Cancer

About Nayati Centre Of Excellence For Oncology (Cancer)

Nayati Cancer Centre (Oncology) is concerned with screening, early detection, staging and management of cancer. The cencer offers holistic integrated care taking into consideration views of specialist of all the three divisions – Hemato-medical, Surgical and Radiation. The centre provides end to end cancer management.It has world-class facilities and its faculty members are recognized internationally for their expertise in cancer treatment and research. Equipped with world-class technology, the department matches the highest global standards in healthcare. It is the first in the region offering most advanced treatment of cancer with the use of Versa HD.

The services at the centre include evaluation for solid tumors and blood cancers, along with treatment planning and coordination of all modalities . Minimal access and open surgical interventions are available for cancer of thte head and neck, brain, spinal cord, lungs, pleura, thorax, thyroid, breast, esophagus, stomach, liver, gall bladder, pancreas, intestine, rectum, gynaecological, lymph nodes, kidney, bladder, prostrate and pediatric cancers. High-end radiation therapy, isolation rooms, critical care, bone marrow transplantation, palliativie care, plastic and reconstructive surgery, pain clinics and counselling services are also available. Facilities for immune-compromised patients with trained nursing staff. Our state-of-the- are day care facility ensures comfort to patients during chemotherapy sessions . It Provides end to end cancer management

Our Services

The services at the Center include evaluation for solid tumors and blood cancers, along with treatment planning and coordination of all modalities.

Minimal access and open surgical interventions are available for cancer of the head and neck, brain, spinal cord, lungs, pleura, thorax, thyroid, breast, esophagus, stomach, liver, gall bladder, pancreas, intestine, rectum, gynecological, lymph nodes, kidney, bladder, prostrate and pediatric cancers. High end radiation therapy, isolation rooms, critical care, bone marrow transplantation, palliative care, plastic and reconstructive surgery, pain clinics and counselling services are also available.

Our state-of-art day care facility ensures comfort to patients during chemotherapy sessions. The main modalities of treatment are chemotherapy, immunotherapy, targeted therapy and Bone Marrow Transplantation .

  • Out Patient Department
  • In Patient Department
  • Day Care Services
  • Radio sensitizers, Radio protectors and Concomitant Therapies
  • Biologically Targeted Therapies
  • Tumour Board Meetings
  • Oncological Emergency Services
  • Palliative Medicine
  • Cancer Pain Management
  • Lymphoedema Management
  • Stoma Clinic
  • Counselling Support
  • Preventive Oncology Services
  • Special nursing and rehabilitative services as required

DEPARTMENTS

  • RADIATION / CLINICAL ONCOLOGY

    Versa HD system – For the first time in the region

    Patients with cancer can now receive the fastest, most precise radiation therapy possible. Versa HD will benefit a wide spectrum of patients suffering from head-and-neck, breast, prostate, lung cancers and all other types of cancers.

    Versa HD is the only radiation therapy machine available that combines the most sophisticated beam-shaping technology with advanced capabilities for high-speed delivery of the radiation beams.

    Radiation dose will be three times faster than usual, which will significantly shorten treatment time for patients.

    Super Specialized Modalities

    • 3DCRT (3 Dimensional Radiotherapy)
    • IMRT (Intensity Modulated Radiotherapy)
    • IGRT (Image Guided Radiotherapy)
    • VMAT (Volumetric Arc Radiotherapy)
    • SRT/ SRS (Stereotactic Radio Surgery)
    • SBRT (Stereotactic Body Radiotherapy)
    • 4D CT (4 Dimensional CT Simulation)
    • INTRACAVITORY, INTERSTITIAL,INTRALUMINAL BRACHYTHERAPY
    • IGBT (Image Guided Brachytherapy)

  • SURGICAL ONCOLOGY

    Head &Neck Surgery

    • COMMANDO, Skull base, Larynx/ Mandible preservation and
      Reconstructive Surgeries
    • Surgeries with Free and Pedicle Flaps

    Breast

    • BCS (conservative) and Radical Mastectomy
    • Breast Reconstruction
    • Frozen Section & Sentinel Node Biopsy

    Abdominal Surgeries – Laparoscopic/ Open Radical Surgery

    Skin and Soft Tissue Tumors

    Gynecology Oncology

    • Advanced treatment of cervical, ovarian, fallopian tube, uterine,
      vaginal and vulvar cancer
    • Preventive aspect of all female cancers
    • Cervical cancer prevention vaccine

    SICU – Operation Theatre Complex

    OT complex with 7 modular Operation theatres, with Heppa Filters, Bilaminar flow, Harmonic scalpel, Ligasure, Advance Laparoscopic set, Operating microscope, Advance anesthesia system, Surgical ICU.

  • MEDICAL ONCOLOGY, HEMATOLOGY & BONE MARROW TRANSPLANTATION

    SERVICES OFFERED

    • Molecular, Therapeutic and Pharmaco-genomics testing to aid cancer treatment.
    • All types of Chemotherapy, immunotherapy and targeted therapy for adult cancer patients
    • Complete treatment for childhood cancer
    • All types of Blood Cancers
    • Bone marrow transplantation for both Benign and Malignant disorders
    • Complete treatment for elderly people with cancers
    • Central venous access- PICC, Hickman’s catheter and chemo ports
    • The clinical specialities are fully backed by other supporting specialities
    • Intracavitory Chemotherapy

  • NUCLEAR MEDICINE

    SERVICES OFFERED

    • Whole body PET-CT with Contrast Study.
    • Whole body PET-CT with Non Contrast Study.
    • Cardiac PET-CT Study.
    • Brain PET-CT Study.

Our Team

Team of doctors trained from the best cancer institutes of the country and recognized nationally & internationally.

Technology

World’s best in class Next Generation Elekta Radiation Therapy System for High Precision, High Speed Treatment of Cancer PatientsRadiation dose is three times faster than usual, which significantly shortens treatment time for patients

PET Based Radiotherapy Planning and diagnostic PET-CT- The PET scan can measure blood flow, oxygen use, glucose metabolism( how one’s body uses sugar), and much more.

SRT/SRS (Stereotactic Radio Surgery)– A dedicated system for non-invasive stereotactic radiosurgery and stereotactic radiotherapy( SRS and SRT), represents cutting-edge technology for treatments of the highest precision. Its X-ray-based localisation technology allows our physicians to localize tumors with sub-millimeter accuracy and to position patients automatically and with the highest degree of precision.

VMAT(Volumetric Arc Radiotherapy)– 3D dose distribution with a 360-degree rotation of the gantry in a single or multi-arc treatment.it also modulates the radia-tion for higher conformity while rotating the machine around the patient.

IGRT(Image Guided Radiotherapy)– Image Guided Radio Therapy is a type of therapy which can shape the radiotherapy beams around the area of the cancer. This technology helps in treating the cancers precisely and accurately and reduces the side effects of the treatment.

IMRT (Intensity Modulated Radiotherapy)– IMRT is a sophisticated treatment involving high conformity and high precision. it reduces the probability of in-field recurrence, minimise the degree of morbidity associated with treatment.

Our Team

Our Clinicians
  • Dr. (Prof) Santanu Chaudhuri, Chairman Oncology
  • Dr. Amit Bhargava, Director, Medical Oncology
  • Dr. Ravikant Arora, HOD and Sr. Consultant, Surgical Oncology
  • Dr. Sangeeta Tikoo, Director, Nuclear medicine
  • Dr. Sanjeev Kumar Gupta, Consultant Clinical Oncology
  • Dr. Pradeep Kumar, consultant hemato-oncology
  • Dr. Debashis Panda, Attending consultant, clinical Oncology
  • Dr. Neeraj Kumar, Attending consultant, clinical Oncology
  • Dr. Pankaj Khandelwal, Senior resident, Medical Oncology
  • Dr. Harendra Singh, Senior resident, Medical Oncology
  • Dr. Mohd. Sajid , Senior resident, surgical Oncology
  • Dr. Saurabh Varshney, Senior resident, surgical Oncology
  • Dr. Shaivaar Ali, junior resident, Medical Oncology Medical Physicist
Medical Physicist
  • Mr. SujitNath Sinha, Chief Medical Physicist
  • Mr. Palanivel, Medical Physicist
Anaesthesiology& Pain Clinic
  • Dr. NeerjaJohar
  • Dr. H. Saini and team
Our Technologists
  • Mr. Aneesh PM, Chief Radiation technologist
  • Mr. Birinder Singh, Radiation technologist
  • Ms. Jui Deb, Radiation Technologist
Nursing staff
  • Dhanya Krishnan
  • Shyamli
  • Ashwani
Supporting staff
  • Mr. Ajay Parashar
  • Ms. Deepti Sharma
  • Ms. Radha
Biostatistics
  • Dr. Mamata, Dr. Ankita, Naveen
Nutritionist
  • Dr. Astha
Occupational therapy
  • Apurv, Praveen
General Duty Staffs
  • Archana, Piyush
Psychology counsellor
  • Pushpanjali

Our Team

  • Dr. Sanjeev Kr Gupta, Consultant, Clinical oncology
  • Mr. SujitNath Sinha, Chief Radiation Physicist and RSO
  • Dr. Pradeep, consultant hemato-oncology
  • Dr. Debashis Panda, Attending consultant, clinical Oncology
  • Dr. Neeraj Kumar, Attending consultant, clinical Oncology
  • Dr. Pankaj Khandelwal, Senior resident, Medical Oncology
  • Dr. Harendra Singh, Senior resident, Medical Oncology
  • Dr. Mohd. Sajid , Senior resident, surgical Oncology
  • Dr. Saurabh Varshney, Senior resident, surgical Oncology
  • Dr. Shaivaar Ali, junior resident, Medical Oncology
Our Technologists
  • Mr. Aneesh PM, Chief Radiation technologist
  • Mr. Birinder Singh, Radiation technologist
  • Ms. Jui Deb, Radiation Technologist

SIX COMMON SITES

  • Breast Cancer

    1. More than 1 million cases per year (India).
    2. Both sexes are involved, females > males.
    3. Age group affected >40 years, commonly.

    Risk factors

    Risk factors can be divided into two categories:

    1. Modifiable risk factors (things that people can change themselves, such as consumption of alcoholic beverages).

    2. Nonmodifiable risk factors (things that cannot be changed, such as age and biological sex).

    The primary risk factors for breast cancer are being female and older age. Other potential risk factors include genetics, lack of childbearing or lack of breastfeeding, higher levels of certain hormones, certain dietary patterns, and obesity. Recent studies have indicated that exposure to light pollution is a risk factor for the development of breast cancer.
    Symptoms & Signs Lump, thickening different from the other breast tissue, one breast becoming larger or lower, a nipple changing position or shape or becoming inverted, skin puckering or dimpling, a rash on or around a nipple, discharge from nipple/s, constant pain in part of the breast or armpit, and swelling beneath the armpit or around the collarbone. Pain is not a reliable symptom, usually occurs in late stage after involvement of nerve roots.

    Pathology

    Originates from ducts, lobules, or interstitial tissues. Most commonly originates from ducts.

    Pathological varieties

    1. In-situ cancers (DCIS, LCIS)
    2. Invasive cancer(Ductal, Lobular)
    3. Metaplastic carcinoma (Squamous, Adenosquamous)
    4. Sarcoma
    5. Pagets

    Diagnosis & Staging

    1. History & physical examination.
    2. Tissue diagnosis (FNAC, HP & IHC)
    3. Mammography
    4. MRI (staging)
    5. Bone scan (metastatic work up)
    6. Whole body PET-CT (for staging & metastatic work up)
    7. Chest X- Ray & USG (abdomen/pelvis) (metastatic work up)
    8. Genetic study (Oncotype Dx, Mammaprint)

    After diagnosis the disease is staged properly for risk stratification, treatment and prognosis.
    Treatment

    Multidisciplinary approach

    1. Surgery (Breast conservation Surgery, Simple mastectomy, radical mastectomy, modified radical mastectomy, palliative toilet mastectomy)
    2. Chemotherapy ( Neoadjuvant, Adjuvant, Palliative)
    3. Radiotherapy (as a part of BCT, Adjuvant, Palliative)
    4. Hormone therapy (depending on hormone receptor positivity: Tamoxifen, Letrozole, Anastrazole, Trastuzumab)
    5. Targeted therapy (Bevacizumab)
    6. Bone stabilizing agents (Zoledronic acid, Evadronic acid) Prognosis

    Better prognosis, if detected in early stage. We can expect a complete cure in early stages. In later stages chance of getting cured is still there, but solely depends on the treatment response. In stage IV, metastatic disease survival percentage is dismal, but wide ranges of treatment available to control the symptoms and disease progression. The aim of treatment is not only to cure or control the disease, but also to give the patient a better quality of life.

    Screening

    1. Self breast examination.
    2. Breast examination by health workers or health care givers.
    3. Routine screening (using Breast Sonomammography, Mammography or MRI) of the high risk population having a genetic risk i.e. with one first degree relative or two second degree relatives with breast cancers.

  • Cervix Cancer

    Fewer than 1 million cases per year (India)

    A malignant tumour of the lower-most part of the uterus (womb) that can be prevented by PAP smear screening and a HPV vaccine.
    Causes & risk factors

    1. Human papilloma virus
    2. Smoking
    3. Oral contraceptive pills
    4. Multiple pregnancies
    5. Early age of pregnancy
    6. Early menarchy
    7. Late menopause
    8. Unhygienic living condition
    9. Promiscuity

    Pathogenesis

    1. CIN 1 -> CIN 2 -> CIN 3 -> Invasive malignancy.
    2. This takes a long time to progress from precancerous to frank malignancy. (more than 15 years)
    3. So screening is very effective in early detection and cure.

    Clinical symptoms & signs

    1. The early stages of cervical cancer may be completely free of symptoms.
    2. Vaginal bleeding, contact bleeding (one most common form being bleeding after sexual intercourse), or (rarely) a vaginal mass may indicate the presence of malignancy.
    3. Also, moderate pain during sexual intercourse and vaginal discharge are symptoms of cervical cancer.
    4. In advanced disease, metastases may be present in the abdomen, lungs, or elsewhere.
    5. Symptoms of advanced cervical cancer may include: loss of appetite, weight loss, fatigue, pelvic pain, back pain, leg pain, swollen legs, heavy vaginal bleeding, bone fractures, and (rarely) leakage of urine or feces from the vagina. Bleeding after douching or after a pelvic exam is a common symptom of cervical cancer.

    Diagnosis & staging

    1. History & physical examination
    2. PAP smear.
    3. Histopathology
    4. Cystoscopy
    5. Chest X-Ray, Ultrasonography (abdomen & pelvis) as metastatic work up
    6. CECT/ MRI Abdomen & Pelvis for knowing the disease extension.

    Staging is completely clinical staging, as per FIGO guidelines. Staging is necessary for choosing the treatment modality and for prognostication.

    Treatment

    1. Very early stage- Surgery or Surgery followed by RT/CTRT depending on post operative histopathology report.
    2. Moderately or locally advanced- Neoadjuvant Chemotherapy followed by Radiotherapy or Chemoradiation in radical intent.
    3. Very advanced/metastatic- Palliative Radiotherapy/ Chemotherapy.

    Prevention

    1. HPV Vaccine- They are recommended for women who are 9 to 25 years old who have not been exposed to HPV.
      a. Since the vaccine only covers some high-risk types of HPV, cervical cancer screening is recommended even after vaccination.
    2. Creating awareness among public regarding preventable nature of the disease.

    Screening

    1. PAP smear- recommended to begin at the age 21.
    2. 3 yearly PAP in between age group 21 – 65 years.
    3. In USA PAP smear with HPV testing is recommended.

  • Colorectal cancer

    1. More than 1 million cases per year (India)
    2. Early cases can begin as non-cancerous polyps. These often have no symptoms but can be detected by screening. For this reason, doctors recommend screenings for those at high risk or over the age of 50.

    Causative agents & risk factors

    1. Greater than 75–95% of colorectal cancer occurs in people with little or no genetic risk.
    2. Risk factors include older age, male gender, high intake of fat, alcohol, red meat, processed meats, obesity, smoking, and a lack of physical exercise.
    3. Streptococcus gallolyticus is associated with colorectal cancer.
    4. Inflammatory bowel disease- ulcerative colitis, Chrohn’s disease.
    5. Genetics- 20% cases have got genetic predisposition.

    Clinical features

      The signs and symptoms of colorectal cancer depend on the location of the tumour in the bowel, and whether it has spread elsewhere in the body (metastasis).

      The classic warning signs include: worsening constipation, blood in the stool, decrease in stool caliber (thickness), loss of appetite, loss of weight, and nausea or vomiting in someone over 50 years old. While rectal bleeding or anemia are high-risk features in those over the age of 50, other commonly described symptoms including weight loss and change in bowel habit are typically only concerning if associated with bleeding.

    Diagnosis & staging

    1. History & physical examination.
    2. Lower GI Endoscopies (Rectosigmoidoscolpy, Colonoscopy)
    3. Endoscopic ultrasonography
    4. Histopathology/ Cytopathology
    5. CECT (abdomen/pelvis)
    6. MRI (abdomen/pelvis)
    7. Serum markers like CEA
    8. PET – CT when indicated

    Staging done for risk stratification, treatment decision and prognostication.

    Treatment

    1. Surgery- hemicolectomy, total colectomy, APR, LAR depending on indication.
    2. Radiotherapy-
      a. Neoadjuvant CTRT
      b. Adjuvant RT/ CTRT
      c. Palliative RT
    3. Chemotherapy-
      a. NACT
      b. Adjuvant
      c. Palliative
    4. Immunotherapy-
      a. Immunotherapy has been found to be useful for a type of colorectal cancer with mismatch repair deficiency.

    Prognosis

    Early stages of disease, has got a better prognosis and survival, and as the stage progresses prognosis becomes poorer.

    Screening

    1. The three main screening tests are colonoscopy, fecal occult blood testing, flexible sigmoidoscopy.
    2. If used, screening is recommended every 3 years, starting at age 50.
  • Head & Neck Cancers

    1. More than 1 million cases per year (India)
    2. Commonly affects adults of any age group.
    3. About 75% of head and neck cancer is due to the use of alcohol or tobacco.

    Causative agents & risk factors

    1. Use of alcohol or tobacco.
    2. Human papilloma virus
    3. Radiation exposure
    4. Certain workplace exposures
    5. Epstein-Barr virus
    6. Gastroesophageal reflux disease

    Sites affected

    1. Nasopharynx
    2. Oral cavity
      a. Lips, oral tongue, hard palate, buccal mucosa, gingivo-buccal sulcus, floor of mouth, alveolus
    3. Oropharynx
      a. Base of tongue, valeculla, pharyngeal wall, soft palate, uvula, tonsils.
    4. Hypopharynx
      a. Post cricoid area, pyriform fossa, pharyngeal wall
    5. Larynx
      a. Supraglottic, glottic, subglottic.
    6. Maxillary sinuses
    7. Orbital tumours
    8. Thyroid malignancies

    Histopathology varieties

    1. Squamous cell carcinoma
    2. Adenocarcinoma
    3. Others
      a. Lymphoma, Sarcoma, adamantinoma, esthetioneuroblastoma, adenoid cystic carcinoma etc…

    Clinical features

    1. Mass in the neck
    2. Neck pain
    3. Bleeding from the mouth
    4. Sinus congestion, especially with nasopharyngeal carcinoma
    5. Bad breath
    6. Sore tongue
    7. Painless ulcer or sores in the mouth that do not heal
    8. White, red or dark patches in the mouth that will not go away
    9. Earache
    10. Unusual bleeding or numbness in the mouth
    11. Lump in the lip, mouth or gums
    12. Enlarged lymph glands in the neck
    13. Slurring of speech (if the cancer is affecting the tongue)
    14. Hoarse voice which persists for more than six weeks
    15. Sore throat which persists for more than six weeks
    16. Difficulty swallowing food
    17. Change in diet or weight loss

    Diagnosis & staging

    1. History & physical examination
    2. Endoscopies
    3. Histopathology/ cytology/ IHC
    4. CECT (face & neck)
    5. Chest X-Ray, Ultrasonography (abdomen & pelvis)
    6. PET – CT when indicated.

    Treatment

      Surgery- mainstay of treatment. One must go for surgery, when it is indicated.

      Radiotherapy-
      a. Radical intent (organ preservation in cases of Ca- Larynx, Oropharynx.
      b. Adjuvant intent- after surgery, depending on post op histopathology report.

      c. Palliative- for symptom control like bleeding, pain in case of very advanced or metastatic cases.

      Chemotherapy-
      a. Neoadjuvant- before any definitive treatment, for organ preservation plan.
      b. Concurrent- along with radiation for enhancing the effect of radiotherapy.
      c. Adjuvant- tried in the past, but no definite role.
      d. Palliative- in very advanced/metastatic cases for symptom control.

    Prognosis

    Curable if detected early. As the stage progresses prognosis becomes poorer.

    Prevention

    1. Quit tobacco & alcohol.
    2. Creating public awareness.
    3. Regular screening programs.
  • Lung Cancer

    1. Lung cancer, also known as lung carcinoma, is a malignant lung tumor characterized by uncontrolled cell growth in tissues of the lung.
    2. This growth can spread beyond the lung by the process of metastasis into nearby tissue or other parts of the body.
    3. Males, Age > 50 years are at highest risk, but mortality in females is increasing.

    Causes

    1. Smoking. (Active/ Passive)
    2. Radon Gas.
    3. Asbestosis.
    4. Air pollution
    5. Genetics.
    6. Toxic gas, heavy metal fumes (Factory workers).
    7. Ionizing radiation.

    Types

    1. Small Cell Lung Cancer.
      Neuoendocrine cancer.
    2. Non Small Cell Lung Cancer.
      adenocarcinoma, squamous-cell carcinoma and large-cell carcinoma,
    3. Others
    4. Adenosquamous, carcinoid, sarcomatoid

    5. Metastasis
      Depends on primary histopathology.

    Signs & Symptoms

    1. Respiratory symptoms: coughing, coughing up blood, wheezing, or shortness of breath
    2. Systemic symptoms: weight loss, weakness, fever, or clubbing of the fingernails
    3. Symptoms due to the cancer mass pressing on adjacent structures: chest pain, bone pain, superior vena cava obstruction, or difficulty swallowing

    Diagnosis & Staging

    1. History & physical examination.
    2. Cytopathology & Histoipathology. (Bronchoscopy, CT/USG guided)
    3. Computed Tomography (CT)
    4. Magnetic Resonance Imaging (MRI)
    5. PET- CT
    6. Others- For routine check up and for fitness for receiving treatment.

    Total four stages are there stage – I is well localised and stage – IV is advanced/ metastatic.

    Treatment

    Multimodality Approach

    1. Surgery (Removal of tumour with regional draining lymph nodes)
    2. Radiotherapy/ Chemoradiotherapy (Radical, neoadjuvant, adjuvant, palliative)
    3. Chemotherapy (Neoadjuvant, Adjuvant, palliative)
    4. Targeted therapy (Gefitinib, Crizotinib, Bevacizumab etc)
    5. Palliative/ Symptomatic (depends on symptoms)

    Prognosis

    Good prognosis expected in early stages of disease, but as the stage progresses the chance of getting cure and survival comes down, but with advancement of technologies and availability of newer drugs makes the patient to have a better quality of life and symptom free survival.

    Prevention

    1. Personal level
      • Quit smoking, Quit tobacco and choose life.
      • Life style and diet modification (Not proven yet, it may be a confounding factor)
    2. Community level
      • Regular screening.
      • Creating public awareness regarding lung cancer cancer.
  • Prostate cancer

    1. More than 1 million cases per year (India)
    2. A man’s prostate produces the seminal fluid that nourishes and transports sperm.
    3. Affects men only with old age predilection.

    Causes & risk factors

    1. Genetic- BRCA-1, BRCA-2, HPC-1, Vit-D repressor
    2. Dietary factors- diet lower in antioxidants and vitamin- D may increase the chance of prostate cancer, but no proven yet.
    3. Medication exposure- cholesterol lowering drugs decrease the chance of prostate cancer.
    4. Infection- chlamydia, gonorrhea, or syphilis increase the chance.
    5. Metabolic disorders- Obescity & increase testosterone level is associated with this.
    6. Having many lifetime sexual partners or starting sexual activity early in life substantially increases the risk of prostate cancer.
    7. Association with HPV is still unknown.

    Symptoms & signs

    1. Similar to benign prostatic hyperplasia, obstructive symptoms.
    2. Nocturia, hematuria, dysura
    3. Painful ejaculation
    4. Pain depending on metastatic site

    Diagnosis & staging

    1. History & physical examination
    2. Serum PSA
    3. Histopathology
    4. CECT/MRI pelvis
    5. Bone scan
    6. Chest X-ray, Ultrasonography (abdomen & pelvis)
    7. PET – CT
    8. Serum testosterone level

    Disease is classified into stages for proper management decision and prognostication.

    Treatment

    1. Surveillance-
      a. In low risk diseases with less life expectancy, the patient can put into surveillance mode.
    2. Surgery-
      a. Radical prostatectomy
      b. Bilateral orchiectomy
      c. Metastasectomy (in case of Oigometastasis)
    3. Total Androgen blockade
      a. After bilateral orchiectomy or medical castration antiandrogens are started for total androgen blockade, because prostate is an androgen dependant organ.
      b. Medical castration is done by certain hormonal agents like leuprolide.
    4. Chemotherapy
      a. Docetaxel, Cabazitaxel are few drugs which are effective in adjuvant setting along with total androgen blockade.
      b. Palliative chemotherapy in cases of castration resistant prostate cancers.
    5. Radiotherapy-
      a. One of the site for doing hypofractionated radiotherapy.
      b. Radical/ adjuvant/ palliative
    6. Prognosis

      Most important prognostic factors are stage, serum PSA, Gleasson’s score, grade, age etc.
      Low risk cancers carry a better prognosis than the high risk diseases.

      Prevention

      1. Diet & life style modification
      2. Medication
        a. 5-alpha-reductase inhibitor (finasteride and dutasteride)

      Screening

      Serum PSA and digital rectal examination in high risk cohorts.

Patient Speak

  • I am from Australia. During my trip to Agra, I suffered a heart attack. I was brought to Nayati Hospital, the entire team here is fantastic. Thanks to them that I am fine and going back home.

    Gregory PeterThomas

  • We came to Nayati Medicity for treatment from Shanghai and we never imagined such a world class hospital and care here in Mathura.

    Anant Sarogi

  • In November 2017, I was diagnosed with tuberculosis in my right hip. All the doctors I visited suggested that the only treatment to this is a hip replacement surgery. When we met the team at Nayati, he assured us that it can be treated with medicine only, without any surgery. Today, I have recovered completely.

    Avnesh Chauhan

  • I am thankful to Nayati for my recovery from Cancer, The expert care here is truly unparalled

    Mr. Mohammad Shafeeq

  • Nayati is the best Hospital in our City, Mathura.I am thankful that this Hospital has good, co-operative and friendly staff.

    Vijay Singh

  • It is really very good hospital equipped with all first class technology. The best thing about the hospital is that it is at Mathura and close to near by places so the cost of going to Delhi/NCR for emergency and major operation reduces. I’ll recommend this to all my dear friends.

    Shefali Rastogi

  • My friend’s mother had high BP problem a few days back. She was admitted in Nayati Hospital. I was delighted to see the infrastructure as well as the facilities offered by the hospital. She is now well and I would like to thank all the doctors and staff for their support and help .

    Urmi Varshney

  • Nayati is a very good hospital. The facilities offered in the hospital are commendable. The behaviour of doctors and nursing staff is very nice and friendly.

    Kavya Bhatia

Patient Speak

  • by Maj. Gen C.P Singh

    Delhi

  • by Mrs Mamta

    Delhi

  • by Mr. Pankaj Mishra

    Delhi

    An initiative by Nayati Healthcare to spread the awareness about cancer, also telling people about the benefit of early detection.

  • by Mrs. Rita Bhalla

    Delhi

    A inspiring story by Mrs Rita Bhalla, one of survivor of cancer tells about the benefit of early detection, healthy lifestyle, good hospital and doctor.

  • by Mrs. Veneeta Batra

    Delhi

    A inspiring story by Mrs Veneeta Batra, one of survivor of cancer.

  • by Sanjay Aggarwal

    Delhi

    A inspiring story by Mr Sanjay Aggarwal, one of survivor of cancer.

  • by Gyan Prasad Rastogi

  • by Bhagwati (Keshav)

Cancer FAQs

What causes cancer?

What causes cancer?

Things people do

Some cancers are caused by things people do or expose themselves to. For example, tobacco use can cause cancer of the lungs, mouth, throat, bladder, kidneys, and many other organs. Of course, not everyone who uses tobacco will get cancer, but it greatly increases a person’s risk. It increases their chance of developing heart and blood vessel disease, too.

Spending a lot of time in the sun without protection can cause skin cancer. Melanoma is a very serious form of skin cancer linked to UV light from the sun and tanning beds.

Other things people are exposed to

Radiation can cause cancer. For instance, people exposed to nuclear fallout have a higher cancer risk than those who were not exposed. Sometimes, radiation treatment for one type of cancer can cause another cancer to grow many years later. This is why doctors and dentists use the lowest possible doses of radiation for x-rays and scans (much lower than the doses used for cancer treatment).

Certain chemicals have been linked to cancer, too. Being exposed to or working with them can increase a person’s risk of cancer. Call us to learn more about the carcinogens (substances that cause cancer) that may be around you, or see the What Causes Cancer? section of our website.

Genes that run in families

About 5% to 10% of all cancers are linked to genes that are inherited from parents.

Bottom line

No one knows the exact cause of most cases of cancer. We know that certain changes in our cells can cause cancer to start, but we don’t yet know exactly how it all happens. Scientists are studying this problem and learning more about the many steps it takes for cancers to form and grow. See the “What Causes Cancer?” section of our website to learn more about the things that have been linked to this disease.

If you are interested in taking steps to help reduce your cancer risk, see the section below called “Can cancer be prevented?”

Can injuries cause cancer?

Can injuries cause cancer?

It’s a common myth that injuries can cause cancer. But the fact is that falls, bruises, broken bones, or other such injuries have not been linked to cancer. Sometimes a person might visit a health care provider for what’s thought to be an injury and cancer is found at that time. But the injury did not cause the cancer; the cancer was already there. It also sometimes happens that a person will remember an injury that happened long ago in the place cancer was found.

Rarely, burn scars can be the site of cancer many years after the burn has healed. Most often, skin cancer is the type that starts in a burn scar.

Can stress cause cancer?

Can stress cause cancer?

Researchers have done many studies to see if there’s a link between personality, attitude, stress, and cancer. No scientific evidence has shown that a person’s personality or outlook affects their cancer risk.

There are many factors to look at in the relationship between stress and cancer. It’s known that stress affects the immune system, but so do many other things. Despite many studies, a link between psychological stress and cancer has not been found.

What are the risk factors for cancer?

What are the risk factors for cancer?

A risk factor is anything linked to your chance of getting a disease, such as cancer.Different cancers have different risk factors. For instance, exposing skin to strong sunlight is a risk factor for skin cancer, but it’s not linked to colon cancer. Some risk factors can actually cause cancer, while others may simply be more common in people who get cancer. For example, old age by itself doesn’t cause cancer, but it is a risk factor.

Still, risk factors don’t tell us everything. Having one risk factor, or even many, does not mean that someone will get cancer. Some people with one or more risk factors never develop the disease, while others who do develop cancer have no known risk factors. Even when a person who has a risk factor is diagnosed with cancer, there’s no way to prove that the risk factor actually caused the cancer.

There are different kinds of risk factors. Some, like a person’s age or race, can’t be changed. Others are linked to cancer-causing factors in the environment. Still others are related to personal actions, such as smoking. Some factors influence risk more than others, and a person’s risk for cancer can change over time, due to factors such as aging or lifestyle.

Some of the major cancer risk factors that can be controlled:

  • Tobacco use
  • Diet
  • Physical activity
  • Weight
  • Alcohol use
  • Sun exposure
  • Environmental exposures, such as radon, lead, and asbestos
  • Exposure to infections such as hepatitis, HPV, and HIV

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Is cancer contagious?

Is cancer contagious?

In the past, people often stayed away from someone who had cancer. They were afraid they might “catch” the disease. But cancer isn’t like the flu or a cold. You can’t catch cancer from someone who has it. You won’t get cancer by being around or touching someone with cancer. Don’t be afraid to visit someone with cancer. They need the support of their family and friends.

You can get more details on this in Is Cancer Contagious?

Can cancer be prevented?

Can cancer be prevented?

There’s no sure way to prevent cancer, but there are things you can do to help reduce your chances of getting it.

Tobacco

Many cancers might be prevented if people didn’t use tobacco.
Smoking damages nearly every organ in the human body and accounts for about 1 out of 3 cancer deaths in the US. Cigarettes, cigars, pipes, and oral (smokeless) tobacco products cause cancer and should not be used. People who use tobacco should try to quit. Studies clearly show that ex-smokers have less cancer risk than people who continue to smoke. When you quit smoking, it also reduces exposure to secondhand smoke for those around you.

It’s best to never use tobacco at all and to stay away from secondhand smoke, which also causes cancer – even in non-smokers.

See the “Stay Away from Tobacco” section of our website for more on this.

Alcohol

Drinking alcohol is linked to a higher risk of certain types of cancer.
Some people think that certain types of alcohol are safer than others. But ethanol is the type of alcohol found in all alcoholic drinks, whether they are beers, wines, or liquors (distilled spirits). Overall, it’s the amount of alcohol that’s drunk over time, not the type of drink, which seems to be the most important factor in raising cancer risk.

If you drink, limit your intake to no more than 2 drinks per day for men and 1 drink a day for women. This may help curb your cancer risk. You can find out more in Alcohol Use and Cancer.

Drinking and smoking

The combined use of alcohol and tobacco raises the risk of mouth, throat, voice box, and esophagus cancer far more than the effects of either one alone.

Ultraviolet (UV) rays and sunlight

You can lower your chances of getting skin cancer by

  • Staying out of the sun between the hours of 10 a.m. and 4 p.m.
  • Wearing a hat, shirt, and sunglasses when you are in the sun
  • Using broad-spectrum sunscreen with a sun protection factor (SPF) of at least 30
  • Not using tanning beds or sun lamps

See the “Ultraviolet (UV) Radiation” section of our website to learn more about the link between UV exposure and skin cancer and to learn how to protect yourself and the people you care about from UV skin damage.

Diet

We know that our diet (what we eat or don’t eat) is linked to some types of cancer, but the exact reasons are not yet clear. The best information we have suggests a lower cancer risk for people who:

  • Eat a lot of fresh vegetables and fruits (at least 2½ cups a day)
  • Choose whole grains rather than refined grains and sugars
  • Limit red meats (beef, pork, and lamb)
  • Limit processed meats (bacon, deli meats, and hot dogs)
  • Choose foods in amounts that help them get to and stay at a healthy weight
  • Limit alcohol intake to 1 alcoholic drink a day or less for women and 2 or less for men

We have a lot of information on how diet and physical activity can affect cancer risk. Call us or visit our website to learn more.

Does sugar feed cancer?

Does sugar feed cancer?

Sugar intake has not been shown to directly increase the risk of getting cancer, having cancer spread, or having it get worse (progress). Still, sugars and sugar-sweetened drinks add a lot of calories to the diet and can cause weight gain, which is linked to cancer.

Vaccines that help reduce cancer risk

We now know that some cancers are caused by infections, mostly viruses. One virus that’s clearly linked to cancer is the human papilloma virus (HPV). It’s been linked to cervical cancer, anal cancer, many genital cancers, and even head and neck cancers. (See HPV and Cancer for more details.)

There are vaccines to help prevent HPV infections. But most adults have already been infected with HPV, and the vaccines haven’t been proven to help people who already have HPV. Young people who are not yet sexually active should have a lower future cancer risk if they get one of the vaccines before they’re exposed to the virus.

Early detection

To find cancer early, while it’s small and before it has spread, adults should have regular tests called cancer screening tests. These tests help health care providers find common cancers before they cause symptoms. For example, regular screening can find cancers of the breast, colon, rectum, cervix, mouth, and skin early. If cancer is found early, it can be easier to treat. Survival also tends to be longer for those with early cancer. Talk to a health care provider about which screening tests might be right for you.

How is cancer diagnosed?

How is cancer diagnosed?

A person’s signs and symptoms are not enough to know whether they have cancer. (See Signs and Symptoms of Cancer for more on this.) If your health care provider suspects cancer you will need more tests, such as x-rays, blood tests, or a biopsy. In most cases a biopsy is the only way to be sure whether cancer is present.

To do a biopsy a piece of the lump (tumor) or abnormal area is taken out and sent to the lab. There, a doctor who specializes in diagnosing diseases (called a pathologist) looks at the cells under a microscope to see if cancer cells are present. If there are cancer cells, the doctor tries to figure out what type of cancer it is and how fast it’s likely to grow.

Imaging tests can measure the size of the cancer and can often show if it has spread to nearby tissues. Blood tests can tell providers about your overall health, show how well your organs are working, and give information about blood cancers.

How is cancer treated?

How is cancer treated?

Surgery, chemotherapy, and radiation are the 3 main types of cancer treatment. A person with cancer may have any or all of these treatments. In choosing a treatment plan, the most important factors are generally the type of cancer and the stage (amount) of the cancer. Other factors to consider include the person’s overall health, the likely side effects of the treatment, and the probability of curing the cancer, controlling it to extend life, or easing symptoms.

Surgery

Surgery is often the first treatment used if the cancer can be taken out of the body. Sometimes only part of the cancer can be removed. Radiation or chemotherapy might be used to shrink the cancer before or after surgery.
For more on this, see our surgery information.

Chemotherapy

Doctors use chemotherapy or “chemo” drugs to kill cancer cells. Usually, the drugs are given intravenously (IV or into a vein) or taken as a pill by mouth. Chemo drugs travel throughout the body in the bloodstream. They can reach cancer cells that may have spread away from the tumor.

See our information on chemotherapy to learn more about chemo and its effects.

Radiation therapy

Radiation therapy is treatment with high energy rays (such as x-rays) to kill or shrink cancer cells. The radiation may come from outside the body, called external radiation, or from radioactive materials placed right into the tumor (internal or implant radiation). Getting external radiation is a lot like getting an x-ray.
Visit our radiation therapy pages to learn more.

Other types of cancer treatment

Other kinds of treatment you might hear about include targeted therapy, stem cell or bone marrow transplant, and immunotherapy. Hormone therapy is another type of treatment that’s sometimes used to treat certain kinds of cancer.

Clinical trials

Clinical trials are studies in which people volunteer to test new drugs or other treatments. In cancer treatment, clinical trials may be used to learn whether a new treatment works better than the treatments used today. For instance, clinical trials are used to see if adding a new drug to the standard therapy makes it work better. In studies like this, some patients get the standard drug(s) (which are the best available at the time) and the new one being tested, while other patients get the standard drug(s).

Clinical trials are one way to get “cutting-edge” cancer treatment. Contact us and talk to your cancer care team to learn more about clinical trials and whether one might be right for you.

Does surgery cause cancer to spread?

Does surgery cause cancer to spread?

Surgery does not cause cancer to spread. Still, there are some important situations when this can happen. Doctors who have a lot of experience in treating cancer with surgery are very careful to avoid these situations.

One common myth about cancer is that it will spread if it’s exposed to air during surgery. Some people may believe this because they often feel worse after surgery than they did before. But it’s normal to feel this way when recovering from any surgery. Another reason people may believe this is because during surgery the doctor may find more cancer than was expected from scans and x-rays. This can happen, but it’s not because of the surgery – the cancer was already there – it just didn’t show up on the tests that were done.

What are the side effects of cancer treatment?

What are the side effects of cancer treatment?

Each type of cancer treatment has different side effects. It’s hard to predict what side effects a person will have; even when people get the same treatment they can have different side effects. Some can be severe and others fairly mild. It’s true that some people have a tough time with cancer treatment, but many others manage quite well. And most cancer treatment side effects can be treated.

Chemo side effects

Short-term (and often treatable) side effects of chemo can include things like nausea and vomiting, appetite loss, hair loss, and mouth sores. Because chemo can damage the blood-making cells in the bone marrow, patients may have low blood cell counts. This can lead to:

  • Higher risk of infection (from a shortage of white blood cells)
  • Bleeding or bruising after minor cuts or injuries (from a shortage of blood platelets)
  • Anemia (from low red blood cell counts), which can cause tiredness, shortness of breath, pale skin, and other symptoms

(See Understanding Your Lab Test Results for more details in blood counts and what they mean.)
Cancer care teams work carefully with patients to manage the side effects of chemo. Most chemo side effects go away after treatment ends. For example, hair lost during treatment usually grows back after treatment is over.

Radiation side effects

Radiation treatments are much like x-rays and are not painful. The most common side effectsare skin irritation in the treatment area and fatigue. Fatigue is a feeling of extreme tiredness and low energy that doesn’t get better with rest. It often lasts for many weeks after treatment ends. Other side effects can happen, too, depending on what part of the body is being treated.

Is cancer treatment worse than cancer?

Is cancer treatment worse than cancer?

This is a belief that can be dangerous to many people when it affects whether they decide to get cancer treatment. People who think treatment is worse than cancer might not get the treatments that can save their lives.

A person who is thinking of refusing cancer treatment due to fear of side effects or other concerns should talk with a health care provider to clearly understand the likely outcomes of both treatment and non-treatment before making a decision.
If cancer is allowed to progress without treatment, symptoms get worse and new symptoms build up over time. Symptoms differ based on the type of cancer and where it is. Later in the course of cancer, when more serious symptoms start, curative treatment may not be an option. Cancer kills by invading key organs (like the intestines, lungs, brain, liver, and kidneys) and interfering with body functions that are necessary to live. Untreated cancer commonly causes death.

In contrast, cancer treatment often saves lives – especially when cancer is found and treated early. Even when it can’t cure the cancer, treatment can often help people live longer. And medical care can always be used to help a person feel better by reducing pain and other symptoms (palliative care). It’s important that a person knows the goal of each course of treatment, and makes informed decisions throughout the cancer experience.

There are times when every person being treated for cancer questions their commitment to the difficulties that come with treatment and its side effects. Sometimes they get discouraged by the uncertainty of treatment and wonder if it’s worth it. This is normal. It may help to know that doctors are always learning better ways to work with patients to control side effects. And remember, each year brings advances in cancer treatments, too.

What is remission?

What is remission?

Some people think that remission means the cancer has been cured, but this isn’t always the case. Remission is a period of time when the cancer is responding to treatment or is under control.

In a complete remission, all the signs and symptoms of cancer go away and cancer cells can’t be detected by any of the tests available for that cancer.
It’s also possible for a patient to have a partial remission. This is when the cancer shrinks but doesn’t completely disappear.
Remissions can last anywhere from several weeks to many years. Complete remissions may go on for years and over time the cancer may be considered cured. If the cancer returns (recurs), another remission may be possible with more treatment.

Can cancer be cured?

Can cancer be cured?

Many cancers can be cured, but not all of them and not always.
Cure means that treatment has made the cancer go away, and there’s no chance that it will come back. It’s rare that a doctor can be sure that cancer will never come back. In most cases it takes time, and the longer a person is cancer free, the better the chance that the cancer will not come back.