Cancer: The good news

While statistics for cancer are getting deadlier by the day – it is estimated that one out of every three people are at risk of contracting the disease – there is some hope from new cutting edge treatments that are being launched worldwide, some of which thankfully are on their way to India too.

Portugal's Champalimaud Centre For The Unknown is offering revolutionary cancer treatment. Its Cancer Centre is working on cutting-edge science – 'translational medicine' (there are only four more such centres globally), a discipline that aims to improve health of individuals and the community by translating research findings into diagnostic tools, medicines and medical procedures. It specialises in non-invasive Edge Radio Surgery (created by cancer specialist Varian Medical Systems) where targeted rays are beamed to tumours with accurate precision. It's extraordinarily fast too. What normal radio surgery can do in 30-40 sessions, this new technology can apparently do in 10 to 15 minutes.

While there was some talk about the same centre opening a branch in Rajasthan, nothing seems to have come of it till now.

Closer home as well, work is already on to offer something along similar lines, but different. Philips Healthcare has recently tied up with Belgium headquartered-IBA to bring the first Proton Therapy Center to India and South Asia. This, too, provides treatment along the same lines: fast, precise and fully.

While talks are on with Tata Memorial Centre and some other government bodies, the first Proton Center is already being developed at Apollo Chennai, which should be ready by first quarter of 2017. This will be a step up from the radiation based CyberKnife Robotic Radio Surgery currently offered at the same Apollo Hospital. "The aim is to help reduce cost, increase precision in cancer cure and provide the best in terms of treatment," shares Dr Prathap C. Reddy, founder chairman of Apollo Hospitals.

They were the first to bring the CT scan to India, and then MRI and PET CT scans. "Now my aim is to get the latest in cancer cure too, thus Proton. This will be the first such centre in this side of the world. Although it is expensive (the project cost is Rs690 crore), I feel it is worth it, as the precision of proton therapy kills just the tumour cell, sparing the normal tissues. In fact, it is the best option for small brain tumours, multiple lung lessons, eye, head and neck cancers, certain types of breast cancers and cures prostate cancer 100 per cent," says Reddy.

"I am extremely excited about its application for children. And even though the cost is more (normal surgery costs approximately Rs4-5 lakh, this will cost Rs12-15 lakh) the incidental costs, hospitalisation, side effects are way less, so the patient benefits excessively " he adds.

Advent of robotic surgical technology
Dr. Somashekhar SP, head of department and consultant surgical oncologist and robotic surgeon at Manipal Comprehensive Cancer Center in Bangalore, is extremely excited about robotic surgical technology, specifically the da Vinci® System (Intuitive Surgical Systems, Inc., Sunnyvale, CA), as he believes it represents the most significant advancement in minimally invasive surgery.

Here, a surgeon performs surgery using a computer that remotely controls very small instruments attached to the robot with a 3-D camera mounted on an additional arm. It allows surgeons to perform delicate operations by manipulating the machine's robotic arms, which translate the doctor's hand movements into smaller and smoother strokes.

"With robotic surgery, highly complex surgical procedures that normally require large open incisions can be performed with tiny holes utilising robotic assistance. Thus, the key advantage in cancer surgery is enhanced precision and reduced trauma. Patients have less pain and fewer complications, which translates into faster recovery. It is extremely effective for gynaecological (uterus) cancer, colorectal cancer, esophagus (food pipe) cancer, chest wall or lung cancer and thyroid cancer," he adds.

New research frontiers
In most cases where treatment for metastatic cancer (cancer that has spread from the part of the body where it started to other parts) fails, the reason is that the cancer is resistant to the drugs being used. The doctors then try to use combination therapy (multiple drugs simultaneously), where the greatest challenge is determining which ratio and combination is best for each case. Now, two UCLA researchers have developed a revolutionary approach that brings together traditional drugs and nanotechnology-enhanced medications to create safer and more effective treatments. They published their results in February this year in the journal ACS Nano. This discovery will help design optimized combinations for virtually every type of drug and any type of nanotherapy (targeted drug delivery) doctors feel.

India is regrettably number one in breast cancer deaths globally, at 70,218 deaths in 2012 (Ref: GLOBOCAN, IARC, WHO). But there is some good news when it comes to breast cancer cures too. Researchers at the University of California San Francisco's Comprehensive Cancer Center are conducting clinical trials with a new technology called immunoliposomes, where a molecule of a lipid (fat) ball will be used to release a therapeutic agent to kill the cancer. This will take some time. But at least some good work is on to tame this deadly disease.