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Blood Diseases, Bone Marrow Transplant and Cancer Immunotherapy

The Centre for Blood Diseases, Bone Marrow Transplant and Cancer Immunotherapy provides specialized care for all kinds of cancers and blood disorders. The department offers advanced treatments in the field of systemic therapy for cancers like immunotherapy and targeted therapy apart from chemotherapy. In the field of Hematology, the department is equipped to fight complex diseases for patients with acute and chronic blood disorders. With a state-of-the art Bone Marrow Transplant Program, the department serves as one of the most preferred destinations for blood diseases or related complexities in the region and abroad. The department is backed by expert doctors trained from leading institutes and nursing staff specialized in the care of cancer and BMT patients, sophisticated intensive care units and allied medical/surgical departments for holistic patient care.

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BONE MARROW TRANSPLANT

MEDICAL ONCOLOGY AND CANCER IMMUNOTHERAPY

SURGICAL ONCOLOGY

The Surgical Oncology department is a dedicated team of highly skilled surgeons with extensive experience in performing the full range of cancer surgeries and reconstructive procedures with high precision and efficiency. Some of the key malignancies and types of cancers treated at the department include:
– Head and neck cancer
– Breast cancer
– Gastro-intestinal cancer
– Hepatobiliary and pancreatic cancer
– Genitourinary cancer
– Thoracic cancer
– Gynae oncology
– Limb preservation surgeries for sarcomas

  • Head and Neck Cancer Surgeries
  • Breast Cancer Surgeries
  • Gastrointestinal Cancer Surgeries
  • Gynecological Cancer Surgeries
  • Urological Cancer Surgeries
The different types of head and neck cancer like thyroid cancer, laryngeal cancer, parathyroid cancer, nasopharyngeal cancer, oral cavity cancers etc are treated using surgery, chemotherapy, radiation therapy, immunotherapy and targeted therapy, or a combination of different types. The course of treatment is decided based on factors such as the stage and location of the tumour, age, and overall health. The goal is to ensure that there is minimal damage caused due to the surgery and cancerous tumour and some healthy tissue surrounding the tumour is removed.
 
The different types of surgeries performed for head and neck cancer:
•     Laser Technology to treat an early-stage tumour found in the larynx
•     Excision to remove any cancerous tumour and the surrounding healthy tissue
•     Neck Dissection, also known as Lymph node dissection, when the doctor suspects spreading of the cancer and the need to remove the lymph nodes from the neck. This can be done alongside an excision.
•     Plastic or Reconstructive surgery to replace the missing tissues after a cancer surgery where the some of the major tissues are removed to help fix the patient’s appearance and restore functioning of the affected portion in the body
Surgery to remove a tumour from the head and neck depends on the stage, location and type of cancer and at times, may need more than one surgery and additional treatment to recover completely.

Dr Deepak Janardhan

Senior Consultant – ENT & Head and Neck Surgery
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For most women suffering from breast cancer, surgeries are suggested as part of the treatment. Breast cancer surgeries are recommended only when there is a necessity to remove as much of the cancer cells, to find out if cancer has spread under the arm to the lymph nodes, to reconstruct and reshape the breast after cancerous cells are removed and to relieve any advanced cancer symptoms. Surgeries are considered based on the patient’s medical history, type and severity of breast cancer. Following are the two main types of breast cancer surgeries performed:
•     Breast-conserving surgery/ lumpectomy:  Through this type of surgery, only the cancerous part in the breast is removed alongside few normal tissues surrounding the cancerous part. Measuring the portion to be removed is dependent on the tumour size and location.
•      Through Mastectomy , entire breast, including the breast and other nearby tissues is surgically removed.
•      Lymph node removal surgeries  also carried out to find out if the cancer has spread in the underarms where the lymph nodes are located. They use Sentinel lymph node biopsy (removal of only those lymph nodes where the chances of spreading of cancer is higher) or Axillary lymph node dissection (removal of several lymph nodes) in such cases.

Dr Saju Narayanan

Senior Consultant – Plastic, Reconstructive, Microvascular & Cosmetic Surgeon
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Dr Shaji K Ayillath

Senior Consultant –Surgical Oncology, Meitra Hospital
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Gastric cancer, as it is commonly referred to as, occurs when cancer cells are found forming on the stomach lining. Factors such as diet, age and recurring stomach diseases are known to increase the chances of developing gastric cancer. Doctors evaluate the condition of the patients based on the symptoms such as pain or discomfort in the stomach and conduct diagnostic tests to examine the stomach and the oesophagus. The cancer begins from the mucosa layer in the stomach and spreads thereafter as it progresses. For patients with gastric cancer, treatment options are suggested based on their condition. However, surgery is recommended as a common treatment option for gastric cancer, irrespective of the stage it is in. Following are few types of gastric cancer surgeries:
 
Subtotal gastrectomy  used to remove the cancerous parts and the nearby lymph nodes of the stomach, other tissues or organs located near the tumour. The spleen may also be required to be removed.
 
Total gastrectomy  refers to complete removal of the stomach along with the nearby lymph nodes, portions of the other organs such as oesophagus, small intestine, other tissues formed near the tumour. The doctors may remove the spleen too.
In case when the tumour cannot be removed completely with standard surgery, doctors consider the following procedures.
 
Endoluminal stent placement  performed to insert a stent to create an open passage in the oesophagus to the stomach or from stomach to small intestine when the tumour blocks the passage.
 
Endoluminal laser  therapy wherein an endoscope and a laser attached to it is inserted.
 
Gastrojejunostomy  to remove the cancerous part that blocks the opening from stomach into the small intestine to allow medicine and food to be passed.

Dr. Rohit Ravindran

Senior Consultant GI Surgery, GI Oncosurgery, Advanced Laparoscopic & Liver Transplantation
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Dr. Shanavas Kakkat

Consultant GI Surgery, GI Oncosurgery, Advanced Laparoscopic & Liver Transplantation
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These are cancers of the female reproductive system affecting the cervix, ovaries, uterus, vagina and the vulva. The doctors perform comprehensive evaluation using diagnostic tools such as imaging tests, ultrasound, and pelvic examination to determine type and stage of the cancer. Since these types of cancers are complex, the treatment also involves multiple stages including surgery, radiation and chemotherapy.
·       Common surgical procedures for gynaecologic cancers include:
  • Simple Hysterectomy or removal of the uterus or cervix or Radical Hysterectomy to remove the cervix, uterus, upper part of vagina and other nearby tissues either by abdominal incision, laparoscopy or using robot-assisted surgical tools
  • Bilateral Salpingo-oophorectomy for menopause patients to remove fallopian tubes and ovaries
  • Lymph node removal near the tumour to check if there is cancer beyond the uterus using a sentinel lymph node biopsy or lymphadenectomy .

Dr Shaji K Ayillath

Senior Consultant –Surgical Oncology, Meitra Hospital
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This type of cancer includes cancers affecting the urinary tract in male and female as well as the male reproductive organs. Prostate, kidney and bladder cancers are relatively common and are treated using several diagnostic tools and technologies. A Urologic Oncologist diagnoses the severity of the cancer and then devises a specific treatment plan to ensure that the side effects are minimal and does not affect the sexual function. For treating urologic cancers, surgery is recommended as the primary treatment, depending on the cancer type and its stage. In case the cancer has progressed, the treatment approach may include radiation therapy, immunotherapy, chemotherapy, or targeted therapy.
Surgeries performed for treating prostate cancer:
•             Prostatectomy  to remove prostate gland using robotic surgical tools where smaller incisions are made with precise cuts. This procedure also helps in keeping the nerves required for sexual function safe.
•             Prostate Biopsy  is a surgical procedure to collect a sample of the suspected affected prostate cancer cells for examining them by the pathologist. Biopsies are usually performed using endoscopic procedures or ultrasound, MRI or CT scans for image guidance.
Surgeries to treat bladder cancer:
•             Transurethral Resection  of the Bladder Tumour is commonly performed in case of bladder cancers diagnosed at an early stage. It is also performed on those tumours that are restricted to the upper covering layer of the wall on the bladder. An Oncosurgeon performs this surgery without opening the abdomen and through the urethra by passing a resectoscope wherein a wire loop tied at one end of the resectoscope remove the tumour or the diagnosed abnormal cancer tissues.
•             Cystectomy  is used when the oncosurgeon decides to remove either some portions of the bladder or the entire organ itself. At times, an incision is made into the abdomen to get access to the bladder using laparoscopic tools. Through the small incisions, long and thin instruments with a video camera are inserted to help the surgeon view the inside of the pelvis. There are two types of Cystectomies:
o             Partial cystectomy  is performed to remove a part of the bladder when cancer is diagnosed to have invaded the muscle layer of the bladder wall, is not large in size and confined to only a portion of the bladder.
o             Radical cystectomy  when the cancer is of aggressive type and the entire bladder needs to be removed along with the lymph nodes located nearby.
•             Reconstructive surgery  performed when the cancer is in its advanced stage and cannot be removed surgically. Using this treatment approach, urine is diverted to treat blockage of the flow away from the bladder which is not removed.
Surgeries to treat kidney cancer include:
•             Radical nephrectomy  for entire affected kidney removal using incisions in the abdomen.
•             Laparoscopic radical nephrectomy  (LRN) by making a few small incisions to remove the kidney causing less scarring and bleeding
•             Partial nephrectomy  to remove only the cancerous part of the kidney to preserve its function
Surgeries for testicular cancer:
•             Radical inguinal  orchiectomy to remove the testicle containing the tumour, the spermatic cord
•             Retroperitoneal  lymph node dissection when the doctor suspects that cancer cells might have spread to nearby lymph nodes

Dr. P. Roy John

HOD, Senior Consultant & Robotic Surgeon, Urology Sciences
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Dr Kiran S

Senior Consultant – Urology-Nephro Uro Sciences and Kidney Transplantation
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