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Interview with Dr Harshvardhan (Medical Oncologist)

Interview with Dr Harshvardhan (Medical Oncologist)

Dr Harshvardhan Atyeya is a Medical Oncologist, Hematologist and Cancer Specialist currently working at Apollo Medics Hospital, Lucknow. His expertise spans across all types of chemotherapy, intensive protocols, Immunotherapy and hormonal therapy. In addition to dealing with oncological emergencies, including medical care of patients. He holds a deep interest in Breast cancer, Lung Cancer, Gastrointestinal cancers and Blood cancers such as Lymphoma, Leukaemia and Myeloma. He also did his MBBS from LLRM Medical College, Meerut, qualified as a Senior Resident at AIIMS, New Delhi and completed his Doctorate of Medicine Hematology from Cancer Institute, Adyar, Chennai.

Multi-Disciplinary Approach

Since cancer is not a single disease but a group of diseases that affects not one but multiple organs in our body, it needs multiple treatment disciplines such as surgery, chemotherapy, radiation, etc. Even if a patient doesn't need Surgery at the initial diagnosis, we anticipate the problems that may occur during the course of the Cancer Treatment and involve the doctors from all the departments needed. We also need to collaborate with specialists from various disciplines to make a comprehensive Cancer Treatment plan and effectively treat it.

Chemotherapy, Hormone therapy and Immunotherapy

Chemotherapy is a group of drugs that we use for Cancer Treatment. Initially, we had very minimal drugs made from the bark of trees, plants, oils, and purified and created. Nowadays, we have come a long way, and there are around 2000 more drugs available for cancer treatment, which we manufacture synthetically. We administer these drugs orally or through injections and cause the cancer cells to die. The general principle behind chemo drugs is that they kill cells that are rapidly-dividing-cells. Therefore, the drug won't differentiate between cancer cells and body cells and affect the hair follicles, the lining of the mouth, intestinal lining and skin. But these effects are temporary, and Cancer Treatment is now advance enough to properly treat these side effects.

Hormone therapy is the use of hormones in cancer treatment, usually used in cancer types such as Prostate Cancer. The basic principle is that cancer cells grow by hormones, and we cut off the hormone supply using another hormone. Hormone therapy is popular in Breast Cancer Treatment also.

Immunotherapy is the administration of drugs that increase the body's defense system to fight against cancer cells. Cancer cells secrete a hormone that stops our body's immune system from fighting the cancer cells. Immunotherapy suppresses the secretion of this hormone by cancer cells, thereby enabling our body's immune system itself to fight against cancer. Not every cancer has treatment from Immunotherapy, but advanced research is going on in this field.

Genetic Counselling

When a family has a cluster of cancer cases, mainly in first-degree or second-degree relatives, we need to check their genetic structure and changes. In such cases, we look for genetic mutations and find whether there are any genetic mutations like BRACA1 or BRACA2 genes that are causing the cancer cells' growth. If we find such a mutation, we warn the family members that they are in the high-risk category for cancer and inform them about the need for regular screening and preventive measures. We check the high-risk patients yearly until they reach a particular age. We have the option of removing the breasts or ovary according to their risk category to avoid the occurrence of cancer at that site. This is the power of genetic counseling; we can save the family members after finding cancerous mutations in their genes.

Hodgkin's and Non-Hodgkin's Lymphoma

Lymphoma is a type of Blood Cancer which affects the lymph nodes. Lymph nodes are present throughout our body, and we usually find lumps on the armpits or collar bones.

Lymphomas affect two age groups, youngsters before 20 and adults above 50. In most instances, Lymphomas are curable. Additionally, if patients are appropriately counseled, even stage 4 Lymphoma patients can live up to 5 years. The usual Cancer Treatment procedure for Lymphoma is Chemotherapy and radiation, and additionally, Surgery is required only in exceptional cases. Only when all these treatment procedures are ineffective, we go for Bone Marrow Transplantation.

Bone Marrow Transplantation

Earlier, bone marrow transplantation used to be a complex process, but now it has become a routine procedure. It is basically done in hematological malignancies and benign diseases like Aplastic Anemia, Sickle cell disease and other Immunodeficiency diseases.

In Leukemia patients, we do Allogenic Bone Marrow Transplants, where we take the marrow from the siblings and transplant it to the patient's body. In Autologous transplants, patients' own bone marrow is taken for the transplantation.

It is important that patients have a sibling because only if the DNA matches can we have a successful bone marrow transplantation. If they don't have one, we have to search for unrelated donors or try more complicated procedures.

Even after bone marrow transplants, the patients will be required to take immune-strengthening medicines for around six months as their Immuno-strength would be that of a baby after the transplant.

Hemophilia, Leukemia, Lymphoma and Myeloma

All these are blood-related diseases. Hemophilia is a genetic disorder that occurs due to faulty genes. In this condition, the blood doesn't clot, leading to excessive bleeding at minor cuts.

Leukemia is a bone marrow disease where the blood cells do not mature, leading to depletion of RBC, WBC and Platelets. The deficiency of these cells leads to several complications like fever, weakness and immunodeficiency.

Lymphoma affects the lymph glands in our body. Myeloma is also a bone marrow disease, where the immune system plasma cells grow out of control. They secrete proteins that thicken the blood, which leads to several difficulties like kidney failure, weakening bones, high Calcium levels and anemia. Myeloma is generally seen among the older generation.

Gastrointestinal Cancer

The gastrointestinal system is from our food pipe to the anus. Therefore, it contains our food pipe, stomach, small intestine, large intestine, liver, pancreas, gall bladder and colon and rectum. The deadliest GI cancers are pancreatic cancers and gall bladder cancers. These cancers don't usually have any curable treatment options as they would have already spread to the nearby organs. Other cancers like esophagus cancer, Stomach Cancer and intestinal cancers can be treated and cured if found early.

Preventive Care Expert

In India, cancer care experts are far and few. And if we talk about Preventie Care Experts, I'd say such doctors are not seen in India as it is a very new concept. In the West, we can see many doctors and social workers who work in the preventive care field. But being an Medical Oncologist, I feel I should take responsibility for both treatment and diagnosis and preventive care also.

In preventive care, we should inform the society of the risk factors and also tell the importance of a healthy lifestyle, addiction-free life and the importance of exercise. More and more people should come forward in this field of Cancer Treatment so that the society becomes aware of what they should and shouldn't do.

How is helping?

I think is doing a wonderful job by helping and educating cancer patients. More cancer platforms are also needed to help them meet the right doctors and provide holistic treatment. Proper guidance about food habits, physiotherapy, psychological counseling are essential factors in a cancer journey, and it is excellent to know that you guys are holding hands with the cancer patients


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