Ovarian Cancer Treatment in India | Best Cancer Hospitals for Most Advanced Ovarian Cancer Treatment in India

Ovarian cancer is a type of cancer that begins in the ovaries. Women have two ovaries, one on each side of the uterus. The ovaries - each about the size of an almond - produce eggs (ova) as well as the hormones estrogen, progesterone. Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. Ovarian cancer is a type of cancer that begins in the ovaries. Women have two ovaries, one on each side of the uterus. The ovaries — each about the size of an almond — produce eggs (ova) as well as the hormones estrogen, progesterone and testosterone. Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. At this late stage, ovarian cancer is difficult to treat and is often fatal.

Symptoms of ovarian cancer are not specific to the disease, and they often mimic those of many other more-common conditions, including digestive and bladder problems. When ovarian cancer symptoms are present, they tend to be persistent and worsen with time.

Symptoms of Ovarian Cancer

There are no specific symptoms of the ovarian cancer. They are very similar to other diseases like digestive or bladder problems. However, they worsen with time.

It is very important that an early diagnosis of Ovarian Cancer is made for complete treatment of the patient and better quality of life.

Few of the symptoms of Ovarian Cancer may include:

• Abdominal pressure, fullness, swelling or bloating
• Pelvic discomfort or pain
• Persistent indigestion, gas or nausea
• Changes in bowel habits, such as constipation
• Changes in bladder habits, including a frequent need to urinate
• Loss of appetite or quickly feeling full
• Increased abdominal girth or clothes fitting tighter around your waist
• A persistent lack of energy
• Low back pain

What are various Stages of Ovarian Cancer?

There are four stages of ovarian cancer. Your doctor will determine your stage of ovarian cancer. Ovarian cancer is treated differently depending on which stage you are diagnosed with.

Stage I

The cancer is completely contained within the ovary or ovaries:

•  Stage IA- One ovary involved

•  Stage IB- Both ovaries involved

•  Stage IC- One or both ovaries involved, but with cancer on the surface of an ovary, rupture of an ovarian cyst malignant ascites or positive abdominal washings.

Stage II

The cancer is in one or both of the ovaries and has spread to additional organs located in the pelvis such as the bladder, colon, rectum or uterus.

• Stage IIA - Spread to uterus or fallopian tubes

• Stage IIB - Spread to pelvic peritoneum

• Stage IIC - Confined to the pelvis, but with malignant ascites or positive abdominal washings

Stage III

The cancer is in one or both ovaries and has spread to one or both of the following: the lining of the abdomen or the lymph nodes.

• Stage IIIA - Microscopic spread to the upper abdomen

• Stage IIIB - Cancer nodules less than 2 cm in the abdomen

• Stage IIIC - Nodules more than 2 cm, or positive pelvic or aortic lymph nodes

Stage IV

The most advanced stage of cancer. The cancer has spread from one or both ovaries to additional organs such as the liver or lungs, or there may be cancer cells in the fluid surrounding the lungs.

Diagnosis of Ovarian Cancer

A pelvic exam is performed for examining rectum, vagina and lower abdomen for growths or masses. If the growths are visible on ovaries then certain other tests are also performed for producing detailed images of the ovaries. Some of the tests include –

• Exploratory Surgery : This surgery is performed for confirming the diagnosis of ovarian cancer.

• Ultrasound : High-frequency sound waves are produced in order to get precise images of the structures inside the body.

• Blood Tests: CA 125 blood test is performed for those women who are suspected of having ovarian cancer or previously had ovarian cancer. This blood test helps in detecting a protein antigen that can be found at abnormally high levels in the blood serum of those women who have ovarian cancer.

• Positron Emission Tomographic Scan (PET) : This test helps in defining those areas that altered blood supply and also helps in identifying cancer.

• Upper G.I. and Lower G.I. Scopy: It helps in ruling out the primary cancer present in G.I. tract.

• CT scan: This helps in generating two dimensional images of the body that may show whether the cancer has spread.

• Mammography: Metastatic tumors can be ruled out with this test.

• Magnetic Resonance Imaging (MRI): Magnetic energy is used for generating highly detailed images of the anatomy such as tumors.

Most Advanced Ovarian Cancer Treatment in India

Surgery

Three types of surgeries are involved in treating ovarian cancer such as:

• Laparoscopy : Gynaeoncologist perform laparotomy through a large abdominal incision, most often removing your ovaries, uterus, fallopian tubes, nearby lymph glands, a fold of fatty tissue called the omentum and as much of the tumor as possible.

• Frozen Section Tissue Analysis : The rapid analysis of the tissue is done under a microscope. The nature of the tumor is determined as whether it is cancerous or non-cancerous that also helps surgeons to perform a suitable procedure during the first surgery.

• Laparotomy : This procedure is used by making a large abdominal incision. This incision is done for removing uterus, ovaries, Fallopian tubes surrounding lymph glands, omentum (a fold of fatty tissue) and tumor. Cytoreductive or debulking surgery is another name for this surgery.

Chemotherapy

After surgery, you'll most likely be treated with chemotherapy - drugs designed to kill any remaining cancer cells. Chemotherapy may also be used as the initial treatment in some women with advanced ovarian cancer. Chemotherapy drugs can be administered in a vein (intravenously) or injected directly into the abdominal cavity, or both methods of administering the drugs can be used. Chemotherapy drugs can be given alone or in combination.

Radiation therapy

Radiation therapy uses high-energy beams to kill cancer cells. The use of radiation therapy to treat ovarian cancer has declined in recent years, but Gyneconcologist use it in certain cases, such as when patient have a recurrence of cancer at the original site or if she can't tolerate chemotherapy. Gyneconcologist may use whole abdominal radiation to treat ovarian cancer that remains or recurs in the abdomen.

Latest and Advanced Minimally Invasive Surgery for Ovarian Cancer in India

Indian Hospitals gives women with ovarian cancer access to the latest in cancer treatment. For example, Indian surgeons use fertility-sparing surgery, minimally and robotic surgery in select cases, when app minimally invasive surgery — also called laparoscopic surgery — for several conditions. In minimally invasive procedures, your doctor makes one or more incisions, each about a half-inch long, to insert a tube. The number of incisions depends on the type of surgery. The tube or tubes let the doctor slip in tiny video cameras and specially designed surgical instruments to perform the procedure.

When you have minimally invasive surgery, you're likely to lose less blood and have less postoperative pain, fewer and smaller scars, and a faster recovery than you would after open surgery. Depending on your condition, you may need only a short hospital stay. For some conditions, your doctor may recommend robotic surgery. That technology gives your doctor great precision, flexibility and control by providing a magnified, 3-D view of the surgical site.

Gallbladder Cancer Treatment at Top Cancer Hospitals in India

Gallbladder cancer is very uncommon. Women are more likely to have gall bladder cancer than men. The risk increases with increasing age. It is more common in patients who have stones in the gall bladder, the risk being about 1%. Other diseases of the gall bladder, such as, porcelain (calcified) gallbladder, choledochal (bile duct) cyst and chronic gallbladder infection also increase the risk of gall bladder cancer.

It's not clear what causes gallbladder cancer. Most gallbladder cancer begins in the cells that line the inner surface of the gallbladder and is called as adenocarcinoma. Gall bladder cancer tends to spread to nearby organs and tissues such as the liver, bile ducts or small intestine. It also spreads to lymph nodes in the region of the liver. Ultimately, distant organs and lymph nodes can become involved.

What are the signs and symptoms of gall bladder cancer?

Gallbladder cancer is difficult to diagnose because it often causes no signs or symptoms. When present, the symptoms may be non-specific and similar to many other chronic diseases. The relatively hidden nature of the gallbladder probably makes it easier for gallbladder cancer to grow without being detected.

Jaundice (yellowing of the skin and whites of the eyes), itching, bloating, abdominal pain, weight loss, decreasing appetite, fever, nausea & vomiting or an enlarging abdominal mass are all signs that may be attributable to gall bladder cancer. Frequently, jaundice is a late development and the other symptoms have been present for a long time. Sometimes, it is detected incidentally on the biopsy after cholecystectomy (gallbladder removal operation) for gallstone disease. When diagnosed in this situation, it is generally at a very early stage and the chance for cure is very good.

Stages of Gallbladder Cancer

The following stages are used for gallbladder cancer :

•  Stage 0 (carcinoma in Situ) : Abnormal cells are found in the inner (mucosal) layer of the gallbladder; these abnormal cells may become cancer and spread into nearby normal tissue

•  Stage I : Cancer has formed and has spread beyond the inner (mucosal) layer to a layer of tissue with blood vessels or to the muscle layer

•  Stage II : Cancer has spread beyond the muscle layer to the connective tissue around the muscle.

•  Stage IIIA : Cancer has spread through the thin layers of tissue that cover the gallbladder and/or to the liver and/or to one nearby organ (eg, stomach, small intestine, colon, pancreas, or bile ducts outside the liver)

•  Stage IIIB : Cancer has spread to nearby lymph nodes and [#Section_218] beyond the inner layer of the gallbladder to a layer of tissue with blood vessels or to the muscle layer; or beyond the muscle layer to the connective tissue around the muscle; or through the thin layers of tissue that cover the gallbladder and/or to the liver and/or to one nearby organ

•  Stage IVA : Cancer has spread to a main blood vessel of the liver or to 2 or more nearby organs or areas other than the liver. Cancer may have spread to nearby lymph nodes.

•  Stage IVB : Cancer has spread to either lymph nodes along large arteries in the abdomen and/or near the lower part of the backbone or to organs or areas far away from the gallbladder.

Diagnosis of Gallbladder Cancer

•  Physical Examination and History

•  Liver Function Tests

•  Carcinoembryonic Antigen (CEA) Assay

•  CT Scan (CAT Scan)

•  Ultrasound Exam

•  PTC (Percutaneous Transhepatic Cholangiography)

•  ERCP (Endoscopic Retrograde Cholangiopancreatography)

•  Biopsy

•  Laparoscopy

Treatment for Gall Bladder Cancer in India

Surgery, chemotherapy and radiotherapy are all used to treat gallbladder cancer. Many patients get a combination of treatments. For example, chemotherapy or radiotherapy can be used to shrink the tumour before surgery.

Your treatment will depend on the stage, grade and type of cancer cells you have. The stage looks at the size of your cancer and if it has spread from where it started. The grade of the cancer can tell if your cancer grows quickly or slowly. You can have a low, moderate or high grade cancer.

Surgery

Surgery offers the best chance of curing early-stage cancer that has not spread beyond the gallbladder. To determine if surgery is possible, surgical oncologist at DHRC may order images of the gallbladder, bile ducts and the liver. Surgeons will use a camera and miniature instruments inserted through tiny incisions in the abdomen (laparoscopic surgery) to see if the tumor has spread (metastasized). Surgery options include: .

•  Simple cholecystectomy

If the tumor is very small and has not spread to the deeper layers of gallbladder tissue, the surgeon may use this procedure, which removes only the gallbladder. Occasionally this procedure can be done using laparoscopic surgery.

•  Extended cholecystectomy. This is the most commonly performed surgery, involving removal of the gallbladder, the liver tissue next to it, and nearby lymph nodes.

•  Chemotherapy When the cancer has spread to other organs, medical oncologists may recommend chemotherapy.

•  Chemotherapy currently does not cure advanced gallbladder cancer, but sometimes slows the disease's progression.

Radiotherapy

Radiotherapy treats cancer by using high-energy x-rays that destroy the cancer cells while doing as little harm as possible to normal cells. It is occasionally used for cancer of the gall bladder. It can either be given externally from a radiotherapy machine or internally by placing radioactive material close to the tumour (brachytherapy).

Robotic Surgery for Gallbladder Cancer in India

Single-Site da Vinci Surgery gallbladder cancer hospitals indiais minimally invasive – performed through a single small incision using state-of-the-art technology. This procedure is performed using the da Vinci Surgical System. da Vinci is a state-of-the-art robotic surgical platform that translates your surgeon’s hand movements into smaller, more precise movements of instruments inside your body. da Vinci’s vision system provides your surgeon with 3D-HD visualization allowing for enhanced vision, precision, dexterity and control. During the entire procedure, your surgeon is 100% in control of the da Vinci System.

Head and Neck Cancer Treatment in India | Best Head and Neck Cancer Hospital in India

Most head and neck cancers begin in the cells that line the mucosal surfaces in the head and neck area, e.g., mouth, nose, and throat. Mucosal surfaces are moist tissues lining hollow organs and cavities of the body open to the environment. Normal mucosal cells look like scales (squamous) under the microscope, so head and neck cancers are often referred to assquamous cell carcinomas. Some head and neck cancers begin in other types of cells. For example, cancers that begin in glandular cells are called adenocarcinomas.

Types of Head and Neck Cancer

• Nasaopharyngeal Cancer :The nasopharynx is the airway passageway at the upper part of the nose at the back of the nose.

• Salivary Gland Cancer : Saliva produced by the salivary gland is the fluid that is released within the mouth in order to keep the mouth moist. Mouth helps in breaking down the food as it contains certain enzymes

• Hypopharyngeal and Laryngeal Cancer : A tube shaped organ located in the neck used for swallowing, breathing and talking is the larynx. The hypopharnx, also referred to as gullet, is the lower part of the throat surrounding the larynx.

• Oropharyngeal and Oral Cancer : Both tongue and the mouth is included in the oral cavity. The middle part of the throat is included in oropharynx.

• Paranasal Sinus and Nasal Cavity Cancer : The air-filled areas surrounding the nasal cavity is known as the paranasal sinuses. The space at the back of the nose from where air passes on the way to the throat is known as the nasal cavity.

Diagnosis of Head and Neck Cancer

If a person has symptoms and signs of head and neck cancer, the doctor will take a complete medical history, noting all symptoms and risk factors. In addition, the following tests may be used to diagnose head and neck cancer:

•  Physical exam. The doctor will feel your neck and check yourthyroid, larynx, and lymph nodes for abnormal lumps or swelling. To see your throat, the doctor may press down on your tongue.

•  Indirect laryngoscopy. The doctor looks down your throat using a small, long-handled mirror to check for abnormal areas and to see if your vocal cords move as they should. This test does not hurt. The doctor may spray a local anesthesia in your throat to keep you from gagging. This exam is done in the doctor's office.

•  Direct laryngoscopy. The doctor inserts a thin, lighted tube called a laryngoscope through your nose or mouth. As the tube goes down your throat, the doctor can look at areas that cannot be seen with a mirror. A local anesthetic eases discomfort and prevents gagging. You may also receive a mild sedative to help you relax. Sometimes the doctor uses general anesthesia to put a person to sleep. This exam may be done in a doctor's office, an outpatient clinic, or a hospital.

•  CT scan. An x-ray machine linked to a computer takes a series of detailed pictures of the neck area. You may receive an injection of a special dye so your larynx shows up clearly in the pictures. From the CT scan, the doctor may see tumors in your larynx or elsewhere in your neck.

Treatment of Head and Neck Cancer at World Top Hospitals in India

Each and every Head and Neck cancer patient is evaluated by a special team of surgical oncologists (Head & Neck unit), medical oncologists, Radiation Oncologists, Onco-pathologists and Imaging Specialists. Depending on the age, general condition, type of pathology and stage of the disease

Treatment Available for Head and Neck Cancers

• Surgery

• Radiation

• Chemotherapyp

• Rehabilitation

The treatment plan for an individual patient depends on a number of factors, including the exact location of the tumor, the stage of the cancer, and the person's age and general health. The patient and the surgical oncologist should consider treatment options carefully. They should discuss each type of treatment and how it might change the way the patient looks, talks, eats, or breathes.

Surgery

Surgery is one of the main treatments for mouth, head and neck cancers. The aim of surgery is to remove the cancer cells. If the cancer is found early, surgery can often cure it. Depending on where the tumour is found, your surgeon may need to remove skin, muscle or bone along with your cancer. This can be replaced by skin or muscle or prosthesis. Surgery may also affect how you eat or drink or how you look. A plastic surgeon might also work with your surgeon to reconstruct the affected area to give you the best possible function and appearance. This is called reconstructive surgery.

Radiotherapy

Radiotherapy is the use of high-energy rays to kill or shrink the cancer cells. Radiotherapy can be used alone or with other treatments like surgery or chemotherapy. If given after surgery, it can destroy any cancer cells left behind. There are two main ways to give radiotherapy: external beam radiation and internal radiation.

External beam radiation aims high-energy X-rays at a cancer to cure or control it. These X-rays come from a machine called a linear accelerator. The treatment does not hurt but you must lie very still during it. For most mouth, head and neck cancers, a ‘mask’ is needed. These masks are moulded from plastic to the shape of your face and make sure your head keeps still during treatment.

Internal radiotherapy involves giving radiotherapy from within your body. Usually an implant containing a source of radiation is put directly into the tumour and left in place for several days. It will release radiation and kill the cancer cells. Internal radiotherapy is also known as brachytherapy. The implant is usually put in under general anaesthetic.

Chemotherapy

Chemotherapy is the use of drugs to cure or control cancer. Chemotherapy drugs can be given on their own or with each other. Chemotherapy can also be given before or after radiotherapy and surgery. The drugs are either injected into the bloodstream or given in tablet form. Your doctor will decide the type and dose of your chemotherapy based on the size and location of the tumour, if it has spread, and your general health. Some drugs used for mouth, head and neck cancer are carboplatin and Taxol. See the booklet Understanding Chemotherapy, which you can download from our "Important cancer information booklets" list on the right hand side of this page, for more information about chemotherapy.

Biological therapies

Biological therapies are drugs that block the growth of cancer cells by interfering with molecules needed for the cancer to grow. Unlike chemotherapy, biological therapy can tell the difference between cancer cells and normal cells. Biological therapy can be given on its own or with chemotherapy drugs.

Most Advanced Treatment for Head and Neck Cancer in India

Minimally invasive surgical techniques are used when possible to remove tumors that are located near structures involved in sensory and physical functioning. In many cases, patients can recover more quickly when treated with minimally invasive surgery compared with traditional, open surgery.

• Endoscopic Laser Surgery :This technique may be used to remove tumors in the larynx or pharynx (throat) while preserving the structures involved in speech and swallowing. The surgeon inserts a thin, lighted tube called an endoscope through the patient's mouth and into the throat. Surgeons remove the tumor using a special laser that is attached to the endoscope. Endoscopic laser surgery is often performed on an outpatient basis with a safe, fast-acting anesthetic that wears off quickly after the procedure.

• Minimally Invasive Video-Assisted Thyroidectomy (MIVAT): A tiny video camera that is attached to an endoscope is used to remove thyroid tumors through a small incision.

• Robotic Surgery : Tumors of the tongue and tonsils can be removed with the aid of small robotic arms that are placed in the mouth, avoiding the need to make a large incision or to split the jawbone.

What is Radiofrequency Ablation?

Radiofrequency ablation (RFA) is a new technique used to treat benign and malignant liver tumors, often without the long incisions traditionally used in liver tumor ablation. In the past, destruction of liver tumors could only be accomplished by freezing (cryoablation) or injection with toxic chemicals. RFA combines the advantages of improved technology and minimally invasive surgery to give patients another option for treatment of liver tumors.

It is the preferred treatment when diseased tissue is small or cannot be surgically removed. It can be most frequently performed by our radiologists under ultrasound guidance using a probe passed through the skin and into the liver tumor. Sedation is required during the ablation procedure and patients return home typically the same day. This procedure has a high chance of cure for tumors less than about 1 inch in diameter and can be repeated if necessary.

How Does RFA Work?

Using intraoperative imaging of the tumor with ultrasound, an electrode is positioned strategically within the lesion. Then, the electrode is connected to a unique radiofrequency generator and electrical current is delivered into the tissue. As the cells are heated, they are destroyed. The mechanism of RFA is similar to that of a microwave oven, heating from the inside out. The body eliminates the destroyed tumor cells over a period of time.

How is RFA Performed?

Radiofrequency ablation can be performed using many different approaches, but usually requires surgery and general anesthesia to be done safely. In most cases laparoscopic surgery is used, employing small incisions with a camera placed inside the abdomen to guide the ablation procedure.

Typically three or four small incisions are made. Ports are then inserted into these incisions, which enable the surgeon to easily guide the radiofrequency and ultrasound probes into the liver (see illustration on reverse). The location of each incision depends upon the location of the tumor within the liver. In rare situations, the tumor may be too large for the laparoscopic approach, or may be located in an area that is not safe for laparoscopic surgery. In these cases, a traditional open incision will be used.

During surgery, a small ultrasound probe is also placed into the abdomen to accurately locate the tumor and guide the RFA probe into the center of the tumor. Patients typically spend four hours in surgery.

What are the Advantages of RFA?

Radiofrequency ablation has many advantages over other ablation techniques, including:

• More effective tumor destruction

• Fewer complications

• Can be performed laparoscopically in most patients

• Usually requires only one treatment session

• Allows for faster recovery

On average, patients who undergo RFA spend two or three days in the hospital following surgery. While RFA can be repeated, this is rarely necessary.

What are the Risks of RFA?

Radiofrequency ablation is very safe, although it usually requires laparoscopic surgery. Therefore, the risks can include bleeding and the development of infections, and a small chance that your liver disease may become worse following ablation. There is also an exceedingly small chance (1 in 200) that the tumor may spread outside the liver during the operation. The majority of patients do not experience any complications following RFA.

Is RFA a Good Choice for Me?

Radiofrequency ablation is not for everyone. If you have severe portal hypertension, a very large tumor or your tumor has spread outside of the liver, the risk of undergoing RFA may outweigh the potential benefit. Only your doctors can determine if RFA is right for you.

Outcome

The outcome of this procedure is very encouraging especially for persons with large tumor who are not in a position to withstand the stresses of conventional surgery. Single ablation requires around 10-30 minutes and in case of multiple ablations the procedure takes 1-3 hours. The patient is kept in the recovery room till the effect of sedation wears away. He is then permitted to go home. Very few patients experience any pain at the site of needle entry. This pain goes away in a week’s time and the person is then able to resume his daily activities.