JOIN USCancer is one of the most complex and oldest diseases to affect mankind. From trying to understand its disease mechanism to developing new ways to detect and treat it, our oncology journey has been a slow but eventful one.
Looking back at this journey, it is a matter of pride for oncologists and research experts to acknowledge where we are today. Winning the war against cancer has been the focal point of national and global oncology research. The complexity of this disease requires us to fight on all fronts.
Studies reveal that all types of cancers have been reported including cancer of skin, lungs, breast, rectum, stomach, prostate, liver, cervix, oesophagus, bladder, blood and head and neck. Low rate of early stage detection and poor access to care are leading factors that contribute to the country’s enormous cancer burden.
India can greatly benefit from the use of advanced cancer treatment and our task at hand is to make these available and accessible to every patient in the country. When it comes to cancer therapy, the most significant developments came in the early 20th century when the growing understanding of cancer led to several medical breakthroughs.
The introduction of different imaging tests such as ultrasound (sonography), computed tomography (CT scans), magnetic resonance imaging (MRI scans) and positron emission tomography (PET scans) made cancer diagnosis far more efficient and reliable than it was decades ago.
Much like cancer diagnostics, the quest for cancer treatment intensified during the 19th and 20th centuries. Surgery became the first intervention to treat cancerous tumours with the discovery of anaesthesia. This was followed by radiation and chemotherapy, both of which dramatically revolutionised our approach to cancer treatment and management.
In the decades that followed, experts developed more efficient surgical instruments and investigated different combinations of surgery with chemotherapy and/or radiation to improve treatment outcomes. Today, instruments with fibre-optic technology and miniature cameras enable surgeons to perform surgery with a greater degree of confidence through minimally invasive incisions.
Other advances include the development of cryosurgery (using liquid nitrogen spray or a very cold probe to freeze and kill cancer cells), lasers (that can cut through tissue instead of using a scalpel) and radiofrequency ablation (transmitting radio waves to a small antenna placed in the tumour, which kills cancer cells with heat).
Through the use of such novel technologies, oncologists have succeeded in minimising damage to normal tissue surrounding malignant tumours. Since the first use of radiation as a cancer treatment intervention in 1903, our understanding of radiation therapy has greatly progressed, enabling us to develop a range of technologies that use different radiation sources to kill cancer cells.
Radiation techniques
Examples of this include: proton beam therapy, where a proton beam is used to kill tumour cells instead of X-rays in order to spare more normal tissues; stereotactic surgery and stereotactic therapy, which involved delivering high doses of radiation quickly, in just one to five treatment sessions, in order to shrink or kill a tumour with sub-millimetre accuracy; and intra-operative radiation therapy, which involves surgical removal of the tumour followed by radiation to the adjacent tissues.
The use of precise and advanced radiation techniques has enabled us to treat tumours situated near critical organs and structures while minimising the damage to surrounding healthy tissues. More recently, radiation techniques have further advanced allowing us to treat even tumours that move due to respiration or other natural processes during treatment.
Such unique, targeted oncology systems help reduce many side-effects associated with cancer treatment such as nausea and pain as well as reduce the number of treatments needed to enable survivors to live better, more fulfilling lives.
Further, new developments in knowledge guidance into the treatment paradigm is assisting clinicians in making the best decision at point of care which will also dramatically improve outcomes associated with cancer therapy.
If these high-precision oncology systems to India is available in India, it will enable clinicians to navigate the complexities of cancer care with greater confidence. It will also significantly improve treatment outcomes for cancer patients across the country.
(The writer is Vice-President, Medical Affairs, Varian Medical Systems)