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Preventive Oncology

Introduction
Most of the cancers are preventable. Scientific studies have shown that almost half of all major cancer cases are either the manifestations of poor lifestyle choices or the precancerous lesions that could be detected even before they present themselves as tumours. Understanding cancer as a disease and practising necessary preventive measures help in lowering the risks of various types of cancer.
What is Preventive Oncology?
Preventive Oncology is a special discipline in oncology that focuses on key measures that can prevent cancer development or delay the progression of the malignant process. Cancer prevention measures can be taken on three major levels:

  1. Primary Cancer Prevention:

    Identifies the cancer-causing factors and reduces the risk of cancer formation. This is achieved through alcohol and tobacco cessation, obesity management, vaccination, practising a healthy lifestyle, etc.

  2. Secondary Cancer Prevention:

    Focuses on detecting cancer before the onset of symptoms when it is likely to be treated successfully. Screening is one of the major secondary cancer prevention measures.

  3. Tertiary Cancer Prevention:

    Focuses on delaying the progression and preventing the complications like secondary malignancies, once the disease has become symptomatic.

Services Offered Under Preventive Oncology:

1. Cancer Screening
Cancer Screening is a collective term given to a series of medical tests performed on asymptomatic and apparently healthy individuals to check for the presence of precancerous lesions. At HCG’s Preventive Oncology OPD, screening is done for the cancers of breast, colon and rectum, prostate and cervix.

Breast Cancer Screening:

It is the evaluation of symptom-free, apparently healthy females aged between 20-70 years for early detection of breast cancer. Breast cancer screening is done through clinical examination and mammography.

  • Clinical Breast Examination (CBE):

    It involves a detailed evaluation of history, physical examination of breasts and under-arm regions, palpation of breasts in different positions and examination of lymph nodes.

  • Mammography:

    Mammography uses low-dose X-ray radiation to detect precancerous and cancerous growth in the breasts. It detects the smallest tumours and other abnormalities that are missed during clinical breast examinations.

Colorectal Cancer Screening:

Colorectal cancer screening is performed to detect abnormal growths called polyps, which protrude from the inner walls of colon and rectum. Colorectal cancers become symptomatic only in the advanced stages. Therefore, regular screening becomes extremely important. Colorectal cancer screening is done through faecal occult blood test and upper/lower gastrointestinal endoscopy.

  • Faecal Occult Blood Test (FOBT):

    It is performed to check for tiny amounts of blood in the faecal matter, which is a sign of a polyp or early-stage colorectal cancer.

  • Upper/Lower Gastrointestinal Endoscopy:

    Upper and lower GI endoscopies act as extremely sensitive cancer screening tools and help doctors in detecting precancerous lesions or polyps that could be signs of early-stage colorectal cancer.

Prostate Cancer Screening:

Prostate cancer progresses at a slower rate; therefore, regular screening may help in catching cancer even before it starts exhibiting symptoms. Prostate cancer screening is done through PSA test and digital rectal examination.

  • PSA test (Biomarker Assessment):

    It is a simple blood test performed to assess the levels of Prostate-Specific Antigen (PSA), which is a special protein biomarker produced by both malignant and benign prostate tissue. High PSA levels in the blood may indicate the risk of prostate cancer.

  • Digital Rectal Examination (DRE):

    A physical examination conducted by the doctor to examine for lumps, hard regions or any other abnormalities in the prostate gland.

Cervical Cancer Screening:

Cervical cancer screening is performed to detect any abnormalities in the cervical cells that could lead to cervical cancer. It usually takes 3-7 years for the high-grade changes in the cervical tissues to present themselves as tumours, and regular screening helps in their early detection. Pap test is an effective cervical cancer screening method.

  • Pap test:

    During a Pap test or Pap smear, samples of cervical cells are collected and checked for irregularities. Precancerous cellular changes can be addressed with appropriate treatment. All women should begin cervical cancer screening at age 21.

Whole-Body MRI Scan:

Whole-body MRI is a valuable tool in cancer screening with an ability to detect tumours that measure less than one centimetre. With excellent sensitivity and specificity, these scans can provide accurate information on precancerous lesions in lesser time. In some cases, whole-body MRI scans eliminate the need for invasive screening and diagnostic procedures that involve radiation exposure.
2. Tobacco and Alcohol Cessation Clinic
Tobacco and alcohol are the causes of several preventable diseases, including cancer. Abstaining from tobacco and alcohol consumption is proven to reduce the risk of crucial diseases like cancer.
Through psychological (behavioural) and pharmacological intervention, successful tobacco and alcohol cessation can be achieved. Psychological therapy identifies specific triggers like stress, anxiety, depression, issues in professional and personal life, loneliness, etc., that lead to smoking and drinking. Later, patients are taught to recognise them, build healthier coping mechanisms and replace their smoking or drinking habits with those healthy habits. Medications also help in quitting tobacco and alcohol by controlling the urge to smoke or drink.
3. Obesity Clinic
Obesity is associated with inflammation, hormone imbalance and hampered fat metabolism; these factors can increase the cancer risks.
Healthy weight management helps in bringing down the risks of various cancer types. Carefully planned diet regimens can help obese individuals maintain a healthy weight and reduce the risk of various chronic diseases. Along with dietary advice, medicines can also help in obesity management by suppressing the appetite or altering the calorie absorption.
4. Primary Prevention for Cancer Through Vaccination
Vaccinations may help in preventing the cancers caused due to oncoviral infection. Currently, vaccinations are available for the oncoviruses - Human papillomavirus (HPV) and Hepatitis B Virus (HBV). However, these vaccines are to be taken before getting infected by the viruses.

  • Human papillomavirus (HPV) vaccination:

    HPV vaccine helps prevent cervical, vaginal, vulvar, penile and anal cancers along with oropharyngeal cancers. HPV vaccines are recommended for individuals aged 9-26 years.
  • It must be noted that the HPV vaccine is not a substitute for cervical cancer screening; all women, including those who are vaccinated, should undergo cervical cancer screening regularly.

  • Hepatitis B Virus (HBV) vaccination:

    HBV causes Hepatitis-B, which if left untreated, may cause liver cancer. Individuals of all age groups can take HBV vaccines.
5. Counselling on Lifestyle Modification
According to many studies, cancer is a lifestyle disease that a healthier and active lifestyle can prevent. Factors like sedentary lifestyle, unhealthy diet and chronic stress can trigger tumour formation. These factors also aggravate the tumour growth in patients with stage 1 and stage 2 cancers.
Lifestyle modification counselling sessions at HCG, focus on creating awareness on the importance of having an active lifestyle, prudent diet and effective stress management strategies.
6. Research
Through extensive research carried out in recent years, the development of cancer and the factors that contribute to the formation of cancer are clearly defined. The data from these studies have paved the way for the development of several novel cancer prevention strategies. Some of the unique approaches adopted at HCG include:
  • Identifying biological mechanisms by which obesity and diabetes are associated with the risk of cancer
  • Studying the mechanisms that stimulate the immune system to attack the cancer cells
  • Developing novel drugs for cancer prevention
  • Assessing the strategies that can be used to address the socioeconomic and biological factors that contribute to higher cancer rates among specific population groups
  • Studying the impact of environmental exposure on cancer risk and intervening to downgrade those exposures.
7. Neo-Preventive Strategies:
Neo-preventive strategies are novel prevention measures that help individuals prevent cancer development. Neo-preventive strategies are extremely helpful in assessing one’s cancer risk at a molecular level and providing accurate insights. The key neo-preventive strategies adopted at HCG are primary and secondary cancer prevention through the administration of anti-inflammatory medication and nutritional therapy, genetic testing and counselling to assess the cancer risks and devising immunotherapy and nanotechnology-based cancer prevention strategies.

Preventive Oncology OPD Details:

HCG Preventive Oncology Unit

Specialists:

Dr.Radheshyam Naik, Dr.Nalini Rao, Dr.Vinod R.K

OPD timings:

9.00 am to 1.00 pm, Monday to Saturday except on General holidays

Location:

Between Tower 1 and Pharmacy, HCG K.R.Unit, Bangalore.
doctor vinod

Dr. Vinod K. Ramani

Consultant at the Preventive Oncology unit

Specialist Profile:

Dr. Vinod main interest is clinic-epidemological research and he will be at the helm for common cancer screenings, de-addiction treatment, obesity clinic & coordination of academic and research activities with focus on Preventive Oncology at HCG. He has vast knowledge and experience in academics, having taught community medicine in reputed medical colleges in Bangalore. Dr. Vinod also has experience in administrating health clinics across the state and was a consultant for the Karnataka State Health Department in the Non-communicable disease (NCD) Program planning which was aided by World Bank.

Dr. Vinod’s focus also lies within study designs and data analytics and is trained in data analytic tools such as SAS and STATA used in medical research.