Cancer Treatment and Cure Depends on Monitoring, Accurate Diagnosis

By Jawahar Malhotra

HOUSTON: For most of the nearly hundred people in the hall, midway through the description of chemotherapy by the fourth speaker, it was as if a light bulb had gone off and the nature of the dreaded disease Cancer had suddenly been understood. All except for the skeptic who gripped the microphone at the end of the panel discussion and declared that it was all bunk. “All you have to do is take one teaspoon of baking soda in water and drink it every day,” he growled, “and all the Cancers will be gone.”

Another took the panel’s time to ask pointed questions about his treatment that left him Cancer free but still needing to do follow up therapies. But the rest of the people, judging from their questions understood the basics of what Cancer is, how it is diagnosed and what the cures and chances of survival are.

That was certainly due to the panel of five experts who had been assembled by the Indian American Cancer Awareness Network at its free seminar, open to the public, at India House this past Sunday afternoon, June 30. But the skill of the experts in imparting their hard won knowledge, and keeping it rudimentary enough for the general public to comprehend had a lot to do with it.

Dr. Shalin Shah a young Radiation Oncologist opened the seminar up by summing up the IACAN’s mission statement, “No one travels the journey alone after Cancer is diagnosed.” The two main goals of the organization are to clear confusion about the dreaded disease and work with local hospitals to get spiritual counseling available for people of all faiths. Shah also concluded the seminar with a description of his work which involves treatment using x-rays from outside or inside, depending on the cancer and location.

Dr. Sagar Naik a Radiologist with St. Luke’s Episcopal Hospital began by impressing that an accurate diagnosis and location of the Cancer is imperative to the type of treatment, and used slides from a case history to illustrate the process. Aside from standard x-rays, spot CAT Scans, PET scans, Interventional radiology in which a probe is pushed in to get a sample for a biopsy and ultrasounds can give more accurate information on what needs to be treated.

Dr. Savitri Krishnamurthy, a Professor of Pathology at MD Anderson Cancer Center explained what happens when the biopsy is sent for analysis. She explained how the human cell is affected and how the DNA chromosome regulates its function. Mutations in the chromosomes happen routinely, but are discarded or are repaired and the sequence continues on. It is when this doesn’t occur that the cancer kills the good cells, metastasizes and can become a malignant tumor.  Krishnamurthy explained that there were many causes for developing cancer: hereditary, environmental, but many times it is sporadic and there are many types of cancer.

The process of detecting cancer starts with a screening process for the symptoms exhibited, then do a biopsy which could be with fine needle or core needle and then do a sectional tissue analysis. The final pathology report identifies the tumor type, size, stage and how spread out it is and the treatment that could be employed.

Dr. Ali Mahmood, a Colorectal Surgeon with Methodist Hospital explained that a Tumor Board composed of many oncologists then meets to discuss the best treatment. He said that colon cancer was the third most common type and second leading cause of death, claiming 630,000 people annually, and 150,000 new cases diagnosed every year. The likelihood of getting the cancer increases with age, and the longer it takes to find it, the more aggressive it is. He explained what a polyp is and how it can become cancerous, illustrating the process with slides of horrific looking tumors that were removed from patients.

Dr. Sewa Singh Legha, a Medical Oncologist who retired from MD Anderson Hospital explained the different stages of cancer and what each meant for diagnosis, treatment and survivability. “There are very few cures for Stage 4, we can only treat and extend life,” he cautioned. He also explained that cancer is usually painless in early stages, and that 30% of the cases are cured in India versus 60% that are cured in the US. His role was to treat the cancer with drugs, mostly in stage 3, and described how, in the last 15 years, molecular targeted drugs have been developed based on learning the genetics of cancers.

According to Legha, what was insidious is that the same hormones that feed healthy cells can feed and spread the cancerous cells. He said that the immune system was very important in the treatment therapy and a healthy and vigorous one may explain why young people have less incidence of cancer compared to older people.

Kanchan Kabad, President of IACAN announced the commencement of SAHNA, for South Asian Health Needs Assessment, that will allow the South Asian community to benefit from Asian oriented treatment facilities such as the sixth floor at Southwest Memorial Hospital which is right now geared towards Chinese, Korean and Vietnamese people. The survey requires 1,500 respondents and will be open from August 15 to December 31 and then the results will be submitted to various area hospitals.

Dr. Shakin Shah said his specialty dealt with treating damaged DNA cells through targeted radiation therapy from the outside, or by seeds implanted within the tumor and used the case of prostate and breast cancers to illustrate the process. He added that there were no better cure rates using x-rays were the more sophisticated Proton Beam therapy which is performed in a multi-million dollar center downtown, although the costs of the Proton therapy are significantly higher.

Although none of the experts gave any false expectations of miracle cures, their explanations did allow the audience to better understand what to expect if the disease where to affect them or any of their loved ones.