Dr. Harpreet Singh

Hi,

I am Dr Harpreet Singh. I am a doctor in as senior consultant radiation oncology action Cancer Hospital Paschim Vihar New Delhi.

My topic is going to be about cancer treatment and the role of radiotherapy in that radiotherapy is the most important type of treatment which is given for treatment of cancer. We use rays of high energy to treat cancer. In this modality the treatment is painless and the principal is that the high energy X-rays or Gamma Rays which we used to treat they kill the cancer cells which divide rapidly but the difference is that the cancer cells they cannot recover but the normal cells they can recover after radiation treatment.

Nowadays we see that 60% of all the cancer patients receive radiotherapy as a part of the treatment radiation is again of two types one is external radiotherapy which give from distance and other is internal therapy for which we keep radioactive sources inside the tumor or near the tumor external radiotherapy also called teletherapy and has seen many advances 5 to 10 years the teletherapy or the external radiotherapy has seen lot of advances in last decade or so where we have come from age of many side effects.

Nnow negligible or you can say long term side Effects are negligible in these patients where we treat with cancer the various forms of Advanced treatment at we have 3D conformal radiotherapy IMRT intensity-modulated radiotherapy which we can give very high doses of radiation to the tumor and at the same time do this to the normal organs are within the tolerance limits and the side effects are very less similarly the other forms of Advanced treatments that we have is ITRT VMAT a rapid 8 as we call it and now a days we have lot of patients on SEO tactics radiotherapy which is very high conformal radiotherapy treatment in which patients are given a very high dose of radiation which will be completed in 2 or 3 fittings only compared to what 5 to 6 weeks which is routinely given all these facilities are currently available in our setup at action Cancer Hospital.

As much as you want to avoid, there are things you have no control over. Lung cancer (Bronchogenic Carcinomas) is one such nemesis that can throw life in shambles. The malignant tumor that originates in the lungs slowly spreads onto the other distinct and vital organs as well. Thought to be mostly affecting men who are chain smokers and into severe tobacco consumption, incidences of lung cancer in women are rising at an alarming rate over the past few years. Non-smokers may also be susceptible (to a lesser extent though) to lung cancer.

Lung cancer can be either

• Non-small cell lung cancers: The NSCLC, accounting for ~85% of the lung cancer is one of the most common types of lung cancer affecting people, NSCLC may further be divided into
• Adenocarcinoma: This type of NSCLC originates mostly in the peripheral regions of the lungs and may affect (spread) the lymph nodes. Non-smokers and women are mostly at the receiving end (other than the chain smokers).
• Squamous Cell Carcinoma: Also known as Epidermoid Carcinoma, often affects men, epidermoid carcinoma may originate in the tissues that line the bronchial tubes. The lymph nodes are often affected by Epidermoid Carcinoma.
• Large-cell Undifferentiated Carcinoma: The point of origin of large-cell undifferentiated carcinoma is the surface of the lungs. They have a higher probability of spreading to the lymph nodes.
• Bronchioalveolar Carcinoma: Though rare, bronchioalveolar carcinoma originates close to the air sacs.
• Small Cell Lung Cancer (SCLC, accounting for ~25% of the lung cancer): As the name suggests, SCLC is marked by the rapid proliferation of small cells into large malignant tumors. SCLC can move throughout the body (affecting vital organs).

Radiotherapy to treat Lung cancer:
Radiotherapy plays a pivotal role in the treatment of lung cancer. The radiation therapy is mainly of two types

• External beam radiation therapy (EBRT)
• Internal radiation therapy (Brachytherapy)

In external beam radiation therapy, high-energy rays are focused on the cancer cells (thereby resulting in the apoptosis of the cancer cells) externally, from outside the body. EBRT is particularly helpful in case of Non-small cell lung cancers.

The EBRT may be of the following types

• 3D-CRT (Three-dimensional conformal radiation therapy): An advanced radiation therapy, 3D-CRT accurately marks the position of the cancer cells (using advanced computers). The treatment ensures minimum damage to the other healthy cells and tissues (energy rays are directed at the affected cells from different positions).
• SBRT (Stereotactic body radiation therapy): This is a radiation therapy used in the treatment of NSCLC, when it is at a nascent stage.
• IMRT (Intensity modulated radiation therapy): As the name suggests, in IMRT, the intensity of the radiation reaching the normal tissues and cells can be modulated. Like 3D-CRT, the radiation in IMRT is directed from different angles (for maximum results).
• Internal radiation therapy (Brachytherapy): This type of radiation therapy is generally used to deal with lung cancers that tend to block the airways. In this therapy, the radiation process is carried out through a narrow tube, thereby, shrinking and collapsing the tumor.

The effect, dosage, and duration of radiation therapy depend on the stage and severity of the condition. In some cases, radiation therapy may be given together with chemotherapy.

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

Cancer can occur in any part of the body. In this article, we will discuss head and neck cancer, which occurs when cells in these regions grow abnormally. Cancer cells that grow in the head and neck can spread to other parts of the body as well, and there are reported cases in which head and neck cancer has spread to the lungs.

Symptoms for Suspicion of cancer 

1. Non-healing sore or ulcer, 
2. Neck lymph nodes, 
3. Hoarseness of voice or difficulty in swallowing
4. Red or white patch in the mouth.
5. Lump, bump, or mass in the head or neck area, with or without pain.
6. Persistent sore throat.
7. Foul mouth odor not explained by hygiene. 

Common Types of Head and Neck Cancer-
The common type of head and neck cancer is called carcinoma, and it can start in the nose, mouth and throat. Lymphoma cancers affect the immune system of the neck and head and can spread to other body parts.

Tests that are done for diagnosing head and neck cancer
A patient may feel some pain in the head and neck region. At first, the patient might visit an ENT specialist in order to diagnose the reason for the pain. In case the ENT specialist is not able to relate the issue with common causes of such pain, he refers the patient to a head and neck specialist. Then the first thing that the doctor will check for is the growth of any lymph nodes. Special fiber optics, mirror and lights are used for the examination of the head and neck as some regions are not easily visible.

A panendoscopy is performed on patients to confirm the growth and spread of cancer cells. This test is done under anesthesia and may need to be performed in an operation theater. Thin tubes called scopes are used for viewing the tissues and the doctor may take a sample for a biopsy test.

A biopsy test confirms whether the growth of cells is cancerous or not, and if it has spread. The biopsy will tell us whether the growth is cancerous or not. For staging of cancer, we do scans which may be CT, MRI or PET CT. A scan helps the doctors to understand whether the cancer cells have spread to other parts of the body such as the lungs. The barium swallow method is used to check if there are cancer cells in the throat.

How serious can head and neck cancer be?
There are various stages of head and neck cancer, and they are classified based on the seriousness of the growth. Normally, cancer starts at stage 1 and could progress till stage 4 if left untreated and undiagnosed. Different stages require different types of treatment and medications. Stage 1 and 2 usually involve radiotherapy or surgery whereas stage 3 and 4 would require radiotherapy, surgery and chemotherapy. Also, avoid tobacco and alcohol for prevention.

One should always consult a doctor for diagnosis and treatment of head and neck cancer, and must follow the advice of the doctor for a speedy recovery. In case you have a concern or query you can always consult an expert & get answers to your questions!