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.
The PET CT Scan is one of the sought after diagnostic tests. Let’s find out more about what is a PET CT and why is it preferred over other diagnostic tests, such as an MRI, CT Scan or an ultrasound.
What is a PET Scan?
A PET Scan is a nuclear medicine technique which produces images of the human body at a molecular level.
A PET CT uses radioactive tracers in conjugation with isotopes such as oxygen, nitrogen, carbon etc. These radioisotopes act at a molecular level and work as probes which seek out disease, cancer in the body while giving out radio signals which are captured to produce an image.
This can help in the diagnosis of even the tiniest lesions, thus increasing the accuracy of the investigation, subsequent diagnosis and hence cancer treatment.
A PET CT Scan, therefore reveals a lot more about the body than standard diagnostic tests such as MRI, CT Scan or an ultrasound.
What happens during a PET Scan?
A PET CT Scan, is always on a price appointment basis as the radioisotopes, having a very short half-life need to be brought in just before the scan.
A PET CT, is usually carried out empty stomach on overnight or at least 6 hrs fasting.
The creatinine levels, need to checked prior to conducting the PET CT by simple blood tests called KFT or Kidney function test
If the creatinine levels are in order, the patient is tested for blood sugar and if found in order, the patient is given an injection of glucose with a radioactive tracer.
After the injection, the patient is made to rest for about 90 mins and then taken for the actual scan which takes about 30 mins to 45 mins depending on the imaging required.
During the scan, the patient is made to lie on a comfortable table that moves slowly through the ring like PET scanner.
After the scan, the patient can leave immediately. However close contact with others especially children and pregnant women is best avoided for the next 4-6 hrs.
It is also good to drink a lot of water, to flush out the radioactive tracer from the body.
The imaging can be seen by the doctors and the nuclear medicine specialists almost immediately for evaluation, though a formal written report takes a day to be handed over to the patient.
Are there any side effects or discomfort due to the scan?
There are no side effects or discomfort due to the PET CT Scan, except the minor prick while injecting the tracer.
The PET CT scanner also does not make any sounds while the scan is going on, unlike a few other diagnostics tests.
What are the diseases for which a PET CT Scan can be used?
The most common use case for a PET CT Scan is for detecting and treating cancer. However other applications, include diagnosing cardiac or heart problems and also neurology.
During the initial stages of the disease, a PET CT helps distinguish between benign and malignant disease and also cancer staging, that is knowing and determining the stage of the disease and also its characteristics, which further helps oncologists decide the best treatment option for the patient.
During the course of treatment, it helps determine response to therapy or cancer treatment and if the metabolic activity decreases on the PET CT Scan, the oncologists know that the drugs being administered are working.
On the other hand, if the metabolic activity on the scan increases, it indicates that the treatment option is losing its efficacy or is not working and helps oncologists change the line of treatment to benefit the patient.
Neurology: Alzheimer’s at an early stage can be diagnosed using a PET Scan leading to early intervention.
A PET CT Scan helps locate tumors, distinguish between benign and malignant tumors and also scar tissue for brain surgery.
A PET CT is also useful for the treatment of epileptic seizures. It can help locate the origin and focus of seizures and assess sites for intervention if any is required.
What is the difference between a PET CT and an MRI or a CT ?
A CT or an MRI works on the physical level and can give the size and location of the tumor with accuracy.
However since both tests do not work on the molecular level, they cannot indicate metabolic activity of the tumor which only a PET CT Scan can indicate, thereby making a PET CT, a diagnostic test of choice for oncologists, cardiologists, cardiac or heart surgeons and interventional neurologists.
To know more about, PET CT Scans, cost, and implications, from the best cancer hospitals in India, write to us on firstname.lastname@example.org or send us a query.
Childhood cancers or Paediatric cancers are biologically different from adult cancers.
They grow faster than most adult cancers.
Factors which trigger cancer or cause childhood cancers are different from those causing adult cancers for example smoking a leading cause of adult lung cancer is not a cause for childhood lung cancer.
Most Paediatric cancers are non hereditary and happen due genetic mutations of growing up cells, though pollution, exposure to radiation, chemicals are also contributory factors in a few cases.
Common cancers in children:
The most common childhood cancer is Leukemia or Blood Cancer. Of all types of blood cancers, ALL is the most common one. It affects children in the age group of 2-6 years.
Other common paediatric cancers are tumours of the brain, retinoblastoma, neuroblastoma, lymphoma, tumours of the kidney, tumours of the adrenal gland, sarcomas , bone tumours etc.
Symptoms of Childhood Cancers:
Unusually High Fever
Bruise marks or blue marks on the body
Prolonged fever with no established cause
Unusual weight loss
Nose bleed, gum bleed
Swelling in the abdomen
Pale palor, accompanied with fever, body ache
Swelling in the neck or axilla.
Increase in size of lymph nodes, along with cough, fever, weight loss
Unusual Redness in the eye
Early morning vomiting, loss of appetite
If you notice any of these, it may be a good idea to plan a visit to the doctor.
Are Childhood cancers curable ?
As childhood cancers grow faster than adult cancers, they are also more responsive to chemotherapy and other forms of treatment.
Depending on the stage of cancer and the spread of cancer, a combination of surgery, chemotherapy and radiation may be advised.
With advances in medical treatment, it is now possible to save limbs in bone cancers, eyes in retinoblastoma depending upon stage of cancer and response to treatment options.
Most blood cancers in children respond extremely well to chemotherapy and get cured.
The pancreas are a small gland situated near the stomach that secretes digestive fluid into the intestines through one or more ducts and also secretes insulin – a hormone which regulates the amount of glucose in blood. Pancreas are responsible for secreting enzyme which aid in digestion,
Pancreatic problems are usually hard to detect and one of the most dangerous pancreatic problems is pancreatic cancer.
Unfortunately pancreatic cancer is hard to diagnose as it gives few early signs and most patients already reach an advance stage before being diagnosed.
Post prognosis, due to detection at an advanced stage when the cancer is in metastasis, the 5 year survival rate is 1%. Compare this to a 5 year survival rate for patients when diagnosed early with the cancer in a resectable stage( when surgery can be done) , at a whopping 61% . Therefore early diagnosis is critical in pancreatic cancer.
Even if there are few early signs, self awareness is often the key to diagnosis.
Given below are a few warning signs which indicate that your pancreas may be in trouble :
Sudden Onset of Diabetes : Diabetes and Pancreas have a direct relationship. Pancreas contain cells called the Islets of Langerhans which secrete the hormone insulin. Insulin helps regulate the glucose in the body. If you have sudden onset of Type 2 diabetes, do visit the doctor.
If you existing diabetes,which suddenly becomes unmanageable it warrants a visit to the doctor as instability in blood sugar levels can also be an early sign of pancreatic cancer
Light coloured, Floaty Stools, with or without an oil layer : Pancreas our responsible for secreting enzymes, which help in digestion. When optimum functioning is affected, sometimes there is an oil layer on top which indicates fats not digested properly. Because the pancreas help the intestines break down fats with the help of enzymes which does not take place,it leads to stools become greasy.
Light coloured, floaty stools also indicate sub optimal digestion which happens when the pancreas become affected.
Dark Coloured Urine : Pancreatic cancer usually begins near the top of the bile duct. Since the bile duct is unable to drain the bilirubin produced in the liver, it results in dark coloured urine. As the cancer spreads, it affects the liver and results in liver cancer. Pancreatic cancer led to the liver being affected for Steve Jobs and a liver transplant was carried out which gave him a new lease of life for a few years.
Stomach Ache : Abdominal pain especially pain in the middle of the abdomen is also a sign of pancreatic cancer. The cancer starts presses on surrounding organs causing pain. If pain is intense and persists for weeks, does not wear off even after prescription medication, do ask your doctor to check your pancreas.
Weight Loss : It is a common sign of pancreatic cancer – it usually occurs because the pancreas do not secrete enough enzymes to digest food so nutrients are not absorbed normally.
Though there are several other reasons for weight loss, sudden, progressive weight loss coupled with intense pain in the abdomen does call for a visit to the doctor.
Poor Appetite : Nausea and lack of appetite can be directly linked to problems in the pancreas. The pancreas are responsible for the secretion of enzymes which break down the fats in the digested food and hence, if your body is unable to digest fatty foods, it may be a sign of trouble with the pancreas.
Usually a ultrasound, CT Scan, endoscopy or an endoscopic biopsy are the initial diagnostic tests.
A PET CT along with cancer markers is used for cancer staging.
If diagnosed early, while the cancer is resectable, a procedure called Whipple is carried out to remove the cancerous part and whipple procedure is followed by chemotherapy and or radiation depending upon spread.
Sometime, TACE ( trans arterial chemo embolisation, TARE ( Trans arterial radio embolisation) or TAE ( trans arterial embolisation) may also need to be used depending upon the type of cancer and cancer staging.
At times RFA( radio frequency ablation) or cryoablation may also be used to treat the cancer.
Cancer of Connective tissue is known as Soft Tissue Sarcoma. It includes various tissues of the body including muscle, fat, and fibrous tissue. The most common sarcomas in children are Rhabdomyosarcoma (muscle), Osteosarcoma (bone cells), and Ewing Sarcoma (in or outside of bone). However, about there are more than 50 other types of soft tissue sarcomas that affect around 900 children each year
Soft Tissue Sarcomas is further categorized as following:
Immunotherapy, also called biologic therapy, is designed to boost the body’s natural defenses to fight cancer. It uses materials made either by the body or in a laboratory to improve, target, or restore immune system function.
Interleukin-2 (IL-2) is a drug that has been used to treat later-stage kidney cancer. It is a cellular hormone called a cytokine that is produced by white blood cells and is important in immune system function, including the destruction of tumor cells.
High-dose IL-2 can cause severe side effects, such as low blood pressure, excess fluid in the lungs, kidney damage, heart attack, bleeding, chills, and fever, so patients may need to stay in the hospital for up to 10 days during treatment. However, some symptoms may be reversible. Only centers with expertise in high-dose IL-2 for kidney cancer should recommend IL-2. Some centers use low-dose IL-2 because it has fewer side effects, although it is not as effective.
Alpha-interferon is another type of immunotherapy used to treat kidney cancer that has spread. Interferon appears to change the proteins on the surface of cancer cells and slow their growth. Although it has not proven to be as beneficial as IL-2, alpha-interferon has been shown to increase survival when compared with an older treatment called megestrol acetate.
Researchers have tested many combinations of IL-2 and alpha-interferon for patients with advanced kidney cancer, and these treatments have also been combined with chemotherapy. It has not been shown in research studies that these combinations are better than IL-2 or interferon alone.
Researchers are working to learn more about how IL-2 and interferon destroy kidney cancer cells and which patients can benefit the most from these treatments. Newer forms of immunotherapy called checkpoint inhibitors are also being tested in clinical trials .