Coming back stronger
Detecting colon cancer got easier this week. A small start-up called Check-Cap in Israel has developed an imaging capsule that transmits X-rays, with minimal radiation, to create 3D images of the colon's internal surface.
All that patients have to do is pop the capsule and go about their day as it travels painlessly through the colon, to be excreted naturally a day or two later. A physician then analyses the data that has been transmitted to a waist or wrist-worn receiver.Since X-ray technology, unlike optics, can see through colon content, the little pill detects potentially malignant polyps with the same accuracy as standard colonoscopy, a procedure involving insertion of a camera in the colon under general anaesthesia after a special diet and bowel cleansing rituals.
Colon cancer is 90% curable with early detection.
Diagnosis was a lot tougher for Poonam Bagai, 49, a colon-cancer survivor who was diagnosed with it in Warsaw in 2000.
"I was okay one day, the next day I had cancer. I was just 38," recalls Bagai, whose two sons were 7 and 3-years-old at the time of her diagnosis.
"I was devastated when the nurse at a Polish military hospital broke the news. I ended up with a colostomy - one end of the large intestine is surgically taken out through the abdominal wall to drain stools into a bag - and slipped into deep, deep depression," she recalls.
The first few months, Bagai was "afraid of dying the whole time". But nine cycles of chemotherapy and three surgeries killed her cancer and she bounced back.
"All that's left now is the memory and a lot of scars on my body," she says.
She came back to Delhi and decided to help others survive cancer. In 2004, with the support of Indian Cancer Society, she founded CanKids, which has helped 6,000 children with cancer get treated.
Medical innovations in cancer diagnosis and treatment are among the fastest-growing in the world, making life after diagnosis longer and less painful.
Unlike conventional toxic drugs that target all actively dividing cells - including healthy sperm cells, bone-marrow cells and cells in the gastro-intestinal tract that are shed every day - newer targeted therapies just attack cancer cells.
"Innovations travel to India within weeks of approval abroad. But these drugs and tools are expensive, priced about four times more than conventional therapies, though disease-free survival (life without the cancer progressing) for many more years after diagnosis make it worth it," says Dr Sameer Kaul, a surgical oncologist at Apollo Hospitals.
Very few, however, can afford them.
"Health insurance is the only answer, though it does not cover all aspects of treatment, such as palliative care," says Dr Kaul, who founded the Breast Cancer Patients Benefit Foundation to screen and treat people for cancer.
The tech edge
Conventionally, surgery and radiation therapy are used to treat primary stage cancers and chemotherapy is used to treat cancers that have spread.
Most upscale cancer centres provide stereotactic body radiation therapy (SBRT) machines that use high-dose of radiation to precisely target the tumour while avoiding healthy tissue.
"Stereotactic body radiation therapy (SBRT) machines track real-time respiratory movements to deliver radiation to tumours that move during the breathing cycle, such as those in the lungs, liver, kidneys and pancreas, prostate, brain, spine and kidney. It's called respiratory gating," says Dr Ganesh K Jadhav, senior radiation oncologist, Apollo Hospitals.
"Higher accuracy and better access also shortens the duration of radiation therapy from the conventional six to eight weeks to one to 10 sittings," adds Dr Jadhav. The difference in cost is minimal.
"If the conventional radiation course costs Rs 2.5 lakh, treatment using SRBT costs about Rs 3 lakh," he says.
"Treatment modalities are now tailormade for patients even within the same cancer, depending on the type of tumours, the age of the patient, co-existing diseases such as high blood pressure and diabetes, and genetic and molecular factors," says Dr Harit Chaturvedi, director, surgical oncology, Max Cancer Centre.
"Better specification and visualisation allows us to offer treatment to patients who were untreatable five years ago, such as a colon cancer patient with more than two or three liver deposits. Now we can treat patients with as many as five and six, taking up five-year survival rate from the earlier 10% to 25%," says Dr Chaturvedi.