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Dr. Ashish Rustagi

Oncologist, Delhi

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Dr. Ashish Rustagi Oncologist, Delhi
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I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family....more
I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family.
More about Dr. Ashish Rustagi
Dr. Ashish Rustagi is a trusted Oncologist in Saket, Delhi. You can visit him at Max Super Specialty Hospital-Saket in Saket, Delhi. Book an appointment online with Dr. Ashish Rustagi on Lybrate.com.

Lybrate.com has top trusted Oncologists from across India. You will find Oncologists with more than 41 years of experience on Lybrate.com. You can find Oncologists online in Delhi and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Max Super Specialty Hospital-Saket

#2, Press Enclave Road, Saket. Landmark: Near Malviya Nagar Metro Station & Hauz Rani Bus Stop, Select City Walk Mall, DelhiDelhi Get Directions
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My mother is a patient of breast cancer which was detected in 2015 in 4th stage chemotherapy and necessary surgical treatment done .but in years 2016 herpes was detected and so her oral chemo was stopped which resulted in redevelopment of cancer germs near the brain and lungs. The chemotherapy was restarted from spinal chord. As a result some problems developed in the heart and she had to depend on oxygen for 15 days. Her chemo was stopped since 2months ago. Now from few days she felt constipation and nauseatic and vomiting tendency. WBC increased along with sever pain in her back and sever headache too memory loss to some extent and also of appetite. She had to be hospitalised with increased BP, body trembling and sugar after blood Dr. Said it a case of sever infection. She was admitted in ICU for 3 days since 18.12.17 and the said trouble is controlled to a very little extent. She is not feeling comfortable and behaves unruly and aggressively. I am requesting your honour to think over her trouble and advice or suggest for her early relief.

Bachelor of Ayurveda, Medicine & Surgery (BAMS), PG Dip Panchakarma, PG Dip Ksharsutra For Piles, Pilonidal, Sinus & Fistula Management, Post Graduate Diploma In Hospital Administration (PGDHA), Certificate In Diabetes Update
Ayurveda, Navi Mumbai
Got your pain you and your mom went through and concern. Though it's unfortunate but very common with chemo and Radiation therapy. Thanks for trusting and expecting assertively healthy and progressively fit with Holistic ayurved approach. Ayurved offers amazing outcome with such issues I.e. Primarily your aim is to be pain free nothing life. Till you consult ayurved college hospital in your city or clinic follow Kshirbala thailam Application on palm feet naval area and on head and Basti as well. As her Gastric mucosa got irritated, skin and per rectal route is most best suited way to avail soothing effect.
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Is there any kind of cancer which affect lung or due toh asthma problem. Actually one of my friend was saying so I want toh know is it dangerous like other cancer or not?

Oncologist, Gurgaon
At 20, you r highly unlikely to have lung cancer. Chronic smoking can lead to COPD where sulymptoms mimic asthma and it can be a precursor to lung cancer.
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What is cervical lymphadenopathy with cervical changes? Neck sonography shows: There is enlarged hypoechoic necrotic lymph node of size 13*9 mm in right supraclavicular region. Few necrotic and non necrotic subcentimetric left level 4 lymph nodes are also noted. What does this sonography result mean?

C.S.C, D.C.H, M.B.B.S
General Physician,
Cervical lymphadenopathy refers to lymphadenopathy of the cervical lymph nodes (the glands in the neck). The term lymphadenopathy strictly speaking refers to disease of the lymph nodes, often however the term refers to enlargement of the lymph nodes.An infection is cause and necrotic means it could be TB infection
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Is there any medicine of bone cancer. If yes wt are the perfect medicine for that.

MBBS, MD - Medicine, MD - Oncology
Oncologist, Delhi
Dear lybrate-user, bone cancer is of many varieties. To give you exact version I need to know the full details of bone cancer as regards type, site of involvement and the extent of involvement. If you mean preventive measures for bone cancer, healthy balanced diet with adequate calcium and vitamin d are helpful. Berry fruits considered to contain vitamin b17 is regarded as the best preventive agent for bone cancer, also flex seeds and sesame seeds are also known to have same effects.
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Hello I am from dhaka, bangladesh. My mother (54 years) was diagnosed with lung cancer 4th stage (metastatic adenocarcinoma) one month ago. She was going through dry cough for like 3 months so further investigation like biopsy confirmed it's lung cancer. But we didn't rely on our country's (bangladesh) report. So we went to apollo specialty hospital, chennai, india an ran pet ct scan followed by tapping as she had fluid in her lungs and then again biopsy. This time during the biopsy, my mother caught pneumothorax. So the doctor admitted her to emergency and inserted a tube in her backside. They called it drainage system. This will let the fluid come out of her lungs along with air that entered through pneunothorax. They kept the tube for 3/4 days and then released it. Now the doctor asked to do the chemotherapy. I get scared whenever I hear about chemotherapy. Is it the only way out? will this chemotherapy be effective for a long time? I did few researches over internet about the survival rate of lung cancer patient and it seems to be very low. Now I will write you the comments of pet ct scan and biopsy. 1. Pet ct scan: a) hypermetabolic primary mass in lingula b) hypermetabolic pleural metastases with effusion in left hemithorax. C) hypermetabolic metastatic paraaortic with non fdg avid left hilar nodes. D) no other demonstrable metabolically active disease in whole body survey. F) imaging is suggestive of bronchogenic malignancy in lingula segment of left lung with nodal and pleural metastases (t2an2m1a- stage iv) 2. Biopsy report: a) biopsy from left lung mass: consistent with adenocarcinoma, grade ii: ct guidedbiopsy from left lung mass. So what do you think, is it controllable? it is very worse? I want her to live. What kind of chemotherapy would you suggest? apart from chemo, is there any other way to treat or control it along with the chemo? I heard there is some drug called terceva. Internet says it treated their fourth stage cancer. I don't know but I am seeking your help regarding this

MD - Radiation Oncology, MBBS, DNB (Radiotherapy)
Oncologist, Howrah
Thanks for providing good patient profile. From your reports, the only site of distant metastasis is paraaortic lymph nodes. Yes you are right that stage iv lung cancer has a poor prognosis. However a certain subpopulation of these patients still have a chance of favorable outcome. However this depends on number of things 1. Histology (adenocarcinoma favorable) 2. General condition of patient (performance status) 3. Presence of egfr mutations (favorable prognosis) 4. Absence of solid organ involvement (good prognosis). So egfr mutation study is next step. You have also asked any alternative option to chemotherapy. Yes there is a option. That is erlotinib (tarceva). But the tumor has to be egfr positive. Erlotinib is now recommended for egfr positive metastasic adenocarcinoma of lung (without any concomitant chemotherapy) until progression of the disease.
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Gastric Cancer - In a Nutshell!

Post Doctoral Research (Ph.D.) (A.M) (Oncology), Integrative Oncology for Physicians (MSKCC, N.Y, USA), Doctor of Natural Medicine (N.D/ N.M.D), Ayurveda (I) Cert., Advanced Strategic Management (APSM), B.E (Computer Sc. & Engg.), Clinically Relevant Herb-Drug Interactions (CME) - (Cine-Med Inc. USA) , PG Diploma in Clinical Counseling
Alternative Medicine Specialist, Bhubaneswar
Gastric Cancer - In a Nutshell!

Gastric (stomach) cancer occurs when malignant cells form in the lining of the stomach. By far, it is known to be the second most common cause of cancer-related deaths not only in Asia but also worldwide. Though it can affect both male and female populace, it is seen more commonly in men and in people aged 50 years or older.

  1. Type: Gastric cancers can present as one of the following types - 

    1. Adenocarcinoma: Begins in the glandular cells lining the inside of the stomach. This forms a majority of the stomach cancers.
    2. Lymphoma: Begins in immune system cells present in the walls of the stomach. Occurrence of lymphoma, in the stomach, is rare.
    3. Carcinoid Tumor: Begins in hormone producing cells of the stomach.  Occurrence of carcinoid cancer, in the stomach, is rare.
    4. Gastrointestinal Stromal Tumor (GIST): begins in nervous system cells of the stomach. Occurrence of GIST, in the stomach, is rare.
  2. Gender: It affects both male and female populace.

  3. Etiology: The factors that are associated with increased risk of gastric cancer include the following mostly –

    • ‘Helicobacter Pylori’ bacterial infection in the stomach is a common cause of gastric cancer of both the intestinal (expanding) & diffuse (infiltrative) type. Furthermore, studies indicate that high salt intake is synergistic with H. Pylori infection in the manner that it is likely to increase the risk of gastric cancer that is induced by H. Pylori bacteria.
    • Smoking, consuming alcohol, red meat, salty/ smoked/ processed foods, low intake of fruits and vegetables, diets rich in nitroso compounds, eating foods contaminated with aflatoxin fungus etc all.
    • Atrophic gastritis characterized by chronic stomach inflammation is known to increase the risk multi-fold. Chronic gastric inflammation can lead to atrophy of the gastric mucosa, metaplasia, dysplasia and finally carcinoma.
    • History of pernicious anaemia, gastric ulcers, adenomatous gastric polyp etc all.
    • Family history of gastric cancer. Several familial syndromes that have been associated with a pre-disposition to gastric cancer include familial adenomatous polyposis, Lynch syndrome, Peutz-Jeghers syndrome and e-cadherin mutation (diffuse type)
    • Blood group A, Obesity etc all are known to be associated with diffuse or cardia gastric cancer.
    • Low socioeconomic status - persistent lifestyle issues/ irregularities including high stress coupled with an improper diet/ dietary pattern.
    • Epidemiological evidence is indicative of a risk or pre-disposition to gastric/ stomach cancer for people suffering from diabetes mellitus (DM).
    • Very high dose ionizing radiation exposure is an uncommon risk for gastric cancer.
  4. Features: There are often no early stage symptoms. Early stage symptoms, if any, are non-specific and are likely to be ignored, thus delaying the diagnosis most often. Hence, gastric/ stomach cancer is often detected at an advanced stage where the disease is either locally advanced or metastatic. The various presentations (of signs & symptoms), by stage (early or advanced), of gastric cancer are as enumerated below:

    1. Early Stage – can present with one or more of the following non-specific symptoms/ signs -

      • Dyspepsia (Indigestion),
      • Stomach/ Epigastric discomfort,
      • Bloated feeling after eating,
      • Mild Nausea/ Vomiting,
      • Blood in Vomit (Haematemesis),
      • Heartburn,
      • weight loss (Cachexia)
      • Anaemia,
      • Occult blood in stool/ Melaena,
    2. Advanced Stage – presents with one or more of the following symptoms/ signs -
      • GI Bleeding with black tarry stools (Melaena),
      • Persistent Nausea/ Vomiting,
      • Blood in Vomit (Haematemesis),
      • Early Satiety,
      • Anaemia,
      • Loss of Appetite (Anorexia),
      • Weight loss (Cachexia),
      • Persistent pain in the abdomen,
      • Fluid build-up in the peritoneal cavity (Ascites),
      • Edema of the lower extremities,
      • Liver Enlargement (Hepatomegaly)/ Jaundice,
      • Difficulty swallowing food (Dysphagia)
  5. Screening: Is generally recommended for asymptomatic populations in high incidence areas or as surveillance for high risk individuals. The goal of screening, as usual, is to be able to detect & diagnose gastric cancer at an early stage which is potentially curable. It is mostly endoscopic/ radiologic.
  6. Diagnosis: Following are the diagnostics employed in gastic cancer -​

    • Physical Examination: May be remarkable for palpable abdominal mass, weight loss (cachexia), abdominal distension, ascites, hepatomegaly, lower extremities edema and lymphadenopathy for gastric cancers in the advanced stage. For early gastric cancers, however, physical examination is largely uninformative.
    • Blood: Hb- may be low, ESR – raised, tumor markers CEA & CA-19-9 could be raised sometimes in adenocarcinoma but are not frequently elevated. Abnormal blood test results may be indicative of malignancy, but a follow-up gastroscopy/ biopsy is always the gold standard for accurate diagnosis.
    • Stool: Occult blood may be +ve
    • Barium Meal X-Ray: Could show a filling defect at the site of the carcinoma/ cancer growth.
    • Gastroscopy/ Biopsy: Clinches the diagnosis.
    • Endoscopic Ultrasound: Maximizes tumor staging as it helps determine the depth of invasion of the tumor.
    • CT Scan: Of chest, abdomen & pelvis helps detect metastatic disease, if any, and also helps stage the disease (TNM) appropriately.
    • Bone Scan: Helps detect osseous metastasis (bone mets), if any.
  7. Treatment: Conventional treatment includes surgery, chemotherapy and radiotherapy as contextually appropriate. Surgery (i.e. gastrectomy either sub-total or total), with an adjuvant chemotherapy and/ or radiotherapy as contextually relevant, is the only treatment that is known to cure the disease in light of the prognostic indicators as briefly enumerated in the section below. Chemptherapy and/ or radiation alone cannot be curative. Mostly, it can improve symptoms, and may prolong survival. Simultaneously, an adjunctive or integrative naturopathic treatment with suitable complementary & alternative medicines (CAM) too can help improve clinical outcomes and facilitate recovery as feasible contextually.
  8. Prognosis: For gastric cancer is variable. Preventive measures, earlier diagnosis and right early treatment is key for an effective therapeutic management & better prognosis. Like most other cancers, the chances of cure for an early stage gastric cancer are more. The cure/ recovery chances are influenced by the grade, stage of cancer, recurrence and the patient’s general health & vitality etc all. Distal tumors are known to be cured more often than the proximal ones. Again, intestinal-type gastric cancers are known to have a better treatment outlook in comparison to the diffuse-type gastric cancers.

  9. Prevention: Rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an adherence to a relative Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising, de-stressing and relaxation is highly recommended for reducing the risks of many cancers including gastric cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. The consumption of alcohol, if any, has to be strictly in moderation, and is best avoided in a high risk scenario. Smoking is to be avoided too. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly. Not only it is important to eat healthy, but also it is equally important to eat properly. Insufficient chewing, eating until full, eating meals within a short time etc all are best avoided so as to ease off digestive burden on the stomach/ other organs in the GI tract. Last but not the least, consumption of clean and filtered water, natural probiotics like freshly prepared yogurt/ butter milk, maintenance of cleanliness & hygiene including oral hygiene etc. all can help guard against H. Pylori infections. Breastfeeding is known to be protective against H. Pylori infections too.

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There is a lump below right breast of my mother. Though it is not paining but we want to know why is it so? Doctors said it is a level 1 lymph nodes which is a sign of cancer. We are confused. Please tell us which hospital should we go to and to which doctor should we consult? Please tell us.

MBBS, CCEBDM, Diploma in Diabetology
Endocrinologist, Hubli-Dharwad
There is a lump below right breast of my mother. Though it is not paining but we want to know why is it so? Doctors s...
Hello, Thanks for the query. There are many reasons for enlargement of lymph nodes around the breast and in other areas. Local infection is one such reason. However if there is any suspicion it is necessary to get a mamogram and USG done. Without doing any investigations it is difficult to give any opinion. Further if there is any lump noticed in the breast which is painless then one needs to get it thoroughly checked and investigated as early as possible. Thanks.
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What is the main cause of cancer or tumor? Do we really know the causative agent for cancer?

MBBS
General Physician, Faridabad
Genetic changes that cause cancer can be inherited from our parents. They can also arise during a person’s lifetime as a result of errors that occur as cells divide or because of damage to DNA caused by certain environmental exposures. Cancer-causing environmental exposures include substances, such as the chemicals in tobacco smoke, and radiation, such as ultraviolet rays from the sun.
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My frnd is suffering from blood cancer but doctors says that it is his initial stage nd can be cure with the help of medicine nd it's been about four months that he didn't get chest pain but before 4 months in the initial day he got some blood spot from his mouth so I want to knw that what this sign signifies .abhi 4 months se asa kuch ni hora h but phela asa ku hua tha. Bcz tub uska initial day he chal ra tha.

Post Doctoral Research (Ph.D.) (A.M) (Oncology), Integrative Oncology for Physicians (MSKCC, N.Y, USA), Doctor of Natural Medicine (N.D/ N.M.D), Ayurveda (I) Cert., Advanced Strategic Management (APSM), B.E (Computer Sc. & Engg.), Clinically Relevant Herb-Drug Interactions (CME) - (Cine-Med Inc. USA)
Alternative Medicine Specialist, Bhubaneswar
Hi lybrate-user, I appreciate you seeking opinion for your friend. Well, as far as I understand, gums are likely to bleed, which is one of the presenting symptoms at the onset of leukemia. This may as well have been triggered by some other reason including chest or throat infection too. Now that he is free from any such symptoms (of bleed), I do not think there is any reason to worry on this front. Nevertheless, I would still advise that you check this aspect with his consulting oncologist too, and proceed as he/ she advises you to. Do take care and all the very best.
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