Cancer is a growing global problem affecting the rich and poor, the literate and illiterate, educated and uneducated, males and females, the young and old cutting across the society at large.
The name Cancer is a common vocabulary in many families. The death from cancer and its incidence even may take over heart attacks and deaths from cardiac factors in the near future unless preventive measures are undertaken. There are several causative factors for the common cancers. But truth is cancer can never strike overnight. The initiation and manifestation even in early stage requires several years of waiting.
The developing nations and developed nations are fathoms apart with regard to the incidence of common cancers and the availability of financial resources and national health policy plans. Developing nations are reeling under economic crisis which may not permit to get free treatment for all. Hence, the only possibilities open for these nations are prevention and early detection.
Renai Medicity oncology division has been set up addressing these global issues of economic recession and crunch of resources and giving great importance to life style changes and early detection. We are focused and committed to spread the message that ‘cancer is curable if detected early’. Our preventive oncology and early detection centre will be a role model for other institutions in its uniqueness.
Unlike the past, cancer strikes at younger ages are becoming a big social issue. Many at their prime of youth fall victims. Hence quality of life and non disfiguring surgeries, organ and function preservation procedures or in short cosmetic and function preservation surgery has become our primary motto. Advancements in medical Oncology and radiation oncology coupled with latest state of the art surgeries have lead to more survivors than the counterparts in the past. Hence our vision is to set up ‘function and organ preserving cosmetic cancer surgery’ division the first of its kind in the country, to help the survivors lead a normal life like healthy adults in the society. This vision that we have introduced surely will add morale of our clients.
Different organ systems in the body have different functions to perform and the tumour that affects each one will be different. Different types of cancers in turn can affect same organ even. Even if similar is the pathology or stage stratification of cancer in two individuals, the behaviour of that particular cancer, its cure or death of the individuals with cancer may not be identical in both. This is due to the fact that body immunity system works differently in different individuals. This biologic difference does play a great role in the treatment plans and approach to cancer and the individuals in general. Such changes in the philosophical approach to cancer in different individuals with different pathologies or tumour characteristics and individual aspirations have brought in the new concept of ‘Personalised Medicine’ in Cancer treatment.
This new philosophy of personalised medicine in cancer care is the foundation of modern Oncology centre at Renai Medicity Hospital, under the guidance and patronage of world renowned cancer surgeon and Oncologist Dr. Thomas Varughese who has been credited with several surgical innovations and research papers. We at Renai are on the constant move of putting into practice the recent changes happening in the field of Oncology for the benefit of our patients. Whatever, the latest state of the art treatment protocols for different cancers in various organs in world renowned centres be, we are committed to incorporate into our practice. The team under Dr Thomas also will be leaders in several areas of Cancer surgery and treatments for others to incorporate into their practice since there are several innovations to our credit at Renai Medicity.
Our team is committed to excel in the research work and patient care to offer the best treatment protocols in the country in different cancers.
Head and Neck Cancer
In this country and several developing nations, Head and Neck Cancers forms the major issue among males. There are several factors which contribute for the same however tobacco usage is the primary cause. In the Oral cavity, oropharynx and hypopharynx, pan chewing or smokeless tobacco is the major culprit where as for cancers of nasopharynx and Larynx, tobacco smoking is the major cause.
Cancer detection in the early stage is possible in head and neck. Even the person who is at risk could identify the colour changes occurring in the mouth and throat which forms the early warning signals. Early detection of disease may avoid even major surgeries. A simple laser excision could even leave no mark of surgery and obviate further therapies including radiation or chemotherapy. However cessation of tobacco habituation is a pre requisite to avoid recurrences.
Oral cavity has 5 parts. If the full blown cancer is picked up at an early stage, depending on which part of the oral cavity the disease has affected, there are several options available including laser surgery, organ preservation or cosmetic cancer surgeries which will eradicate the disease yet offer cosmetic outcomes. These challenging concepts respecting oncologic principles and plastic surgery have revolutionised Cancer surgery of Head and Neck region. There are areas like vocal cord cancer where radiation could control the cancer in early stage. However for tumours of larynx (other than vocal cord), organ preservation after neoadjuvant chemotherapy and radiation plays major role. Tumours affecting base skull or Paranasal sinuses also could be attempted without disfigurement.
To implement these path breaking concepts to practice, a well trained cancer surgeon has to be at the helm of affairs. We have with us Dr. Thomas who has over 10 years of training from Tata memorial cancer centre Mumbai, and later on received advanced training in Head and neck oncology from Washington Cancer centre and Dr. Jatin Shah of Memorial Sloan Kettering cancer centre, New York, to provide state of the art cancer treatment of Head and Neck region.
Breast cancer unlike other cancers in the females, is showing increasing incidence in India. The situation is alarming in several metros due to westernisation of life style, food habits including energy dense foods, milk and milk products, indulgence in alcohol, smoking and lack of exercise. Estrogen is considered as the single potent agent which can act as carcinogen. Combined with genetic predisposition the situation is worst.
Several studies in India has shown increasing incidence of the disease in women younger age group (less than 35). This is definitely an important issue which points to several issues in the disease management. When struck with the disease at the pinnacle of their youth, the women in urban India has to face several other issues, right from loss of womanhood, feminity to psychosocial traumas, which in a modern nuclear family poses multiple problems.
Hence management of breast cancer in the modern era requires high levels of integration of modern principles of treatment. Dr. Thomas has had highly integrated training programme apart from surgical oncology and breast cancer surgery training from Tata memorial, from MD Anderson Cancer Centre Breast unit under Dr. Singletaire and plastic surgeon Dr. Rob Smith. He also got advanced training from Peter Mc Callum Cancer Centre, Melbourne, Australia. Inheritance of this legacy and providing such unique treatment protocols to our people is our aim. Dr. Thomas has bestowed with several International Awards for the pioneering and original clinical research work done in the surgical management of operable breast cancer.
Drain-less oncoplastic surgery is the latest technique where the beauty of breasts are preserved and best oncologic results are given. The trauma of surgery will be avoided in toto. Knowledge regarding the availability of such novel techniques will prompt women to come forward for early detection because we at Renai wish to popularise the concept that in early detected cancers we preserve the breasts, beauty and womanhood. We therefore are setting new bars in the quality of care for breast cancer victims, by offering unique quality of life.
Traditionally, Kocher’s Thyroidectomy is the approach done for thyroid neoplasms for more than a century. This approach not only leaves behind a scar at the most exposed part of the neck, but also has several complications including nerve injuries, parathyroid deficiencies, haemorrhage and ugly scar in many cases. Clinical research with the aid of 3D digital interactive anatomy has paved way to an innovative approach to the commonest surgery done in the world, thyroidectomy, called scar less thyroid surgery or minimally invasive open thyroidectomy or horizontal lateral thyroidectomy (Thomas Technique).
This is a surgical Innovation by Dr. Thomas and hence named as ‘Thomas Technique’. Currently Renai Medicity Hospital is offering this unique surgery at affordable cost. Patients could go home in 24 hrs and it’s a bloodless surgery avoiding transfusions. It takes care of the several complications described in Kochers’ surgery and cosmetically unique.
Thoracic Oncology and Lung Cancers
Unlike the past, modern oncology has shown great hopes for lung cancer victims. Early cancers merit to lung preserving surgeries (function preserving) like lobectomy which adds to quality of life in that the performance status is always superior. Even in locally advanced lung cancer, similar to breast cancer, down staging is possible to offer salvage/organ preservation/function preservation surgeries.
Early detection of lung cancer is possible with simple screening tools like chest X-rays. At Renai Medicity thrust is given to organ preservation in lung cancers. We have ongoing programmes for early diagnosis and screening. Video endoscopy, thoracoscopy etc have added to the gadgets for this crusade.
Mediastinal tumours of different categories can affect human beings. Many a time mediastinal dissections form integral part of cancer treatments in lung cancers, oesophageal cancers, primary mediastinal tumours, Tumours of Thymus gland or even thyroid neoplasm with metastasis to mediastinum, as in medullary cancer or papillary cancer. High calibre in thoracic oncology and understanding of tumour biology are mandatory for perfect end results. Excellent infrastructure to undertake such surgeries too are set up at Renai.
Cancer of oesophagus is on the rise. It has predilection for men who are habituated to tobacco, especially smokeless. Women are no exception.
Oesophagus cancer is one of the best examples of cure if detected early and lethal if diagnosed late. In early cancers (mucosal types) a non invasive Endoscopic surgery also is possible called EMR (Endoscopic Mucosal Resection).
We have pioneered novel treatment for down staging of cancers of the Gastro oesophageal cancers and give better cure rates than upfront surgery.
Cancer of Stomach, Pancreas Colon and Rectum
Several novel concepts in the management of these organs have appeared. The most important being down staging of the cancers with upfront targeted or other type of medication so that better cure rates and quality of life could be offered in otherwise inoperable situations. Several challenges for organ preservations like pyloric preserving Whipples’ pancreaticoduodenectomies, anterior resections or Low anterior resections after neo adjuvant chemotherapy for rectal cancers, neo adjuvant targeted chemotherapies for colon cancers have revolutionised treatments of Gastrointestinal malignancies. Our experts have undergone extensive training in GI cancer management.
Early detection of Cervix cancer, the 2nd commonest cancer in women could result in cure. Awareness of sexual hygiene and proper bath has reduced cervix cancer incidence in India. We are aware that vaccination against cancer cervix is a reality and cervix cancer is preventable. A pap smear examination could detect cancer cervix years before the actual cancer sets in. Hence at Renai we are committed at the women’s cancer initiative of early detection and prevention. We have strategies for those who present even in a locally advanced condition by adopting novel targeted anti cancer drugs to downstage the disease so that many cases who otherwise will have imminent death could be helped to have better disease control which was not there few years ago. Many patients unlike in other sites with similar cancers could even get a cure.
Surgical oncology unit at Renai also has got the technical knowhow to perform extensive Pelvic exenteration for those who develop local recurrences after radiation for cervix cancer.
State of the art strategies are adopted for ovarian cancers. Those who present early and in whom fertility preservation is needed, it is offered. Young unmarried girls benefit from this approach.
Advanced cancers are down staged and our surgical oncology leader Dr. Thomas Varughese received special training to offer total Peritonectomy from Dr. Paul Sugarbaker of Washington Cancer Hospital, DC. Total Peritonectomy is today regarded as the ONLY approach that could impart a meaningful difference in the survival patients with ovarian cancer. Renai Medicity is the only centre in south India offering total Peritonectomy for such patients. Neo adjuvant chemotherapy also offers quality of life in that it avoids unwanted bowel resections. Once tumour bulk is reduced this even provides spillage free resections and hence better survival.
Cancers of Vulva also poses big issue for women. Early cancers are curable. Locally advanced cancers could be tackled with neo adjuvant chemotherapy and state-of-the-art plastic and reconstructive surgeries.
Cancers affecting the Kidney, Ureter, Bladder, Prostate and Penis
Kidney cancers present in different stages. Early cancers necessitating nephron sparing nephrectomies are offered the same. There is changing philosophy in the management of locally advanced kidney cancers to adopt a down staging principle. This not only helps to downsize the tumour but also helps to prevent distant dissemination but makes surgery easier and gives long term disease free survival.
Early bladder cancers requiring conservative approaches and others requiring total cystectomies are offered state-of-the-art treatment. Ureteric cancers which are highly malignant merits comprehensive cancer care and are offered the same.
Prostatic cancers both hormones responsive or otherwise too get advanced treatment protocols. Early detection programme for prostate cancer also is in full swing.
Conservative approaches for early penile cancers and radical surgeries for other cases are done.
Soft Tissue Sarcomas and Bone Tumours
Management of soft tissue sarcomas poses great challenges for the surgical oncologist. Organ preservation emerged in the field of oncology for the first time in the management of bone and soft tissue tumours. At Renai, limb salvage surgeries are the approach than amputations. Primary bone tumours are common in paediatric age group requiring comprehensive cancer care.