•Newer techniques of surgery to improve the cosmetic outcome

•Improved quality of life and psychological health

Metronomic chemotherapy in Breast & Lungs

•The study in Breast and lungs cancer and on patients who have failed on bone marrow transplant

•This is a very low dose chemotherapy that needs to be taken in the form of a medicine
-Very economical
-None of the patients have had side effects
-Works even in other failed standard treatment
-About3/10 patients keep the disease stable
-Good quality of life
-Can be combined with other targeted therapy and standard therapy

•BMT and Mesenchymal Stem Cell Therapy

-This study is based on 50 transplants including Auto and Allogeneic transplants

-specializing in High risk transplants and have treated patients successfully even in whom there was no response to standard life of chemotherapy

-Transplants can be optimized by using reduced conditioning or mini- transplant even in the elderly and those with poor performance status

-Advent of Mesenchymal therapy for multiple sclerosis and antilogous transplants for disease of auto reactivity like SLE, Rheumatoid Arthritis is now becoming feasible in patients who have failed all lives of standard treatment.

Dr. B S Ajaikumar, Chairman, HCG Group, said, “As a healthcare provider that seeks to attract the finest talent, this award holds significant importance, as no other organization is people intensive. When the patient walks into the hospital, he believes that his life is in his our hands. However modern technology can be, it can never replace the human intervention in healthcare. HCG has always believed in inclusive growth.”

Ms. Ragini Dwivedi, Actor, launched the breast cancer APP. The APP explains on various self breast examination techniques for women, facts on breast cancers and FAQ on breast cancer. The APP can be freely downloaded. For Android phone’s it can be downloaded from Google play store and I phone from I store.

Name of the APP – HCG BCA
Some of the common myths & misconceptions about cancer.
• Cancer is just a health issue
• Cancer is a disease of the wealthy, elderly and developed country.
• Cancer is a death sentence
• Cancer is my fate

Dr. B S Ajaikumar, Chairman, HCG Group, said, “Myths are major hindrance for cancer treatment. Patients believe the treatment is painful and try to avoid it. Fear is a major factor, overcoming fear is important to overcome cancer. The social stigma around the disease can only be eradicated by educating the public. We have to bring about a change by creating awareness that, cancer is treatable and is more like a chronic disease.”

Ms.Ragini Dwivedi, Actor, said, “I am pleased to be associated with HCG and its initiative in creating awareness on cancer. The people of Karnataka look up to me and I am sure my support to this initiative will help many women to come forward for self examination and early diagnosis.”

HCG has been in the forefront of creating newer methods of communication keeping in mind the shift in this medium. Technology has been playing an important part in communication today, this is the first of its kind initiative which will help many women to be educated on cancer. Breast cancer is an urban disease and raising at an alarming rate, the plan to educate through this APP is on self examination as it is important to identify early signs & symptoms of breast cancer to beat it.

In the next few months HCG will be creating apps for all types of cancer which will be freely available on a Google play & I store.

Dr. Pramod Chinder, Consultant, Ortho Oncologist, HCG, said, “Initially, when he was admitted, the patient was completely paralyzed. He had severe spinal cord injury. The case was studied in detail. The stem cells of the patients were cultured and two injection of stem cell was given to him. Post the stem cell treatment, the patient has progressed significantly, with the movements of hands and there is sensation in his legs. There is increasing evidence in the benefits of stem cell therapies and spinal cord injuries are one of the most researched. In patients, who do not have any other option of recovering from spinal cord injuries, stem cell treatment is the way to go forward.”

Dr. B S Ajaikumar, Chairman, HCG Group, said, “When I met the patient he was bed ridden, quadriplegic. Being a gymnast and leading an active life, I felt we should take up this challenging case and how regeneration can happen through stem cell treatment. We are glad our efforts are paid off and the patient is leading a more active life, than a year back. His case was taken up by HCG Foundation for both clinical and financial support. Stem cell therapies will play a crucial role in the future of healthcare.”

Dr. Pramod Chinder, Consultant, Ortho Oncologist, HCG, said, “Initially, when he was admitted, the patient was completely paralyzed. He had severe spinal cord injury. The case was studied in detail. The stem cells of the patients were cultured and two injection of stem cell was given to him. Post the stem cell treatment, the patient has progressed significantly, with the movements of hands and there is sensation in his legs. There is increasing evidence in the benefits of stem cell therapies and spinal cord injuries are one of the most researched. In patients, who do not have any other option of recovering from spinal cord injuries, stem cell treatment is the way to go forward.”

Dr. B S Ajaikumar, Chairman, HCG Group, said, “When I met the patient he was bed ridden, quadriplegic. Being a gymnast and leading an active life, I felt we should take up this challenging case and how regeneration can happen through stem cell treatment. We are glad our efforts are paid off and the patient is leading a more active life, than a year back. His case was taken up by HCG Foundation for both clinical and financial support. Stem cell therapies will play a crucial role in the future of healthcare.”

Dr. G Kasthuri, Dean of Nursing, RGUHS, said, “In developed countries, oncology nursing is seen as area of specialization. The need of the hour in India, for nurses in oncology care is specialized training which will benefit immensely, as nurse’s play a great role in the health care delivery system.”

Dr. B S Ajaikumar, Chairman, HCG Group, said, “Nurses play a vital role in the multi disciplinary approach to cancer care patients. Effective specialized training, will help them in acquiring necessary skills in oncology care. Improving, standardization and education is important for nurses who are looking who are looking at onco nursing. This will help in optimal safe cancer care treatment to patients.”

Sino Thomas, Head of Nursing, HCG, said, “This conference will enable the participants to acquire knowledge on the scope of oncology nursing, get acquainted with emerging trends, improve patient communication skills and the quality of cancer care.”

In Karnataka, according to Population Based Cancer Registry Data, about 8 out of 1, 00, 000 Men, are diagnosed with prostate cancer. Prostate cancer is third most common type of cancer in men in Karnataka and in general, prostate cancer constitutes 10 % of all types of cancer. In 1982, the incidence was 3 out of 1, 00,000 Men in Karnataka, which clearly indicates the rising trend.

Dr. Kumar Swamy, Senior Consultant, Radiation Oncologist, HCG, said, “The incidence of prostate cancer is on the rise. The treatment for prostate cancer has advanced over the years. Before, in majority of the patients their testis was removed, nowadays the organ is preserved. RoboticRadio surgery is an option now, where the duration of the treatment lasts for about 2 weeks, instead of 8 weeks in normal radiation therapy. It can also be combined with initial regular radiotherapy and with Cyberknife boost of three sittings for better medical outcome. The side effects have drastically reduced with the present day radiation therapy and radio surgery .By modifying lifestyle and diet one can reduce the risk of developing prostate cancer. In the initial stages prostate cancer is asymptomatic and in most cases the patients present with symptoms where usually it is locally advanced or metastatic. This is potentially curable cancer if detected early. After 50 years of age, yearly PSA test (Prostate Specific Antigen – Test) is recommended and if anyone with a family history of this disease, they should start screening as early as from 35 years. Advancements in hormone therapy and chemotherapy has improved the survival rates of the patients and also the quality of life.”

But above all that now there is an inseparable link between the doctors. Two years ago, in December 2010, Kilara underwent a kidney transplant at M.S, Ramaiah Memorial Hospital, and Bangalore. And Bilimagga turned from a friend to a lifesaver when he became Kilara’s unrelated altruistic kidney donor.

“We have a family history of hereditary polycystic kidney disease (PKD) that was inherited from my mother’s side. My mother’s elder sister had lost a son to PKD and her other son had to undergo a kidney transplant, “says Kilara. “My elder brother, who is a food scientist in the US, was also diagnosed with PKD and underwent a Kidney transplant eight years ago. My younger sister has also been diagnosed with PKD”.

Kilara had got screened for PKD in 1984, but was not diagnosed with the condition then. “That was mainly because the ultrasound scanning procedure was new in India. The Radiologist might have somehow missed the diagnosis,” he says.

It was in 1990, when Kilara was diagnosed with hypertension at age 39, that he underwent another round of abdominal scanning, which revealed that he had, indeed, in-herited adult PKD and his hypertension was secondary to it. : As I was diagnosed with KPD within a fortnight of my mother’s demise, I was totally devastated,” he recalls. Kilara was advised an appropriate anti-hypertensive treatment and was leading a near-normal healthy life. But, 2002 turned out to be yet another testing period for him.

“I was at a dinner party, when one of my friend a neurologist, who was also diagnosed with PKD, said, ‘Guru, for my sake, kindly get an MR-angiogram of the brain (which reveals any pathology in the blood vessels of the Brain) done tomorrow itself”, recalls Kilara. “Just the diagnosis of PKD in me prompted him to advice me to undergo a higher investigation.” Kilara, though taken aback, laughed off his friend’s advice. “But he held my hand and pleaded with me, ‘Please listen to y advice!” recalls Kilara.

As he had professional commitments, he got the angiogram done two days later. “The MR-Angiogram revealed a 0.9cm left middle cerebral artery aneurysm (a bulb-like enlargement of a portion of a vital artery), which was like a ticking time bomb!” he says. “That pulsating aeurysm could have burst anytime and the situation then would have been anytime and the situation then would have been quite alarming. I had to undergo an emergency brain surgery called ‘open-triple clipping if the aneurysm’ which, in fact, was like defusing a time bomb!”

Dr. A.S. Hegde, the neurosurgeon at Manipal Hospital, Bangalore, who successfully conducted the surgery, advised a month’s rest and medication. After the period of convalescence, kilara bounced back and resumed his profession.

Nearly eight years later, Kilara decided to undergo a kidney transplant. “In September 2010, I Made ups my mind to get a transplant done, because I felt that PKD has started reducing my stamina. My quality of life was deteriorating slowly, with stress intolerance and fatigue,” explains Kilara. “Going for dialysis sessions and then waiting for a kidney would have further reduced my energy levels and professional life-span. As I was already 59, I decided to have the transplant done at the pre-end stage renal phase, so that the chances of success would be fairly high.”

Since his siblings also had PKD and his father was too old, Kilara needed an unrelated donor. When he confided his dilemma to Bilimagga, his colleague and friend of three decades, he readily volunteered to donate a kidney to Kilara. Another female colleague of Kilara also came forward to donate her kidney. Says Bilimagga, a founder member of the Bangalore Institute of Oncology: “When I Volunteered, I was not even sure whether our blood groups and tissues would be compatible. It was a spontaneous decision.”

“In India, unrelated kidney transplants are not permitted unless the donor genuinely proves his/her altruistic gesture. Living organ donors should also be metabolically fit, says Bilimagga, who first obtained the consent of his wife, Dr. Sudha (who is also a cancer specialist) before visiting his only son and daughter-in-law in the US to tell them about his decision. “My other relatives came to know o the donation only six months ago,” he says.

Through Bilimagga had already signed up for eye donation long ago, the official procedure for altruistic kidney donation was different. “Police verification about my address proof and profession was carried out. In the local city civil court, my wife and I had to give an affidavit stating that it was a voluntary, emotional donation, not involving financial transaction and not due to coercion, “he explains. “We had to fill up a detailed application form to be submitted to the authorization committee that approves ethical, altruistic and unrelated kidney donation. We were then independently interviewed by the members of the committee, which consisted of six eminent persons including a retired judge and the chairman of the Karnataka Medical Council.”

Bilimagga and his wife also had to submit their bank statements. In a month, he was officially and legally permitted to donate his kidney to Kilara. “Pre-transplant, besides blood typing and tissue matching, I had to undergo a CT-angiogram of the kidneys, to detect any abnormal vasculature that could pose a challenge to the surgeon. No such abnormality was found in my case,” says Bilimagga, who is neither hypertensive nor diabetic.

After the kidney donation surgery, he had to stay in the hospital for five days and later was advised to take ten days of rest at home. “Except for a very minimum rise in my blood keratinize level n the initial postoperative period and weight loss of about two and a half kilos; I did not feel a negative effect. I was given pain-relieving medication and was allowed oral intake of food from the second day of the surgery,” says Bilimagga, who recently completed a high-altitude Manasaraovar yatra, where he had to walk 40km.

Kilara has now established The Kilara Foundation, along with his sister and brother-in-law, to help the underprivileged get access to treatment for kidney disease, cancer and malnutrition. “Ramesh has told me that I should never say that I owe his something and that our occasional arguments as radiation oncologist should continue as before,” says Kilara.

He emerged a new person from the experience, he says, and has accepted his condition without blaming heredity. Though there are imposed disciplines like a low-salt diet, decreased fluid intake and a compromise on infection-fighting capacity due to medication, Kilara is full of life. Without bothering to dissect life’s puzzles, he happily attends his ghazal classes, three evenings in a week. The one song which Kilara should definitely be humming is Tere Jaisa Yaar Kahaan, Kahan Aisa Yaarana (Where does a friend and friendship like this exist)!

Dr.Vivek Bansal, Director, Radiation Oncology, HCG Cancer Center Ahmedabad, said, “The cancer patients will benefit with the introduction of FFF technology. With FFF dose rates of 2400 (as compared to 600 or below in filtered beam) the beam on time gets reduced by one third to one fourth. This probably is the biggest add on as of today adding to patients comfort and minimizes the effect of movement during treatment or during respiration also. The treatment time in delivering doses will come down from minutes to seconds. The high doses are delivered with precision and accuracy not affecting the normal tissues and thereby reducing the chances of secondary cancers, and optimizing medical outcomes.”

Dr. Bharath Ghadvi, CEO, HCG Cancer Center Ahmedabad, said, “We are the first hospital in India to get approval to use the FFF Flattening Free Filter Mode, technology. This is only possible because we are a center of excellence for cancer treatment. The introduction of FFF is to ensure precision and quality of life to the patients.”

HCG is one of the few hospitals in the world to treat more than 1000 patients with Cyberknife. Cancer patients have benefitted immensely, with this technology with better medical outcomes and quality of life.

Professor Ramesh S Bilimaga, Senior Consultant, Radiation Oncology & Medical Director, HCG, said, “The incidence of cancer is on the rise.With the advancements in technology, cancer treatment has become more precise. Robotic Whole Body Stereotactic Radio Surgery has revolutionized cancer treatment. The areas which were supposed to inoperable can be treated with Cyberknife. We are now able to target the disease with larger doses of radiation. Cyberknife tracks the organ motion in real time and directs radiation with sub millimeter precision at the tumor tissue. This is typically applicable in Brain Tumors, Prostate Cancer, Spine, Lungs, and Liver…etc where we effectively treat with better clinical outcomes and quality of life. Because of the high doses of radiation per sitting (Hypo Fractionation), in some cases the entire process of treatment can be completed in 8 to 10 days as opposed to 7 to 8 weeks with conventional treatments.”

He further adds, “We have patients who travel from various parts of Northern India and Lucknow. With increased awareness now we are seeing a trend where 60% of the cancers are diagnosed early.”

CyberKnife:

It is the world’s first non-invasive whole body robotic radiosurgery. CyberKnife offers patients new hope for the treatment of tumours and lesions, including ones that previously have been diagnosed as inoperable or untreatable with the existing technology. CyberKnife uses state-of-the-art real-time image guidance, similar to cruise missile technology, to precisely target tumours anywhere in the body with pinpoint accuracy and delivers high doses of radiation.

Advantages of CyberKnife:

 Non-invasive and pain-less
 Treats inoperable tumors
 Pin-point accuracy
 Significantly reduces treatment time
 Automatic movement tracking
 No need for invasive body or head frame
 Higher radiation dose possible
 Minimizes side effects