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How tough is the job of an oncologist? I am often asked this question and I have probably never admitted the whole truth. An oncologist is a strange amalgam of extremes of emotions....it is a never ending balancing act.While he or she has to create that environment of positivity to enable the patient to make the right choices for his/her treatment, without being overwhelmed by the side effects of treatment, he or she also has to ride the see saw of ups and downs that are likely to happen during the course of treatment with the patient. Being cheerful in the face of adversity yet remaining detached from the outcome of treatment is learnt painstakingly over years. The troubles don't end here. The oncologist is subject to scrutiny all the time....an innocuous expression could be read by the attendant or patient as despair or hopelessness, a phone call for another seriously ill patient could be extrapolated to one's own self by the patient across the table, a slight drop in the wattage of your smile could be interpreted as doomsday......and so on.It is a tough life but it becomes worth the effort when patients defy statistics, come back to meet you, year after year, treat you like a part of their extended family contributing to crucial personal decisions..... and threaten to outlive you! For more details, please contact Dr Geeta Kadayaprath, Head Breast Surgical Oncology, Max Cancer Centre, Patparganj, Delhi, India
SURGERY FOR BREAST CANCER IS NOT ABOUT REMOVING BREASTS, ALWAYS… With improvements in chemotherapy, radiation therapy, hormonal treatment and targeted therapy, breast conservation surgery has now become the treatment of choice in select patients. While it is possible to conserve the breast in early breast cancer, it is possible to offer this treatment in patients with locally advanced breast cancer also, where chemotherapy is administered first to shrink the tumor. If the tumor shrinks towards the centre and is marked while the patient is on chemotherapy, it may be possible to conserve the breast when surgery is performed after completion of chemotherapy. The philosophy behind this paradigm shift is quite obvious- that long term outcomes in terms of disease free survival and overall survival is not different with either surgical procedures. The choice is real and scientific… For more information on breast cancer, please contact Dr Geeta Kadayaprath, Breast Surgeon, Max Cancer Centre, Delhi, India
It was Breast Support Group meeting on Thursday, 18.12.14.The Champions who had been through the journey of breast cancer had come in to encourage the ones who had just started treatment. What is exceptional about this interaction is that the conviction of being able to go through treatment goes up manifold when the ones who have gone through the process and have recovered completely, counsel the new kids on the block. I believe it is the fear of the unknown and the feeling of isolation that puts you on the back foot. The interesting methods of coping with the situation related by the champions, is very encouraging. The smiles, laughters, jokes...... all give the impending process of treatment, the much desired sanity!!! For more information on breast cancer, please contact Dr Geeta Kadayaprath, Delhi, India
Breast support group meetings on 1st and 3rd Thursday of every month from 3-4 pm at Tumor board, max Patparganj. It is open to all who wish to celebrate their lives with those who need support through treatment and beyond....
It was Breast Support group meeting yesterday!Psychological problems during treatment and the coping mechanisms were discussed. Most ladies were of the view that they hated being excluded from all those activities that were their forte before the illness. All that they desired was normalcy or..... Whatever was closest to being normal!
...SURGERY FOR BREAST CANCER IS NOT ABOUT REMOVING BREASTS, ALWAYS…(contd.) The treatment of breast cancer has undergone major improvements and this has been reflected in how the outcomes have changed dramatically for the better. While curing the disease is a priority, maintaining quality of life is as important. The journey that has been covered before us is no less fascinating and the constant endeavor to make it better for the patient has driven the change. Mutilating surgeries in the form of amputation of the breast and then radical mastectomy (removal of the breast, muscles of the chest and the lymph nodes in the armpit ) or the extended radical mastectomy( same as radical mastectomy but with the additional removal of lymph nodes inside the chest) remained in vogue for a larger part of the 20th century. ...to be continued.....More history in the next update
SURGERY FOR BREAST CANCER IS NOT ABOUT REMOVING BREASTS, ALWAYS… In the 1960’s, the conviction that breast cancer was a systemic disease at inception and not a local disease, prompted trials to address one question- ‘Are we doing too much?’ Radical mastectomy was replaced by modified radical mastectomy- a procedure not as mutilating as radical mastectomy ( the chest muscles were preserved)but still one, which involved loss of an organ. Moreover, to a woman, it meant much more than the loss of an organ. It probably entailed a huge psychological blow besides casting a shadow on her feminity. She, being the woman she was, in those days, came to terms with this loss, in the best manner possible. All that mattered to her was her getting well, on her feet and ready to discharge the duties of a wife, mother, daughter and more. And there was really no choice then because the doctors treating her were also convinced that sacrificing the breast was the only chance of getting well. More tomorrow.....on Evolution of treatment
Today, the first Delhi Breast Oncology Group (DBOG) CME was held in Max Patparganj, Delhi. There is a palpable enthusiasm in the creation of this group which will be one of the subspecialty arms of the Oncology Forum. The meeting started with myself introducing the proposed functional unit of DBOG. The proposal was to have coordinators for various tasks assisted by committees.There will be stock taking at each CME to be held on the first saturday, every two months. The Secretary will coordinate the pre-CME meetings at each of the CMEs. The CME itself was an academic feast with 3 case discussions and review of literature relevant to each topic. Dr Vineeta Goel, Radiation Oncologist at Max Cancer Centre, Patparganj, presented the relevance of radiation in 1-3 positive axillary nodes. Dr Randeep Singh, Medical Oncologist at Max Cancer Centre, Patparganj, presented a case of metastatic triple positive breast cancer and the current treatment options and Dr Rohan Khandelwal, Breast Surgeon at Max Cancer Centre, Saket presented a case of Triple negative breast cancer and brought in Dr Amit Verma, Genetic consultant, to unravel the rogue pathways involved in Triple negative breast cancer. The meeting ended with Dr Vaishali Zamre, Senior Consultant, Surgical Oncology, Action Balaji Hospital, Delhi, accepting the responsibility of holding the next meeting at Action Balaji Hospital. The presence of 80 attendees at this CME was a reaffirmation of the fact that like minded people need to work together to achieve larger goals.A beginning has been made.....and there is a lot to do to make big strides in the right direction. I thank all the participants for being part of this endeavor and hope to see you all on 7th March, 2015 at Action Balaji. For further details, please contact Dr Geeta Kadayaprath, Head, Breast Surgical Oncology, Max Cancer Centre, Patparganj Delhi
Does cancer give you a new lease of life? Today, a patient, Mrs Sharma (name changed), I had treated 2 years back, came for follow up to my clinic with her very beautiful and supportive daughter.When I saw her two years ago, I was taken aback by the fact that an educated lady like her had ignored a lump in the breast completely to let it grow to the size she came to me with. Big it was....ulcerated, infected and bleeding. She had large lymph nodes in her armpit.She was weak and it made me wonder if it was the anemia due to chronic blood loss from the breast cancer or spread of disease to other organs which was contributing to this. I was almost certain she would have spread to other organs. Fortunately for her, her PET CT did not show spread to the other organs.The lady was amazing....she knew she was in big trouble, but she was most cheerful and accepting. She was dealing with a lot in life already....a husband confined to bed for two years prior to her diagnosis and a son who had lost his bearings.I knew then her reason for self neglect. She went through the entire treatment, cheerfully and recovered. She went back to looking after her ill husband till he passed away a few months back. Today she surprised me. She looked well.....and I thought a bit relieved.I examined her, went through her reports ....she was absolutely fine. She was her happy self. She dug out a packet from her bag and gave it to me.She said she had made that bag and told me how she had started this NGO to support women in Haryana. They made the bags according to her specifications.... Beautiful bag! She was putting her talent to good use and just talking about it lit up her face.Mrs Sharma had rediscovered herself and will soon embark on fulfilling yet another dream -to paint and hold an exhibition.And then she is off to Canada to meet her friend of 50 years.Wow!!I can only salute her resilience! I want her to know, she really made me proud!! For more details, please contact Dr Geeta Kadayaprath, Head Breast Surgical Oncology, Max Cancer Centre, Patparganj, Delhi, India
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