the body before anatomical changes take place, while the CT scan provides information about the body’s anatomy such as size, shape and location. By combining these two scanning technologies, a PET/CT scan enables physicians to more accurately diagnose and identify cancer, heart disease and brain disorders. 

A PET scan helps in detecting the abnormalities of those areas of the body where chemical activity is happening. This scan is most effectively used for those people who have brain disorders, cancer or heart disease.

• Brain disorders : The different areas of the brain having majority of activities while performing various tasks can be revealed by a PET scan. Specific brain abnormalities can also be evaluated by this scan that includes:
  • Seizures
  • Memory disorders
  • Tumors
• Cancer : Bright spot of cancer cells can be seen in a PET scan due to their high metabolism rate as compared to normal cells. The scan helps in determining:
  • Whether the cancer has recurred
  • The response of the cancer to the treatment
  • The spread and extent of some cancers
• A proper interpretation of the PET scans is required as some non-cancerous conditions may look like cancer. It is also possible that certain cancer types may also not appear on PET scans. Following are the different cancer types that will appear on PET scans such as:
• Thyroid
• Brain
• Pancreatic
• Lymphoma
• Breast
• Melanoma
• Lung
• Cervical
• Esophageal
• Colon

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