Cervical Cancer

Author: Dr. Sapna Nangia

Cervical cancer is the commonest cancer in Indian women and a quarter of the world’s cervical cancer patients live in India! It is indeed ironical that a cancer that can be prevented by a vaccine and detected in a pre malignant state receives such little attention from the media.

 

Caused by infection with the Human Papilloma Virus( HPV), cervical cancer involves the opening of the uterus into the vagina. It occurs more commonly in women who start sexual activity at a young age and is also more common in women with many childbirths and partners. Given that girls in rural India marry at a younger age and have more children than their urban counterparts, it is not surprising that the incidence of cervical cancer is more in rural India. Other risk factors are poor personal hygiene and, of late, HIV infection.

 

The process of transformation of a precancerous state to cervical cancer takes approximately 10 years or more. During this period, a simple test called Pap smear can detect this precancerous state. The affected area of the cervix can be effectively treated by a gynecologist using simple treatment methods such as laser, cryosurgery and LEEP. Pap smears are recommended for all sexually active women, the test being repeated at three yearly intervals if normal and at 5 yearly intervals if both Pap smear and testing for high risk strains of HPV are negative.

 

Organist ions looking to make a contribution towards improving the health status of Indian women would do well to think of mass screening of women using a technique called VIA. This simple test, which basically consists of applying vinegar to the cervix and then inspecting it, can be easily administered by health workers. In a landmark study by Tata Memorial Centre, Mumbai, mass screening of women was found to reduce the risk of dying due to cervical cancer by a whopping 30 %. It is known that mass screening for cervical cancer once in 10 years can reduce the incidence of this disease by 60 %!

 

Vaccines are now available against some strains of HPV. Gardasil from Merck and Co. protects against 4 strains, 2 of which cause cervical cancer and 2, genital warts. Cervarix, from  Glaxo Smith Kline Beecham, protects against 2 cancer causing HPV strains. The HPV strains that these vaccines act against are responsible for about 70 % of all cervical cancers; women who have  been vaccinated should  therefor still undergo Pap smears for early detection of cervical cancer.

 

The ideal time for vaccination is prior to initiation of sexual activity. It is  usually administered to  at the age of 12 – 13 years to girls, but can be administered between the ages of 9 – 45  years.  When administered after initiation of sexual activity, the vaccine does not protect against pre- exiting infection.

 

A course of three injections is recommended, the second  and third injections being administered one and six months, respectively, after the first. The cost of the vaccine is approximately Rs. 2500 per dose.

 

HPV is responsible for other cancers besides cervical cancer; anal cancer, vulval cancer and that of the throat are also caused by strains of this virus. Vaccination is likely to reduce the risk of these cancers too.

 

HPV vaccination is a part of the National Immunization Program in Australia, United Kingdom and Canada. Besides girls, immunization of  boys  to prevent the above mentioned cancers as well as the transmission of cervical cancer is also being considered and is already a part of the national Immunization program of some countries.

Roko Cancer Celebrated World No Tobacco Day, 2014 in association with IHC

Roko Cancer Charitable Trust, on the occasion of World No Tobacco Day, organized an Awareness Event. This event included a Skit and a Collage competition for the underprivileged children of Delhi-NCR, on 10^th May, 2014, in association with The India Habitat Centre. The event took place in the amphitheatre (with sun filters), 10 am onwards and was conducted and coordinated by Roko’s in-house doctors, Dr. Sakshi & Dr. Mahak Varma, who run successfully an Anti-Tobacco Campaign and can be contacted for Tobacco Cessation Counselling on Roko’s Medical Helpline.

Every year, on 31^stMay, WHO and partners mark World No Tobacco Day, highlighting the health risks associated with tobacco use and advocating for effective policies to reduce tobacco consumption. The theme for 2014 being, “RAISE TAXES ON TOBACCO”!!!

Ms. Sudha Murgai, Director India, Roko Cancer said: Higher taxes are especially effective in reducing tobacco consumption among developing countries, lower-income groups and in preventing young people from starting to smoke.

WHO states that 13-15 years of age is the correct age to target the children from getting into this bad habit, as this is the age when children have more influence of their peers and indulge into such malpractice’s. Roko aims at correcting them and stopping them at this very tender age. This initiative was organized to nip this habit in the bud before it becomes an addiction. The theme of this event is“BE SMART, DON’T START” !!!

 Young and Dynamic out of school and underprivileged main stream schools came forward and portrayed their ideas against consumption of tobacco by making thoughtful collages. The children also presented their take on the theme by enacting them through skits. We had a total of 15 entries in collage making and 8 entries in Skit competition from a total of 9 organizations across Delhi working for the underprivileged children. We also had with us children from Habitat Learning Centre to present their ideas on Anti-Smoking. The first prize was won by Amba Foundation and Srijanatmak Manushi Sanstha (SMS) in Skit and Collage making competition respectively.

Roko firmly believes that these young children are the future of our country, and making them aware is hitting the bull’s eye, as they shall further spread the message to their friends and family and stop this menace.

To advocate for the cause and judge the competition we had with us on the occasion, Director-Designate, India Habitat Centre, Mr. Rakesh Kacker, Roko’s Director- India, Ms. Sudha Murgai; Renowned Lawyer, a motivational speaker and writer, Mr. Ashok Arora; Social Activist Ms. Neerja Sharma. Also to grace the occasion and support the cause, we had with us Director, India Habitat Center, Mr. Liberhan; CMD & Director of National Fertilizer Limited, Ms. Neeru Abrol.  Famous Fashion Designer, Ms. Anupamaa Dayal and Mr Ashok Arora.The prizes were given away by Director Mr Raj Liberahns.

Details:

• Time:   10.30 Am – 5Pm
• Venue: The India Habitat Centre, Lodhi Road, New Delhi (Amphitheater)
• Contact Person: Mrs. Sudha Murgai, Director-India, Roko Cancer Charitable Trust
•  Contact Details: 9810092807, 011-2627062; dirindia@rokocancer.org

Fortis launches India’s first Comprehensive Centre for Treatment of End-stage Heart Failure & Transplant, at Fortis Malar Hospital, Chennai

Becomes the largest Heart Failure Program in the Country

• Only centre in India for completely implantable Artificial heart
• Heart Transplantation for all age groups
• Outcomes are at par with international standards

Chennai, 09th May 2014: Having set benchmarks in patient care with its path breaking work, Fortis has set up a world-class comprehensive centre for heart failure and heart transplant, at the Fortis Malar Hospital, in Chennai, known for over two decades for its excellence in cardiac care. The speciality centre under the leadership of Dr. K R Balakrishnan, Director Cardiac Sciences and Dr. Suresh Rao K. G, Chief of Cardiac Anesthesia and Critical Care, is ably supported by an experienced team of leading cardiac experts. It offers India’s first ComprehensiveHeart Failure, Heart Transplant and Artificial Heart Program with extensive options for treatment and management of Congestive Heart failure.

Inaugurating the centre, Mr Aditya Vij, CEO, Fortis Healthcare Limited and Chairman, Fortis Malar Hospitals Limited, said, “Advances in medicine have made heart transplants safer and a real option in managing cases of end stage heart failure. Cardiac care at Fortis Malar is well established and ranked amongst the finest in the country. Our team of highly accomplished doctors led by Dr Balakrishnan and Dr Rao have done pioneering work in the field and have performed the largest number of successful heart transplants in the country. We are therefore pleased to institutionalize the programme by setting up a specialized Fortis Centre for Heart Failure and Transplant at the facility. I am sure the Centre will benefit many of our patients who will no longer have to seek treatment abroad for treatment of heart failure.”

Dr. K R Balakrishnan, Director, Cardiac Sciences, Fortis Centre for Heart Failure and Transplant, at Fortis Malar, said, “The majority of patients who can benefit from our advanced therapy are not aware of the facilities available in India. Moreover, in Tamil Nadu alone, each year, 100-150 organ donors are available but the heart transplants carried out are around 20. Our goal is to provide the highest quality of patient-centered care to many more patients, right here in India, utilizing our interdisciplinary approach, enormous talent and the multi-skilled resources within our team.”

Heart Failure is a major health concern worldwide including in India. Twenty million people world-wide suffer from heart failure, out of which India witnesses two million new cases every year with at least a third of them requiring advanced therapy to survive. It is also important to note that, the mortality in heart failure patients is as high as 30-40%, within a year of diagnosis. In India, the treatment for heart failure is restricted to medical therapy, revascularization therapy (restoration/augmentation of blood supply to the heart), valvular surgeries and cardiac resynchronization (heart pacing) therapy. 

With copious and wide ranging experience in handling heart failure patients including the implanting of India’s first artificial heart, Fortis Malar Hospital is recognized all over the world today as a centre of excellence providing the latest technology in heart care.

The Fortis Centre for Heart Failure Management and Heart Transplant

What sets the Fortis Centre for Heart Failure Management and Heart Transplant apart is its designation as a Ventricular Assist Device (VAD) Destination Therapy Center, a bridge to a transplant incase it is required later. Ventricular Assist Devices (VADs) are implantable mechanical heart pumps. They have been used in recent times to sustain patients who are candidates for heart transplant as they await a donor heart and are increasingly being used as a substitute for transplantation. Emerging research shows that VAD patients find that their hearts actually improve with help from these mechanical pumps.

The comprehensive heart disease management programme also includes preventive measures to avoid Heart Failure, Cardiopulmonary testing including peak oxygen consumption measurement, ECMO (lung heart machine) as a bridge to a transplant or a bridge to a decision, nutritional counselling designed to help patients adhere to a complex medical regimen and a specialized low-sodium (salt) diet. In addition, patients learn to recognize fluid retention, that signals heart failure.They are counselled on aspects of Cardiac rehabilitation and individualized exercise plans are drawn up for them to strengthen their heart muscle, improve blood circulation and support the recovery process.

The cardiac Transplant team at Fortis Malar has so far performed 35-ECMO, 16 heart-transplants, 5-VAD’s and is credited with India’s first successful implantation of Heartmate II LVAD and HVAD, a mechanical artificial heart pump.

The entire team of physicians, coordinators and nursing staff are highly trained individuals with many years of experience in the field of  transplant and heart failure management providing pre-operative, peri-operative and post-operative care.

Fortis Malar Hospital in association with IMA Conducts CME in ‘Tribute to Asthma’

Chennai, April 21st, 2014: Fortis Malar Hospital, Adyar, Chennai in association with Indian Medical Association (IMA) conducted a Continuing medical education (CME) programme to spread awareness in connection with World Asthma day.

A group of Medical Practitioner came together to bring awareness for the disease by singing Old Melodies to the group of Asthmatics. This programme was termed as “A Tribute to Asthma” and was sung by a group called “Music for healing”.

The Concept of prescription through songs was conceived by a group of doctors who were part of the singing group. The programme was initiated as a unique attempt by doctors singing to their patients. The programme was inaugurated by Film Actor Mr.Yugi Sethu, Music Director Mr. Ramesh Vinayagam, Rap singer MR.Blazee and Playback singer Dr.G.K Lavanya.  

SANTHIGIRI NATURAL FOOD AND AYURVEDA

• Healthy food Fest-- Food has to be a way of life, something that has to be taken responsibly. Adopting a right food regime means we are preventing diseases of all kinds.’ 

New Delhi: Santhigiri Ashram has organized a work shop on healthy eating and ethnic preparations of raw food at New Delhi.


Dr Gangadharan DNYS (doctor of naturopathy and yogic sciences) from Santhigiri Ashram,  Kerala said, ``We are a society mostly believe in cure and treatment . Healthy eating is key  to good health and especially when most of us are under some kind of life style diseases like  diabetes, high blood sugar, cholesterol, stress, ulcers, heart, kidney or liver ailments or  even cancer.’’

Dr Gangadharan does not need a kitchen to dole out a health feast that comprises of 12  different items that are made of select vegetables, fruits and desiccated rice. The order in  which we consume different types of foods---solids, salads, fruits, etc---is also critical for  proper digestion (to avoid the formation of acids and gases) and to maintain good health.  Salads digest much faster than solids.

Even under home-cooking scenario, we are unable to chart out different menu and recipes that fit various health conditions. For instance, someone who suffers from high blood sugar can only take limited rice with Sambar, because Daal, tamarind and Asafoetida, etc will have an adverse effect on a sugar patient. However, rice can be consumed with avIyal (mixed vegetable semi-dry). Diabetics should avoid consumption of tea and coffee and can switch  to ``jaappy’’ (coriander, fenugreek, dry ginger, Jeera and Jaggery with coconut milk) can  help. Diabetics can also drink juices of tomato, cucumber, cabbage and curry leaves.

Juices of carrot, leafy vegetables, potato (with skin) cucumber, apple, guava are good for someone who suffers from severe constipation. Also, one can keep acidity at bay by drinking juices of carrot, cabbage and potato, water melon and snake gourd.

``This style of healthy preparation does not require a kitchen or fuel. Also kitchen so far has been the monopoly of women and now men can also try their hands in preparing health food,’’ he says.

The workshop was organized at the residence of Shri D R Kaarthikeyan, Former Director CBI and while addressing the audience Mr Kaarthikeyan praised Santhigiri Ashram for its efforts to propagate the traditional knowledge systems like Ayurveda and Siddha. Swami Padmaprakasha Jnana Thapaswi , the In charge of Santhigiri Ashram’s New Delhi Branch ,has welcomed the audience and while addressing them Swami has mentioned the importance of diet in maintaining a healthy life style.

K.J. Somaiya Hospital sets up most modern blood bank for the under served

• Collaborates with Rotary Club of Mumbai Queen's Necklace to set up comprehensive facility

Mumbai. April 19, 2014: Bridging the gap for a modern, comprehensive and low-cost Blood Bank facility, Somaiya Hospital, Sion has replaced its existing Blood Bank with a full-fledged infrastructure with state-of-art technology.  Rotary Club of Mumbai Queen's Necklace has come forward with financial assistance with an aim to address the poor and needy patients. The Blood Bank was inaugurated by Mrs. Lata Subraidu, first lady Governor of District 3140 and Dr.Sendurai Mani, Co Director at the Metastasis Research Centre, MD Anderson Cancer Center, Houston TX.


With capacity of 550 beds, the multi-specialty Somaiya Hospital's Blood Bank would be among the biggest such facilities and would have everything a modern facility would have. It includes an enhanced blood storage room to ensure safe storage of blood through plasma freezers, incubators and agitators. An initiative to develop a quality control room and component preparation room has also been incorporated in this project.
Speaking on the occasion, Mr. Samir Somaiya said that the city of Mumbai is woefully short in infrastructure related to blood management and this shortage is impacting the overall standards of medical care.

Chairman of K.J. Somaiya Medical trust, Mr. Samir Somaiya mentioned that, ‘’Our dream is to ensure a centre where the best treatment, best education and best access to care are provided. We are in the process of building a vision to take a step forward in the pursuit of this dream. This facility will ensure the prominent arrival of a blood bank that is among the best. The Somaiya Trust has always tried to make hospital care available to all, irrespective of their financial condition or any other socio-cultural parameters’’.
Dean of K J Somaiya Medical College and Research Centre, Geeta Niyogi, said, ''The state-of-art blood bank will cater highly to the locals in the north eastern suburbs and central Mumbai. Also, with the Asian institute of Oncology existent in our hospital the blood bank would ensure further essential assistance''.

Speaking about joining hands with Somaiya Hospital, Mr.Sanjiv Mehta, President of Rotary Club of Mumbai Queen's Necklace said, "We are happy that we could contribute towards making this a reality.  We humbly believe that enhancing quality of healthcare for the underserved is a responsibility that should be shared by everyone in Mumbai" 

Cancer Awareness

Cancer of the mouth and throat are the most common cancers in Indian males, because of the high incidence of smoking and chewing tobacco and the widespread use of pan masala. In fact, the diasporic Indian population has even led to an increase of cancer of the mouth in the Western world!

Cancer of the mouth usually presents as an ulcer on the cheek, gums or tongue and any blister / ulcer in these areas persisting for more than three weeks, warrants a visit to a doctor. The symptoms of throat cancer are a foreign body sensation in the throat, change in voice, painful swallowing persisting for three weeks. Both mouth and throat cancer may also manifest simply as  a lump in the throat.

Radiotherapy is the treatment of cancers using x rays or other forms of electromagnetic rays that have the ability to destroy tissue by damaging the DNA of cells.

Radiotherapy is an integral part of the treatment of head neck cancer, having the ability to destroy cancer in this site,  thus curingcancer of the mouth and throat. The probability of cure is excellent, with more than 90 %  early vocal cord cancer patients getting cured and up to 70 % stage III and IV A patients getting cured.

Modern radiation techniques have led to a dramatic improvement in the quality of life of cancer patients undergoing radiotherapy. A technique called Intensity Modulated Radiotherapy, in use for a little more than a decade, has resulted in this dramatic change. This technique allows the radiation oncologist to target the cancer accurately and yet reduce the radiation dose to normal structures adjacent to the cancer.

Patients treated for head neck cancer without using IMRT have to change their diet to a liquid or porridge like diet, often also losing the ability to taste food forever. They also develop a permanently dry wood like mouth, being troubled by oral blisters and bad teeth.

Dr. Sapna Nangia, Cancer specialist at the Indraprastha Apollo Hospital, New Delhi, who has been working in the field of IMRT in mouth and throat cancer for more than a decade  and has  vast experience in this field, says that in contrast, patients treated with IMRT quickly regain normal taste and salivary function and have a good quality of life. They are also less likely to have dental problems following radiotherapy. Since dose to all normal structures is reduced with this treatment, there are fewer blisters during treatment, and less chance of scarring or damage to the jaw bone.

Dr. Nangia feels strongly that in the interest of patients suffering from mouth and throat cancer , radiotherapy , whether being used alone or in combination with surgery or chemotherapy, should always be in the form of Intensity Modulated Radiotherapy. She feels that primary physicians, dental surgeon and ENT surgeons, who are often the people who first diagnose cancer of the mouth and throat, need to be aware of this advanced form of radiotherapy, so that they can guide their patients correctly. The general public , too, should be aware of the latest advances in the field of cancer treatment, a field in which rapid advances are taking place and which are available in India at the same time as they are in the western hemisphere.

Cancer Awareness Program in Artemis Hospital, Gurgaon

To spread mass consciousness, Artemis Hospital, Gurgaon organized a cancer awareness program on Monday, with world renowned Oncologist, Dr. Olufunmilayo F. Olopade gracing the event as the guest lecturer. The event revolved around understanding genetics and genomics of  cancer risk assessment and revolutionizing treatment for breast & ovarian cancer.

A global leader in cancer genetics, Dr. Olopade seeks to identify those at risk for hereditary  breast and ovarian cancer earlier in life, intervene aggressively to reduce risk and pre-empt  disease development, and thereby more effectively control cancer. She is a member on the  National Cancer Advisory Board, nominated by President Barack Obama in 2011. Dr. Olopade  said, “A better understanding of the most aggressive type of breast cancer in young women will  lead to improved methods for prevention, early detection and treatment of all breast cancers.”  She further added, “Everyone who has a cancer case in the family should get themselves tested  as a preventive measure.”  Indian Cancer Society, medical practitioners, education authorities and corporate were also  present at the event. 

A TB Test, Treatment and Cure for All

A TB Test, Treatment and Cure for All

Left to Right - Dr.Ashok Grover, Dr narendra Saini, 

Ms Nancy Godfrey,  Mr Pritpal Marjara, 

Dr Rita Leavell, Dr Niraj Kulshrastha, Dr R S Gupta

India has more new TB cases annually than any other country in the world, with an annual reported incidence of 2.2 million cases per year. A matter of grave concern is that 9.3 lakh TB cases in India are not notified, as per the WHO Early diagnosis and complete treatment of TB is the corner-stone of the Revised National Tuberculosis Control Program (RNTCP) implemented by the Central TB Division’s (CTD), Ministry of Health and Family Welfare. RNTCP’s program provides quality assured diagnostic and free medicines to all the TB patients, including the necessary supportive mechanisms for ensuring treatment adherence and completion. For further information log onto www.tbcindia.nic.

The private sector in India predominates in health care and TB treatment. Extremely large quantities of anti-TB drugs are sold in the private sector, sometimes without a prescription. Non-standardised prescribing practices among some of the  private providers, with inappropriate and inadequate regimens and unsupervised treatment continues. This frequently leads to treatment interruptions and subsequent drug resistance.

If the TB patients diagnosed and treated under all sectors are reported to public health authorities, the mechanisms available under RNTCP’s program can be extended to these patients, to ensure treatment adherence and completion. The impending epidemic of Drug Resistant TB (DRTB) can only be prevented to a large extent by this intervention.

In order to ensure proper TB diagnosis and case management, reduced TB transmission and to address the problems of the emergence of Drug Resistant TB, it is essential to have complete information of all TB cases. Therefore, the Government of India declared TB a notifiable disease on 7th May 2012. It is now mandatory for all public and private health providers to notify TB cases diagnosed and/or treated by them to the nodal officers for TB notification.

This Word TB Day, observed every year on 24March, a social media campaign supported by USAID and implemented by Population Services International (PSI), India, a leading NGO engaged in public health in partnership with Improving Health Behavior Program, FHI 360; will be launched. The campaign targets allopathic doctors in the private sector, to raise awareness of TB notification in India and to provide a convenient platform for allopathic doctors to register with the RNTCP’s national notification system called ‘Nikshay’ which can be accessed at http://nikshay.gov.in.

Speaking on the occasion Mr. Pritpal Marjara, Managing Director, PSI, India said “By June 2014, India will have 243 million internet users, second only to China. We must leverage the power of social media channels to raise awareness of TB notification and ensure a TB test, treatment and cure for all."

The social media campaign has two platforms – a facebook page and a microsite. The facebook page provides an opportunity for allopathic doctors to sign a pledge supporting TB Notification and to ‘like’ and share the page with professional friends and colleagues. The microsite provides in-depth information about TB in India and an opportunity for doctors to easily register their details, so that the District TB Officials can contact them and register them on Nikshay.

PSI is confident that this initiative will play a big role in realizing CTD’s vision of zero deaths from TB and will provide each and every TB patient with to access free tests, free medicines and good quality care,to ensure a complete cure. Do visit the microsite on www.tbnotification.in and the facebook page – tb pledge.

For more information, please contact:
Niketan Dave – 9811582428
niketandave@gmail.com

Cancer Awareness Cup

        Inviting women's football teams from Mumbai to participate in the Riso Cancer Awareness Cup 2014. Riso Cancer Awareness Cup is an initiative to spread awareness about breast cancer, its causes and prevention. The maiden year of Riso Cancer Awareness Cup  will see participation of 32 women’s football teams from across Mumbai. The tournament will be held on the occasion of World Cancer Day on 4th February 2014 at MSSA grounds, Azad Maidan, Mumbai.  The tournament will be followed by a silent march from Azad Maidan to Gateway of India to spread awareness on breast cancer.

    Entry is free and strictly based on first come first serve basis. So ladies, come forward and be a part of this initiative to fight against breast cancer.

For registrations of your team and further information, kindly send a mail to:

info@cancerawarenesscup.in OR Call Vinay Maurya:+9197733 98007