Sunday August 18, 2019

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) 

  • 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.

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By Advancing Interdependence, India will Bring New Dawn for Democracy in 21st Century

All citizens must be active participants in shaping the future of India

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Interdependence can be achieved by creating a country in which there is a shared understanding of the value of each citizen and a reliance on one another to eliminate discrimination. Pixabay

In his first speech after winning the election for his second term, Prime Minister Narendra Modi proclaimed that “…we have to win ‘sabka vishwas’ (everyones trust).” What will be required to win that trust is establishing a true state of interdependence. Interdependence can be achieved by creating a country in which there is a shared understanding of the value of each citizen and a reliance on one another to eliminate discrimination, hostility, and prejudice and to provide equality and opportunity for all. All citizens must be active participants in shaping the future of India. They must be equal partners in Indias inclusive economic mobility and in Indias shared prosperity.

Independence Day is the perfect day to highlight the importance of and advance the concept of interdependence. This can be accomplished by promoting the need for a unified India on this national holiday.

The need for doing this is critical. Unfortunately, in the period since the Prime Minister called for winning “trust” in his speech, some Indians have engaged in actions destroying it.

Sadly, the heinous crimes at the beginning of Modi’s second term are nothing new. There were several lynchings and numerous attacks on Muslims during his first term.

Interdependence, India, Democracy
In his first speech after winning the election for his second term, Prime Minister Narendra Modi proclaimed that “…we have to win ‘sabka vishwas’ (everyones trust).” Pixabay

Modi did not speak out vigorously then. He must do so now to demonstrate the essential leadership that will be required to create a state of interdependence. There are other serious conditions that must be addressed as well. To name just a few: sexual violence and subjugation of females continues; the caste system still exists; and, the problematic conditions of those in the weaker sections persist.

By speaking out, Prime Minister Modi can bring the country together to confront the matters that are hardening India’s democratic arteries. He cannot do that alone, however. He will need buy in and support from across the country and the citizenry.

A first step should be to “find our spiritual common ground”. That step can be initiated by recognizing that spirit is the invisible force that brings us together regardless of our caste, race, religion, region or political predisposition. The goal in discovering that common ground should be to create one nation under God. That nation would be an interdependent one and its God would be ecumenical and non-denominational. Its God would be welcoming to all.

As one nation, India would celebrate and embrace the richness of religious diversity

Also Read- BBC Decides to Expand its Shortwave Radio Service in Kashmir to Beat Communications Blackout

As one nation, India would be inclusive and accepting unity over division and hope over fear

As one nation, India would elevate citizenship above angry and mindless partisanship and bring people together to pursue the common good

As one nation, India would be the place known for sharing and caring as opposed to blaming and shaming

As one nation, India would emphasize building bridges instead of constructing boundaries and barriers

Interdependence, India, Democracy
What will be required to win that trust is establishing a true state of interdependence. Pixabay

As one nation, India would ensure that all its people are literate and equipped with the skills to succeed in the 21st century

As one nation, India would extend life lines instead of drawing battle lines

As one nation, India would be a land of big dreams, small treasures, brave people, kind deeds, and tender mercies

As one nation, India would ensure the importance of the freedom of the free press, not to bury it

Also Read- Gold Price May Increase to Rs 40,000 per 10 Gram by Diwali

As one nation, India would be a role model and exemplar for other democracies to emulate

Everyone must play a role in establishing India as one nation. Each citizen should engage in small acts of kindness by reaching out to those less fortunate and to the downtrodden by extending a helping hand and a hand up.

Some people can make special contributions. Religious leaders should promote interfaith dialogue. They should bring people together followers of different persuasions for meaningful conversations. They should promote a dialogue of understanding and a shared sense of community with other faiths. They should call the fact that attack on one faith is attack on all faiths. Political leaders should promote a framework of unity and civility. Civic and community leaders should promote collaboration in problem-solving. They should toil together their creeds to plant the seeds for doing good deeds.

There is no better day on which to resume our journey than Independence Day. There is no better way to make that journey than to chart a course to interdependence. By reaching that destination, India will establish itself as the beacon of hope for democracy worldwide. By realizing that potential, India will bring a new dawn for democracy in this 21st century. (IANS)