Conversation with Dr Ninad Katdare (Surgical Oncologist): “Do everything in moderation.

About Dr Ninad Katdare

Dr Ninad Katdare is a specialist in Surgical Oncology, with more than 11 years of total experience and eight years of experience working as a specialist. He completed his training from Tata Memorial Hospital, and in the three years there, he did more than 300 surgeries independently and assisted in a lot more. He mainly deals with head and neck cancer, breast cancer, thoracic cancer, gastrointestinal cancer, urogyn cancer and reconstruction Surgery in oncology.

Dr Ninad has been trained extensively in Europe. He completed his Masters in Advanced Oncology from UMI University, Germany. This is a one of a kind course, which covers research, clinical management, integration of complementary, alternative and conventional medicine, in the management of advanced cancer patients.

He completed his fellowship in Cytoreductive Surgery and HIPEC, and Peritoneal Oncology from CHU Lyon, France. He is one of the few doctors in India to not only do HIPEC Surgery but also other forms of peritoneal cancer treatments like EPIC (Early Post-operative Intra-peritoneal Chemotherapy) and NIPS (Neoadjuvant Intra Peritoneal Surgery and Chemotherapy).He pioneered PIPAC (Pressurised Intra Peritoneal Aerosolised Chemotherapy) in India and was one of the first surgeons in India to be trained for PIPAC.

He has also done his fellowship in Minimally Invasive And Robotic GI Surgery, advanced Laparoscopy And Robotic Surgery, Minimal Access Gynecologic Oncology and even in Gynecologic Oncology, from Le Centre Oscar Lambret, Lille, France; an “ESGO certified centre of excellence in Gynecologic Oncology. He then completed his D.U – a one year Masters in Surgical Endoscopy from the Universite de Strasbourg, France. This is a master’s program which trains the surgeon in the use of endoscopy, laparoscopy, and Robotic Surgery in oncology.

Cytoreductive Surgery and HIPEC

Cytoreductive Surgery and HIPEC is a new concept in Cancer Treatment. Previously, the advanced cancers were just left untreated, or palliative Chemotherapy was administered to them, but the lifespan would be around 5-6 months. Now, with the advancements in cancer treatments such as Cytoreductive surgery, improvements in perioperative care and ICU care, intraoperative patient monitoring, and use of HIPEC technology, the lifespan is extended up to 10 years. Using cytoreductive Surgery and HIPEC can give extra benefits to the patient.

NIPS and EPIC

EPIC stands for Early Post-operative Intra-peritoneal Chemotherapy. It has only limited uses.

NIPS stands for Neoadjuvant Intra- Peritoneal-Systemic Chemotherapy. It is most commonly used in Stomach Cancer. In NIPS, we give IV Chemotherapy with IP (intraperitoneal) Chemotherapy. It’s a new way to administer Chemotherapy in certain cancers, where the patients don’t respond to traditional Chemotherapy.

PIPAC

PIPAC (Pressurised Intra Peritoneal Aerosolised Chemotherapy) is a unique way of giving chemotherapy; it is totally different from the normally followed procedure of Cancer Treatment.

We convert standard liquid Chemotherapy into an aerosol form using a special device called Capnopen. The main advantage of PIPAC is that the Chemotherapy dose we need in PIPAC is just 1/3rd the dose of standard Chemotherapy.

PIPAC

PIPAC (Pressurised Intra Peritoneal Aerosolised Chemotherapy) is a unique way of giving chemotherapy; it is totally different from the normally followed procedure of Cancer Treatment.

We convert standard liquid Chemotherapy into an aerosol form using a special device called Capnopen. The main advantage of PIPAC is that the Chemotherapy dose we need in PIPAC is just 1/3rd the dose of standard Chemotherapy.

Fertility Preservation Surgery in Gynecologic Cancers

It is quite a neglected topic in India because, initially, cancer was rarely seen in younger people. In my opinion, cancer is a disease of modernization. The more modern we are becoming, the more cases of cancer are coming out.

Fertility preservation means that while undergoing cancer treatment, either you try to preserve the uterus, ovaries, and fallopian tubes, or at least you try to save the egg from the ovaries and uterus so that it can later be used for procreation.

Rising trends of breast cancer

Breast cancer is a lifestyle cancer. The rise in the consumption of junk food, refined oil, refined sugar, obesity, and lack of exercise increases the chances of getting cancer. It is one of the primary reasons why Breast Cancer is increasing day by day.

Laparoscopic and Robotic GI surgery

Until recently, laparoscopy and Robotic Surgery were not part of traditional Cancer Treatment procedures, since it was feared that the Cancer Treatment would not be adequate, and the cancer would not be properly removed.But in some cancers such as Prostate Cancer or cervical cancer, robotic surgeries are handier nowadays. We cannot do the laparoscopy or robotics Surgery in every case, but in some cases, it is always a better option. Nevertheless, while using it for cancer, it should be oncologically adequate and safe.

Conventional and Alternative treatment

Traditional methods, like Chemotherapy and radiation therapy, is still essential in Cancer Treatment. But now, we have a lot of support systems.Conventional treatment is the scientifically proven treatment that helps cancer patients. But simultaneously, patients can go for naturopathy, Homoeopathy or Ayurveda if it boosts their immunity, or helps them tolerate the Chemotherapy better.

Head and Neck cancers

The most common cancer found in India is Head and Neck Cancer. The biggest culprit for it is tobacco; by chewing or smoking. When people keep Tobacco in their mouth, it affects the entire head and neck region. These cases will only go down once the use of Tobacco also goes down.

Colorectal cancer

Colorectal cancer is of two types, i.e., Colon Cancer and rectum cancer. In colon cancer, usually, the treatment is Surgery and Chemotherapy. In rectum cancer, we can do Endoscopic Surgery.If it is a very early cancer, endoscopic Ultrasound is also used. Advanced medical research has now resulted in Cancer Treatment procedures, where the use of stoma can be removed, thus reducing the mental trauma of the patients of living with a stoma.

Rare forms of cancer

There are types of peritoneal cancer that are very rarely seen. Now, we are in the process of forming a network for rare cancers. The problem with rare cancers is that the evidence for us to work with is significantly less. Therefore, through this network, we aim to collect maximum evidence regarding these cases, which will help us in deciding a proper Cancer Treatment plan for the patients.

Cancer treatment during COVID 19

I would say that don’t delay your treatment because of the pandemic. A 15 days delay would not harm you, but a 2-3 months delay can affect your body. Take the necessary precautions and try to continue the Chemotherapy sessions as regularly as you can.

A healthy lifestyle

The key thing is that whatever you do, do it in moderation. Anything in excess can be harmful to the body. Have adequate greens, adequate carbs, protein, and fats. You should eat at least five fruits a week. Walking for 45 minutes a day will do wonders to your body. Avoid excessive use of spicy food, refined flour, sugar, and oil.

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