Saturday April 21, 2018

Robot surgeries for head, neck and cancer in India: US surgeon

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New Delhi: A leading US robotic surgeon said, “with expertise in traditional head and neck surgical procedures, the country is ready for robot-assisted surgeries to treat head and neck patients in days to come.

Dr Chris Holsinger, 48, who leads Stanford Cancer Centre’s Head and Neck Oncology practice, has been interacting closely with leading Indian head and neck oncologists since 2008.

“I would love to work with more hospitals in India and do collaborative work for providing succour to head and neck cancer patients,” Holsinger told IANS in an e-mail interview.

According to the Indian Council of Medical Research (ICMR), over 200,000 head and neck cancers are reported in the country each year. Of these, nearly three-fourths relate to cancer of the oral cavity, throat and voice box.

“The Stanford Medical Center is working with leading oncologists with Indian healthcare providers like (Delhi’s) Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC) and (Mumbai’s) Tata Memorial Cancer Hospital for a study of Human Papilloma Virus (HPV) negative patients. About 80 percent of Indian cancer patients test negative for HPV,” Holsinger said.

HPV negative is a more aggressive head and neck cancer and may be hard to treat with standard approaches of radiation therapy and concurrent chemotherapy.

“But in the US, the incidence of this disease is too rare. I believe this consortium of Indian robotic head and neck surgeons that gathered in Delhi can pave the way to launch this study and (we hope) to improve outcomes for patients with this disease,” Holsinger stressed.

When it comes to radiotherapy vs robotic surgery, he sees both treatment choices as complementary rather than competitive.

“In the US, we see better results for patients when a multi-disciplinary approach is used. In other words, both the surgeon and the radiation oncologists must be strong but flexible advocates for their patients,” he elaborated.

Consumption of tobacco in various forms – smoking, chewing of paan (betel leaf) and gutka – is a major contributor to head and neck cancer, especially oral cancer.

“Using tobacco and also consuming alcohol only further increase that risk. There are many genes now known to be associated with head and neck cancers, but only rare inherited syndromes are associated with the disease,” said Holsinger, who was in New Delhi last week to attend a workshop.

“I was able to observe Dr Surender Dabas (of RGCIRC) perform two surgical procedures for removal of two head and neck cancers. Afterwards, the team at RGCIRC organised a lively workshop with over 125 attendees,” Holsinger said.

“This kind of collaboration allows the multidisciplinary team to provide a more personalized treatment depending on the stage of cancer and the affected head and neck organs as well as the patient’s preferences and his or her speech and swallowing function at the time of diagnosis.”

Use of computer-assisted surgery (via a surgical robot) to remove cancerous tissues or tumours in the head and neck areas helps the surgeon see the affected areas far more clearly – which is not possible in open surgery.

“A surgical robot helps in accessing the head and neck area through the oral cavity (mouth) thus reducing trauma, pain and blood loss. Best of all, minimally invasive surgical procedures do not leave any scars on the face or neck and recovery is much quicker,” the surgeon said.

Dr Dabas had spent nearly two months with Dr Holsinger at Houston’s MD Anderson Cancer Center some years ago.

Dr Dabas told IANS: “Head and neck cancers represent the fifth most common type and cause of cancer-related deaths worldwide. In India, head and neck cancers account for nearly one-third of all cancer tumours. Poor oral hygiene escalates the chances of contracting oral cancer manifold.”

Any visible lesions, ulcers, difficulty in swallowing food, change in voice and pain in the ear present themselves as early signs of cancer.

Oral and pharyngeal carcinoma represent a significant public health problem worldwide, with more than 400,000 new cases per year.

India and the US, as also western Europe, have the highest incidences of oropharyngeal cancer worldwide, ranging from seven-17 cases per 100,000 people.

“In the US, we are seeing an epidemic of these cancers, especially in the oropharynx, due to an association with the HPV, which may be rising in India as well,” Dr Holsinger stated.(IANS) 

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  • Most maxillo-Facial surgeon in Pretoria attends dental school that the other dental practitioner would, and afterward go to an extra residency for surgery purposes and hands-on practice. This is as same as a cardiologist who would start their career with a semester in a hospital.

Next Story

Shoot The Rapist At The Sight

 And which type is contributing more dangerously to the society can easily be measured with our simple plus and minus equation

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This glaring aberration in the world of media is visible as clearly as stars in the darkness of the night.
India is plagued with a disease called Rape. Wikimedia Commons

Salil Gewali

  • India is plagued with a disease called Rape
  • There are no rigorous punishments for rape
  • Rapists openly commit crimes without anny fear

Why the clamour only for the rigorous punishment for rape and other sadistic crimes which have their roots in the mental-degeneration? Apart from the toughest punishment to the perpetrators, let’s go deeper to analyze what could be the possible  “causes”  that push men to commit rape. Why so much mental degeneration that certain individuals can stoop to the gutter being to their status, their position and social values? Well, how to address those issues is certainly a challenge. And that “challenge” certainly calls for a serious brain-storming and a serious self-assessment vise-a vise the environment in which we all are living.

Ranaghat Nun Rape Case
Rape culture in India garnered more spotlight following the Nirbhaya-gang rape, after which the issue has continue to remain a burning topic in the country. Pixabay

True, in the physical world we are highly convinced brag about that healthy environment is a must for our healthy living. Even kids know these days that we can’t breathe well if our surroundings are filled with high levels of  “toxicity”. We have well studied through our academic textbooks that people invite the environmental disaster if they keep on allowing excessive emission of CO2, CO, methane and other dangerous gases into the atmosphere. We have fully acknowledged that each tall and black chimney of the industries and the nozzles of the motor vehicles are here only to mar the beauty of this planet? What kind of damages the toxic gases are doing to our ecosystem are not at all tough job to analyze with modern appliances. Again, a lot amount of books have been published to create the awareness, to inform us about the scientifically tested measures to resolve the environmental concerns.

However, do we have the same amount of literature that pinpoint the “causes” which contribute to turning “males into perverts”? Who else is emitting the “toxic substances” that overpower the inborn sensitivity of the deviant? What are the properties of toxic filth that is polluting the mind-scape of the society? Now we have Donald Trump, the president of the USA, whom many prefer call him a pervert. At this rate, the number perverts are increasing and they have become dangerously ubiquitous. And, all those perverts have brought nightmares to the ill-fated females. We often stage candle march in protest against the rape, but remain blind to the glaring “causes”. Should we still fiddle about and be appreciative of the society that shameless covers itself with the vulgarity — the “toxicity” that might numb the sanity of males? Watch out, dear friends, those perverts have begun to see even “baby girls” as objects of lust!

Please note:  what our sages said:  “What you see that you think, what you think that you do and what you do that become !!!!”

Also Read: Eat Grapes To Ward Off Depression

Again, I would like to draw another similarity with what prompt big people to “rape”/violate the harmony of the Mother Earth. The case is very regularly brought out by the conscious citizens across the country. A senior journalist Patricia Mukhim of Meghalaya has pointedly driven home recently how the “greed for money” has corrupted many leaders who are trying hard to justify the senseless exploitation of the “body” of Mother Earth. Many big shots of big companies struggle to convince the politicians to tweak the laws to grant the permission to perpetually “rape” the country.

In my mind, both are infected with common syndromes! While the one type is interested in the body of the females, the other type has a fetish for the rocky body of the “Mother Earth”. And which type is contributing more dangerously to the society can easily be measured with our simple plus and minus equation.

The rape victims are not getting the justice they deserve.
The rape victims are not getting the justice they deserve.

Let’s assess the issues from another angle, given the advancement of medical science. Till some years back malaria, dengue, cholera, HIV, smallpox were life-taking diseases. But the medical science has pretty successfully eradicated or contained them all. The scientists have correctly identified the causes of those dangerous diseases and recommended the remedial measures. No doubt, that is a very productive achievement. However, why have the modern studies practically failed to “identify the causes”  of the pandemic rise of the horrendous instances of rapes and criminality associated with them? Is it not a strong slap in the face of the modern civilization considering we have not yet spelt out the causes and the characteristic symptoms the  “toxic emitters” who turn decent males into sadists? How long will we endure the depravity which has already strangulated the decency of the society? Should we still wait to work out the tough laws? Should we still hitch to explore for the “causes” and remedial measures? I guess the time is ripe that each morally conscious individual be allowed a shotgun to shoot the “perversion and depravity” of any kind at sight!

Salil Gewali is a well-known writer and author of ‘Great minds on India’. Twitter: @SGewali.