A Quickie on role of “Robotics in cancer treatment ?

Robotic surgery
robotic robot-assisted brain surgery,

Robotics or computer assisted surgeries are helping patients with advanced cancer care. Robotic surgery effectively means’ robotic systems designed specifically to assist surgeons perform, complex surgical procedures with precision, control and dexterity.

These are often difficult to reach cancerous tumours, which the surgeons are able to view with increased vision and hence excise with precious thanks to video assisted robotic systems.

In general,  the surgeon uses the robotic systems, arms to perform the surgery instead of his own hands. Most good systems come equipped with cameras and 3D imaging to enable surgeons to view deeper locations inside the body and reach the diseased tissue with greater range of motion and precision.

Cyberknife, Gamma Knife, Novalis, Da Vinci are various forms of robotics systems available to assist surgeons.

Robotics can today be used for prostate cancer treatment, oral cancer treatment, breast cancer treatment, throat cancer treatment, thyroid cancer treatment, ovarian cancer treatment, uterine cancer treatment, oesophageal cancerbrain tumour surgery, treatment of bone and soft tissue sarcoma, lung cancer,  and several other cancers.

Even basic procedures like thyroidectomy, hysterectomy can now be done robotically and several surgeons are trained to perform robotic thyroidectomy and robotic hysterectomy.

Though we will cover each of these procedures in greater detail in subsequent posts, here are a few significant benefits of minimally invasive, Robotics assisted surgeries

  • Fewer incisions- Maximum size of incisions is usually not more than 7mm .
  • Significantly lower blood loss as compared to open surgeries.
  • Targeted, Higher Dose of Radiation.
  • Less Trauma, pain Quicker, faster recovery.
  • Reduced hospital stays of sometimes even one day( specific to surgery)
  • Added benefits for obese and diabetic patients with co morbidities where wound healing and open surgery complications need to be avoided.

To know more on whether you can be helped with robotic assisted surgery , write to us on info@ihealthkonnect.com or click to send us a query.

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Understanding Precision Medicine for Cancer.

We often hear of Precision Medicine for Cancer, but what is Precision Medicine, how is it different from standard treatment protocols and what can be the benefits for choosing Precision Medication over standard protocols?

The diagnosis and treatment of cancer at a cellular or molecular level is known as Precision Medicine.

Cancer
Precision medicine : Tailored medication for cancer based on specific patients, genetic profile .

Cancer is a heterogenous disease, with different genetic profile not only between patients with different cancers but also differences in genetic , molecular and cellular profile even within the same type of cancer.

All cancers are genetic by nature and with cellular profile changing over time even in the same patient, till now no single drug is known to cure even a single type of cancer let alone different types of cancer’s.

Standard chemotherapy protocols focus of administering standard chemotherapy drugs ( one size fits all) without taking into account cellular or genetic profile of the patient.

Precision medicine on the other hand focuses on accurate and effective treatment to each patient based on the genetic profile, the proteins feeding the tumours or the cancers.

There are sufficient number of detractors even amongst the best doctors but precision medicine or administering drugs based not a specific tailored patient profile not being the best option is a pre mature conclusion.

This week being Breast Cancer week, let’s shed some light on Precision medicine for breast cancer.

Breast cancer treatment in India beyond surgical options of lumpectomy, mastectomy involves administering chemotherapy and radiotherapy, with chemotherapy being the first line of treatment.

Difference in outcomes depends upon whether the patient has been tested for HER2(human epidermal growth factor receptor 2), ER, PR or not.

For patients testing positive for HER 2, addition of trastuzumab to chemotherapy slows down disease progression. Lapatinib plus chemotherapy (i.e., capecitabine) achieved a longer median time to disease progression compared with chemotherapy alone.

A combination of pertuzumab, trastuzumab, and chemotherapy further improved the median overall survival time to a median of almost 5 years compared with a combination of only trastuzumab and chemotherapy for a median of 3 and half years.

Similarly treatment with ado-trastuzumab emtansine, a conjugate of a HER2 monoclonal antibody and a cytotoxic drug, significantly improved the length of progression-free survival and overall survival with lower adverse effects when compared with lapatinib and chemotherapy

The above examples clearly show how genetic profiling, identification of key mutations like the Bcr-Ablfusion or HER2 can benefit a large number of breast cancer patients.

Genetic profiling also enables identification of molecular targets for intervention.Cell death is caused by a combination of deficiencies in the expression of two or more genes, whereas deficiency in only one of these genes can increase viability or enhance multiplication of mutant cells. For example, BRCA (mutant gene responsible for particularly aggressive breast cancers( and poly ADP ribose polymerase (PARP) genes were found to have a synthetic lethal relationship.

For example, by using olaparib, a PARP inhibitor, to treat BRCA-mutant ovarian cancer patients, the progression-free survival of BRCA-mutant ovarian cancer patients was significantly prolonged by olaparib compared with standard chemotherapy protocols.

This methodology focusses on identifying cancer vulnerabilities and subsequent tailored treatment based on patient profile.

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Decoding CyberKnife, for cancer treatment and benign tumours

We often get queries on CyberKnife and what is CyberKnife used for ?

CyberKnife is an excellent treatment option for treating cancer’s such as prostate cancer, gliomas ,brain cancer, kidney cancer, lung cancer, spine cancer, cancer of the pancreas, head and neck cancer, liver cancer, early stage -localised breast cancer and several types of malignant tumours, benign tumours and several other medical conditions.
CyberKnife delivers stereostatic radiation( SBRT) with extreme precision and a tissue margin of 1-5mm

Non invasive, CybeKnife vaporises a brain tumour

Cyber knife is totally non invasive and offers hope for inoperable localised cancers such as small cell lung cancer,for inoperable lesions where there is no other alternative for the patient to be treated.
CyberKnife can spot the exact size, shape and location of the tumor and delivers highly concentrated beams of radiation with precision ranging from 1 to 5 mm and this leads to minimal damage and bleeding.

Since CyberKnife treatment is totally non invasive, it is used for treatment of inoperable cancers as an alternate to surgery or as an alternative to surgery to minimise trauma, avoid complications and reduce risk.

Most patients can be treated several times with the CyberKnife and even treated again or retreated with minimal side effects leading to a better quality of life.For example for prostate cancer, even for a repeat surgery, CyberKnife can be used very successfully.

CyberKnife treatment is FDA approved and can spot patient movement even while breathing. The radiation beams can be aimed from several directions, thereby never losing the precision which is hall mark of a CyberKnife treatment.

CyberKnife treatment usually gets completed in 3 to 5 sessions spread over a week. Most patients can lead normal lives post CyberKnife treatment Most CyberKnife treatments are covered by insurance providers all over the world.

To know more on CyberKnife and how it works, click here.

Since the treatment involves a high degree of expertise, CyberKnife treatment is not offered by most hospitals.

The stage, location and size of the tumour or the cancer plays an important role, hence multiple teams of doctors and oncologists need to be involved before a decision on  use of CyberKnife as treatment option can be arrived.
To connect to the best hospitals in India, offering CyberKnife, and to know if CyberKnife is a treatment option for your medical condition, send us an email on info@ihealthkonnect.com or Consult Now.

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Check your boobs !

Breast Cancer Treatment in India

Treatment of breast cancer in india

Breast Cancer if detected early is completely curable.
Breast cancer treatment in india is offered at most of the good hospitals, however it is good to check on the medical and surgical oncology doctors and evaluate before commencing treatment.
Breast cancer treatment cost may vary from depending upon stage and whether surgical intervention is required or not.
Chemotherapy is often the first line of treatment along with lumpectomy or mastectomy with or without reconstruction for early stage breast cancer.
For late stage breast cancer, surgery is often carried out with a palliative intent and cost is often the cost of chemotherapy drugs and often radiation depending upon metastasis
Since prevention is better than cure most cancers, it is imperative to get BRCA 1 and 2 tests done for other female members in the family too.
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