Photodynamic therapy or PDT is a relatively new and non-invasive treatment for non melanomaskin cancer. It is mostly used in cases where the cancer is superficial and has not spread too deep. PDT is used mostly to treat Actinic Keratoses on the face and scalp, Basal cell carcinomas, Bowen s disease, as well as other conditions such as head and neck, mouth, lung and gullet cancer.

How does it work?
This treatment involves the use of a drug known as photosensitize or a photosensitizing agent with a specific type of light. When the photosensitizing agents get exposed to a light of a specific wavelength, a form of oxygen is produced, which eliminates nearby cancer cells. Every photosensitizer gets activated by the special light. The wavelength of the light determines how much it can penetrate into the body.

Process of Photodynamic therapy
Skin cancer is cured by PDT in several steps. The first step involves the injection of a photosensitizer into the patient s bloodstream. The blood cells absorb the agent all over the body, but in the cancer cells, it stays for a longer duration. Within 72 hours after the injection is given, the skin is exposed to light. The photosensitizer agent present in the cancer affected cells absorbs the light. An active oxygen form gets produced, which kills the cancer cells.

Other than killing the cancer cells directly, PDT uses two other ways to destroy cancerous tumors. The blood vessels in the tumor are affected, which leads to its death. The immune system also gets charged up and activated for fighting the cancer cells.

The light used for PDT is usually in the form of a laser. LEDs are also used to treat tumors present on the surface of the skin. The primary photosensitizing agent used in PDT is called porfimer sodium or Photofrin.

PDT can be undertaken in the outpatient department in a hospital. After taking the treatment, you have to keep the cancer affected area of the skin dry and covered for 36 hours. The area should be treated with care while showering. In case of thick skin lesions, repeat treatments are required within 4 weeks.

When is PDT used for skin cancer
PDT can be undertaken instead of surgery for treating basal cell cancer, Bowen s disease and actinic keratosis. PDT is used in cases where surgeries are required. It is used to treat large skin cancers, which are not very deep and in the case when several cancers develop in an area. For many skin conditions, PDT is a better remedy than undergoing a surgery.

Advantages of PDT

    There are no long term side effects.
    The process is less invasive compared to surgery.
    A very short time is taken for this therapy to be undertaken.
    The process can be repeated several times in the same area.
    Very less scarring takes place in the affected area.
    The cost of this procedure is lesser than surgery.

Treating Skin Cancer with Photodynamic Therapy

Let s start with some mind-boggling statistics: in India, over 2.5 million patients are diagnosed with cancer. Moreover, it is estimated that around 700,000 new patients are found to have cancer, each year, and around 550,000 annual deaths are related to cancer.

While these perturbing numbers might unnerve you, there is, however, a case for cautious optimism. While there are certain causes of cancer like genetics and environment which are beyond your realms of control; there are certain causes which can be controlled by you. Research shows that nearly 70% of cancer causes are in your hands   including your own diet.

Your daily nutritional intake is vital for two reasons:

There are definite cancer-preventing nutrients and food items;
Conversely, there are certain types of nutrients and food items which cause cancer.
While research typically points to links between food items and cancer than well-established cause-effect relationships, it is found that certain dietary items have a greater influence. Here are some general guidelines to guide you better:

Avoid processed and red meat: Processed and red meat are generally considered as any meat which has been artificially modified for taste or purposes of preservation. It must be noted that during this process of preservation there are certain chemicals mixed with it which makes it carcinogenic in nature. Though the WHO (World health organization) hasn t recommended any specific amount for consumption, it has categorized processed and red meats as a Group 1   carcinogen.
Consume more fruits and vegetables: Plant foods including fruits and vegetables contain essential micronutrients like flavonoids and carotenoids which researchers  state are powerful antioxidants. Antioxidants help prevent the destruction of cells as they diminish free radicals. It is recommended to regularly consume fruits and vegetables like berries, broccoli, leafy greens, apples, papaya, among others.
Reduce your alcohol and smoking habit: Along with processed and red meats, alcohol is designated as a Group 1   carcinogen by the WHO. Cancer research has repeatedly linked consumption of alcohol to higher chances of cancer, irrespective of the alcohol type. A number of cancers including pharynx, liver, and breast are directly connected to alcohol.
Furthermore, it is suggested that an individual must limit to no more than a drink on any given day.

In conclusion, it must be stated that our diets play an indispensable role in the prevention of cancer. The consumption of healthy food items will only bolster our physical well-being along with the reduction of cancer occurrence.

How Your Diet Can Potentially Prevent Cancer?

Brain metastases from systemic cancer are the most common type of intracranial neoplasm in adults, being almost 10 times more common than primary malignant brain tumors, which cause a significant burden on the management of patients with advanced cancer (1). The lungs represent one of the most frequent sources of metastases to the brain, with a probability of (36 64%) (3). Symptoms suffered by the patients include headaches, epilepsy, focal weakness, numbness or changes in mental status. The prognosis of patients with brain metastases is not optimistic and the median survival time is  1 2 months if left untreated. The 1-year survival rate has been recorded as 10.4% (4,5). The treatment of metastatic brain tumors is complex; not only due to being able to provide local control and improve neurological function, but also due to factors such as age, performance and systemic disease status and the size, volume, location and number of metastases at presentation

CyberKnife is a robotic radiosurgery system with a linear particle accelerator (linac), which is coupled with real-time imaging to track and compensate for the patient s or target s motion. As a relatively non-invasive treatment modality, CyberKnife demonstrates certain benefits, including a more accurate target localization and improved dose delivery for the management of metastatic brain tumors that allows higher biologically effective dose delivery without increased incidence of toxicity.

In the present case, the results for the treatment of multiple brain metastases after CyberKnife surgery with a 7 8 Gy marginal dose was promising. CyberKnife for metastatic brain tumors is an effective and safe method for reducing the marginal dose prescribed for multiple brain metastases and for minimizing the radiation-related neurotoxicities. In conclusion, CyberKnife, a focused, highly-targeted radiosurgery and fractionated radiotherapy is particularly useful for multiple brain metastases. CyberKnife provides the advantage of the management of local recurrence and a tolerable complication rate. Although the treatment of brain metastases has been performed with CyberKnife, the clinical significance and optimal dose fractionation scheme require further investigation.

In case you have a concern or query you can always consult an expert & get answers to your questions!

CyberKnife Therapy Of 24 Multiple Brain Metastases From Lung Cancer!

Irrfan Khan's saddening revelation about his health and diagnosis of Neuroendocrine tumour (NET) has undoubtedly created a rage amongst his fans, which is now being followed by good wishes for speedy recovery from his supporters all across social media.  

The actor shared in an emotional Twitter post that he s been diagnosed with NET, a rare tumour that develops from cells of the neuroendocrine system and grows predominantly in the digestive or respiratory tract - lungs, appendix, small intestine, rectum, and pancreas - it can occur in any part of the body.

Here is more on Irrfan s disease:

What is NET?

A neuroendocrine tumor is characterized by a rapid and abnormal growth that happens in the nerve cells which produce hormones. Hormones control how different organs in the body work.

It is a condition wherein, endocrine cells, the hormone-producing cells of the body, develop a tumor in any part of the body - while it can can grow in lungs or the thymus, or more rarely, in the ovaries, kidneys, or testicles - the most common is lung, intestines, and pancreas.

What causes NET?

A neuroendocrine tumour is quite a rare disease, occurs in less than one per million cases. The exact cause is not known.

The Symptoms-

It can cause a myriad of symptoms, depending on where in the body the NET is.

If it is in your digestive system, it can cause pain or discomfort in the abdomen area that comes and goes. You may feel sick, nauseated, vomited, or there may be a change in how often you pass stools.
If the NET is in the lung, it can cause shortness of breath, chest infections, or you can even have a cough up blood.
Weight loss and loss of appetite may also be some common signs of a neuroendocrine tumour.
Some NETs may overproduce a hormone-like substance called serotonin. This causes a group of symptoms called carcinoid syndrome. Symptoms include wheezing (like asthma), flushing of the skin and diarrhoea.
Who can be affected with NET?

These tumours, depending on the type, are more common in certain age or sex. And few have very strong family history too.
People who have a rare condition called multiple endocrine neoplasia 1 have an increased risk of developing a NET.
Did You Know?

Apple founder  Steve Jobs  died from the same disease in 2011. The tumour affected his pancreas.

Know The Different Types of NET:

Based on the organ that is affected, NET can vary a lot. When the chromaffin cells that produce adrenaline are affected, it is called Pheochromocytoma, and it is related to the stress levels of the body.

When a cell is formed abnormally under the skin and the hair follicles, it is called Merkel cell cancer. This is also called neuroendocrine carcinoma of the skin and the condition can occur anywhere in the body. The commonly occurring places include lungs, gastrointestinal tract, and brain.

The status of the tumour, cancerous (malignant) or noncancerous (benign), decides the survival rate. Often slow-growing and noncancerous, they can invade surrounding parts of the body and at times, turn cancerous and spread across the body. However, you can still choose to live a good quality life with strict modifications in diet and lifestyle. The changes are made after taking into consideration the symptoms of the tumor. The organ where the tumor is formed also matters.

How Is It Treated?

Treatment depends on the location of the tumour, its type, how severe it is and whether it has spread to other parts of the body. Usually, the first treatment choice is surgery to remove the tumour. And, if the NET cannot be removed, your will prescribed with a treatment that will not only relieve the symptoms but will also improve the quality of your life.

How can a NET be prevented?

The first thing you need to do for the prevention of NET is to curb stress. Stress affects the entire body severely.

Lifestyle modifications:

A healthy lifestyle is what you need to stick to if you want to manage its symptoms during the treatment cycle. Your doctor will prescribe you to do exercises at least 4 days a week for a minimum of 30 minutes. You can also try a walk instead of strenuous exercises.

People with carcinoid syndrome may be advised to avoid food or activities that may trigger flushing, such as eating spicy food or drinking alcohol.

Indulge yourself in therapies that help in gaining more positive energy. If you are already affected by NET, eliminate all the sources of stress and get a good night's sleep every day. Join the support groups that make you grow strong and happy. After all, the mind is devised to do miracles when it is full of life and positive thoughts.

Is Irrfan Khan's tumour curable?

Dr Saumitra Rawat, HOD, Surgical Gastroenterology & Liver Transplant, Sri Ganga Ram Hospital, said, "NeuroEndocrine Tumour is an abnormal growth of Neuroendo cells which are present in bodies. When there is an abnormal growth, then it forms a tumor - Normally seen in intestine, pancreas, lung, thyroid and other parts of the body".

On commenting on Khan's case, he said, "It depends on the location of tumour, its size, and what is its mitotic index".

"Depending on where the tumour is localized, you can take it out surgically and the chances of cure are very high", Dr Rawat explained.

Actor Irrfan, who has been diagnosed with the disease is one of the most versatile actors in India, has also made a name for himself in the west, where he has been an important part of critically-acclaimed films such as  The Namesake ,  Jurassic World , and  Life of Pi . At home, the actor has delivered remarkable performances in films such as  Haasil ,  Paan Singh Tomar ,  Maqbool ,  Lunch Box ,  Piku , and the most recent  Hindi Medium .

Irrfan Khan is not just a disarmingly natural actor, but also an endearing human being -- honest and humble to the core. It s time to stand together and pray for him a speedy recovery!

Irrfan Khan - Battle Against Neuroendocrine Tumour!

How to become less prone to cancer

There are various known reasons why cancer takes root in a healthy body. The deadly disease takes away millions of lives worldwide and remedies in food to tackle it are constantly a subject of research. However taking this one food item off your daily diet can help becoming less prone to cancer.

Senior cancer experts stress that sugar feeds cancer. According to his belief, backed by years of research and medical expertise, it is possible to starve cancer out of a person’s body. When sugar breaks down in the body in a non-oxidative manner, adenosine triphosphate (ATP) is generated which causes cancer cells and tumor to grow.

Research states that cancer is a dysfunction of the mitochondria caused by fermentation of sugar in the cells instead of orthodox respiration of normal cells. This can be tackled by limiting the supply, just by cutting down the intake of sugar every day. A small amount of sugar in a healthy and requisite proportion is acceptable but excessive sugar must be avoided in order to choke cancer out from the body.

Specifically, the intake of sugar in processed foods must be cut down. Everything that is sweet isn't sugar! Avoiding processed foods will simply eliminate the bad salts and bad sugars from your diet. Eating at fast food joints too must be cut down completely as the food they serve is frozen and needs a lot of preservatives. You can always switch to fruits if you have a sweet tooth. Diet-wise, consume more green leafy vegetables, developing a plant and natural nutrient based diet is an ideal method to tackle cancer.

If you would like to consult with me privately, please click on 'Consult'.

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Are You Aware That You Are Feeding Cancer Daily?

One of the most common problems faced by ageing men is benign prostatic hypertrophy. Prostate is the gland at the base of the urethra near the bladder and when it enlarges it can lead to symptoms, mostly related to urination.

1. Frequent urge to pass urine
2. Prolonged urination
3. Frequent nocturnal visits to the toilet
4. Intermittent urination
5. Difficulty to start urinating
6. Inability to completely empty the bladder
7. Urinary tract infections

There are medications available to manage this, but offer only temporary relief. Many men therefore prefer to have the surgery undergone to manage these bothersome symptoms. However, like any surgery, the risks and benefits need to be considered along with other conditions like age, overall health status, other comorbid conditions, etc.

Surgical removal of the enlarged prostate gland is a more definitive approach to manage these symptoms. In addition to providing a quick cure, it also is used in the following cases:

1. Patients who do not respond to medications
2. Presence of blood in the urine
3. Associated bladder stones
4. Frequent infections of the urinary tract
5. Associated damage to the kidneys

Procedure of Surgery
During the procedure, a tube is passed through the tip of the penis into the urethra towards the bladder neck. Once it is in the desired position, laser is passed through it to deliver energy that acts on the prostate to either completely or partially destroy it. There are two methods by which laser acts on the enlarged prostate and making way for free flow of the urine.

1. Ablation: Excess prostate tissue is melted away by the laser by using photosensitive vaporization of the prostate. This is also known as Greenlight laser therapy or KTP laser vaporization. Alternately, Holmium can be used as the source of laser energy to ablate the prostate tissue.

2. Enucleation: Excess prostate tissue is cut and teased out through the urethra. Holmium laser is used to resect the prostate into smaller pieces, which are then removed out through a resectoscope. Another technique uses a tissue morcellator which grinds the enlarged prostate into smaller pieces to enable easy retrieval.

More men now opt for laser prostate removal as it has the following advantages:

1. Reduced risk of bleeding: This becomes essentially important in patients who are on blood thinners.
2. No hospitalization: This can be done either as an outpatient or with minimal one day stay at the hospital
3. Immediate symptom relief: As compared to medications, the relief is felt almost immediately after the surgery
4. No catheter: With laser surgery, a catheter may be required for less than 24 hours unlike in open surgical cases.

As noted above, as with any surgery, once enlarged prostate symptoms set in, have a detailed discussion with your doctor to identify if you are a suitable candidate for laser surgery.

Know About Laser Prostate Surgery

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