World cancer day: En route to living cancer-free

CHENNAI: With a fatality of over 10 million a year across the globe (according to the World Health Organization), cancer is definitely one of the most dreaded C words mankind has ever known.

However, modern medicine has evolved, and continues to progress, at a pace that is, at the very least, enabling patients and their caregivers to cope with the disease.

Tamil Nadu especially, which is often hailed for some of the best known medical practices in the country, has been making great strides in treating the disease. The introduction of new technologies like robotic-assisted surgery, Artificial Intelligence and other advanced devices, have not only transformed the landscape of cancer treatment in the State, it has also improved the survival rate among cancer patients.

Robotic-assisted surgery

Among various innovations, robotic-assisted surgery stands out as a game-changer, due to its less-invasive options, better surgical outcomes, affordability and accessibility.

“The da Vinci Surgical System, made by US-based Intuitive Surgical, allows surgeons to perform even complex surgeries with minimal incisions, resulting in potentially less blood loss, shorter hospital stays, and faster recovery times for patients,” explained Dr S Rajasundaram, director, Institute of Oncology, and chairman, Robotic Surgery, Gleneagles Global Health City. “It helps navigate complex anatomical structures with unmatched precision, especially when tumours are located near vital organs or blood vessels.”

Robotic-assisted surgery also enables patients to experience less post-operative discomfort and quicker recovery periods, allowing them to resume normal activities and adjuvant therapies sooner. Unlike a regular open surgery where recovery takes 10-15 days, or sometimes even a month, a patient could recover in a week after a robotic-assisted surgery.

“It’s particularly crucial in cancer care, where prompt intervention and rehab are critical components of the treatment process. The advances in Artificial Intelligence (AI) and machine learning are set to further enhance the capabilities of robotic-assisted surgery with predictive analytics, real-time decision support, and personalised treatment planning based on specific patient profiles,” he added.

Immunotherapy

One of the most widely used interventions for treating patients with cancer, immunotherapy comprises a wide range of different treatment types using drugs to enable the immune system to attack cancer.

On the other hand, you have targeted therapy that prevents molecular pathways that enable tumour growth and maintenance.

The development of onco-pathology has become more significant in oncology, as it paved the way for better chemotherapy drugs, and less use of radiation, toxic surgery, and other mutilating procedures.

“We were treating patients five days a week for six weeks, and this is the conventional radiotherapy technology. In those days, we were using a method called ‘hypofraction fast radiation’, but the problem was it had a lot of toxicity in it because normal structures got a heavy dose. Immunotherapy, or probably chemotherapy, along with radiation, could enhance the effect of radiotherapy to increase the response to the treatment,” stated Dr AN Vaidhyswaran, director and senior consultant, Radiation Oncologist, Kauvery Hospital.

Precision oncology, genetics

Cancer is curable if caught early and treated well, but the process of treatment is exhausting, and can have an irreversible impact on the body. That’s where precision oncology plays a crucial role.

“Traditional cancer therapies like chemotherapy are cytotoxic to most cells. As in, they damage healthy cells in addition to killing cancer cells. While chemotherapy can be effective and is a mainstay of cancer treatment for many patients, precision oncology aims to overcome the limitations of conventional approaches,” stated Dr Kumanan J, consultant medical oncologist, Apollo Cancer Centre.

Precision medicine in cancer often means looking at how changes in certain genes or proteins in cancer cells can affect care. For example, the patient’s treatment options. “By leveraging genomics and molecular profiling, precision oncology enables tailor-made treatment plans based on specific genetic and molecular characteristics of an individual’s cancer,” he added. “Streamlining regulatory processes ensures that innovative therapies reach patients on time.”

Recent advancements in next-generation sequencing have empowered oncologists to unravel the genomic landscape of tumours. This enables a deeper understanding of the underlying mechanisms of cancer and helps identify targeted therapies.

Stem cell transplants

Blood cancer includes diseases such as leukaemia, lymphoma, and myeloma that have the abnormal proliferation of blood cells, which take a toll on the body’s ability to function.

Traditional methods of combating blood cancer constitute treatments like chemotherapy, which although kills the malignant cells, also destroys the stem cells in the body. Hence, the need for alternative treatments like stem cell transplants has become the need of the hour.

“Blood stem cell transplant works by infusing healthy blood-forming stem cells into a patient’s body. These stem cells have the unique ability to differentiate various blood cell types, and rejuvenate the immune system and replace damaged or cancerous cells. To make it successful, the patient needs a compatible donor willing to give stem cells,” averred Dr Nitin Agarwal, HoD-Donor Request Management, DKMS BMST Foundation India.

Though there are challenges in stem cell transplants, and requires meticulous matching, they stand as a ray of hope, significantly improving blood cancer treatment.

Nutrigenomics

Several medical researchers have stated that food habits are a significant modifier of cancer risk and cancer progression. However, understanding the intricate relationship between our diet, our genes, and their influence on disease risk is crucial.

From a genetic point of view, nutrients are like dietary signals that sensors in the cells detect and act accordingly.

So, for your body to truly benefit from a nutrient, the signal needs to reach the right place, get detected, and trigger the right amount of enzyme or protein for it to be processed effectively. So, even with a healthy diet, if any of these steps fail, there may still be gaps in your nutritional health. This field of study is called nutrigenomics, which proves that effective nutrition is not one-size-fits-all.

Deepika Suresh, genomics specialist, Xcode Life, said, “According to a study, there was a marked difference in cancer management between two people who had the same diet. This points to something that’s happening internally more than what’s on the plate.”

One very important vitamin for cancer management is Vitamin C. According to studies, Vitamin C concentrations from the plasma of cancer patients were significantly reduced when compared to healthy controls.

“Two important genes transport Vitamin C to the required places. If there’s a change in any of them, it can lead to vitamin deficiency. An important gene involved in vitamin D level regulation in the body produces a ‘switch’ that turns on the actions of Vitamin D in our body, influencing how cells grow and change,” she explained.

It not only underscores the importance of personalised dietary recommendations but also opens up new avenues for targeted nutritional therapies in cancer management and prevention.

Not without risk

Despite such medical advancements in cancer treatment, and the mitigation of severe life-threatening events is warranted, patients and caregivers must remember that every treatment comes with its own set of risks. So, they must calibrate expectations about results, and make informed decisions while choosing a treatment plan.

From a systemic point of view, it also calls for a more streamlined regulatory framework to ensure the safe and effective application of these technologies.