Monday, February 29, 2016

8th Edition of the TANCARE conference organized by FICCI (Tamil Nadu State Council)

Global Health City participated in the 8th Edition of the TANCARE conference organized on 19th Feb'16 by the Tamil Nadu State Council of FICCI in association with the Times of India. The conference had exclusive focus on healthcare industry of the state and the deliberations were centered around the future of healthcare in Tamilnadu. On behalf of GHC, Mr. Hemraj Parmar. Global Health City attended the conference and participated in a panel discussion titled “Tamilnadu as a hub for national and International and tertiary care”.
A coffee table book was also released in the conference by the Times of India themed as “THE HEALERS” , which carries the editorials of some of the prominent healthcare institutions across the state of Tamilnadu including The Global Hospitals Group.

Saturday, February 20, 2016

Bone Cancer

Bone cancer is rare and may arise from cells within or around the bone. These cancer cells arise denovo and multiple aggressively to destroy the bone. The cancer cell may spread through blood circulation to multiple systems like the lung commonly and may spread to other bones and tissues. These tumors grow to a large size and impair the function and may lead to death.

Bone cancer is of different types based on the cell of origin. Bone cancers like Osteosarcoma, Ewings Sarcoma are more common in children between the age of 5 to 20 years. Cancers like Multiple Myeloma, Chondrosarcoma are more common in late adult and old age. Cancers arising from any part of the body like breast, thyroid, lung etc may secondarily spread to the bone and these are called as Secondary (or Metastatic) Bone Cancers.

Patients suffering from Bone cancers may present with persisting pain which is not relieved by rest or pain medication. This may be associated with progressive swelling of the involved part. Tumors which arise from the spine may present with weakness in the hand, foot or even paralysis.

Diagnosis of Bone cancer:
Bone cancers are not easily detected and hence the diagnosis is delayed. As these cancers are rare, the awareness in public as well as the doctors is poor. As early detection is most essential aspect of bone cancer management, it is important for people to consult the concerned doctors at the earliest. Thorough examination and appropriate investigations is essential for making the correct diagnosis. Investigations like Xray, CT scan, MRI scan, Bone scan, PET scan may be needed. Biopsy is a very important investigation which should be performed by the treating surgeon to confirm the diagnosis.

Treatment of Bone cancer:
In the past bone cancers where considered to be incurable and procedures like amputation surgery where performed to relieved patients of pain. Various advances have been made in the management of these cancers. High end investigation modalities like MRI scan, PET scan etc have made diagnosis easier. Various limb salvage procedures are now available for upper limb, lower limb and pelvic cancers. Various reconstruction techniques are now available which includes Megaprosthetic replacement, Allo bone graft, Vascularized fibula, Rotationplasty etc. For children with bone cancer, special implants like expandable megaprosthesis are also available.

Patients with metastatic bone cancer, palliative surgeries are performed to relieve them of cancer pain and improve quality of life and function.

Multimodality approach is now recommended which may include chemotherapy, Surgery and Radiotherapy. Chemotherapy helps prevent cancer spread and save lives. Radiotherapy may be used as an adjuvant to surgery.

Prognosis of Bone cancer:

With an advent of newer technology and skills primary bone cancers can be detected early and cured. The cure rates have improved from 25 % to 70 %. Patients who present late with large local disease and metastasis (spread) where cure is not possible, care is directed towards relieving pain and improving function. Quality of life may thus be improved.

Friday, February 19, 2016

Lifestyle and Cancer

Lifestyle and cancer, in what way are both related, you may be wondering? Well, they are related. Cancer is one disease for which we say all the things under the sun including the sun is the cause. Why not Lifestyle? Let us see how they are related.

By Lifestyle I mean what diet we are going to consume, what kind of life we are going to lead, what are our habits, what are our social and moral values, how much physical activity we indulge in, and all these factors put together have an effect on our health and disease.
Our elders always keep saying that they did not have these many cancers in their times and now they see increase in the cancers. Partly it is true, these lifestyle changes have definitely contributed to increase in some cancers, at the same time decrease in others.

Firstly, let us look at the diet we consume. Vegetarian diet, diet rich in fresh green vegetables and fruits are always rich in fibers and antioxidants like carotenoids and vitamins which have protective action against cancer. High fibre diet is protective against Colonic cancer. The modern lifestyle makes the people eat junk food, refined food which lack natural fibres. Consumption of lot of red meat along with this also predisposes a person for colonic cancer.

Among various risk factors put forward for breast cancer, high fat diet is one. Due to improved education and earning capacity, there is a change towards affluent lifestyle among women, there is increased consumption of high fat diet. High fat diets during the pubertal age and obesity in the post menopausal age are risk factors for breast cancer. Diet rich in legumes like soya and peas are protective as they are rich source of phytoestrogens against both breast and prostate cancer.

Physical activity again has a protective action against breast cancer. Affluency has also made many women accustomed to sedentary lifestyle, spending more and more time in front of computers and television and hence at higher risk of developing breast cancer.

Early age of marriage, early sexual activity, early child birth are all risk factors for cervical cancer, the opposite of it,  that is late marriage, nulliparity, late childbirth are risk factors for breast cancer. Due to urbanization and westernization, improved literacy and better standard of living, more and more women are getting married at a late age, they also have child at later age mostly single child, and so the cervical cancer is on the decline and breast cancer is on the increase.

Not only change in social status of women but also screening for early disease in asymptomatic women and its awareness has brought down cervical cancer. But change in moral values have lead to more promiscuous behavior among modern young women  which may again bring back cervical cancer to forefront since it is considered a sexually transmitted disease.

Our habits also contribute to increase in cancer. Tobacco is a bigger menace in the society. Tobacco in the form of cigarettes, cigars or oral preparations like Gutka is attracting our younger generations both male and female alike. It is a known evil for head and neck cancers and lung cancers.  It is considered as a social status among young men and women to show their maturity, independence and heroism. Tobacco in any disguise is dangerous. Because of its harmful effects we are seeing more and more young men and women in their early twenties and thirties succumbing to head and neck cancers. Lung cancer is on the rise among women due to increased smoking prevalence among them.
Tobacco is implicated in most of the cancers including cervical cancer, urinary bladder cancer gastro esophageal cancer etc. Alcohol intake added to tobacco increases the person susceptible to gastro esophageal and liver cancers.

Drug addiction among young people, use of same needles by all has disposed them to diseases like Hepatitis C and HIV which predisposes them to liver cancer and decreased immunity to many other cancers like lymphomas.  

Now we understand why our ancestors were healthier, because they lived a life of physical activity, good healthy diet, life of moral values, and stress free life.

So it is essential for us also to follow footsteps of our elders to keep healthy and away from cancer.

Department of Radiology, BGS Global Hospitals

Tuesday, February 16, 2016

Myths and facts about Cancer and its treatment

Myth: Cancer is a fatal disease with no chance of cure.

Fact: Cancer is a treatable disease. If diagnosed early, most types of cancer can be completely cured. Even in advanced stage cancer, much can be done to alleviate symptoms and prolong survival. It is a chronic disease like Bronchial Asthma or Diabetes which are also not curable.

Myth: Most cancers are hereditary. 

Fact: It’s estimated that only 5% to 10% of all cancers are truly hereditary. Tests can now determine if a person with a strong family history of breast or colon cancer carries the altered genes that put him or her at high risk for these diseases

Myth: Cancer is contagious.
Fact: Cancer is not contagious. Cancer afflicted person in fact needs your love and moral support to fight the disease. Rather a person suffering from cancer may need your love and support to fight the dreadful disease. Though cancer is not contagious some of the viruses like Hepatitis C virus which cause liver cancer and Human Papilloma Virus which cause cervical cancer are transmitted sexually as well as through infected needle

Myth: Only people with a high risk of cancer need to get cancer screening. 

Fact: No. All adults should get regular cancer screening exams

Myth: Chewing tobacco, snuff is a safe alternative to cigarettes. 

Fact: There is nothing healthy about snuff and chewing tobacco. They are just as addictive as cigarettes and can cause cancers of the throat and mouth.

Myth: If I have smoked for some years, the damage is already done, so quitting is not beneficial.Fact: No, it is never too late to quit smoking. There will be improvement in the lung function and blood flow after smoking is quit. The risk of lung cancer also starts decreasing once smoking is quit. By 10 years it reduces to 50%.

Myth: If there is no case of breast cancer in my family I need worry about it afflicting me. 

Fact: The truth is the majority of women diagnosed with breast cancer don't have a family history of breast cancer. However, having it in your maternal relatives increases your risk of getting it. Hence early screening is advised

Myth: Only women get breast cancer.
Fact: This is by far the biggest cancer myth of all. Men do get breast cancer though uncommon.

Myth: Chemotherapy drugs usually cause death and avoiding these drugs is a better option when they are needed.

Fact: Selection of Chemotherapeutic drugs and their dosage is done by experts looking at the diagnosis and general condition of the patient. Rarely complications do occur. But risks should be weighed against benefits. Better talk to your doctor before denying the chance of cure.

Myth: Radiotherapy means giving electric shock and it burns the skin and internal organs.
Fact: Radiotherapy is using high energy X rays and with the latest technologies no such toxicities occur.

Myth: Patient receiving radiotherapy is harmful to his family members and Children.
Fact: A person is totally safe after he comes out of Radiotherapy treatment room and donot harbor any radiation.

Myth: Radiotherapy causes hair fall
Fact: Radiotherapy causes hair fall in the area that is treated not generalized as with chemotherapy.

Dr. S. Nirmala, Radiation Oncologist, BGS Global Hospitals 

Monday, February 15, 2016

Heart failure , is it a multisystem disorder? Pathogenic gut flora Linked to severity of heart failure

Heart failure develops on multi-factorial background.  Both Intrinsic and extrinsic factors account for the ultimate morbidity. The role of gut in chronic heart failure (CHF) has been in focus in recent times and the current  research  indicates pathophysiological role these gut microbial world to the Heart failure. From a new study published in JACC: ‘Heart Failure,  have suggested that patients with CHF are likely to have "intestinal overgrowth" of pathogenic gut flora and permeability that is associated with disease severity. Patients with CHF were found to have pathogenic bacteria and candida in huge numbers as compared against healthy controls. The specific types of the increased pathogens found in stool samples included Campylobacter, Shigella, Salmonella, Yersinia enterocolitica, and Candidaspecies. Those with CHF also had significantly increased inflammation, intestinal permeability, and right atrial pressure (RAP), which is a signal of venous blood congestion. And most of these associations were stronger in those with moderate-severe HF (NYHA 3-4) vs those with mild HF (NYHA 1-2)’Lead author, Dr Evasio Pasini (Salvatore Maugeri Foundation, IRCCS, Medical Center of Lumezzane, Brescia, Italy) and co-author suggest that gut microbiota need to be continually investigated as soon as CHF is diagnosed. Using simple, noninvasive, reproducible methods to measure gut-flora development could provide "important clinical information to treat complicated multiorgan syndromes."

More than 100 species of microbes are stated to home in our gut. These are bacteria of benefit that help in digestion, prevent blood clotting, produce Vitamin B,  immunity etc.  Advocacy of consumption of fermented foods is only to enhance and stabilize useful bacteria. GUT disturbances producing unrelated disorders are not unknown to Ayurveda. The GUT microbial environment is reflection of our foods and food habits. Any deviation in consumption of  balanced food, I mean from Microbial safety point of view, would result in both Human physical and psychological imbalance. Many are not cognizant of this vital issue. Modern medical research has unraveled the mystery that gut bacterial alteration would produce variety of  disorders such as arthritis, urticaria, depression, anxiety so on. Physicians prescribe medicine for the symptoms ignoring the root cause, possibly many professionals are unaware or do not take cognizance of its relevance.

Every human being is governed by food, followed by actions and finally thoughts. The interrelationship is sensitive and not very obvious. Our beliefs are nurtured by habits including Food. It is said ‘ Our Beliefs become or thoughts, Our thoughts become our actions and our actions become our Habits and our habits determine our Character.  I feel even the disease character is decided by GUT.!.

Comprehensive treatment for Heart Failure at Global Hospitals Group. Read more