Interview with Dr. Harilal Dobaria

He is a surgical oncologist with 32 years of experience in oncology. He worked as a lecturer in GCRI Ahmedabad and a full time surgeon at N P Cancer hospital in 1988. In 1989 he started working as consultant surgeon and Oncologist.

What are the most common cancers which are treatable with surgeries?

The most common cancers in our body are Breast Cancer, Neck Cancer, Colon Cancer and genital Cancers. These can be treatable with by surgeries. 

What are the different surgical procedures in oncology? 

To diagnose cancers, surgical oncologists may perform biopsies. Biopsy procedures can include:

• Needle biopsies such as fine needle aspiration or core biopsies
• Excisional (removing an entire suspicious area, such as a mole or tumor)
• Incisional (removing a portion of a suspicious area)
• Laparotomy (abdominal surgery)
• Endoscopic or laparoscopic surgery (surgery using a scope)
• Skin biopsy

Surgical oncologists may perform open surgeries or minimally invasive procedures such as:

• Laparoscopy
• Laser surgery
• Cryosurgery (freezing of skin and cells)
• Hyperthermia (heating of tissue)
• Microscopically controlled surgery
• Endoscopy

When do you think it's okay to opt for surgery as the prime option and when is it not? 

If the tumor is in its initial stage like stage 1 or stage 2, surgery is the prime option but in advanced cases like stage 3 or stage 4 where the tumor has infected the organs like liver or lungs then surgery may not be the best option. 

What is Minimally invasive neck dissection (MIND) or endoscopic neck dissection? 

It's a new concept. Neck dissection leaves behind many scars over the front of the neck. Various techniques, both endoscopic and robotic, has tried to avoid the scar. Though competitively there are more cases of robotic surgery, than endoscopic neck dissection, the cost and availability of robots precludes many patients from getting the benefit of MIND. The results show that MIND is feasible and oncologically safe. The scars produced are aesthetically better than that of conventional open neck dissection. This procedure leaves no scars in the anterior aspect of the neck. This technique can be replicable at any center with endoscopic equipment without need for purchasing specialized retractors or a robot. According to him, this technique is still not sufficient for Cancer patients. And they still prefer the advanced radical technique.

What is the Advanced Surgical Recovery Program( ASURE), how does it help a patient? 

The Advanced Surgical Recovery Program (ASURE) is meant to assist patients to get over surgery more quickly and with fewer complications. ASURE is meant to enhance surgical outcomes and enhance the patient experience before, during and after surgery. It also reduces patients' overall hospital stay.

What comes under gynaecological cancer and when is the surgery needed? 

Ovarian cancer is the most common cancer for gynecologists. Surgery is effective at the initial stages; stage 1 and stage 2. Cervical Cancer is the second most common cancer for gynecologists. It is too operated in the initial stages. 

Then the third one is carcinoma of  Uterus. It is safe till stage 3. But in stage 4 radiation is necessary. Breast Cancer is also treated under gynaecologist. It can be cured till stage 3 with chemotherapy and requires radiation at stage 4.

How much time does the surgery take

Time depends on the type of Cancer. Breast Cancer patients can be operated in the morning and discharged by the next day.

Colon Cancer patients need at least 4 days for the treatment and 5-6 days of hospitalization. 

Likewise it differs for each type of Cancer. 

What is colorectal Cancer? What are the treatment options? 

It is the cancer of the colon or rectum, located at the digestive tract's lower end.

Early cases can begin as non-cancerous polyps. These often have no symptoms but can be detected by screening. For this reason, doctors recommend colon screening regularly for those at high risk or over the age of 50.

Colorectal cancer treatment depends on the size, location and how far the cancer has spread. Common treatments include surgery to remove the cancer, chemotherapy and radiation therapy.

Is there anything like preventive cancer surgery? 

There is nothing like preventive Cancer. Cancer that can be preventive is simply called preventive Cancer. Just take the preventive steps at every point to prevent cancer. 

Can Metastatic Cancer be operated on? What are the risks of being operated on? 

Basically Metastatic cancer is Stage 4 cancer. At this time, no surgeries can be done. It only requires chemotherapy and radiation. This is the only alternative to Metastatic Cancer. 

What is biopsy? 

Biopsy is the prime step. Like how physicians give paracetamol in a fever, in cancer oncologists ask for biopsy to know the nature of the disease, the type of disease and what steps the doctors have to take next. So Biopsy is the first step. It is the most important step towards cancer management. 

What is the difference between Upper GI and Lower GI? 

Upper GI tract consists of the mouth, esophagus, stomach, and the first part of the small intestine (duodenum). The lower GI tract runs from the small intestine to the large intestine up to the anus.

Which all Cancers can help with self-awareness among people? 

They are breast cancer and colon cancer. These Cancers can be easily cured at the initial stages where even at the third stage also it can be cured. Self-awareness among people should be there. 

What are the misconceptions related to cancer? How can we fill this gap? 

There are many misconceptions about cancer in society. People don't know much about Cancer. We can fill this gap by educating people all over by providing social awareness towards cancer.