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Genitourinary Cancer – 16 – Bladder

Genitourinary Cancer PART – 16
(All the articles published in past are available at
Question: Thank you Chiragbhai for important points related to kidney cancer: 1. Even in stage 4, most patients benefit from removal of affected kidney. This is contrary to all other cancers, where removal of primary tumor is not useful in metastatic stage 4 disease. 2. There are several new medicines now for stage 4 patients, most of them oral. At least 10 medicines are now available. They are not chemotherapy, but may have other types of side effects in some patients. Before we go ahead, let me wish a Happy and Healthy New Year to all our readers.
WE STARTED THE SERIES IN 2007. NOW WE ARE ENTERING 13TH CONTINUOUS YEAR OF THIS SERIES. Dr Chirag, do you feel that purpose of writing this series has been fulfilled?
Answer: The series has certainly created a good level of education among doctor community about cancer, has spread optimism, cleared many myths. It has also led to publication of over 10 books on cancer, using material written in the series. Two of these books have been accepted by renowned national institute, Raja Ram Mohan Roy Library Foundation, for distribution in India. Books have received blessings from several eminent cancer specialists in country, and other people working in field of cancer. Patients have praised the book as a very good source of authentic, easy to read material for them. They feel like “we have gone through a whole consultation”.
Work is of course something that can never be completed. There are still many more cancers to cover. Also, oncology field has major advances every few months. Books have therefore had several editions already. I am very thankful to publisher Dr P G Shah, and his team for their tireless efforts and passion in providing cancer awareness material to doctors and general public.
Let us start new year with a very positive news on the overall impact of Cancer Awareness, Screening and Quality Treatment on cancer survival. This data is from USA, but it shows us proof of the principle that sustained high quality efforts can save so many lives.
Recent article published in CA: a cancer journal for clinicians, showed that Deaths due to Cancer fell 27% from 1991 to 2016. This includes deaths prevented due to reduction in tobacco smoking in USA. This means 26,00,000, yes 26 lac, deaths due to cancer were avoided in USA alone.
Que: This is amazing, and numbers are very impressive too. Especially considering the fact that most people in India, including many doctors, continue to believe that results of cancer treatment are very poor in general. A radiologist friend of mine, a very learned one, recently told me that all cancer patients are anyway going to die sooner or later. I will definitely send him this information.
Ans: Also, remember that this has happened over so many years. But pace of progress is so much faster now. That means, reduction in deaths would have been much larger in last decade, compared to a decade prior to that. And coming decades would be significantly better.
Even though we have several celebrities cured of cancer, like cricketer yuvraj singh, actress manisha koirala, and so many international ones too, patients and lay press continue to write very frequently about negative aspects of cancer care results. Not only that, we have so many cancer survivors in India. During my cancer awareness events, I frequently find at least few long time cancer survivor, or a family member of survivor, when I ask people to raise hands if they know a survivor. About one third of cancer deaths are fairly easily preventable, where early diagnosis is feasible, due to symptoms or screening tests. Such as in many cases, but not all of, breast, cervix, oral, colon, prostate etc.
The article mentions that there has been poor progress in developing countries compared to USA, even with regard to easily screened cancers, such as Cervix cancer.
This is where our readers can play a major role. Start New Year by asking yourself these questions: How many cancer screening tests have I ordered in last two years? How many families did I counsel about tobacco cessation, lifestyle changes, exercise, details of good diet, HPV vaccine? Can I diagnose an early oral cancer or breast cancer on examination? How many early cancers did I detect in last two years? How many patients did I send for genetic counseling where there was strong family history? Do I know basics of cancer, enough to guide my patient – surgery, radiotherapy, chemotherapy and other medicines, precautions during treatment, transplant? Do I know doctor or center (even if trust or government set up) in my region to send my patient for a PAP smear, and how frequently is this test to be done?
What are the Steps taken for cancer prevention for MYSELF and MY FAMILY?
January 14th 2019. Dr. Chirag A. Shah; M.D. Oncology/Hematology (USA), 079 26754001. Diplomate American Board of Oncology and Hematology. Ahmedabad.