CANCER : DIAGNOSIS AND TREATMENT

Cancer is a group of diseases characterized by uncontrolled growth and spread of cells in the body. If the spread is not controlled, it can result in death. Oncology, at the most basic level , involves diagnosis and treatment of cancer.

There were an estimated 14 million cancer cases around the world in 2012 and this number is expected to increase to 24 million by 2035.

The five most common cancers worldwide are lung, breast, bowel, prostate & stomach. Lung cancer is the most common cancer worldwide, followed by Breast cancer (women only) as the second most common cancer

Recent research has shown that cancer has the most devastating economic impact of any cause of death in the world. In addition to the human toll of cancer, the financial cost of cancer is substantial.

Cancer can involve any part of the body, and has varied presentation based organ involved and stage of cancer at diagnosis. Early detection, if not prevention, is the best way to deal with cancer and oncology covers this facet of medicine.

Oncology has evolved over years with huge improvements in prevention, early detection and management of these cancers. The doctors are specialized based on type of cancer, and by mode of treatment such as chemotherapy, radiation and surgery.

We help you to access the best Oncologist in their field who will provide the comprehensive care needed for diagnosis and management of your cancer.

Some of the services related to cancer treatment include:

Medical Oncology:
Diagnostic tests: blood tests, mammography, biopsy, ultrasound, MRI, CT scans, PET scan
Chemotherapy: breast cancer, solid tumors and blood cancers
Immunotherapy and targeted therapy for solid tumors

Radiation therapy:
Intensity Modulated Radiation Therapy (IMRT)
3D conformal Radiation therapy (3D-CRT)
Linear Accelerator (LINAC)
Cobalt Unit
Brachytherapy
Simulator

Surgery:
Surgical resection of cancer tissue such as mastectomy and lumpectomy in breast cancer
Neurosurgery (microscopic brain surgery) : meningiomas, pituitary tumors, craniphryngiomas, glioma, skull tumors, orbital tumors, acoustic tumors.

This cancer often presents as a lump in one or both breast. If you feel a lump in your breast, you must see your doctor.

Test for diagnosis for breast cancer: Mammography (special X-ray ) is often used initially by your doctor to diagnose a breast cancer . If the mammogram shows spots suggestive of cancer, another test called “biopsy” is ordered. During biopsy, a small portion of the lump is taken and looked under microscope for abnormal cancer cells. The doctor then stages the cancer based on the finding how far the cancer cell has spread. The right treatment for you will depend upon the stage of your cancer.

Treatment of breast cancer: Surgery, chemotherapy , radiation therapy or some combination of them based on assessment of the cancer stage, type and your goal of treatment.

Surgery to remove cancer tissue, which includes mastectomy (removing whole affected breast) or breast conserving surgery ( lumpectomy, removing the affected tissue only. This is often followed by radiation therapy after surgery). We suggest you to discuss the pro-cons of each aspect of the treatment and modalities available with your doctor before making decision to proceed with specific therapy based on the information provided to you and your goals and values for treatment.

Radiation therapy: may be needed to kill the cancer cells after surgery depending upon the stage of cancer
Chemotherapy: These are the medication given to kill the cancer cells and help cancer shrink. It can be used as a monotherapy, or an adjunct to surgery and/or radiation therapy

Hormone and targeted therapy: Some breast cancers are responsive to hormone therapy, which is decided by your doctor based on biopsy results.

After treatment: need frequent follow up with your doctor, close watch for symptoms such as a new lump and may need follow up mammograms.

Most people do well after breast cancer treatment if detected early and managed appropriately. Important to get immediate medical advise and care.

It is the most cancer worldwide. Most patients present for diagnostic evaluation because of symptoms suspicious of lung cancer ( cough, chest pain, breathing difficulty or coughing out blood) or an incidental finding on chest X-ray.
The goal of initial evaluation is to obtain sufficient clinical and radiological information to guide diagnostic tissue biopsy , staging and treatment.

The general approach is tailored to the individual value and preferences of the patient and concordant with the published guidelines.The major goals of initial evaluation of patients with suspected lung cancer is to assess clinical extent and staging of the disease, biopsy, and treatment based on staging and patient’s values and preferences.

CT scan along with more advanced technologies are used to assess tumor size, and extent of disease. Chemotherapy, radiation and surgery is used for management of cancer.

This is the second most common cancer in men, more often in men older than 50 years.
Most men with prostate cancer have no symptoms. Need to urinate more than usual, slow urinary stream, trouble having erection and blood in urine are some of the symptoms reported with prostate cancer which are not unique to this condition. Almost 80% of the men currently diagnosed with prostate cancer undergo biopsy because of suspicious PSA (a blood test). Further tests (ultrasound, MRI) are then used to stage the cancer.

Men with prostate cancer are then provided with the following treatment options:
Watchful waiting: You may choose to not have any treatment until there is rapid progression of cancer
Surgery: Removal of prostate (in cancer limited to prostate)
Radiation, chemotherapy and hormone therapy

You and your doctor will work together to choose the right treatment for your prostate cancer based on the stage of cancer, your age, other health issues, and your values and goal for treatment. Discuss the benefits and downsides of all treatment options

After treatment: You may need to be followed closely to check for recurrence of cancer.

Most patients with stomach cancer are already symptomatic and have advanced incurable disease at the time of presentation. When it does produce symptoms, it includes weight loss and persistent belly pain, trouble swallowing, loss of appetite, and nausea. These symptoms are not specific to stomach cancer and can be produced by other conditions.

Stomach cancer is diagnosed by endoscopy, biopsy, blood tests and imaging studies (CT or ultrasound)

The right treatment will depend on the type and stage of tumor. Stomach cancer is usually treated with surgery, chemotherapy and radiation. This cancer can sometimes be cured with treatment, often those diagnosed early.

There are different type of brain cancers, some growing very slowly while others growing much faster. Often the first symptom of brain cancer is seizure ( passing out, abnormal jerky movement of limbs ). Others symptoms include headache with nausea/vomiting, vision changes, memory problems, muscle weakness.

CT /MRI are often used by doctors to diagnose brain cancer followed by biopsy to type the cancer. The treatment will depend upon type of brain cancer, the growth of cancer tissue, your symptoms and your values and goal of treatment.
Treatment options include surgery, chemotherapy and radiation.