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Comprehensive cancer care for:

Division of Breast Diseases

Breast cancer unlike other cancers in the females, is showing increasing incidence in India. The centre has a comprehensive Breast Clinic, which brings all breast related issues under one roof with the primary aim of detecting and diagnosing any cancerous lesions early, which is the first thing that comes to mind when any breast symptoms like pain, discharge or lump appears, and providing treatment thereof, including breast reconstructive surgeries. When struck with the disease at the pinnacle of their youth, the women in urban India has to face several other issues, right from loss of womanhood, feminity to psychosocial traumas, which in a modern nuclear family poses multiple problems.

Hence management of breast cancer in the modern era requires high levels of integration of modern principles of treatment. Drainless oncoplastic surgery (Thomas Technique) is the latest technique where in the beauty of breasts are preserved and best oncologic results are given. The trauma of surgery will be avoided in toto. Knowledge regarding the availability of such novel techniques will prompt women to come forward for early detection because we at Renai wish to popularise the concept that in early detected cancers we preserve the breasts, beauty and womanhood. We therefore are setting new bars in the quality of care for breast cancer victims, by offering unique quality of life.

Head and Neck Cancer

Cancer detection in the early stage is possible in head and neck. Even the person who is at risk could identify the colour changes occurring in the mouth and throat which forms the early warning signals. Early detection of disease may avoid even major surgeries. A simple laser excision could even leave no mark of surgery and obviate further therapies including radiation or chemotherapy. However cessation of tobacco habituation is a pre requisite to avoid recurrences.

If the full blown cancer is picked up at an early stage, depending on which part of the oral cavity the disease has affected, there are several options available including laser surgery, organ preservation or cosmetic cancer surgeries which will eradicate the disease yet offer cosmetic outcomes. These challenging concepts respecting oncologic principles and plastic surgery have revolutionised cancer surgery of head and neck region. There are areas like vocal cord cancer where radiation could control the cancer in early stage. However for tumours of larynx (other than vocal cord), organ preservation after neoadjuvant chemotherapy and radiation plays major role. Tumours affecting base skull or paranasal sinuses also could be attempted without disfigurement.

Thyroid Tumours

Traditionally Kocher’s thyroidectomy is the approach done for thyroid neoplasms for more than a century. This approach not only leaves behind a scar at the most exposed part of the neck, but also has several complications including nerve injuries, parathyroid deficiencies and haemorrhage in many cases. Clinical research with the aid of 3D digital interactive anatomy has paved way to an innovative approach to the commonest surgery done in the world, thyroidectomy, called scar less thyroid surgery or minimally invasive open thyroidectomy or horizontal lateral thyroidectomy (Thomas Technique).

This is a surgical innovation by our Dr. Thomas Varughese and hence named as Thomas Technique. Currently our centre is offering this unique surgery at affordable cost. Patients could go home in 24-hrs and it’s a blood less surgery avoiding transfusions. It takes care of the several complications described in Kochers’ surgery and cosmetically unique.

Thoracic Oncology and Lung Cancers

Unlike the past, modern oncology has shown great hopes for lung cancer victims. Early cancers merit to lung preserving surgeries (function preserving) like lobectomy which adds to quality of life in that the performance status is always superior. Even in locally advanced lung cancer, similar to breast cancer, down staging is possible to offer salvage/organ preservation/function preservation surgeries.

At our centre, thrust is given to organ preservation in lung cancers. We have ongoing programs for early diagnosis and screening. Video endoscopy, thoracoscopy etc have added to the gadgets for this crusade. Mediastinal tumours of different categories can affect human beings. Many a time mediastinal dissections form integral part of cancer treatments in lung cancers, oesophageal cancers, primary mediastinal tumours, tumours of Thymus gland, or even thyroid neoplasm with metastasis to mediastinum, as in medullary cancer or papillary cancer. High calibre in thoracic oncology and understanding of tumour biology are mandatory for perfect end results. Excellent infrastructure to undertake such surgeries too are set up at Renai.

Oesophagus Cancer

Cancer of oesophagus is on the rise. It has predilection for men who are habituated to tobacco, especially smokeless. Women are no exception.

Oesophagus cancer is one of the best examples of cure if detected early and lethal if diagnosed late. In early cancers (mucosal types) a non invasive endoscopic surgery also is possible called EMR (Endoscopic Mucosal Resection).

We have pioneered novel treatment for down staging of cancers of the Gastro oesophageal cancers and give better cure rates than upfront surgery.

Cancer of Stomach, Pancreas Colon and Rectum

Several novel concepts in the management of these organs have appeared. The most important being down staging of the cancers with upfront targeted or other type of medication so that better cure rates and quality of life could be offered in otherwise inoperable situations. Several challenges for organ preservations like pyloric preserving Whipples’ pancreaticoduodenectomies, anterior resections or Low anterior resections after neo adjuvant chemotherapy for rectal cancers, neo adjuvant targeted chemotherapies for colon cancers have revolutionised treatments of Gastrointestinal malignancies. Our experts have undergone extensive training in GI cancer management.

Gynaecological Malignancies

Early detection of Cervix cancer, the second commonest cancer in women could result in cure. Awareness of sexual hygiene and proper bath has reduced cervix cancer incidence in India. We are aware that vaccination against cancer cervix is a reality and cervix cancer is preventable. A pap smear examination could detect cancer cervix years before the actual cancer sets in. Hence at Renai we are committed at the women’s cancer initiative of early detection and prevention. We have strategies for those who present even in a  locally advanced condition by adopting novel targeted anti cancer drugs to downstage the disease so that many cases who otherwise will have imminent death could be helped to have better disease control which was not there few years ago. Many patients unlike in other sites with similar cancers could even get a cure.

Surgical oncology unit at Renai also has got the technical knowhow to perform extensive pelvic exenteration for those who develop local recurrences after radiation for cervix cancer.

State of the art strategies are adopted for ovarian cancers. Those who present early and in whom fertility preservation is needed it is offered. Young unmarried girls benefit from this approach. Advanced cancers are down staged and our surgical oncology leader Dr. Thomas Varughese received special training to offer total Peritonectomy from Dr. Paul Sugarbaker of Washington Cancer Hospital, DC.  Total Peritonectomy is today regarded as the ONLY approach that could impart a meaningful difference in the survival patients with ovarian cancer. Total Peritonectomy for such patients is not done in any centre in south India. Neo adjuvant chemotherapy also offers quality of life in that it avoids unwanted bowel resections. Once tumour bulk is reduced this even provides spillage free resections and hence better survival.

Cancers of Vulva also poses big issue for women. Early cancers are curable. Locally advanced cancers could be tackled with neo adjuvant chemotherapy and state of the art plastic and reconstructive surgeries.

Genito – Urinary Cancers

Cancers affecting the Kidney, Ureter, Bladder, Prostate and Penis

Kidney cancers present in different stages. Early cancers necessitating nephron sparing nephrectomies are offered the same. There is changing philosophy in the management of locally advanced kidney cancers to adopt a down staging principle. This not only helps to downsize the tumour but also helps to prevent distant dissemination but makes surgery easier and gives long term disease free survival.

Early bladder cancers requiring conservative approaches and others requiring total cystectomies are offered state-of-the-art treatment. Ureteric cancers which are highly malignant merits comprehensive cancer care and are offered the same.

Prostatic cancers both hormones responsive or otherwise too get advanced treatment protocols. Early detection programme for prostate cancer also is in full swing. Conservative approaches for early penile cancers and radical surgeries for other cases are done.

Soft Tissue Sarcomas and Bone Tumors

Organ preservation emerged in the field of oncology for the first time in the management of bone and soft tissue tumours. At Renai, limb salvage surgeries are the approach than amputations. Primary bone tumours are common in paediatric age group requiring comprehensive cancer care.

The centre is ably supported by high end radiology and pathology services. We also provide comprehensive cancer rehabilitation by a team of health care professionals including oncologists, physical therapists, occupational therapists, dieticians, psychologists, psychiatrists and speech-language pathologists. They work closely with each patient to help them recover physically and emotionally.

Together with the message of cancer prevention, early detection, organ and function preserving, late cosmetic oncology and implementing path breaking concepts, Renai Medicity’s centre for Function & Organ Preserving Cancer Surgeries is truly world class and stand alone.