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Departments » Medical Oncology

 

Dr. Ram Prabhu
M.B.B.S, M.D. (General Medicine), DM Medical Oncology (AIIMS)
Consultant Medical Oncologist, MIOT Hospitals.

     
 

MIOT Centre for Oncological Sciences provides comprehensive cancer care with a multi disciplinary super speciality treatment approach to all types of cancer (solid tumours and blood cancers). Medical / Haemato - Oncology, Surgical Oncology, Radiation Oncology, Orthopaedic Oncology, Preventive Oncology, etc… are some of the super speciality treatment services offered by this department.

Medical oncology is the treatment of cancer using chemotherapeutic drugs. When cancer is diagnosed at an early stage, chemotherapy supplements the benefits provided by

surgery and radiotherapy. In advanced stages it improves quality of life and prolongs survival. In some cancers, chemotherapy plays a curative role these include lymphomas, leukemia and germ cell tumours.

 

Chemotherapy drugs normally cause side effects as they do not discriminate between cancer cells and normal cells. At MICC these side-effects are anticipated and managed with pre-medications. Our trained and empathetic chemo nurses use their expertise and the latest chemo delivery devices to make treatment easier. This helps patients complete planned drug cycles and prepares them for the next line of treatment, putting them on the path to recovery. The drugs are prepared under an infection-free Laminar hood which maintains effectiveness. Our experienced oncologists are abreast with the latest drugs, oral and injections – including new drugs that target and cure specific cancers.

Here treatment for cancer is provided using Medicine: - a) Injection and b) Tablets. The treatment is given once in 3 weeks and approximately for 6 months, depending upon the nature of cancer and patients health condition. All chemotherapy drugs are administered here. Side effects: Nausea and Vomiting for 1 or 2 days. The pioneering Department of Interventional Radiology is practised in the technique of infusing chemotherapy drugs through the artery. Monoclonal Antibodies and Thyrosine Kinase Inhibitors are available for the target therapy of cancers.

Monoclonal antibody therapy: It is the use of monoclonal antibodies (or mAb) to specifically target cells. The main objective is stimulating the patient's immune system to attack the malignant tumour cells and the prevention of tumour growth by blocking specific cell receptors.


We also provide: a) pain management, b) colony stimulating factors for improvement of WBC, haemoglobin and platelets. Blood bank is available to assist transfusion.

 

FAQs

1. What is cancer

2. Causes of cancer

3. Symptoms of cancer

4. Organs affected by cancer

5. Spread of cancer

6. Treatment of cancer


1. What is cancer?
Cancer is the name given to a group of diseases, which have one feature in common: “uncontrolled growth of cells”, which is of no use to the body. Normally cell growth is balanced by death of equal numbers of cells - a process called apoptosis or programmed cell death. When this process is disrupted, a mass of cells is produced - commonly known as a ‘tumour’.


Tumour:
Tumours may be benign or malignant:

Benign: Here tumour growth is slow and spread does not occur to other parts of the body.

Malignant: A malignant tumour on the other hand, can destroy organs locally and spread to other parts of the body, such as lungs, liver and bones-a unique ability, called metastasis.

 

Cancers are of different types, depending on the tissue from which they arise: Broadly, 4 types are recognized;

Carcinomas - which arise from the layers that cover the body[skin] or line the body-mucosa of nose, throat, lungs, food pipe, stomach, intestine etc,

Sarcomas - which arise from soft tissues such as muscle, fat, blood vessels or from bones,

Leukaemia’s - which arise from the bone marrow and spread into the blood and

Lymphomas - which originate from the lymphnodes and spleen.


2. Causes of cancer
The cause of cancer is multifactorial - multiple agents may act to produce cancer in a particular person. The risk of developing cancer increases with age - 80% of all cancers occur in those aged above 55 years. The final common pathway is damage to the genetic component of the cell (DNA), which leads to uncontrolled cell growth.


The common causative factors may be:

External: such as dietary (high fat diet, alcohol), tobacco, excessive sun exposure, viral infections like Hepatitis B, industrial chemicals; or

Internal: inherited defective genes (which explains how cancer ‘runs’ in some families), or

Reproductive history (late age at first child birth for breast cancer)


3. Symptoms of cancer
Cancer being a disease which affects any organ in the body, the symptoms are varied, and there is no particular symptom which can accurately predict the presence of cancer. The exact symptoms depend on the location of the cancer, which part of the organ is affected, how fast the cancer is growing and whether it has spread to other parts. Cancer occurring in outer parts of the body, such as skin, breast, limbs, testicles or nose and mouth, may present with a visible swelling or ulcer, and may be diagnosed earlier.


There are certain warning signs of cancer, which should be further investigated:

Unexplained weight loss

Loss of appetite

Lump in the breast or bleeding from the nipple

Recent change of bowel habits

Vaginal bleeding after menopause

Change in shape/size or bleeding from a mole

Chronic cough


4. Organs affected by cancer

Cancer can affect every organ and cell type in the body, though some organs such as the eye and heart are rarely affected. Some of the common cancers are:

Mouth and tongue cancers

Throat and voice box (larynx) cancers

Lung cancer

Esophageal and stomach cancer

Liver cancer

Pancreatic cancer

Colon and rectal (Large intestine) cancer

Kidney and bladder cancer

Prostate cancer

Ovarian, uterine and cervix cancers

Breast cancer

Bone cancers

Blood cancer (Leukemias)


5. Spread of cancer
The hall mark of cancer and what makes it a deadly disease, is its ability to destroy surrounding organs and spread [metastasize] to far away organs. Cancer which has spread to a far away organ is called stage IV cancer, and is generally not curable. It is treated with medicines, called chemotherapy. The common organs to which spread occurs are those with rich blood flow, like lung, liver and bone. Each cancer has a preference for certain organs; eg. Stomach cancer spreads to the liver, bone cancer to the lungs.


Once cancer spreads, it causes the patient’s condition to rapidly worsen - weakness sets in, appetite goes down and respiratory or liver failure sets in. Survival after metastases are found is usually less than a year.


6. Treatment of cancer
The aim of cancer treatment is to relieve symptoms, cure the patient and prolong or save life. All these aims may not be met in every case. When cancer is detected early, treatment is very effective and patients are usually cured.


In patients who present with advanced disease, complete cure may not be possible, and treatment aims to control the disease, improve quality of life and to keep the patient normal and comfortable as long as possible. The treatment of each patient is designed to suit an individual and depends on the age of the patient, general condition, type of cancer and stage of disease. There may be only one treatment or combination of treatments.

There are five main modalities of treatment for cancer:

Surgery and radiotherapy eradicate the disease at the primary site (site of origin) of cancer.

Chemotherapy, hormonal therapy and immunotherapy deal with disease which may have spread outside the site of origin of cancer.

Surgery

Chemotherapy

Radiotherapy

Hormonetherapy

 

Immunotherapy

Surgery
Surgery is the most important part of the cancer treatment. Surgery removes cancer cells from the body by cutting away the tumour and any tissues surrounding it which may contain cancer cells, including the lymphnodes. It is a simple, safe and effective method when cancer is small and confined to the site of origin. It is best suited for certain cancers like breast cancer, head and neck cancers, early cancers of the cervix and lung, many skin cancers, soft tissue cancers and gastrointestinal, liver and pancreatic cancers. Surgery may also be used in advanced cases to relieve symptoms such as bleeding and blockage of the food pipe, intestine or urinary passage.


Radiotherapy
Radiotherapy is a form of treatment which uses radiation, a special kind of energy carried by waves or a stream of particles originating from radioactive substances and delivered by special machines. These radioactive x-rays or gamma rays can penetrate the cell wall and damage the nucleus of the cell which prevents growth and division of cells. This also affects the normal cells but these cells recover more fully than cancer cells. Radiotherapy is required in 50% to 70% of patients, usually before surgery to shrink large tumours, or after surgery to destroy cells left behind after surgery at the site of tumour origin. Radiation is also used in patients with metastases, to relieve pain, bleeding or pressure symptoms; eg to relieve paralysis caused by a tumour pressing on the spinal cord.


Modern radiotherapy is very safe, and is technology driven. Recent advances include Intensity Modulated Radiation Therapy [IMRT] which is the delivery of radiation with high precision, so as to spare normal tissues, and reduce side effects. Improvements in radiotherapy equipment, technique and applications, have led to an increasing role both in local treatment and also in its use as a whole-body treatment, as part of bone marrow transplantation techniques for leukaemia’s and lymphomas.


Chemotherapy
Chemotherapy uses drugs which interfere with the growth and division of malignant cells. Once the drugs are administered, they circulate throughout the body. It is advantageous over surgery & radiation for treating cancer that is systemic (spread throughout the body). Chemotherapy is the main modality for cancers like leukemia (blood cancer), lymphomas, certain lung cancers and paediatric cancers. Chemotherapy may be used before surgery to shrink large tumours, and make surgery easier, in breast, esophageal, rectal and bone cancers. Chemotherapy is also used after surgery to treat cells shed in the blood, so as to prevent reappearance of tumours.


The side-effects of the chemotherapy include nausea, vomiting, hair loss, diarrhoea, weakness etc. which are temporary and completely reversible. Modern chemotherapy is very safe and well tolerated and is often given on an outpatient basis.


Hormonetherapy
Hormonetherapy has limited use in cancer treatment since only minority of tumours are hormone sensitive e.g. breast and prostate cancer. This therapy provides systemic means of treatment, i.e. to the whole body, but without the side effects of chemotherapy.


Immunotherapy
Immunotherapy is a form of treatment which stimulates the body’s immune system to destroy cancer cells. It is expensive, and useful only in a few tumours such as melanomas (type of skin cancer) and renal cancers.