Archive for the ‘ Cancer ’ Category

Lung Cancer Awareness

Thursday, November 26th, 2020

Lung cancer is the result of damage to normal cells in the lung. The body programs cells to die at a certain stage in their life cycle to avoid overgrowth. Cancer overrides this instruction, causing cells to grow and multiply when they should not. In lung cancer, this pattern of cell overgrowth occurs in the lungs, which are vital organs for breathing and gas exchange. While anyone can develop lung cancer, cigarette smoking, and exposure to pollution highly increases the risk of developing lung cancer.

Around 50 % of  Indians being diagnosed with lung cancer are non-smokers. Air pollution both outdoor and indoor – that includes coal and biomass burning is linked to rising lung cancer cases among non-smokers in India. Lack of awareness, delayed diagnosis, and unavailability of specialist care is the leading cause of lung cancer deaths in India. Most lung cancer cases in India are detected at advanced stages where chances of survival are grim.

Symptoms of Lung Cancer
Lung cancer symptoms may take years to develop, and often there are no symptoms at all until the later stages of the disease. The early symptoms of lung cancer are often mistaken and ignored. These include:

  • Coughing — A persistent cough that lasts more than two weeks, or coughing up blood
  • Chest infection — Infections, like bronchitis or pneumonia
  • Trouble breathing — Shortness of breath or wheezing
  • Chest discomfort — Chest pain or sudden and severe discomfort
  • Loss of appetite — Many illnesses, including cancer, cause changes in appetite
  • Weight loss — If you are losing weight for no known reason, inform your doctor
  • Fatigue — Excessive tiredness or weakness is a common sign of cancer

Late signs and symptoms of lung cancer:

  • Neck and facial swelling
  • Aching bones or joints
  • Headaches and dizziness
  • Lumps in the neck
  • Pain and swelling around the chest

If you have any of the above symptoms or if you are at high risk for developing lung cancer, consult a cancer specialist. Early diagnosis of lung cancer can be lifesaving and offers best chances of survival.

Risk factors of Lung Cancer
Research has found several risk factors that may increase your chances of getting lung cancer. These include:

  • Smoking – Cigarette smoking is the number one risk factor for lung cancer. Tobacco smoke is a toxic mix of more than 7,000 chemicals out of which at least 70 are known to cause cancer. People who smoke cigarettes are 15 to 30 times more likely to get lung cancer. Second-hand smoke is equally harmful and may also lead to lung cancer.
  • Chemical exposure – Radon is a naturally occurring gas that comes from rocks and dirt and can get trapped in houses and buildings. It cannot be seen, tasted, or smelled however it is may cause lung cancer.
  • Other Substances – Certain occupational exposure to chemicals like asbestos, arsenic, some forms of silica and chromium may harm your lungs and increase the risk of getting lung cancer.
  • Family history – Your risk of lung cancer may be higher if your parents, brothers or sisters, or children have had lung cancer.

Tips for healthy lungs

Here are a few health tips to follow to keep your lungs healthy and strong:

  • Quit smoking and avoid second-hand smoke.
  • Have a healthy diet that is high in fibre and includes at least five portions of fruits and vegetables, and has plenty of whole grains.
  • Exercise regularly and practice breathing techniques to strengthen your lungs.
  • Follow health and safety guidelines in your workplace and avoid carcinogens.
  • Laugh often as it helps replenish the lungs.

Lung Cancer care at Kokilaben Dhirubhai Ambani Hospital
Are you showing any symptoms of lung cancer? Meet our highly trained and experienced oncologists for an expert opinion and world-class treatment. Our Centre for Cancer is equipped with high-end technologies that provide excellent outcomes. 50 per cent of surgeries for lung cancer at Kokilaben Hospital are done using Video Assisted Thorocoscopic Surgery (VATS). This is a keyhole surgery that reduces postoperative pain, avoids scars, reduces hospital stay, and helps in fast recovery.

Our Lung cancer experts use state-of-the-art technology such as:

  • Video Assisted Thoracoscopic Surgery for lung resection aiding early recovery
  • Robot-Assisted Thoracoscopic Surgery for early cancer
  • Lung Sparing surgery (including Sleeve Lobectomy)
  • Mediastonscopy for staging
  • Endobronchial Ultrasonography (EBUS)
  • Stereotactic Body Radiation Therapy (SBRT)

If you or a loved one need help for diagnosis, or treatment of lung cancer, consult specialist at our Centre for Cancer. Please find below the link for our website:

Breast Cancer Awareness

Monday, October 12th, 2020

Breast cancer ranks as the number one cancer among Indian females with a rate as high as 25.8 per 100,000 women and mortality of 12.7 per 100,000 women. One woman is diagnosed with breast cancer every 4 minutes in India. Almost 50 percent of breast cancer patients in India first visit the doctor when they are in stage 3, and 15-20% of patients visit when they are in phase 4. Low awareness levels about breast cancer, its preventive screening and treatment options contribute to these alarming statistics. Patients diagnosed with breast cancer need the right treatment at the right time for higher chances of recovery.

Breast Cancer: Risk factors
There are a number of factors that make you more prone to getting breast cancer. Here are the most common risk factors:

Risk factors you cannot change

  • Being a woman
  • Age over 50 years
  • Family history of breast cancer
  • Gene mutations – BRCA1 and BRCA2
  • Early menstruation
  • Late menopause
  • Having dense breasts

Risk factors you can control

  • Smoking
  • Being overweight or obese
  • Sedentary lifestyle
  • Alcohol consumption
  • Using hormone replacement therapy

Make conscious efforts every day to live healthy and make wise lifestyle choices to help reduce your risk of breast cancer.

Breast Cancer: Symptoms
The first symptom of breast cancer that most women notice is a lump or an area of thickened tissue in their breast. See an oncologist for further investigation if you notice any of the below symptoms:

  • A new lump or area of thickened tissue
  • A change in the size or shape of one or both breasts
  • A discharge of fluid from either of your nipples
  • A lump or swelling in either of your armpits
  • Dimpling on the skin of your breasts
  • A rash on or around your nipple
  • A change in the appearance of your nipple

Breast Cancer: Screenings
If breast cancer is found early, there are more treatment options and a better chance of survival. Women whose breast cancer is detected at an early stage have a 93 percent or higher survival rate in the first five years.

Breast self-examination
All women should check their breasts for lumps, thicknesses and other changes every month. By examining your breasts regularly, you will know how your breasts normally feel. Consult your doctor for any unusual changes.

Mammograms play a key role in early breast cancer detection and help decrease breast cancer deaths. A mammogram is an x-ray picture of the breast. Women should get a mammogram once a year beginning at age 40. If you have a family history of breast cancer or any other risk factors you must start screenings early.

Breast Cancer – Myths & Facts
Myth: Presence of BRCA1 or BRCA2 means you will develop breast cancer.
Fact: It’s true that women with one of these genes have a higher risk. However, not everyone with a breast cancer gene will develop breast cancer.

Myth: Having a biopsy will cause breast cancer to spread.
Fact: A biopsy is the surest way to diagnose breast cancer. If the disease spreads, it’s not because of the biopsy.

Myth: A breast cancer diagnosis requires immediate surgery.
Fact: That is not always true and depends on your stage of cancer. Take a second opinion, and make sure you have the right information about all the treatment options available before you start treatment.

Myth: Breast Cancer surgery always results in ugly scars.
Fact: Although breast surgery does involve leaving scars, it’s possible to hide them. Advanced technology, minimally invasive techniques, cosmetology as well as breast reconstruction surgery leave minimal or no scars.

Myth: Most women with breast cancer have a family history of the disease.
Fact: About 80 percent of women with the disease don’t have a family history. There are a lot of other factors that play a role in developing breast cancer.

Treatment at Kokilaben Dhirubhai Ambani Hospital
Expert oncologists at our Centre for Cancer work together to help women for screening and early treatment of breast cancer. The Comprehensive Breast Care Unit offers advanced screening, diagnosis, treatment as well as rehabilitation for breast cancer.

Our Centre for Cancer is well-equipped with state-of-the-art radiation machines and daycare chemo suites that provide comprehensive treatment options. Our team of specialists has conducted over 1,100 breast cancer surgeries, of which over 50 percent have been breast conservation surgeries. In addition to breast conservation, commonly performed procedures are modified radical mastectomy with whole breast reconstruction pedicle free flaps/implants using oncoplastic surgery for good cosmesis.

Our team of highly trained specialists follows the model of Evidence-Based Medicine so that our patients can receive the highest level of care in surgery, chemotherapy, or radiotherapy that is prevalent in the world.

If you or a loved one need help for screening, diagnosis, or treatment of breast cancer, meet our experts. Please find below the link for our website:

Causes, Risk Factors & Symptoms of Cervical Cancer

Thursday, February 27th, 2020
What causes Cancer Cervix?

The causative factor for cervical cancer is a virus called Human Papilloma Virus (HPV), which causes over 99% cases of cervical cancer. This virus is transmitted through sexual contact. There are over 90 types of HPV viruses which have been identified. These are categorized into Low risk /high risk depending on there ability to cause cervical cancer. Women with persistent infection with High risk types are likely to develop cervical cancer

What are risk factors for developing cervical cancer?

Sexual intercourse at an early age, multiple sexual partners, multiple childbirth, smoking and weakened immune system are known risk factors associated with the development of cervical cancer.

Is it preventable?

Cervical cancer is definitely preventable, as there is an effective screening test available to detect precancerous changes which can be treated and progression to cancer can be stopped.

What is screening?

Screening is looking for cancer before you have symptoms. It is a test which helps us to diagnose the precancerous changes or cancer early and hence the disease can be treated more effectively.

What are the screening tests available for cervical cancer?

Worldwide cervical cytology (Pap smear) is used as a screening test for cervical cancer.

Current evidence also points effectiveness of HPV- DNA testing as a screening test for cervical cancer.

What is a Pap smear test?

It is a simple outpatient procedure in which cells will be collected from the cervical surface by scrapping and will then be evaluated by Pathologist to see if abnormal cells are present. Depending on the result further evaluation is planned.

When should I get myself tested?

As per international recommendations, one should start getting regular Pap tests at age 21, or within three years of the first time you have sex, which ever happens first. The Pap test is one of the most reliable and effective cancer screening tests available.

It is vital for women over 30 yrs to be part of the screening programme. The screening initially is done at yearly interval and after three negative smears the interval can be increased. It is also important to follow-up results of the test, after you have done a Pap smear

What are the signs and symptoms of cervical cancer?

Following are some of the symptoms of cervical cancer: –

  • Abnormal bleeding-.
  • Unusual heavy discharge-
  • Pelvic pain
  • Pain during urination-
  • Bleeding between regular menstrual periods, after sexual intercourse or douching.

Preserving Fertility After a Cervical Cancer Operation Is Possible

Thursday, February 27th, 2020

An anxious 29 yrs old lady walked in my clinic with her husband and family members. She was recently diagnosed with cervical cancer and was advised surgery, which would essentially render her infertile (As conventional surgery for cervical cancer requires complete removal of uterus). As she was childless was very keen to know if, any surgical option is available, which can preserve her fertility. Fertility preservation surgery (Radical Trachelectomy) is an accepted treatment for cervical cancer, but there are strict criteria to identify eligible patients.

After counseling and examination, we started evaluating this patient to identify, if she was a suitable candidate for fertility preserving surgery, which included MRI to note the extent of size and spread. After completion of all necessary tests, she was identified as a suitable patient for radical trachelectomy.

Radical trachelectomy is a surgery in which only the diseased cervix along with lymph nodes are removed, leaving behind the upper part of the uterus which is then sutured with vagina. Also whenever possible this should be done by a minimally invasive (Keyhole) approach, so the handling of tissues during surgery is less and hence problems for future conception are avoided. The Robotic assisted surgery works best in this situation as the suturing of the uterus with vagina can be extremely difficult and the endowrist instruments with magnified 3D vision makes this part of the procedure as well as the dissection extremely safe and effective. At Kokilaben Dhirubhai Ambani Hospital,

We discussed and counseled the patient and her husband about the surgery and the advantages of using Robotic platform. She underwent Robotic Radical trachelectomy with bilateral pelvic lymph node dissection at Kokilaben Dhirubhai Ambani Hospital and Research center .. Her postoperative recovery was uneventful and was discharged from the hospital on 5th Postoperative day. She will be closely observed for a period of 1 year and then if things are fine she can attempt pregnancy.

Cervical cancer is the most common Genital tract cancer seen in Indian women with an incidence on 22.9/100000 women. Every year over 122000 new cases are diagnosed in India and almost 67000 women die every year because of this disease. Radical trachelectomy is an established surgery for early stage cervical cancer for women who desire future fertility.

Unfortunately in India, women do not present early hence there are not many patients who can undergo this operation. This was second such case operated at our hospital. The first case was a 4-year-old girl diagnosed with cervical cancer. Robotic assisted surgical platform is of great help in performing these surgeries as, the technology allows you to overcome some of the problems you face when you do these complex surgeries and also help patient recover fast postoperatively.

In the end it was great to see smile back on her face, not only relieved of all the stress and anxiety regarding her cancer treatment, but also being able to preserve her ability of being a mother.

Dr Yogesh Kulkarni,
Consultant, Gyn Oncology & Robotic Surgeon
Kokilaben Dhirubhai Ambani Hospital. Mumbai
M: 93215427311


World Cancer Day

Tuesday, February 4th, 2020
What is Cancer?

Cancer is a broad term. It describes the disease that results when cellular changes cause the uncontrolled growth and division of cells. Some types of cancer cause rapid cell growth, while others cause cells to grow and divide at a slower rate. Certain forms of cancer result in visible growths called tumours, while others, such as leukaemia, do not.

Cancer statistics in India
  • One woman dies of cervical cancer every 8 minutes in India.
  • For every 2 women newly diagnosed with breast cancer, one woman dies of it in India.
  • Mortality due to tobacco use in India is estimated above 3500 persons every day.
  • Tobacco (smoked and smokeless) use accounted for 3,17,928 deaths (approx) in men and women in 2018.
  • Cancer took 7 lakh lives in India in 2018.
  • India has around 22.5 lakh people living with cancer.
  • Every year, more than 11 lakh new cancer patients are registered in India.
Cancer Symptoms

Signs and symptoms caused by cancer will vary depending on what part of the body is affected. Some general signs and symptoms associated with, but not specific to, cancer, include:

  • Lump or area of thickening that can be felt under the skin.
  • Weight changes, including unintended loss or gain.
  • Skin changes, such as darkening or redness of the skin, sores that won’t heal, or changes to existing moles.
  • Difficulty swallowing.
  • Persistent indigestion or discomfort after eating.
  • Persistent, unexplained muscle or joint pain.
  • Unexplained bleeding or bruising.
What causes cancer

Cancer is caused by changes (mutations) to the DNA within cells. The DNA inside a cell is packaged into a large number of individual genes, each of which contains a set of instructions telling the cell what functions to perform, as well as how to grow and divide. Errors in the instructions can cause the cell to stop its normal function and may allow a cell to become cancerous.

What do gene mutations do?

A gene mutation can instruct a healthy cell to:

  • Allow rapid growth. A gene mutation can tell a cell to grow and divide more rapidly. This creates many new cells that all have that same mutation.
  • Fail to stop uncontrolled cell growth. Normal cells know when to stop growing so that you have just the right number of each type of cell. Cancer cells lose the controls (tumor suppressor genes) that tell them when to stop growing. A mutation in a tumor suppressor gene allows cancer cells to continue growing and accumulating.
  • Make mistakes when repairing DNA errors. DNA repair genes look for errors in a cell’s DNA and make corrections. A mutation in a DNA repair gene may mean that other errors aren’t corrected, leading cells to become cancerous.

These mutations are the most common ones found in cancer. But many other gene mutations can contribute to causing cancer. 5 to 10% gene mutations are due to genetic reasons. Others are caused due to smoking, radiation, viruses, cancer-causing chemicals (carcinogens), obesity, hormones, chronic inflammation and a lack of exercise.

Prevent Cancer

Here are a few steps to take in daily life to prevent cancer.

1. Say No to Tobacco – The use of tobacco products has been linked to many types of cancer, including lung, colorectal, breast, throat, cervical, bladder, mouth and oesophageal. It’s never too late to quit.

2. Protect your skin from sun – Skin cancer is the most preventable form of cancer. Exposure to the sun’s ultraviolet radiation causes most skin cancer. Be sure to use adequate sun protection year-round.

3. Eat a healthy diet – Eat lots of fruits, vegetables, beans and whole grains. Limit red meat and cut out processed meats. It is also important to limit alcohol consumption because alcohol can increase your risk for liver, colorectal and breast cancers.

4. Maintain a healthy weight and be physically active – Getting at least 30 minutes of physical activity each day can make a big difference in your general health and well-being. Inactivity and obesity have been linked to breast and colorectal cancer.

5. Practise safe sex – Many strains of the human papillomavirus, also known as HPV, are spread through skin to skin contact during vaginal, anal and oral sex. High-risk strains of HPV have increasingly been found to cause many types of cancer.

6. Get immunized – Certain viruses have been linked to cancer, but are preventable through vaccination. Talk to your doctor about preventive cancer care.

7. Be regular with cancer screenings – Talk to your family doctor to know more cancer screening tests. Early detection highly increases your chances of recovery.

Cancer treatment

Below are examples of approaches to cancer treatment:

  • Chemotherapy aims to kill cancerous cells with medications that target rapidly dividing cells. The drugs can also help shrink tumors, but the side effects can be severe.
  • Hormone therapy involves taking medications that change how certain hormones work or interfere with the body’s ability to produce them.
  • Immunotherapy uses medications and other treatments to boost the immune system and encourage them to fight cancerous cells.
  • Radiation therapy uses high-dose radiation to kill cancerous cells. Also, a doctor may recommend using radiation to shrink a tumor before surgery or reduce tumor-related symptoms.
  • Stem cell transplant can be especially beneficial for people with blood-related cancers, such as leukemia or lymphoma. It involves removing cells, such as red or white blood cells, that chemotherapy or radiation has destroyed. Lab technicians then strengthen the cells and put them back into the body.
  • Surgery is often a part of a treatment plan when a person has a cancerous tumor. Also, a surgeon may remove lymph nodes to reduce or prevent the disease’s spread.
  • Targeted therapies perform functions within cancerous cells to prevent them from multiplying. They can also boost the immune system. Two examples of these therapies are small-molecule drugs and monoclonal antibodies.

Doctors will often employ more than one type of treatment to maximize effectiveness.

Cancer care at Kokilaben Dhirubhai Ambani Hospital:

Our Centre for Cancer is equipped with high-end technologies like:

  • EDGE Radiosurgery system, Asia’s first equipment which enables precise, non-invasive treatments helping patients heal faster with less discomfort.
  • We are the first hospital in India to have Novalis TX machine, which performs high precision surgeries to remove deep-seated tumours.
  • We have the first Trilogy (linear accelerator) in India, which is capable of performing on-board CT scan, KV and MV imaging with respiratory gating systems.
Cancer Care in rural Maharashtra:
  • Our team has started Cancer care centres across Maharashtra under Reliance Hospitals. We plan to establish 18 cancer care centres across Maharashtra. The centres will be managed and operated by Kokilaben Dhirubhai Ambani Hospital. The new cancer centres will be equipped with advanced TrueBeam® medical linear accelerators to equip them with the latest technology. The Akola, Gondia and Solapur Reliance Cancer centres are now open and the rest will follow in a few years. We aim to make world-class cancer care accessible to all Indians.

Please find below link of our Cancer care facilities in Mumbai, Navi Mumbai and in rural Maharashtra: