Sunday January 21, 2018

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


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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Research Yields Possible Blood Test for Cancer

The test was most successful with ovarian cancer, followed by liver, stomach, pancreatic, esophageal, colorectal, lung and breast cancers.

Scientists have found a way of detecting cancer through blood tests. IANS
Scientists have found a way of detecting cancer through blood tests. IANS
  • Scientists have developed a blood test which can detect cancer
  • This blood test can detect eight types of cancer
  • They have developed a way of detecting DNA which comes specifically from cancer

Scientists at Johns Hopkins University (JHU) are reporting progress in developing a blood test to detect eight types of cancer at an early stage, including some of the most deadly ones that are difficult to detect with existing screening tools.

In a study published Thursday in the journal Science, JHU scientists examined how well their experimental test detected cancer in people already diagnosed with the disease.

Also Read : How broccoli can help keep colorectal cancer away 

This blood test can detect 8 types of cancers. Pixabay
This blood test can detect 8 types of cancers. Pixabay

In blood samples from more than 1,000 patients already diagnosed with cancer, the test detected the cancer in about 70 percent of the subjects.

Nikolas Papadopoulos, a professor of oncology and pathology at Johns Hopkins Sidney Kimmel Cancer Center, said the test is noninvasive.

“All [patients] have to do is give a little bit of blood,” he told VOA. “What we detect is DNA, which is the genetic material that is present in all of our cells, but we have developed a method to detect DNA that comes only from the cancer cells.”

Scientists have been focused on liquid biopsy tests which look for mutated DNA that floats freely in the blood and in cancer-related proteins to try to find cancer before it spreads. They focused on cancers for which there is little or no early-screening process — the ones that are often serious enough to be deadly by the time they are detected.

“That’s one of the tricks that cancer plays on us,” Papadopoulos said. “It grows inside of us and we feel fine until we start having something like a pain or a cough or something like that. And many times, it’s too late.”

Also Read : Alcohol can be linked with seven types of Cancer

This test detects DNA which is specifically formed due to cancer.
This test detects DNA which is specifically formed due to cancer.

The test was most successful with ovarian cancer, followed by liver, stomach, pancreatic, esophageal, colorectal, lung and breast cancers.

“This study that’s just published, it’s the first step,” Papadopoulos said.

He said a larger study is under way, with a pool of thousands of people. Unlike the earlier study, which dealt solely with patients already known to have cancer, the new group makes up a more representative sample of the general population — that is, most do not have cancer, at least not that has been diagnosed.

“The new study is different in that it simulates what is going to be the population that this test will be applied to,” he said. “And hopefully, we will get good results.” VOA