Treatment Facilities of Cancer Institutes (Cancer Care) at Indraprastha Apollo Hospitals Delhi, India

Image Guided Radiotherapy (IGRT): 

Radiation administered after imaging the patient on the treatment couch. This ensures accurate treatment, addresses motion and positioning of patients on the treatment couch and of tumors / organs that move e.g. prostate, which may move consequent to the filling of the bladder or rectum that lie adjacent to it. In addition, it also provides information to the radiation oncologist regarding changes required in treatment parameters to account for the weight changes or response to treatment.

Frameless Stereotactic Radiosurgery (SRS): 

Sharply focused radiation beams, and sophisticated planning on the Brainlab iPlan system, backed by the very accurate Exactrac system, to ablate intracranial targets, both malignant (i.e. recurrent gliomas, metastases) and benign tumors. The latter include Arterio-Venous malformations, meningiomas and acoustic neurinomas. In addition (functional radiosurgery), for (trigeminal neuralgias) can also be performed. This painless, knife-less surgery is the preferred treatment modality for many brain lesions 

Stereotactic Body Radiotherapy (SBRT): 

The principles of radiosurgery applied outside the brain, high doseradiationis administered in a sharply focused manner to destroy cancerous lesions. This treatment is specifically lesions and for patients with early lung cancer, suitable for surgery but unable to undergo the same because of medical reasons. 

Intensity Modulated Radiotherapy (IMRT): 

Application of computerized algorithms to create a radiation treatment that targets the tumor and spares the normal tissue from radiation, this treatment is the standard of care in many disease sites. It is applied in brain tumors to spare the visual pathway, the brain stem and the hippocampus which is the seat of memory, in head neck tumors to spare the salivary apparatus and the structures involved in swallowing. Similarly in chest, abdominal and pelvic tumors to, this technique is used to reduce dose to normal organs that lie adjacent to the tumor. 

3D Conformal Radiotherapy: 

This forms basis of mod-ern radiotherapy techniques outlined above, the essence of this treatment method is the creation of a virtual model of each individual patient in a treatment planning computer and then creating a radiation plan using radiation “beams” that match the shape i.e., conform to the tumor. 

High Dose Rate (HDR) Brachytherapy: 

Is the insertion or application of a radiation source directly into or on a tumor. An essential component of the treatment of gynecological cancers, it is also used in the treatment of cancer of the tongue and cheek. In addition it can be placed in the “tumorbed” in cancers such as soft tissue sarcomas, for a short, intense course of radiotherapy. The High Dose Rate Cobalt 60 source ensures a short treatment time, measured in minutes rather than days, as is the case in low dose rate radiotherapy 

Tumor Board & Group Tumor Board:

The paradigm in cancer treatment today is multidisciplinary care. Apollo Cancer Institute is committed to delivering top notch quality care not only in terms of technology but also in terms of individualized treatmeplans tailored to the patient's specifc indications. The thrice weekly tumor board and monthly group tumor board meetings fosters discussion between surgical,medical and radiation oncologists. For discussing sequencing of treatment as per the latest evidence based guidelines, hence optimising treatment outcomes. 

Cancer Awareness Program:

Cure of cancer can be just prevention. We are organizing cancer awareness camps and health talks on regular basis in our community, so that the facts about cancer are correctly disseminated in the society and importance of timely diagnosis is reite ated among the members of our community. 

Hopes Program (Helping Our Patients and families Through Education and Support):

The HOPES program includes a variety of wellness services, educational and support workshops on topics of interest for patients and families. 

Psycho-Social Counseling: 

Apollo Cancer Institute has the best supportive care facilities in the form of psycho-social therapies for the managementof cancer. It includes:

• Complete emotional support

• Psychological and spiritual support

• Palliative care to ensure better quality of life. 

Follow-Up & Management of Recurrence: 

Follow-up constitutes an important component of treatment and is an integral part of the management protocols at Apollo Cancer Institute. Early detection and timely management of recurrence is the principle objective of follow-up in cancer management. This not only enhances survival but improves quality of life of patients.

Surgical Oncology at Indraprastha Apollo Hospitals Delhi, India

The discipline is managed by site specific specialists in the areas of:

·         Breast cancer

·         Mammographic localization of small microscopic lesions and sentinel node biopsy.

·         Colorectal cancers

·         Endocrine tumors & Neuroendocrine tumors

·         Tumors of the Stomach, small intestines, Pancreatic tumors, hepatic tumors and tumors of the gall bladder

·         Head and neck tumors

·         Tumors of the Brain and spine

·         Soft tissue and bone tumors

·         Limb conserving surgery in bone tumor and soft tissue tumor

·         Plastic and reconstructive surgery including Micro vascular reconstruction of flap

·         Thoracic surgical oncology

·         Thoracoscopic & Laparoscopic surgery in staging and diagnosis

·         Urologic and gynecological oncology

·         Extensive resection of hepatic and lung tumor

·         Robotic surgery

FAQs on Cause of Cancer

Q- What causes cancer?

Ans- Though it is very difficult to pinpoint the definite cause. Certain substances, known as carcinogens, can definitely increase your chances of getting cancer. For instance, people who smoke or chew tobacco are more prone to mouth, throat and lung cancer, Contrary to popular opinion, beedi smoking is twice as dangerous as cigarettes. Continued irritation of tissues can lead to cancer. Pollution, preserved food, smoked and junk food are also contributory. Even certain viruses can cause cancer (EBV, Hepatitis B, HPV). Among-st other known causes are asbestos, arsenic, pitch, tar, ultraviolet rays.

 Q- Is cancer caused by a germ?

Ans- There is no scientific evidence that cancer is directly caused by a germ. Although certain viruses are known to cause cancer but they form < 2% of the cancer burden.

 Q- Does cancer come form a single bruise?

Ans- No. A single injury to soft tissue or bone does not give rise to cancer.

 Q- What is the relation of food to cancer?

Ans- High fat, low roughage western diet predisposes to colon cancer. Diet rich in animal fats also contributes to breast cancer. Green leafy vegetables and fresh fruits contain certain antioxidants which prevent cancer. Recently tomato, ginger and cabbage etc. have been found to have medicinal antioxidant property. Avoid junk food, smoked food and preserved food. Be vegetarian and prevent cancer!

 Q- Will irregularity in eating cause cancer of the stomach?

Ans- There is no scientific evidence that it will, since cancer of stomach may occur in people who eat most regularly.

 Q- Does eating hot food cause cancer?

Ans- There is little evidence that the temperature of food is an important factor in development of cancer. But recently too hot food has been correlated with food pipe cancer. Too spicy food may be related to stomach cancer as is evident from its high incidence in Southern parts of India.

FAQs on Oncology / Cancer Treatment

Q- How can you tell if you have cancer?

Ans- There are 7 early warning signals. But the real tragedy about cancer is that it produces very minor symptoms at first. So you could have cancer and not know it. The best way to detect cancer is to have a regular yearly check-up.

 Q- How does a doctor tell if growth is cancerous?

Ans- By performing a biopsy or FNAC i.e. examining a small portion of the tissue under a microscope. In advanced cases, physical examination alone may reveal the diagnosis. But the chances of cure at late stage are very poor.

 Q- Are cancer and leprosy related?

Ans- No. Leprosy is caused by a germ. Both the symptoms and the treatment for the two diseases are entirely different.

 Q- Is cancer a modern disease?

Ans- As long ago as 3,000 BC., Egyptian historians made references to " tumours and ulcers". Mummies from the Gizeb Pyramids were found to have cancer involving the bones. But the incidence of cancer is increasing. It is related to 'our life styles and urbanisation i.e, tobacco, alcohol use, pollution, preserved and junk food etc. "It is becoming a disease of modernization.

 Q- Are some people more prone to certain types of cancer?

Ans- Yes. Your life-style may make you more prone to some cancers. e.g. cancers of the colon, lung and skin are common in Britain and U.S.A. Cancers involving the oral cavity are more common in India. In women, cancer of the breast, uterus and gall bladder are common.

 Q- What are your chances of getting cancer?

Ans- One out of every 8 Indians develop cancer in their lifetime. There are about 8.5 lakh cancer patients in India alone (Year, 2000). Though cancer can occur at any age, the incidence is high after the age of 40 to 45.

FAQs on Cancer / Oncology Treatment

Q-What is cancer?

Ans- Cancer is an abnormal growth of a body cell or group of cells. If it is not destroyed or removed, cancer can spread very rapidly, and eventually lead to death.

 Q-What is the difference between normal and cancerous growth?

Ans- There are billions of cells in the human body. Normally, they grow in a well-regulated pattern. When cancer sets in, a group of cells suddenly start multiplying haphazardly and form a lump or "tumour".

 Q- How many kinds of tumours are there?

Ans- There are two kinds of tumour - Malignant & Benign. A benign tumour is more common, and is generally harmless. It doesn't spread to other parts of body. A malignant tumour on the other hand, never stops growing unless until treated and can spread to other parts of the body. cancer is the name given to a malignant growth.

 Q- Is cancer contagious or infectious?

Ans- No. Since cancer is not caused by a germ, it is not "catching", and cannot be transmitted from one person to another.

 Q- Is cancer a blood disease?

Ans- No. cancer cells may move through the blood stream to another part of the body indicating spread of disease. Cancer can however develop in certain tissues, which form the blood cells.

 Q- How does cancer spread

Ans- In 3 ways.

1.       Cancer cells grow through the walls of blood vessels and are carried by the blood stream to other parts of the body.

2.       They enter the lymphatic stream and are carried to the lymph glands.

3.       They grow directly in contiguity from one tissue to another.

Q- How fast does cancer grow?

Ans- There is no definite rate of growth of cancer tissue. Some cancers grow fast and some are slow growing. For example it takes 2 to 5 years for breast cancer to develop to 1cm.

 Q- Is cancer a single disease?

Ans- No. The term "cancer" includes all forms of malignant growth. Very many varieties are known. These have certain characteristics in common, such as uncontrolled growth, a tendency to spread widely in the body and fatal termination if not treated early and adequately. They differ in certain characteristics, such as location in the body, microscopic appearance, and response to treatment.