Best Stomach Cancer Hospital in India - Stomach Cancer Treatment and Surgery

Stomach Cancer Treatment 

Stomach cancer

Stomach cancer is sometimes called gastric cancer. Worldwide it is one of the most common cancers. Stomach cancer is more common in men than in women and ten/ds to occur mainly in older people. Most people who develop stomach cancer are over the age of 55.

In most cases, stomach cancer begins from a cell which is on the inside lining of the stomach (the mucosa). This type of stomach cancer is called adenocarcinoma of the stomach. As the cancer cells multiply :

• The tumour may invade deeper into the wall of the stomach. In time, it may pass through the wall of the stomach and invade nearby organs such as the pancreas or liver.
• The tumour may spread up or down the stomach into the oesophagus (gullet) or small intestine.
• Some cells may break off into the lymph channels or bloodstream. The cancer may then spread to nearby lymph nodes or spread to other areas of the body (metastasise).

Types of Stomach Cancer

• Adenocarcinoma : is the most common type of stomach cancer. More than 95 out of every 100 stomach cancers (95%) diagnosed are adenocarcinomas. The cancer starts in the gland cells in the stomach lining. The gland cells produce mucus and stomach juices.
• Squamous : cells are the skin like cells that lie between gland cells to make the stomach lining. These cancers are treated in the same way as adenocarcinomas.
• Lymphoma : is another type of cancer altogether. It is very rare. There is a whole section on non Hodgkin's lymphoma, which will be more relevant to you if you have been diagnosed with lymphoma of the stomach.
• Gastrointestinal Stromal Tumour GISTs : can be cancerous or non cancerous (benign). These rare tumours develop from the cells of the connective tissue that support the organs of the digestive (gastrointestinal) tract. Most are found in the stomach.
• Neuroendocrine tumours (NETs) : can be cancerous or non cancerous. They grow in hormone producing tissues, usually in the digestive system. They are rare, but the most common is carcinoid tumour.

Diagnosis of Stomach Cancer

If you have symptoms that suggest stomach cancer, your doctor will check to see whether they are due to cancer or to some other cause. Your doctor may refer you to a gastroenterologist, a doctor whose specialty is diagnosing and treating digestive problems. Your doctor will ask about your personal and family health history. You may have blood or other lab tests. You also may have :

• Physical exam : oncologist feels the abdomen of the patient for fluid, swelling, or other changes. They also will check for swollen lymph nodes.
• Endoscopy : Surgical Oncologist uses a thin, lighted tube (endoscope) to look into the stomach after numbing the throat with an anesthetic spray. Patient may be given medicine to help him relax. The tube is passed through the mouth and esophagus (food pipe) to the stomach.
• Biopsy : An endoscope has a tool for removing tissues. Surgical Oncologist uses the endoscope to remove tissue from the stomach. A pathologist checks the tissue under a microscope for cancer cells. A biopsy is the only sure way to know if cancer cells are present.

Stages of Stomach Cancer

• Stage 0 (Carcinoma in situ): In this stage, cancer is present in the inner lining of the mucosal layer of the wall of the stomach.
• Stage I : This stage is categorized into two stages- IA and IB that also depends on the spread of the cancer.
  • Stage IA : Here in this stage, the cancer has spread completely from the mucosal layer of the wall of the stomach.
  • Stage IB : Cancer has spread to the muscularis layer of the stomach wall or has completely spread from the mucosal layer of the stomach wall that can be found in almost 6 lymph nodes surrounding the tumor.
• Stage II : In this stage, the cancer has spread –
  • To the serosal layer of the wall of the stomach but not to other organs or to lymph nodes
  • To the middle layer of the stomach wall and can be found in almost 6 lymph nodes surrounding the tumor, or
  • From the innermost layer of the wall of the stomach and can be found in 7-15 lymph nodes surrounding the tumor
• Stage III : This stage is categorized into IIIA and IIIB that depend on the spread of the cancer. In stage IIIA, cancer has spread to –
  • Organs just next to the stomach that has not spread to other body parts or to lymph nodes
  • The middle layer of the wall of the stomach and can be found in 7-15 lymph nodes surrounding the tumor, or
  • The outermost layer (serosal) of the wall of the stomach and can be found in 1-6lymph nodes surrounding the tumor
• Stage IV : Here in this stage, the cancer has spread to –
  • Different body parts
  • Organs just next to the stomach and to at least 1 lymph node, or
  • More than 15 lymph nodes

Most Advanced Stomach Cancer Surgery and Treatment in India

Surgery

The goal of surgery is to remove all of the stomach cancer and a margin of healthy tissue, when possible. Options include :

• Removing a Portion of the Stomach (Subtotal Gastrectomy). During subtotal Gastrectomy, the surgeon removes only the portion of the stomach affected by cancer. Subtotal gastrectomy can be of two types :
  • Distal subtotal gastrectomy is performed if the tumor cells are present in the lower part of the stomach near to the stomach duodenum junction.
  • Proximal subtotal gastrectomy is done when the tumor is situated in the upper part of the stomach and also involves the esophagus.
• Removing the Entire Stomach (Total Gastrectomy). Total Gastrectomy involves removing the entire stomach and some surrounding tissue. The esophagus is then connected directly to the small intestine to allow food to move through your digestive system.
• Removing Lymph nodes to look for Cancer. The surgeon examines and removes lymph nodes in your abdomen to look for cancer cells.

Chemotherapy

Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. Chemotherapy drugs travel throughout your body, killing cancer cells that may have spread beyond the stomach. Chemotherapy can be given before surgery (neoadjuvant chemotherapy) to help shrink a tumor so it can be more easily removed. Chemotherapy is also used after surgery (adjuvant chemotherapy) to kill any cancer cells that might remain in the body.

Radiation therapy

Radiation therapy may be used to kill the cancer cells. Radiation therapy can be administered using a machine outside the body (external radiation therapy) or using needles, seeds, wires, or catheters placed in the body in or near the cancer (internal radiation therapy). External radiation therapy uses a machine outside of the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.

World’s Most Advanced Cyber Knife Radio surgery in India

Cyberknife Radiation Therapy

Cyberknife is the world's first and only robotic radiosurgery system which treats tumours anywhere in the body without any surgery. Though it is called Radiosurgery or Cyberknife- No knife is used for incision and no surgery is performed to treat the tumours. A new hope for patients who have inoperable or surgically complex tumors, or who may be looking for a non-surgical option.Cyberknife radiosurgery is a non –invasive, high-energy radiation treatment that delivers very precise beams of radiation from many angles outside the body. The accuracy of Cyberknife is so precise that radiation can be 'matched' to the shape of small complex tumors, even those located near critical organs. This ability allows Cyberknife to treat many lesions including some considered inoperable or untreatable with surgery.

The CyberKnife Robotic Radiosurgery System treats both cancerous and non-cancerous tumors anywhere in the body, including the prostate, lung, brain, spine, liver, pancreas and kidney.It provides a pain-free, non-surgical treatment to the patients with complex tumours which are un operable or too risky to be operated and to the patients who are looking for an alternative to surgery.

Common Conditions Treatable By CyberKnife Radiosurgery

• Astrocytoma, Glioma, Glioblastoma Multiforme, Oligodendroglioma : - CyberKnife offers superior conformance to tumour shape, which is important especially for recurrence after surgery and conventional radiotherapy. CyberKnife can also irradiate the tumour bed to delay or prevent recurrence.
• Brain metastases : - Radiosurgery may be equal to surgery for single metastases and better for multiple metastases. Advanced imaging allows CyberKnife® to treat those that are widely dispersed.
• Spinal Tumours : - CyberKnife® is regularly used to treat spinal metastases. It may also serve as a treatment for many primary spinal tumours.
• Pituitary Adenoma : - CyberKnife's® staged treatments may help to avoid or minimize the risk of visual loss and other side effects associated with single-session radiosurgery. Its superior conformance minimizes irradiation of normal tissue, including the optic chiasm and hypothalamus.
• Hemangioblastoma : - CyberKnife® non-invasively treats the tumour nodule, usually in one session, even in hard-to-reach areas. This is especially beneficial for Von Hippel Lindau disease patients who can become disabled by multiple surgeries.
• Skull Base Tumours : - The proximity of these tumours to vital nerve and vascular structures makes them surgically problematic.
• Meningioma :- For smaller meningiomas, radiosurgery is an ideally non-invasive therapy. CyberKnife® is especially safe for meningiomas adjacent to critical structures because it can be delivered in fractions.
• Neurofibroma & Schwannoma : - While these tumours' resistance to radiation makes conventional radiotherapy an option only when surgery is not, CyberKnife's® conformance makes it an effective alternative to radiation therapy and surgery for selected patients.
• Acoustic Neuroma : - Studies show that CyberKnife® treatment in stages offers the highest rates ever achieved for hearing and facial-nerve preservation besides effective control of the tumour-growth.
• Intracranial AVMs : - With CyberKnife®, we can treat locations that can't be safely approached with microsurgery or endovascular therapy. Selected AVMs have an 80% chance of disappearing after a single treatment session though it may take some time. CyberKnife® can also be used in conjunction with other therapies to remove remnants.
• Spinal AVMs : - CyberKnife® is the first and the only system to offer radiosurgical treatment of spinal AVMs .It provides the same or even more accuracy and success as for intracranial AVMs

How is Cyberknife different from Radiosurgery Systems?

The Cyberknife Robotic Radiosurgery System is a dedicated radiosurgery device in the world. Radiosurgery with Cyberknife system is not restricted for treating tumors in the neck and head.

• Non-Invasive : This procedure does not need any invasive body or head frames.
• Accurate : The minimal harm is caused to the nearby healthy tissues. High-doses of radiation are delivered with sub-millimeter accuracy.
• Beneficial : This system offers non-invasive and pain-free alternative for many patients especially for those who are diagnosed with surgically complex tumors, inoperable tumors or who are searching for an alternative to surgery.
• Robotic : This system repeatedly detects the tumor or tracks the position of the tumor, the movement of a patient and it also corrects the delivery of the treatment.
• Flexible : The traditional radiation systems just cannot offer versatility and maneuverability that the Cyberknife system offers.

Benefits of Cyberknife Radiosurgery System

Patients across the world have been successfully treated with the CyberKnife System.

• Pain free
• Non-invasive
• No anesthesia required
• Outpatient procedure
• No recovery time
• Immediate return to normal activity
• No invasive head or body frame
• No breath holding during treatment

Brain Tumour Treatment at Best Cancer Hospital India

What is Brain Tumor?

A Brain Tumor is an abnormal growth of cells within the brain, which can be cancerous or non-cancerous (benign).

Causes:

• Radiation to the head

• An inherited (genetic) risk

• HIV infection

• Cigarette smoking

• Environmental toxins (for example, chemicals used in oil refineries, embalming chemicals, rubber industry chemicals

• Low blood pressure and Eye problems

• Obesity

• Sensitivity to heat or cold

• Changes in the person’s mental function

• Headaches, Seizures, Clumsiness and Dizzines

• Weakness in one part of the body

• Change in alertness (including sleepiness, unconsciousness, and coma)

• Changes in hearing, taste or smell and ability to feel pain, pressure, different temperatures, or other stimuli

• Confusion or Memory loss

• Difficulty swallowing, writing or reading

• Lack of control over the bladder or bowels

• Loss of balance, coordination

• Numbness or tingling on one side of the body

• Personality, mood, behavior, or emotional changes

• Trouble speaking or understanding others who are speaking and walking

• Abnormal nipple discharge

• Absent menstruation (periods)

• Enlarged hands and feet, Excessive body hair and Facial changes

• Family history of brain tumors

• Exposure to Radiation

• Chemical exposure on the job

• Your race

• Your age

How is Brain Tumours Diagnosed?

• A Neurological Exam: A physician will assess the person’s symptoms by asking about the patient’s personal and family health history. This information combined with the neurological exam provides clues about whether a person might have brain tumours.

• Brain scans: To show abnormalities like a brain tumours, a contrast dye is often used. The dye is injected into a vein in the arm. A brain tumour generally soaks up more dye than normal brain tissue and shows up clearly on the scan in brain cancer treatment.

• CT Scans: CT scans are a type of X-ray that creates a three-dimensional picture of the head by scanning the head from multiple different angles. A computer combines these images into a detailed, cross-sectional view that shows abnormalities in the brain, or tumours.

• MRI Scans: The Best type of imaging to diagnose most types of brain tumours is MRI. These scans use magnetic fields and radio waves, rather than X-rays, and computers to create detailed pictures of the brain.

• PET Scans: A PET scan detects changes in cells as they grow. A small amount of radioactive glucose is injected. Depending on the grade on the tumour, tumour cells absorb a characteristic amount of the radioactive glucose in comparison to normal parts of the brain.

• Biopsy: A Biopsy is a surgical procedure to remove a small sample of the tumour for examination under a microscope. Most of the time, the biopsy is done during surgery to remove the brain tumor (called an open biopsy).

BEST BRAIN CANCER TREATMENT IN INDIA

Surgery:  In brain cancer treatment Surgery is often the first treatment if the tumour can be removed without causing harm to the surrounding brain tissue. Treatment of brain cancer is usually complex. Most treatment plans involve several consulting doctors. The team of doctors includes neurosurgeons (surgical specialists in the brain and nervous system), oncologists, radiation oncologists (doctors who practice radiation therapy), and of course, your primary health-care provider. A patient’s team may include a dietitian, a social worker, a physical therapist, and probably other specialists.

Chemotherapy: Chemotherapy is not used to treat all brain tumours. It may be used for people with high-grade primary brain tumours, either as an initial treatment alongside radiotherapy, or where the tumour has come back. In this situation, chemotherapy is unlikely to be able to cure a brain tumour, but it can sometimes shrink a tumour down or slow its growth, which can reduce symptoms.

Radiation therapy: Radiation therapy (also called radiotherapy) is the use of high-energy rays to kills tumour cells, thereby stopping them from growing and multiplying. Radiation therapy may be used for people who cannot undergo surgery. In other cases, it is used after surgery to kill any tumour calls that may remain. Radiation therapy is a local therapy. This means that it affects only cells in its path. It does not harm cells elsewhere in the body or even elsewhere in brain cancer treatment.

Advanced Brain Tumor Surgery in India - MRI Guided Brain Tumor Surgery

 Brain Tumor Surgery in India

A brain tumor is a group (mass) of abnormal cells that start in the brain. Primary brain tumors can arise from the brain cells, the membranes around the brain, nerves, or glands.

Tumors can directly destroy brain cells. They can also damage cells by producing inflammation, placing pressure on other parts of the brain, and increasing pressure within the skull. The cause of primary brain tumors is unknown. There are many possible risk factors that could play a role.

Advanced imaging technique now developed to enable Neurosurgeons with intra-operative MRI to aid in the removal of complex and hard-to-access brain tumors during surgery. This new technique relies on a powerful computer system, which assists the surgeon in precisely localizing a lesion, in planning each step of the procedure on the computer screen, and in calculating the ideal access to the tumour before the operation.

This is particularly useful in reaching a tumour located deep inside the brain, areas traditionally considered to be difficult to reach. During the procedure, the computer tracks instrument movement with an extremely high precision, providing the surgeon with total control inside the brain at all times using "real-time" imaging. The surgeon can also check if the tumor has been removed as planned. This improves the outlook for the patient.

“BRAIN SUITE” in India – Amongst very few such facilities worldwide

It is the most advanced Neuro-Surgical Operating Room with high field MR. This system permits the neurosurgeon to have an MRI study on the patient during surgery, and if tumor has remained which was hidden to the human eye, can be detected by special MRI sequences, and can be targeted using neuro navigation (which works on the same principle as the GPS system).

The Brain Suite has two main parts. There is a high-intensity MRI scanner integrated with an image-guided surgical system. The MRI scanner has a wide-bore opening allowing a patient to lie on his or her side. Previously, tumors that could only be accessed from the side of the skull were not easy to scan. This special MRI system lets doctors repeat scans during the operation to get more accurate information on the location, shape and size of the tumor. This minimizes problems associated with brain tumors shifting during excision.

Advantages of Next Generation Technology over Conventional Neurosurgery to Remove Brain Tumor:-

• The surgeon is guided during the surgery by live Advanced New Generation computer assisted MRI and thus knows exactly where tumor ends and normal brain begins.
• Enhanced ability of Neurosurgeon to excise the complete tumor. Less risk of post operative complications. Functional image guidance with MRI allows for accurate, non-invasive preoperative assessment and planning for brain tumor surgery.
• MRI guided Brain Tumor Surgery allows a more complete tumor removal with much less risk to surrounding brain tissue.
• "Inoperable" tumors (inoperable by conventional surgical techniques) can be resected with MRI Guided Brain Tumor Surgery. Frequently, these are deep seated-relatively benign tumors in children and young adults or elderly patients. Many of these tumors can be cured with this most advanced technology.

Nonsurgical Liver Cancer Treatment in India | Best Cancer Hospital India

Nonsurgical Treatment for Liver Cancer

Liver cancer or Hepatocellular carcinoma (HCC) is one of the commonest cancers in the world which have a high incidence of Hepatitis B infection. Apart from Hepatitis B, it may be caused by other diseases that lead to cirrhosis of the liver such as Hepatitis C infection, and alcohol abuse.

Unfortunately, like many other cancers, liver cancer may go undetected until a late stage. It is often brought to attention by an ultrasound or CT scan done for pain in the upper abdomen or another unrelated symptom. Liver cancers are malignant tumors that grow on the surface or inside the liver. Typers of liver cancer are Hepatocellular Carcinoma , Cholangiocarcinoma  ,Hepatoblastoma .

Surgical removal of liver tumors offers the best chance for a cure. Unfortunately, liver tumors are often inoperable because the tumor may be too large, or has grown into major blood vessels or other vital structures. Sometimes, many small tumors are spread throughout the liver, making surgery too risky or impractical. Surgical removal is not possible for more than two-thirds of primary liver cancer patients and 90 percent of patients with secondary liver cancer.

Diagnosis of Liver Cancer

There are a number of tests that can help in the diagnosis of cancer, including blood tests, physical examination and a variety of imaging techniques including X-rays (e.g., chest X-rays and mammograms); computed tomography (CT); magnetic resonance (MR) and ultrasound. Usually, however, the final diagnosis cannot be made until a biopsy is performed. In a biopsy, a sample of tissue from the tumor or other abnormality is obtained and examined by a pathologist. By examining the biopsy sample, pathologists and other experts also can determine what kind of cancer is present and whether it is likely to be fast or slow growing. This information is important in deciding the best type of treatment.

Although there are no standard or routine screening tests for liver cancer, the following tests are being used or studied to screen for it

• Physical examination : Physical examination may show an enlarged, tender liver. Also, your skin and eyes may be checked for signs of jaundice.
• Blood tests :Physical examination may show an enlarged, tender liver. Also, your skin and eyes may be checked for signs of jaundice.
• Imaging Studies like Abdominal CT scan and Abdominal Ultrasound test
• Liver biopsy or Aspiration.
• Liver enzymes (liver function tests)

In order to check if the Liver Cancer has spread elsewhere in the body, the following tests are to be done:

• PET Scan
• Bone Scan- to check if the cancer has spread to the bones.
  
  
  

Liver Cancer Treatment at Best Hospitals in India

Tumors need a blood supply, which they actively generate, to feed themselves and grow. As vascular experts, interventional radiologists are uniquely skilled in using the vascular system to deliver targeted treatments via catheter throughout the body. In treating cancer patients, interventional radiologists can attack the cancer tumor from inside the body without medicating or affecting other parts of the body by using embolization and radiofrequency heat.

Embolization is a well-established interventional radiology technique that is used to treat trauma victims with massive bleeding, to control hemorrhage after childbirth, to decrease blood loss prior to surgery and to treat tumors. In treating cancer patients, interventional radiologists use embolization to cut off the blood supply to the tumor (embolization), deliver radiation to a tumor (radioembolization), or combine this technique with chemotherapy to deliver the cancer drug directly to the tumor (chemoembolization)

Chemoembolization

Chemoembolization is a minimally invasive treatment for liver cancer that can be used when there is too much tumor to treat with radiofrequency ablation (RFA), when the tumor is in a location that cannot be treated with RFA, or in combination with RFA or other treatments.

Chemoembolization delivers a high dose of cancer-killing drug (chemotherapy) directly to the organ while depriving the tumor of its blood supply by blocking, or embolizing, the arteries feeding the tumor. Using imaging for guidance, the interventional radiologist threads a tiny catheter up the femoral artery in the groin into the blood vessels supplying the liver tumor. The embolic agents keep the chemotherapy drug in the tumor by blocking the flow to other areas of the body. This allows for a higher dose of chemotherapy drug to be used, because less of the drug is able to circulate to the healthy cells in the body. Chemoembolization usually involves a hospital stay of two to four days. Patients typically have lower than normal energy levels for about a month afterwards.

Radiofrequency Ablation

For inoperable liver tumors, radiofrequency ablation (RFA) offers a nonsurgical, localized treatment that kills the tumor cells with heat, while sparing the healthy liver tissue. Thus, this treatment is much easier on the patient than systemic therapy. Radiofrequency energy can be given without affecting the patient's overall health and most people can resume their usual activities in a few days.

In this procedure, the interventional radiologist guides a small needle through the skin into the tumor. From the tip of the needle, radiofrequency energy (similar to microwaves) is transmitted to the tip of the needle, where it produces heat in the tissues. The dead tumor tissue shrinks and slowly forms a scar. The FDA has approved RFA for the treatment of liver tumors.

Targeted Therapy

Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to normal cells. Recent studies show that not all tumors have the same targets. To find the most effective treatment, your doctor may run tests to identify the genes, proteins, and other factors in your tumor.

BENEFITS OF NONSURGICAL TREATMENT FOR LIVER CANCER

• Is most effective when all the cancer is localized in the liver
• Can be used to treat primary liver cancer and tumors that have metastasized (spread) from other areas in the body to the liver
• Usually does not require general anesthesia
• Is well tolerated-most patients can resume their normal routine the next day and may feel tired for a few days
• Can be repeated if necessary
• May be combined with other treatment options
• Can relieve pain and suffering for many cancer patients