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Interview with Dr Premitha (Radiation Oncologist)

About Dr Premitha

Dr Premitha is a Radiation Oncologist at HCG Cancer Centre, Bangalore. She has completed her oncology studies from reputed institutions in Bangalore. And did her MBBS at M S Ramaiah Medical College, Bangalore. She also did DNB-Radiotherapy at Bangalore Institute of Oncology and Diploma in Radio Therapy at Kidwai Memorial Institute of Oncology. She is a member of the Association of Radiation Oncologists of India (AROI) and the European Society of Medical Oncology (ESMO). Dr Premitha specializes in Radiation Oncology and is an expert in head and neck malignancies, brain tumours, gynaecology malignancies, thoracic and gastrointestinal tumours, and urogenital malignancies.

She also has extensive experience with technologies like 2D RT, 3D CRT, IMRT, IGRT, SBRT, SRS (Cyberknife), and Brachytherapy. She has also conducted extensive research in Prostate Cancer and immune responses to Radiotherapy. Empathetical, in her approach, she follows evidence-based treatment for her patients. She also has interest in medical academic activities and has involvement in the post-graduation thesis program and allied health science (technology) courses. She actively participates in cancer awareness programs, medical camps, and works towards raising awareness about cancer to the masses.

Prostate Cancer

Prostate cancer affects the prostate gland in males. It is slow-growing cancer compared to other cancers. Many a time, the person won’t know that he has prostate cancer, and it would have reached stage 4 before diagnosis.

Even at stage four, with advanced treatment facilities, Prostate Cancer can have treatment and cured.

New technologies like 2D RT, 3D CRT, etc

These are the new technological innovations in radiation therapy, which is one of the treatment modalities for cancer patients. Initially, with the invention X-rays, there was proof that these radioactive isotopes could treat a cancer tumor. Since then, advanced research has been happening for more advanced technologies in Cancer Treatment. With 2D RT, 3D CRT and many other advanced techniques, we have reached the extent that we can use higher doses to treat the tumour, in such a way that it doesn’t affect the nearby healthy cells, and thus will not hamper the quality of life of the patient.

Breast Cancer and its Causes

Breast cancer has become very common in this era now. Not just females but males can also get Breast Cancer. Obesity, less physical activities, unhealthy lifestyle, and addictions are the leading causes of Breast Cancer. Nowadays, most women are working too, so the majority order food from hotels; and it is not good for the body on the longer run. Unhealthy lifestyle and eating habits are the primary cause of Breast Cancer becoming the leading cancer in our country, while it was Cervical Cancer until a few years back.

It is a very aggressive cancer, but now with the advancements in cancer treatment, there is a cure at stage four too.

The rising trend in Head and Neck Cancers

Head and neck cancer is primarily caused by Tobacco. The more the exposure to tobacco, in any form, the more the chances of getting cancer. Nowadays, because of lifestyle changes, people are diagnosed with cancer without having any addiction. Head and Neck Cancer can affect the day to day life since the presence of tumour will cause Pain or disturbance during food intake.

People can look into the mirror with a wide-open mouth and see if there is any swelling or changes in their mouths because cancer can be present in any form, and mostly it will be a painless lump. Therefore, you should not ignore it and should get it checked immediately.

Gynaecological and Urogenital malignancies

Gynaecological malignancies- These are the cancers which affect the reproductive parts like uterus, cervix, and ovary. Cervical Cancer is very common in females, but due to advancements in cancer treatment, even stage- 3 Cervical Cancer can be treated using Radiotherapy. Even uterine cancer can be treated well if they are detected early. Some common symptoms are white discharge, foul-smelling discharge which has been there for a long time, and irregular menstruation.

Urogenital malignancies- If there is any problem in urine, hematuria or change in frequency of urine, then it is advisable to get it checked so that anything abnormal can be addressed at an early stage itself.

Brain Tumour

Whenever a person has an uncontrollable headache or epilepsy, we ask him to go for an MRI. If a tumour is found, then the neurosurgeon tries to remove it, send it for Biopsy. The protocol of Cancer Treatment is to treat it with radiotherapy, and people do live for more than five years.

There are some benign tumours too. Initially, they might not cause any problem, but as they grow gradually, at one point, they might cause some problem in some part of the brain. In such cases, the neurosurgeon removes it, but if it recurs, then we go for Radiotherapy. So, in the Cancer Treatment for brain tumours, Radiotherapy plays a vital role.

Thoracic and Gastro-Intestinal tumours

Thoracic includes the lungs, oesophagus and nearby structures. Mostly, the cause of Lung Cancer is the use of Tobacco in any form, such as smoking or chewing. Whenever we find that a person is suspicious of cancer, then we ask for a low dose CT scan because there is a limit to CT scan exposures too, and it can aggravate the problem.

Oesophagus and Stomach Cancer is the cancer of food pipe and stomach, respectively, which mostly happens due to addiction to Tobacco and high intake of spicy and unhygienic food.

In Gastro-Intestine, there are colon cancer, rectum cancer, small intestine cancer and large intestine cancer. These are all well treated, and there are combinations of cancer treatments now available for it, which reduce the side effects and improve the quality of life.

Rare and Challenging Cases

There are recurring cancers that we have to deal with, which may not have Cancer Treatment protocols in place. In that scenario, we have a multi-team meeting with doctors from different disciplines and come to a conclusion best suited for the patient.

I had a young girl who was about ten years old with Xerostomia Pigmentosum, a very rare condition, especially in India. Her skin would turn cancerous if came to exposure under sunlight. She even lost her left eye due to the occurrence in her left cheek. I treated her with advanced Radiotherapy and could successfully remove all her pigments. She again came back with lip cancer and a node in her throat, and I could successfully treat her with brachytherapy and palliative care. It was a challenging case because I had to do repeated radiation therapy, but thanks to the advancements in cancer treatment, I could cure her.

A Healthy Lifestyle

A healthy lifestyle can go a long way in keeping cancer away. Measures such as having a balanced and nutritious diet, including more vegetables in the diet, avoiding soda, tobacco, smoking, Alcohol consumption and sleeping for 8 hours a day can keep you healthy. Exercising regularly and avoiding anything that causes Stress also helps to keep the cancer away.

Palliative Care and Caregivers

Palliative care is given to the patients who have reached a very advanced stage of cancer, where it won’t be wise to continue giving them Cancer Treatment such as Chemotherapy or Radiation therapy. But there are measures that we can do to lessen their discomfort, by using lesser doses for a shorter period of time.

The caregivers should have patience and empathy and should take care of the patient, just like one would take care of an infant. They should have more mental strength and should be able to give motivation to the patient. But the mental Stress of the caregivers are also important, and they should do activities such as Pranayama and meditation to de-stress themselves.

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