Most Advanced Cervical Cancer Treatment in India: The main cause of cervical cancer is HPV , a common virus that spreads through sexual intercourse

Cervical cancer originates in the cervix, the lower part of the uterus (womb) and opens into

the vagina. It arises from the cells present on the surface of the cervix.

The cervix is the muscular lower portion of the uterus that holds in pregnancies and dilates during labor. Cervical cancer occurs in several forms. The most common is squamous cell carcinoma, which accounts for 85 to 90 percent of cervical cancers. Other forms include adenocarcinomas and combination cancers such as adenosquamous carcinoma. Some strains of the human papillomavirus (HPV), a virus transmitted during sex, play a role in causing most cases of cervical cancer.  

Causes

Cervical cancer stands as the third most common type of cancer in women. The main cause is HPV (Human Papilloma Virus), a common virus that spreads through sexual intercourse.

Risk factors

* Having premature sex

* Having more than one sexual partner

* Poor socioeconomic status

* Weakened immune system

Symptoms

* Vaginal bleeding after menopause

* Foul-smelling vaginal discharge

* Bleeding after intercourse

* Heavy menstrual or intermenstrual bleeding

Symptoms of advanced cervical cancer

* Low backache

* Pain in the pelvis

* Exhaustion

* Excretion of urine or feces through the vagina

* Single swollen leg

* Loss of appetite

* Weight loss

Investigations

Screening tests

* For pre-cancer and cancer, Pap smear screens are effective, though not for final diagnosis.

* Colposcopy is carried out if abnormal changes are discovered. In this procedure, pieces of tissue are surgically removed (biopsy) and sent to a laboratory for examination under magnification.

Diagnosis tests

* Endocervical curettage (ECC) is used to examine the opening of the cervix

* Cone biopsy

* Punch biopsy from cervical growth

Staging tests

* Chest X-ray

* CT scan or MRI

* Cystoscopy

* Intravenous Pyelogram (IVP)

Treatment plan

The treatment of cervical cancer depends on:

* Stage

* Size and shape of the tumour

* The woman's desire to have children in the future

* The woman's age and general health

Treatment of early cervical cancers

* To ensure that a woman can bear children in the future, removing the precancerous or cancerous tissue without removing the uterus or harming the cervix, can cure early cervical cancer.

* Pre-cancerous conditions are curable when followed up and administered proper treatment.

* 92 per cent of women with cervical cancer have a five-year survival rate.

Treatment of advanced cervical cancers

* Radical hysterectomy: The uterus and much of the surrounding tissues are removed, including lymph nodes and the upper part of the vagina.

*Radiation therapy: It is used in cases where the cancer has spread beyond the pelvis, or cancer that has returned.

Radiation therapy is of two types:

* External radiation therapy is like an X-ray and delivers radiation from a large

 machine onto the part of the body where the cancer is located.

* Internal radiation therapy or brachytherapy entails placing a device filled with radioactive material inside the woman's vagina.

* Intensity Modulated Radiation Therapy (IMRT) and Image Guided Radiotherapy (IGRT) help deliver radiation to the tumour and adjacent tissues sparing nearby normal structures like urinary bladder, rectum and intestines and thus preventing long term complications.

* Chemotherapy uses drugs such as carboplatin, paclitaxel, 5-FU and cisplatin to destroy cervical cancer. It is generally used along with radiation to sensitize the tumour. Radiation and chemotherapy may be used before or after surgery. 

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Most Advanced Stomach Cancer Surgery and Treatment in India

Stomach cancer

Stomach cancer is sometimes called gastric cancer. Worldwide it is one of the most common cancers. Stomach cancer is more common in men than in women and ten/ds to occur mainly in older people. Most people who develop stomach cancer are over the age of 55.

In most cases, stomach cancer begins from a cell which is on the inside lining of the stomach (the mucosa). This type of stomach cancer is called adenocarcinoma of the stomach. As the cancer cells multiply :

• The tumour may invade deeper into the wall of the stomach. In time, it may pass through the wall of the stomach and invade nearby organs such as the pancreas or liver.
• The tumour may spread up or down the stomach into the oesophagus (gullet) or small intestine.
• Some cells may break off into the lymph channels or bloodstream. The cancer may then spread to nearby lymph nodes or spread to other areas of the body (metastasise).

Diagnosis of Stomach Cancer

If you have symptoms that suggest stomach cancer, your doctor will check to see whether they are due to cancer or to some other cause. Your doctor may refer you to a gastroenterologist, a doctor whose specialty is diagnosing and treating digestive problems. Your doctor will ask about your personal and family health history. You may have blood or other lab tests. You also may have :

• Physical exam : oncologist feels the abdomen of the patient for fluid, swelling, or other changes. They also will check for swollen lymph nodes.
• Endoscopy : Surgical Oncologist uses a thin, lighted tube (endoscope) to look into the stomach after numbing the throat with an anesthetic spray. Patient may be given medicine to help him relax. The tube is passed through the mouth and esophagus (food pipe) to the stomach.
• Biopsy : An endoscope has a tool for removing tissues. Surgical Oncologist uses the endoscope to remove tissue from the stomach. A pathologist checks the tissue under a microscope for cancer cells. A biopsy is the only sure way to know if cancer cells are present.

Stomach Cancer Surgery and Treatment in India

Surgery

The goal of surgery is to remove all of the stomach cancer and a margin of healthy tissue, when possible. Options include :

• Removing a Portion of the Stomach (Subtotal Gastrectomy). During subtotal Gastrectomy, the surgeon removes only the portion of the stomach affected by cancer. Subtotal gastrectomy can be of two types :
  • Distal subtotal gastrectomy is performed if the tumor cells are present in the lower part of the stomach near to the stomach duodenum junction.
  • Proximal subtotal gastrectomy is done when the tumor is situated in the upper part of the stomach and also involves the esophagus.
• Removing the Entire Stomach (Total Gastrectomy). Total Gastrectomy involves removing the entire stomach and some surrounding tissue. The esophagus is then connected directly to the small intestine to allow food to move through your digestive system.
• Removing Lymph nodes to look for Cancer. The surgeon examines and removes lymph nodes in your abdomen to look for cancer cells.

Chemotherapy

Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. Chemotherapy drugs travel throughout your body, killing cancer cells that may have spread beyond the stomach. Chemotherapy can be given before surgery (neoadjuvant chemotherapy) to help shrink a tumor so it can be more easily removed. Chemotherapy is also used after surgery (adjuvant chemotherapy) to kill any cancer cells that might remain in the body.

Radiation therapy

Radiation therapy may be used to kill the cancer cells. Radiation therapy can be administered using a machine outside the body (external radiation therapy) or using needles, seeds, wires, or catheters placed in the body in or near the cancer (internal radiation therapy). External radiation therapy uses a machine outside of the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.  

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Importance of a PET scan - To diagnose and Identify 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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Kidney Cancer Treatment and Diagnosis in India

Treatment and Diagnosis:

If a patient has symptoms that suggest kidney cancer, the doctor may perform one or more of the following procedures:

• Physical exam: The doctor checks general signs of health and tests for fever and high blood pressure. The doctor also feels the abdomen and side for tumors.
• Urine tests: Urine is checked for blood and other signs of disease.
• Blood tests: The lab checks the blood to see how well the kidneys are working. The lab may check the level of several substances, such as creatinine. A high level of creatinine may mean the kidneys are not doing their job.
• Intravenous pyelogram (IVP): The doctor injects dye into a vein in the arm. The dye travels through the body and collects in the kidneys. The dye makes them show up on x-rays. A series of x-rays then tracks the dye as it moves through the kidneys to the ureters and bladder. The x-rays can show a kidney tumor or other problems.
• CT scan (CAT scan): An x-ray machine linked to a computer takes a series of detailed pictures of the kidneys. The patient may receive an injection of dye so the kidneys show up clearly in the pictures. A CT scan can show a kidney tumor.
• Ultrasound test: The ultrasound device uses sound waves that people cannot hear. The waves bounce off the kidneys, and a computer uses the echoes to create a picture called a sonogram. A solid tumor or cyst shows up on a sonogram.
• Biopsy: In some cases, the doctor may do a biopsy. A biopsy is the removal of tissue to look for cancer cells. The doctor inserts a thin needle through the skin into the kidney to remove a small amount of tissue. The doctor may use ultrasound or x-rays to guide the needle. A pathologist uses a microscope to look for cancer cells in the tissue.
• Surgery: In most cases, based on the results of the CT scan, ultrasound, and x-rays, the doctor has enough information to recommend surgery to remove part or the entire kidney. A pathologist makes the final diagnosis by examining the tissue under a microscope.

Staging

To plan the best treatment, the doctor needs to know the stage (extent) of the disease. The stage is based on the size of the tumor, whether the cancer has spread and, if so, to what parts of the body.

Staging may involve imaging tests such as an ultrasound or a CT scan. The doctor also may use an MRI. For this test, a powerful magnet linked to a computer makes detailed pictures of organs and blood vessels.

Doctors describe kidney cancer by the following stages:

• Stage I is an early stage of kidney cancer. The tumor measures up to 2 3/4 inches (7 centimeters). It is no bigger than a tennis ball. The cancer cells are found only in the kidney.
• Stage II is also an early stage of kidney cancer, but the tumor measures more than 2 3/4 inches. The cancer cells are found only in the kidney.
• Stage III is one of the following:
• The tumor does not extend beyond the kidney, but cancer cells have spread through the lymphatic system to one nearby lymph node; or
• The tumor has invaded the adrenal gland or the layers of fat and fibrous tissue that surround the kidney, but cancer cells have not spread beyond the fibrous tissue. Cancer cells may be found in one nearby lymph node; or
• The cancer cells have spread from the kidney to a nearby large blood vessel. Cancer cells may be found in one nearby lymph node.
• Stage IV is one of the following:
• The tumor extends beyond the fibrous tissue that surrounds the kidney; or
• Cancer cells are found in more than one nearby lymph node; or
• The cancer has spread to other places in the body such as the lungs.
• Recurrent cancer is cancer that has come back (recurred) after treatment. It may come back in the kidney or in another part of the body.

Surgery

Surgery is the most common treatment for kidney cancer. It is a type of local therapy. It treats cancer in the kidney and the area close to the tumor.

An operation to remove the kidney is called a nephrectomy. There are several types of nephrectomies. The type depends mainly on the stage of the tumor. The doctor can explain each operation and discuss which is most suitable for the patient:

• Radical nephrectomy: Kidney cancer is usually treated with radical nephrectomy. The surgeon removes the entire kidney along with the adrenal gland and some tissue around the kidney. Some lymph nodes in the area also may be removed.
• Simple nephrectomy: The surgeon removes only the kidney. Some people with Stage I kidney cancer may have a simple nephrectomy.
• Partial nephrectomy: The surgeon removes only the part of the kidney that contains the tumor. This type of surgery may be used when the person has only one kidney, or when the cancer affects both kidneys. Also, a person with a small kidney tumor (less than 4 centimeters) may have this type of surgery.

Arterial embolization

Arterial embolization is a type of local therapy that shrinks the tumor. Sometimes it is done before an operation to make surgery easier. When surgery is not possible, embolization may be used to help relieve the symptoms of kidney cancer.

Radiation therapy

Radiation therapy (also called radiotherapy) is another type of local therapy. It uses high-energy rays to kill cancer cells. It affects cancer cells only in the treated area. A large machine directs radiation at the body. The patient has treatment at the hospital or clinic, 5 days a week for several weeks.

A small number of patients have radiation therapy before surgery to shrink the tumor. Some have it after surgery to kill cancer cells that may remain in the area. People who cannot have surgery may have radiation therapy to relieve pain and other problems caused by the cancer.

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Unbeatable Advantages of Robotic Prostate Surgery over the Conventional Prostate Cancer Surgery

Robotic Prostate Surgery

Robotic surgery involves use of the da Vinci robotic surgical unit in performing complex surgical procedures such as prostatectomy (removal of the prostate gland for cancer). Originally developed for space and military uses, this advanced technology allows the operating surgeon to sit behind a console and control the robot that is next to the patient to perform surgery.

 This technology allows the surgeon to operate with very small and precise instruments under a 3 dimensional (3-D) vision, which is magnified up to 10 times. This is achieved by inserting the camera and the instruments into the patient’s body through small cuts (incisions) ranging from 5 – 12 mm in size.

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.

Unbeatable Advantages of Robotic Prostate Surgery over the
Conventional Prostate Cancer Surgery

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.

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.

MostAdvanced Robotic Surgery for Prostate Cancer  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:- 1. Minimal Bleeding 2. Much quicker recovery 3. Reduced hospital stay 4. Lesser pain killer requirements 5. Lower blood transfusion rates 6. Improved preservation of physical appearance 7. Three (3) D vision enables surgeon to perform Prostate excision with Cancer  8.Control without risk of Post Surgery Continence (control over urinary and fecal discharge) and causing Impotency

Estimated Cost for Robotic Prostate Cancer Treatment at World Best  Hospitals in India :

Treatment Cost	7000- 8000 USD
stay in the hospital	5 Days

How to Recognize the Signs of Leukemia - Leukemia Treatment in India

Cancer occurs when there is uncontrolled abnormal cell growth and development. It disturbs the normal life span of cells wherein they are formed, mature, carry out their intended function, die, and are replaced by new cells which are constantly regenerated in the body to maintain normal cellular function. Cancer represents the disturbance of this process.

Leukemia symptoms vary, depending on the type of leukemia. Common leukemia signs and symptoms include:

• Fever or chills
• Persistent fatigue, weakness
• Frequent or severe infections
• Losing weight without trying
• Swollen lymph nodes, enlarged liver or spleen
• Easy bleeding or bruising
• Recurrent nosebleeds
• Tiny red spots in your skin (petechiae)
• Excessive sweating, especially at night
• Bone pain or tenderness

Bone marrow

Bone marrow is a spongy material that is found inside the bones, and it produces all of the blood cells. It also produces vital cells called stem cells that can create other specialised cells that carry out essential functions. These specialised cells are of three types:

* Red blood cells which carry oxygen around the body

* White blood cells which help fight infection

* Platelets which help stop bleeding

Acute leukaemia prevents the affected bone marrow from producing stem cells that mature into adult blood cells. Instead it releases numerous immature blood cells called blast cells. The immature white blood cells begin to rapidly disrupt the normal balance of cells in the blood, limiting the presence of red blood cells or platelet cells in the body. This can lead to tiredness and other

symptoms of anaemia, and also increase risk of excessive bleeding. The patient also becomes more vulnerable to infection as the white blood cells are not properly formed and thus ineffective in

fighting bacteria and viruses.

Types of acute leukaemia

There are two main types of white blood cells classified according to the type of white blood cells that are affected by cancer:

Lymphocytes which are mostly used to fight viral infections

Myeloid cells which fight bacterial infections defend the body against parasites and prevent the spread of tissue damage

The two main types of acute leukaemia are:

Acute lymphoblastic leukaemia, which is cancer of the lymphocytes

Acute myeloid leukaemia, which is cancer of the myeloid cells

Acute myeloid leukaemia

It is more common in older people, especially when over 50 years of age, and more common in males than females, though it is not clear why. The causes of acute leukaemia are uncertain, but known risk factors include:

Exposure to high levels of radiation

Exposure to benzene, a chemical that is used in manufacturing and is also found in cigarettes

The lack of healthy blood cells in the blood supply causes most of the symptoms of acute leukaemia, which usually begin slowly before rapidly escalating in severity as the number of blast cells in the blood increases.

Acute lymphoblastic leukaemia

ALL is the most common type of cancer found in children, though it is uncommon on an overall basis. Approximately one in every 2,000 children will develop ALL. The majority of cases develop in the age group of two to five year olds, and 85 per cent develop in children below the age of 15.

Treatment

Treatment for AML involves two stages:

Induction: The aim of the initial stage of treatment is to kill the leukaemia cells in the bone marrow, restore the blood to proper working order and resolve any symptoms that may be present.

Consolidation: This stage aims to kill any remaining leukaemia cells that may be present in the central nervous system.

Treatment for ALL involves three stages:

Induction

Consolidation

Maintenance, which involves taking regular doses of chemotherapy tablets to prevent the leukaemia returning. This seems to be the most effective stage.

Other treatments

The other treatments that are used in some circumstances are:

• Radiotherapy
• Stem cell transplant
• Targeted therapies

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