Cancer- Facts and Advice

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Is I am at risk of getting Prostate cancer or other cancer if my parent have cancer? Who can be screened for possibility or presence of Hereditary Prostate Cancer?

Is I am at risk of getting cancer if....................? Mostly children (sometime parents) ask this question. Today again. So, i tried to explain them that Usually NOT. About 10% of cases can be hereditary. Generally, if a person having some special pathology and risk factors then he is suspected for familial cancer. Risk factors for possibility of presence of genetic mutation are- A. If your brother or father has been detected for high risk, advanced or metastatic prostate cancer at age below 60 year, B. Biopsy is having intraductal or cribriform pattern, C. If first degree relative died of Prostate Cancer. Investigation for testing of presence of Genetic mutation- If above, then send family member for counseling with "Genetic counselor". Based on case history and available facts, he may decide need of "Germline" or "Somatic" testing for presence of pathogenic mutation that are responsible for developing cancer. These genetic mutations are Lynch

SBRT of Eye ball Tumors

One need idea and commitment to do innovation. Stereotactic Body Radiotherapy (SBRT) is one of Targeted Radiotherapy technique which require accuracy for precisely targeting tumour cells. Challenges in treatment of eye ball lesions are constant movement of eye ball and if we hold then non availability of verification tools / technique. For this, we recently developed an in-house video cam based verification equipment which made our job easy by making it simple, non-invasive and simple technique. In this patient, we ask to stare through "tubular vision". That indirectly fix position of eye ball. In the still position, linac presicely targets tumour cells with MV photons. https://youtu.be/5WwxharKz8Y

Importance of Lateral Rectal Lymph node in Low Rectal Cancer

1. A case of Lateral Rectal LNs failure, 2. Concept of Lateral Lymph node involvement Reference 1: Key Factor Sammour T, Chang GJ. Lateral pelvic lymph node dissection and radiation treatment for rectal cancer: Mutually exclusive or mutually beneficial?Ann Gastroenterol Surg. 2018;00:1–3. https://doi.org/10.1002/ags3.12197 . LRLN in case of low or mid RC should be considered as a part of regional disease and to be mutually addressed during nCRT & Sx. Low risk of LPLN disease (cT1/T2/early T3) (and Ra*) with cN0-LPLN on MRI: Treatment by TME. Moderate risk of LPLN disease (cT3/4 with cN0-LPLN on MRI <7mm) (or Rb**): treatment by nCRT + TME +/- LPLND. High risk of LPLN disease (cN1-LPLN on MRI >7mm) (Ra or Rb): treatment by nCRT + TME + LPLND. * Ra- above peritoneal reflection **Rb-below peritoneal reflection. Reference 2: Key Factors- Ogura A et al. Neoadjuvant (Chemo)radiotherapy With Total Mesorectal Excision Only Is Not Sufficient t

True Beam STX

True beam STX is installed in Max Hospital Patparganj. This machine is latest and unique in field of Radiation therapy which is loaded with artificial intelligence and able to deliver radiation therapy with stereotactic accuracy in 4D manner even in lesser than previous linac. It will help me to treat moving, life threatening tumour like liver cancer, cholangioarcinoma as well as we able to do knife-less radio surgery in tumour where surgery clearance is difficult like AVM, trigeminal neuralgia, and able to complete treatment in 1 day to within 1-2 weeks in case where time is crucial like stage IV so that we can start chemotherapy early. This is a magic linac having ability to deliver SRS, FSRT, SBRT, SABR, Rapid arc, IGRT, IMRT etc. In simple words " चुन चुन कर कीटाणुअो का सफाई कऱेगी" https://goo.gl/images/DLQYV4 https://www.americanoncology.com/truebeamstx/

No need to remove part of upper or lower limb OR to go for costly prosthesis when cheaper alternative are available for treatment of bone tumour

Ewing sarcoma or other bone tumour mostly involve removal of limb and permanent disability. Even though, possibility of cure is low. Most of patient developed recurrence in lung or other organs which make incurable situations and people live with poor quality of disabled life. Then, one should not go for amputation when limb preserving treatment are oncologically safe and give same level of survival with good quality of life. Today, we saved a leg of a child from bone tumour by doing Extracorporeal Radiation therapy. Extracorporeal radiation therapy is one of safe, effective and cheap treatment option. It this process oncosurgeon remove diseased portion of bone and radiation oncologist sterilize bone by killing all cancer cell using ablative dose of radiation therapy to excised bone. This sterilized bone is now used as prosthesis / implant. Benefits of this implant / prosthesis is 1) free of cost, 2) part of his / her own body and 3) avoid need of postoperative radiation treatment .

Avoid Hot tea with alcohol as it increase risk of Oesophageal cancer

A people drinking of hot boiling tea with alcohol (>15gm/day) have 1.5 times probability of developing oesophageal cancer. This is shown by a prospective study done over 456,155 normal persons (aged 30-79 years) in 2004-2008 in China (follow up period 9.2 years). 0.4% developed esophageal cancer. Reference - Ann Intern Med 2018 Feb 6 early online , editorial can be found in Ann Intern Med 2018 Feb 6 early online