'Voices of Victory: Celebrating the Journeys of Cancer Warriors' Event Triumphs at Manipal Hospitals Old Airport Road, Bengaluru

The event commenced with Dr. Nitin Yashas Murthy, Consultant - Medical Oncologist, Hemato Oncologist, setting a poignant tone. Dr. Murthy emphasized the critical need for early detection in the fight against cancer, aligning with World Cancer Day's rallying cry, 'Close the Care Gap'. His sobering reminder that less than 50% of cases are diagnosed at an early stage, annually, underscored the event's broader mission.

Stating the dedication of Manipal Comprehensive Cancer Care Unit, Manipal Hospitals Old Airport Road, Bengaluru, which has been providing quality cancer care for about 25 years now, Dr. Murthy highlighted the significance of multimodal cancer treatment, which is marked by the seamless collaboration of medical oncology, surgical oncology, hemato oncology, radiotherapy, nuclear medicine, and subspecialties like orthopaedic oncology and gynaecologic oncology, to address the multifaceted nature of cancer. The synergy between these specialties not only enhances treatment efficacy but also emphasizes the significance of personalized care in the complex landscape of cancer management. The subsequent panel discussions featured eminent specialists from Manipal Comprehensive Cancer Care Unit, Manipal Hospitals Old Airport Road, Bengaluru, shedding light on transformative advancements in cancer treatment and the integral role of multimodal approaches.

The first panel discussion by Dr. Amit Rauthan, HOD & Consultant – Medical Oncology, and Dr. Poonam Patil, Consultant - Medical Oncology, focused on how cancer treatment has come a long way with the introduction of medical oncology. Rightly stating that 'Cancer is no more a full stop; it is a comma' and the advent of medical oncology involving targeted therapy, molecular therapy, and immunotherapy, has given rise to a new era of 'precision oncology' and opened doors to new hopes in cancer treatment. Speaking in this regard, Dr. Amit Rauthan eloquently stated, "Gone are the days when surgery, chemotherapy, and radiotherapy were the mainstay of cancer treatment. The development of precision oncology signifies a significant change in the way cancer is treated. By focusing on identifying certain molecular targets, more individualized and efficient treatments can be provided, leading to better patient outcomes and quality of life. The future of cancer care is being shaped by the growing combination of immunotherapy and targeted therapy, which gives patients with a variety of cancer types new opportunities and hope." Adding depth to the conversation, Dr. Poonam Patil said, "Molecular tests help identify the sub-types of breast cancers, particularly hormone-dependent breast cancers, as estrogen-receptor-driven cancers or HER2-gene-driven breast cancers, which is vital in treatment planning. Molecular therapy then focuses on targeting only these cancer-causing molecules to stop cancer progression and also kill the cancer cells."

In the second panel discussion, Dr. Mallikarjun Kalashetty, Consultant - Haematology, Haemato Oncology & Bone Marrow Transplantation, and Dr. Ashish Dixit, Consultant - Haematology, Haemato Oncology & Bone Marrow Transplantation, took the stage to highlight the heterogeneous nature of blood cancers and the role of precision medicine and bone marrow transplant in treating blood cancers. Dr. Mallikarjun Kalashetty provided a comprehensive overview of blood cancers, stating, "There are differences between blood and solid organ cancers. The Tumor, Nodes, Metastasis (TNM) staging does not apply to blood cancer. Some blood cancers may not even need treatment. Blood cancer is a heterogeneous group of cancers with some being good, some bad, and some not even requiring treatment. Most blood cancers are treatable with a combination of chemotherapy, immunotherapy, and cellular treatment. With precision medicine, we have come a long way." Raising awareness about bone marrow transplantation, Dr. Ashish Dixit said, "Bone marrow transplantation, when performed, is done with a curative intent. In some cases, it is done to achieve longer control. The donor doesn't have to undergo any surgery, and the procedure is similar to a blood transfusion done under lots of precautions and extremely hygienic conditions."

'Teamwork makes dreams come true'

The third panel consisting of Dr. Vadhiraja B M, HOD & Consultant – Radiotherapy; Dr. R V Parameswaran, Consultant - Nuclear Medicine; and Dr. Vidya M.N., Consultant - Histopathology & Cytopathology, showcased the power of teamwork in cancer care and highlighted the significance of diagnostic and therapeutic adjuvants of cancer therapy. They spoke about the role of radiotherapy, PET-CT scans, and cellular pathology (histopathology and cytology) in cancer treatment planning. Dr. Vadhiraja B M discussed the technological advancements in radiotherapy and said, "X-rays in the mega-voltage range are used for treating cancers. Patients can't feel anything during treatment, but they may notice temporary skin changes in head and neck cancers. With improved technology and image guidance, radiotherapy has become more precise, reducing the treatment duration from 30 days to 5 days." Dr. R V Parameswaran, explaining the role of PET CT scans, said "PET CT can be called the culmination of advantages of PET scans and CT scans. While the PET scan gives details about the functional aspect of the tumor, the CT scan reveals the structural details of the tumor. This combined information helps in treatment planning." He urged people to not rely on the internet and fear PET scans. "Nuclear medicine can be aptly called — new clear medicine, as it gives vital information useful for oncologists, for the most effective treatment planning," he further added. Dr. Vidya M.N. shared valuable insights on histopathology & cytopathology, saying, "Pathologists are often behind the screen but crucial players in cancer treatment. With pathological tests like histopathology, immunohistochemistry, protein tests, and mutation tests, it is now possible to plan precision diagnostics and treatment. These tests also provide vital information on the gene involved or gene absences that drive family history of certain cancers. This helps in deciding if genetic testing/sequencing is required for the family members of the affected and thus save future generations from cancers, warranting regular screening and preventive measures."

In the fourth panel discussion, Dr. Shabber Zaveri, Chairman, HOD, and Consultant – Surgical Oncology & Robotic Surgery; Dr. Hemanth G N, Consultant - Surgical Oncology & Robotic Surgery; and Dr. Suraj Manjunath, Consultant- Surgical Oncology & Robotic Surger,y painted a vivid picture of technological advances in surgical oncology and introduced the audience to the technological wonders such as robotic surgery and HIPEC that have revolutionized surgical oncology. Speaking about the precision-oriented benefits of robotic surgery, Dr. Shabber Zaveri said, "With the advent of robotic surgery, it is now possible to treat complex cancers with great precision. Robotic surgeries are highly accurate and enable oncosurgeons with a 3D-enhanced vision of the surgical site and also provide the dexterity to reach the areas that were earlier deemed inaccessible to surgery." Adding more insights, Dr. Hemanth G N highlighted the transformative impact of robotic surgery. He stated, "Robotic surgery has enabled surgeons with the precision of machines controlled by human hands, bypassing the human fatigue challenges. These surgeries promise fewer surgical complications, less blood loss, and quick recovery." Sharing insights on Hyperthermic intraperitoneal chemotherapy (HIPEC), Dr. Suraj Manjunath said, "With advances such as Hyperthermic intraperitoneal chemotherapy (HIPEC), multimodality treatment is available for the treatment of various cancers such as ovarian cancer, where the recurrence rate is high. This technique helps experts manage surgery and chemotherapy simultaneously. HIPEC facilitates the circulation of chemotherapy inside the abdomen after tumor removal, ensuring any remnant tumor cell death, thereby significantly reducing the chances of recurrence."

The last panel saw Dr. Srimanth B S, Lead Consultant - Orthopaedic Oncology, and Dr. Pratima Raj, Associate Consultant – Gynaecologic Oncology, driving the focus of cancer on subspecialties and speak about the importance of proper diagnosis and early identification of cancers. Emphasizing on how a multidisciplinary and comprehensive approach can help overcome the challenges in diagnosing and treating bone cancers, Dr. Srimanth B S, Lead Consultant - Orthopaedic Oncology, stated, "It's important to determine the actual cause. In certain bone cancers, it's challenging to arrive at the right diagnosis and adopt a multi- disciplinary approach. Interventional radiology advancements, such as Image-guided pin-hole biopsy and details obtained through PET scans from the nuclear medicine team, often play a crucial role in diagnosis and proper treatment planning." He added, "The treatment for bone cancers is no longer confined to limb amputations and limb-preserving surgeries, with advanced technology revolutionizing bone cancer treatment." Dr. Pratima Raj brought attention to the pivotal role of early identification, stating, "In cases such as cervical, endometrial, or uterine cancer or any cancer in general, survival rate and cure rate are higher (almost complete) with early detection. Women should pay attention to any minute changes or symptoms in their health, including post-menopausal symptoms, and must consult the doctors at the earliest to identify and treat the cancer."

The 'Voices of Victory' event at Manipal Hospitals Old Airport Road celebrated not only the triumphs of cancer warriors but also the strides made in cancer care, promoting a holistic and integrated approach for a brighter, cancer-free future.

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