Tuesday December 18, 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.

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For Delhi Commuters, Google Maps Now Show Auto-Rickshaw Routes

Google Maps provides globally over a billion kilometres worth of transit results every day and has schedules for over three million public transit stops

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Auto rikshaws in India. Pixbay

Commuters in the national capital can now view “auto-rickshaw” routes as well as fares on Google Maps app, tech giant Google Monday said.

“Starting today, commuters in Delhi will be able to see a new public transport mode in Google Maps — auto-rickshaws. By selecting this mode of transport, commuters will be able to view suggested routes for the ride as well as the estimated auto-rickshaw fares,” Google said in a statement.

The new feature will reflect fares based on the official fare model shared by the Delhi Traffic Police, it said.

Google maps, auto-rickshaw
The latest version of the application includes enhanced voice input.

This feature will be available in the Google Maps app on the Android devices.

The idea is to incorporate one of most commonly used modes of public transport in Google Maps and share transparent information about the price of journey, Google Maps Product Manager Vishal Dutta said.

“Currently, for an unfamiliar journey, commuters often overpay and don’t have an idea about the distance or best route,” he added.

auto-rickshaw
By selecting this mode of transport, commuters will be able to view suggested routes for the ride.

Dutta said the feature will also help the users plan their journey better.

“…so they could look at the expected cost of the auto-rickshaw ride and decide whether they want to take it all the way, or perhaps take a different mode of transport instead — like a bus or the metro,” he explained.

Also Read: Google Not Going to Offer Controversial Face Recognition Technology

Google Maps provides globally over a billion kilometres worth of transit results every day and has schedules for over three million public transit stops worldwide, the statement said. (IANS)