Narayana Health Care

Is cancer treatment worse than cancer? No, neither cancer nor treatment of cancer is so bad as understood by a common man. Normally, cancer diagnosis gives a feeling of sadness, fear, panic, and distress. In some cases, it may disturb the normal life. Today, cancer is not a dreadful disease. It is just like another chronic disease like diabetes, cardiovascular diseases, etc. Frequently asked a question to us whether cancer is curable or not. Our answer to everyone is yes, cancer is curable in the early stages. Technical advances enable access to various diagnostic tools like Sonography, Mammography, MRI, Endoscopy, Nuclear Medicine, Tumour Markers have facilitated early diagnosis. With the help of intervention radiology, one can aspirate tumour cell from deep-seated tumours for diagnosis. So,

• Giving away the fear of cancer
• Acceptability to consult a physician
• Will go a long way towards early diagnosis

Mainly three types of cancer treatments are available:

• Surgery
• Radiotherapy
• Chemotherapy – Immunotherapy is an emerging field for treatment

Surgery: There is fear among patients about the loss of organ and function after surgery. Today, surgery is very clean and precise with the availability of Electrocautery, Harmonic Scalpel, Cavitron Ultrasonic Suction Aspirator (CUSA). A shift has taken place from Total Ablative Surgery (Total removal of an organ) to Conservation Surgery (Preservation of organ) and organ reconstruction. Conservation and Reconstructive Surgery maintain near normal cosmesis and function.

Radiotherapy: Radiotherapy techniques have changed significantly over the past few decades. There is an improvement in engineering and computing.

• IMRT (Intensity Modulated Radiotherapy) – It optimizes the delivery of radiotherapy to irregularly shaped volumes of a tumour. It allows greater sparing of normal structures.
• IGRT (Image Guided Radiotherapy) – It is a useful tool that can detect and correct errors that occur during treatment deliveries.
• Stereotactic Radiotherapy enables the delivery of exquisitely conformed radiation in large fraction size, which enables improved tumour control while limiting the normal tissue toxicity.
• Charged particles, such as protons deposit little energy until they reach the end of their range at which point most of the energy is deposited in a small area. This has an advantage in terms of normal tissue sparing, better dose homogeneousity and low radiation to normal tissue.

Chemotherapy: Standard intravenous chemotherapy targets (kill) rapidly dividing cells including cancer cells and certain normal tissue. Today, targeted therapies are now a component of treatment for many types of cancer – Breast, Lung, Large Intestines, Pancreas, Lymphoma, Leukemia, and Multiple Myeloma.

Targeted Therapies, which include monoclonal antibodies and small molecules inhibitors have changed the treatment of cancer. Targeted therapies are better tolerated than traditional chemotherapy. It leads to truly tailored therapy.

Other techniques for the treatment of cancer are hormone therapy, immunotherapy, and bone marrow transplantation. Today, a better understanding of tumour behaviour and the use of multimodality treatment helps to achieve cure with minimal morbidity and near-normal cosmesis and function. So, no one should be afraid of cancer. Neither cancer nor treatment of cancer is dreadful. We are nearly always in a win-win situation if cancer is diagnosed early. Therefore, don’t be afraid of cancer and consult a physician for regular check-up especially after the age of 40 years.

Dr. (Prof.) Amar Bhatnagar, Director – Surgical Oncology, Dharamshila Narayana Superspeciality Hospital, Delhi