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.
Prostate cancer, is curable when detected well in time. Survival is often over decades. With newer treatment options coming in, there is now hope for last stage prostate cancer.
Nicknamed magic bullet therapy, now targeted alpha therapy offers hope for even metastasized, castration resistant prostate cancer( mCRPC and has changed the way metastatic prostate cancer can now be treated.
How does Magic Bullet Therapy work for Prostate Cancer ?
Prostate-specific membrane antigen radiology ( PSMA-RLT) with 177 Lu, holds great potential as the Prostate Specific Member antigen peptide binds itself specifically to prostate cancer cells but not to normal healthy cells. With a range of 0.1mm, this method allows selective irradiation, killing cancerous cells with minimal damage to healthy tissue.
The Alpha emitters work by inducing clusters of DNA damage such as double- stranded breaks and cellular cell modifications which leads to destruction of cancerous cells due to cell cycle arrest.
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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.
As we continue our conversation on Precision Medicine for cancer, a popular therapy used to treat NET tumours or Neuro Endocrine Tumours is PRRT or Peptide Receptor Radionuclide therapy. Neuroendocrine tumours are a rare form of cancer and originate from Neuro endocrine cells in the body and hence the name.They are different from adenocarcinoma’s and often do not do not respond well to chemotherapy, the 1st line of treatment for most cancers.
By administering radioactive protein lutetium octreotate, it is possible to treat NET tumours or neuro endocrine carcinoma with precision and offset progression of disease.
In PRRT a peptide or a cell targeting protein is combined with a small amount of radio active nuclide creating what is called as a radio peptide. The radio peptide when injected into the patients blood stream travels and binds to a neuro endocrine tumour, delivering a high dose of radiation to the tumours. This also limits damage to the nearby healthy tissue and hence lesser and milder side effects than chemotherapy.
What kind of cancers can be treated by PRRT?
Along with Neuroendocrine tumours, carcinoids, islet cell carcinoma of the pancreas, small cell carcinoma of the lung a form of lung cancer, pheochromocytoma (a rare tumor that forms in the adrenal glands), gastro-enteropancreatic (stomach cancer , intestine cancer and pancreas) neuroendocrine tumors, and rare thyroid cancers that are unresponsive to treatment with radio iodine are often treated with PRRT.
Patients with following conditions are often proposed for PRRT
When neuro endocrine tumours are not responsive to other lines of cancer treatment
When surgical removal of tumours is not possible at current stage, PRRT may be used to reduce size of the tumours.
PRRT is also a treatment option for last stage inoperable cancers when metastasis has set in.
The main aim of PRRT is then to slow down progression of disease, offer relief and prolong life.
However, not all neuroendocrine tumours respond to PRRT. First an OctreoScan is done. If the patient is found to have a positive OctreoScan and meets other requirements, PRRT is proposed.
What happens during PRRT ?
For patients having a positive octreoscan, to start with an amino acid solution is delivered to protect the kidneys.
As most net tumours have a lot of a specific type of surface receptor, a protein called somatostatin. Octreotide, is a lab version of somastostatin. During PRRT, a dose of radio nuclides such as Lutetium, Yttrium are often combined with octreotide and injected into the blood stream.
Molecular imaging and scans follow to see whether the radio peptide has latched on of the tumour sites correctly.
The entire session usually lasts for about 4 hrs and is often done as an out patient procedure.
The main goals of PRRT hence are to provide symptom relief, to stop or slow tumor progression and to improve overall survival.
Advantages of PRRT ?
PRRT along with other molecular therapies or targeted therapies offer excellent results as they are tailor made keeping in mind molecular properties of the tumour and also biologic characteristics of the patient.
PRRT is offered in Germany , USA, UK and other developed countries at a significant cost, In India, a single session of PRRT costs approx USD 6300.
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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.
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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 firstname.lastname@example.org or Consult Now.
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Statistics show 1 in 7 men will be diagnosed with prostate cancer within their lifetime. This number increases to about 6 in 10 that is 60% of men are diagnosed with prostate cancer after reaching the age of sixty-five.
Though the statistics may seem disheartening, only one in thirty-nine people die as a result of prostate cancer. That means that the average percentage of people who have died from prostate cancer is about 0.027%, probably the least possible for any form of cancer.
What this indicates is that the survival rate for prostate cancer is rather high, in fact after being diagnosed is almost
one-hundred percent. At ten years, survival rate is 98% and survival rate at 15 years is 95%.
There are many treatments for prostate cancer. The hardest part is simply informing yourself and your family on various
treatment options available , their estimated costs and the ability to choose the best treatment option available based on your specific medical condition.
The surgical options for prostate cancer treatment are Simple Prostatectomy, Radical Prostatectomy and TURP
Simple Prostatectomy: In simple prostatectomy or a subtotal prostatectomy, only part of the prostate is removed.
Radical Prostatectomy: In radical prostatectomy, the entire prostate gland is removed along with seminal vesicles and vas deferens. This can be done laparoscopically or even by using Robotic techniques in what is known as Robotic Prostatectomy.
Robotic Prostectomy: Robotic Prostectomy is essentially the same procedure, except it is done using a robotic console capable of making larger more precise incisions, while having a larger field of vision.
This reduces recovery time, the risk of complications, it minimalizes scarring, and it reduces the risk of leaving cancerous tissue.
Robotic Prostatectomy is more expensive and price ranges from US$ 7000 to US$8600 in best hospitals in India.
TURP: Transurethral Resection of the Prostate (TURP) is a procedure in which the prostate gland is reduced in size by removing prostate tissue.
This procedure helps in relieving prostate cancer symptoms and helps with passage of the urine through the urinary tract if the prostate gland restricts urine flow. This procedure does not involve any incisions in the skin, it is all done by resectoscope through the urethra. Afterwards, in order to drain urine a catheter is inserted. The procedure requires hospital admission for a day to two. TURP usually costs between US$ 3000-US$ 3900.
Radiotherapy: Radiotherapy is the use of high-energy rays that in order to terminate cancerous cells. There are several side effects that you may experience after the procedure. These include but are not limited to, fatigue, nausea, and problems eating or drinking. Radiotherapy typically cost $3500 – $4500 in India. Besides radiotherapy, hormone injections are also used for treatment.
These are just a few of the effective of treatments available to those who are affected by prostate cancer. Knowing the benefits and risks of each procedure is a large part of the battle.
To assist patients and their families looking for best doctors, hospitals and treatment options, ihealthkonnecthas listed estimated cost for major procedures online. Users can search, connect with best hospitals, doctors, compare cost of treatment and also get a free second medical opinion online.
To get a free 2nd opinion based on your medical conditions,