May 30, 2023 | Health and Wellness
Dr. Rajeev Sharan, H.O.D & Sr. Consultant – Head & Neck Cancer and Thyroid Surgery, HCG EKO Cancer Centre
Voice box cancer, also known as Laryngeal cancer, is a type of throat cancer that forms in the tissues of the larynx. It is a part of the throat between the base of the tongue and the trachea. The larynx contains vocal cords that help phonate, breathe, and swallow. Voice box cancer can occur in any part of the larynx; hence, it is essential to understand the risk factors, symptoms, diagnosis, and treatment to detect and treat the disease early.
Risk Factors
There are various risk factors associated with voice box cancer. Below are a few significant ones that should not be ignored –
- Smoking cigarettes or using tobacco products can be one of the most significant risk factors for voice box cancer. Around 80- 90% of voice box/laryngeal cancer occur due to smoking.
- Excessive consumption of alcohol is another significant risk factor which can increase the risk of voice box /laryngeal cancer/ laryngopharyngeal cancer.
- Gender is also a risk factor, as men tend to develop this type of cancer four times more likely than women due to higher smoking/drinking habits.
- Voice box/Laryngeal cancer is most common among people aged 55 and above.
- People who work in specific occupations, such as construction workers, metalworkers, and firefighters, may have a higher risk of developing voice box/laryngeal cancer when exposed to sulfuric acid mist, nickel, wood dust, asbestos, or manufacturing mustard gas.
Symptoms
The symptoms of voice box/laryngeal cancer can differ depending on the affected area and stage of the tumor. Some common symptoms include:
- Hoarseness or change in voice persisting for more than 2-3 weeks.
- Cough and sore throat that is persistent.
- Difficulties in breathing or high-pitched wheezing noise when breathing.
- Pain or difficulty in swallowing
- Swelling or a lump in the neck
Diagnosis
This type of cancer cannot be traced without an expert’s intervention. Hence if a person experience any of the symptoms mentioned above, it is necessary to consult an ENT surgeon or a Head and neck surgeon at the earliest. These patients require physical examination of the neck along with endoscopic laryngeal examination using a rigid or fibreoptic laryngoscope mounted with a video camera. Further, a few tests such as radiological imaging, including MRI or CT scan, can be advised to assess the extent of disease and status of lymph nodes and possible spread. Biopsy is required to confirm the diagnosis.
Treatment
The treatment of voice box/laryngeal cancer depends on the tumour’s location, size of the tumor, stage of the disease, the patient’s ability to talk, eat & breathe as normally as possible, age, gender, & general health of the patient. Below are a few treatment options that are successful in most cases:
- Laser Surgery– Selected patients of early-stage laryngeal cancer may benefit from this laryngeal preserving surgical approach. Patient can go to his work or start routine activities in few days’ time.
- Partial Laryngectomy: This is another voice preserving surgical approach for slightly bigger tumor who is not a candidate for laser surgery and doesn’t want to go for long course of radiation.
- Total Laryngectomy – A common type of treatment for advanced stages of laryngeal cancer wherein the head and neck oncosurgeon removes the cancer-affected tissues along with whole of voice box and the affected lymph nodes from the neck. Patient will lose voice after total laryngectomy so to rehabilitate voice, patient requires tracheoesophageal prosthesis at the same sitting or in the follow up period. With the help of TEP, patient is able to speak.
- Radiation therapy – Radiation therapy is standard of care for treating laryngeal cancer. In early stages, radical radiation alone is sufficient. In advanced stages, radiation is used concurrently with chemotherapy or can be used as adjuvant therapy after surgery.
- Chemotherapy – A treatment that uses drugs to control the growth of cancer cells by killing or stopping them from spreading. Chemotherapy is used concurrently in combination with radiation therapy as an organ preserving approach in case of advanced tumor or can be used as neoadjuvant therapy or in palliative settings to mitigate the symptoms of metastatic disease.
- Immunotherapy – A treatment involves using immunotherapeutic drugs to stimulate the patient’s immune system to fight this disease. In selected patients of metastatic disease, immunotherapy may be useful in controlling the disease and prolonging life with better quality of life.
Understanding the risk factors, symptoms, diagnosis, and treatments can help in early detection and successful treatment. People must seek medical attention at the earliest if they experience the mentioned symptoms for more than 2-3 weeks duration. Quitting smoking or any other forms of tobacco use, or alcohol use is must for prevention and management of laryngeal cancer. Healthy lifestyle, balanced diet and exercises or physical activity may reduce overall cancer risk in long run.
May 30, 2023 | Health and Wellness
Dr G Vasu Babu, Consultant – Medical Oncologist, HCG Cancer Centre, Vijayawada
Bladder cancer is not as common in India as it is in Western countries, however, it is still essential for individuals to beware of the risk factors that go beyond smoking. Many lesser-known risk factors are often overseen or ignored regarding bladder cancer. Here are some of them that one should be mindful of.
- Chemicals and our exposure to them: When exposed to chemicals such as benzene, arsenic, and aromatic amines, either via the workplace or the environment, there can be an increased risk of bladder cancer. It mostly happens when one is exposed directly or indirectly, primarily if one works in an industry with exposure to these chemicals. In this situation, individuals must take proper precautions by following safety protocols and wearing protective uniforms or gear.
- The Age factor: This type of cancer is mainly seen in adults over 55 years of age, with men most prone to the illness compared to women of the same age. Though there is no way to prevent ageing, one can get yearly check-ups to be on the safer side. Through these check-ups, one will also be educated about the risk factors.
- Chronic Bladder Infections: Frequent bladder infections with symptoms such as blood in your urine or pain during urination. These symptoms are common for chronic bladder infections or inflammation and can increase the risk of developing bladder cancer.
- Family History: Genetic factors can also come into play and increase the risk of developing the disease. If one has a history in their family tree of bladder cancer, it is crucial to reveal the information. It is recommended that genetic testing be done to rule out any possibilities.
- Radiation Therapy: Though this factor doesn’t apply to everybody, if one has been exposed to any form of radiation in the past, especially in the pelvic region, it is essential to get consistent check-ups. It is also important to keep your doctor aware of radiation exposure, as this can also be a factor.
How to reduce your risk?
While some risk factors for bladder cancer cannot be changed, there are several steps you can take to reduce your risk. Quitting smoking is one of the most important things you can do to reduce your risk of bladder cancer. If you work in an industry exposed to chemicals, take proper safety precautions, and follow safety protocols. Maintaining a healthy diet and exercise routine can also help reduce your risk of bladder cancer and other types of cancer.
Risk factors cannot be changed, but one can reduce the risk of being exposed to them. As they say, prevention is better than cure, and the best way to stay safe is to be wary of the above-listed risk factors. Apart from being self-aware, it is also best to maintain a healthy diet and lifestyle with a good mix of exercise. This will not only help with a reduced risk of bladder cancer but also helps in preventing other cancers from developing. The best way to stay safe is to keep yourself first, consider yourself a priority and get regularly screened.
May 30, 2023 | Business, Finance, Health and Wellness
HealthCare Global Enterprises Limited (“HCG”), the leader in India in speciality healthcare services focused on oncology and fertility today announced its financial results for the quarter (“Q4”) and year ended FY23.
Highlights for quarter ended March 31st, 2023
- Consolidated Income from Operations (“Revenue”) was INR 4,417 mn as compared to INR 3,639 mn in the corresponding quarter of the previous year, reflecting a year-on-year growth of 21.0%
- Consolidated Profit Before Depreciation and Amortization, Finance Costs, Exceptional Items and Taxes (“EBITDA”) was INR 763 mn, as compared to INR 632 mn in the corresponding quarter of the previous year, a growth of 21% year-on-year
- Consolidated Profit Before Other Income, Depreciation and Amortization, Finance Costs, Exceptional Items and Taxes (“Adjusted EBITDA”), was INR 831 mn, as compared to INR 676 mn in the corresponding quarter of the previous year, a growth of 23% year-on-year
- EBITDA for Existing centers was INR 770 mn, a growth of 14% year-on-year
- EBITDA from New centers was INR 83 mn, as compared to INR 37 mn in the corresponding quarter of the previous year, a growth of 122%
- Consolidated Profit after Taxes and Minority Interest (“PAT”) was a profit of INR 84 mn, as compared to INR 60 mn in the corresponding quarter of the previous year, a growth of 40%
INR million except earnings per share
| Period ended Mar’23 |
|
Q4-FY23 |
|
Q4-FY22 |
|
Growth
(y-o-y) |
|
|
|
|
|
|
|
|
|
|
|
|
| Income from Operations |
|
4,417 |
|
3,646 |
|
21% |
|
|
|
|
|
|
|
|
|
|
|
|
| EBITDA(1) |
|
763 |
|
632 |
|
21% |
| EBITDA margin (%) |
|
17.3% |
|
17.3% |
|
|
|
|
|
|
|
|
|
|
| Adjusted EBITDA (2) |
|
831 |
|
676 |
|
23% |
| Ad. EBITDA margin (%) |
|
18.8% |
|
18.5% |
|
|
|
|
|
|
|
|
|
|
| PBT (3) |
|
131 |
|
9 |
|
1355% |
| PBT margin % |
|
3.0% |
|
0.3% |
|
|
|
|
|
|
|
|
|
|
| PAT (4) |
|
84 |
|
60 |
|
40% |
| PAT margin % |
|
1.9% |
|
1.6% |
|
|
|
|
|
|
|
|
|
|
| Earnings per share (EPS) |
|
0.60 |
|
0.54 |
|
– |
|
|
|
(1) Profit before depreciation and amortization, finance costs, exceptional items and taxes
(2) EBITDA excluding other income
(3) Profit / (Loss) before tax and after share of profit / (loss) of equity accounted investee, exceptional items
(4) Profit / (Loss) for the period after share of profit / (loss) of equity accounted investee, taxes and minority interests, exceptional items
Business Updates for Q4 FY24
- HCG Emerging centers continued their scale-up trajectory:
o Strong revenue growth of 32% y-o-y
o Recorded strong EBITDA growth of 122% y-o-y
- Several regions delivered double-digit revenue growth on sequential:
o Kolkata upsurge continued across all centers and delivered 142% revenue growth y-o-y
o Rajkot witnessed a continuance in its growth path with 58% revenue growth y-o-y
o Ranchi recorded a high growth of 51% y-o-y
o Total AOR for Q4FY23 increased to 65.1% in Q4FY23 compared to 59.9% in Q4FY22
o Emerging centers AOR saw a growth from 65.7% AOR in Q4 FY23 from 52.9% in Q4 FY2
Commenting on the results, Dr. B.S. Ajaikumar, Executive Chairman, HealthCare Global Enterprises Ltd.
said, “HCG being a single specialty hospital network, we have clearly shown how high-quality cancer centres can be established in a country like India, and how well it can perform in terms of clinical outcome and quality of care, at the same time grow financially, in the right way. For me as an Oncologist, and as a founder, it has been satisfying to see how HCG has become a medical destination, today.
Given the quality of our innovation, research, and patient-centricity, HCG ensures access to world-class cancer treatments and services for our patients. At HCG, we actively participate in clinical trials and invest in groundbreaking research to advance the frontiers of cancer treatment. Our Tumor board initiative is a potent platform that brings together a multidisciplinary team of oncology experts to discuss complex cancer cases, share insights, and develop personalized treatment plans. Employing breakthrough technology including Advanced Adaptive AI, Robotics, and Genomics coupled with our pay-per use model for LINACs enables us to provide best-in-class treatment at cost effective prices.
Our relentless fight against cancer is founded on our continuous research and technological innovation towards exploring new therapeutic avenues to move up the value chain of clinical excellence and lasting outcomes.”
Mr. Raj Gore, CEO HealthCare Global Enterprises Ltd., added, “We are extremely happy to announce our stellar performance for FY23. We have been consistently outperforming the industry growth with revenues for FY23 growing by more than 21% on a Y-o-Y basis. Our efforts on operational efficiency coupled with operating leverage has resulted into adjusted EBITDA growth of 31% leading to 139 bps margin expansion which stands at 18.9% in FY23, compared to 17.6% in the previous year.
Our track record of consistent performance reflected in highest ever revenue and EBITDA for 9 and 8 quarters respectively, in a row, is a testimony of meticulous planning and rigor in execution, we have shown as a team.
In addition to driving higher utilization of existing capacity, we would continue to invest in superior clinical expertise, capacity creation and brand building, to fuel future growth, and further fortify our leadership in the industry.
HCG remains to be the trusted healthcare partner for every individual, battling cancer. We are honored to have earned the trust of our patients and the communities we serve, and are committed to upholding that trust every day. Through our relentless endeavor we assure our patients the best of the treatments available across the globe and live up to our promise “Adding Life to Years”
May 30, 2023 | Health and Wellness
Dr Vividha Dubey, MD Radiation Oncology, Consultant – Radiation Oncology, HCG Hospitals, Bhavnagar
Rectal cancer is a significant health concern worldwide, accounting for a substantial portion of colorectal cancer cases. Over the years, the treatment landscape for rectal cancer has witnessed significant advancements, with radiation therapy playing a crucial role in improving outcomes. Here is the evolving role of radiation therapy in managing rectal cancer, highlighting the latest developments and their impact on patient care.
Neoadjuvant Radiation Therapy: Neoadjuvant radiation therapy, delivered before surgery, has become a standard approach in managing locally advanced rectal cancer. By using radiation therapy to shrink tumors, this strategy aims to improve surgical outcomes and increase the likelihood of achieving complete tumor removal. Neoadjuvant radiation therapy, often combined with chemotherapy (chemoradiotherapy), has been shown to reduce tumor size, increase the chances of sphincter preservation, and improve overall survival rates. This approach allows for a potentially less invasive surgical procedure and better patient functional outcomes.
Total Neoadjuvant Therapy (TNT): Total neoadjuvant therapy, also known as the “watch-and-wait” approach, is an emerging concept in managing select patients with rectal cancer. This approach involves delivering neoadjuvant chemoradiotherapy followed by close monitoring of the tumor response. Surgery may be deferred for patients who demonstrate a complete clinical response, sparing them from the potential morbidity associated with surgery. TNT has gained attention due to its potential to reduce overtreatment and improve the quality of life for patients who may not require immediate surgery. However, careful patient selection and long-term follow-up are essential in this approach.
Advances in Radiation Techniques: Radiation therapy techniques have advanced significantly, allowing for more precise tumour targeting while minimizing radiation exposure to surrounding healthy tissues. Intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) are commonly used in rectal cancer treatment. These approaches enable radiation oncologists to shape the radiation beams to conform closely to the tumor, delivering higher doses while reducing toxicity to nearby critical structures. Moreover, image-guided radiation therapy (IGRT) and daily cone-beam CT imaging help ensure accurate tumor targeting, further enhancing treatment precision.
Short-course Radiation Therapy: Radiation therapy for rectal cancer traditionally involves a prolonged treatment course of 5-6 weeks. It has been explored that the feasibility of short-course radiation therapy, typically delivered over one week. This approach has shown comparable oncological outcomes to the standard long-course regimen, with the advantage of reduced treatment time. Short-course radiation therapy is particularly beneficial for patients who may face challenges accessing treatment centres or require expedited treatment due to medical or logistical reasons.
Advances in Imaging and Response Assessment: The integration of advanced imaging techniques, such as magnetic resonance imaging (MRI) and positron emission tomography (PET), has significantly improved the accuracy of rectal cancer staging and response assessment to treatment. Functional imaging modalities, such as diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI, provide valuable information about tumor characteristics and response to therapy. These advancements enable clinicians to tailor treatment plans, monitor response during neoadjuvant therapy, and make more informed decisions regarding surgical intervention or further treatment intensification.
The evolving role of radiation therapy in managing rectal cancer has transformed the treatment landscape, offering new possibilities for improved outcomes and quality of life. Integrating these advancements into multidisciplinary care ensures personalized treatment plans and better patient selection. Moving forward, ongoing research and clinical trials will further refine our understanding of optimal radiation therapy techniques, treatment durations, and sequencing in the context of rectal cancer. Additionally, efforts should focus on long-term follow-up to assess the impact of these advancements on survival rates, local control, and quality of life.
By embracing these advances and leveraging the multidisciplinary approach, we can continue to improve the outcomes and overall well-being of patients battling rectal cancer. Through ongoing collaboration, research, and innovation, we can hope for a future where rectal cancer becomes a more manageable disease, ultimately leading to better prognosis and enhanced quality of life for patients worldwide.
May 30, 2023 | Health and Wellness
Dr. Abhishek Dudhatra, MBBS, MD (Medicine), DNB (Haematology), Fellowship – BMT (NUH, Singapore), Consultant – Haematology and Bone Marrow Transplant at HCG Cancer Hospitals, Ahmedabad
Aplastic anaemia is a rare and potentially life-threatening medical condition that occurs when the body fails to produce enough new blood cells. “Aplastic” refers to the bone marrow’s inability to produce enough new cells, while “anaemia” refers to a deficiency in red blood cells, which carry oxygen throughout the body. Aplastic Anaemia is of several types, however, the most seen type is Acquired Aplastic Anemia. This disorder can develop at any stage in life, at any age, and has no known cause. There are other types of aplastic anaemia which can be hereditary or caused by exposure to chemicals in the environment.
Symptoms to be mindful of
Unfortunately, there are no symptoms specific to Aplastic Anemia. Usual presenting symptoms are pale skin, weakness, fatigue, and even shortness of breath. In severe cases, aplastic anaemia can result in infection and bleeding, which needs immediate care.
Treatment options
It varies from person to person. In young patients with severe disease a bone marrow transplant may be needed to replace the damaged bone marrow with fully healthy bone marrow. Another option is immunosuppressive therapy, which is usually offered to elderly patients and those who are not fit for transplant.
Additional treatment includes blood transfusions that will help replace the missing blood cells, medication to encourage the existing bone marrow to produce new blood cells and antibiotics to treat infections or bacterial growth.
With proper treatment, a lot of people can live completely healthy and fulfilling lives. Lastly it is important to know that every individual’s illness is not the same, every journey is different. So be self-aware and know your own body.
May 29, 2023 | Business, Health and Wellness
In a recent fireside discussion, Dr. Shay Markovitch touched on how routine dentist appointments play a critical role in achieving optimal oral hygiene. According to Dr. Markovitch, regular dental check-ups are not just about fixing problems but also about preventing them from occurring in the first place. The significance of preventive dentistry cannot be understated, said Dr. Markovitch, as it helps individuals maintain healthy teeth and gums, prevents oral diseases, and contributes to a confident smile.
According to Dr. Markovitch, preventive dentistry is a proactive approach to oral healthcare that focuses on preventing dental issues rather than treating them after they arise. Dr. Markovitch noted that, regular visits to the dentist enable professionals to identify and address potential problems early on, thereby reducing the risk of more complex and costly procedures in the future. He added that, by embracing preventive dentistry, individuals can minimize the likelihood of experiencing tooth decay, gum disease, and other oral health problems.
Dr. Markovitch also noted that, during routine dentist appointments, oral health professionals conduct thorough examinations to assess the overall condition of the teeth and gums. He noted that, during such visits, dentists perform professional cleanings to remove plaque and tartar buildup, which cannot be effectively removed through regular brushing and flossing alone. These cleanings are essential in preventing gum disease, cavities, and bad breath.
Another crucial aspect of routine dentist appointments, according to Dr. Markovitch, is the opportunity for early detection of oral health issues. Dr. Markovitch noted that, dentists are trained to identify signs of dental problems such as tooth decay, gum inflammation, oral cancers, and abnormalities in the mouth. He added that, detecting these issues early allows for prompt intervention and appropriate treatment, potentially saving patients from more invasive procedures and complications in the future.
Dr. Markovitch added that, routine dentist appointments also serve as educational sessions where individuals can learn proper oral hygiene techniques and receive personalized guidance. According to Dr. Markovitch, dentists and hygienists provide valuable advice on brushing techniques, flossing, and choosing the right oral care products for specific needs. He also added that, they can address concerns and answer questions regarding diet, tobacco use, and lifestyle factors that can impact oral health.
Moreover, Dr. Markovitch added that, routine dental visits play a crucial role in maintaining a confident smile. He noted that,
A healthy smile can boost self-esteem and positively impact various aspects of life, including personal relationships and professional interactions. Regular check-ups and cleanings help individuals maintain bright, clean teeth and fresh breath, which contribute to a beautiful smile and overall self-confidence.
In light of the importance of routine dentist appointments for preventive dentistry, Dr. Markovitch, recommended that individuals schedule visits at least twice a year. However, Dr. Markovitch noted that, the frequency may vary based on individual needs and the recommendations of oral healthcare professionals. By committing to regular dental check-ups, Dr. Markovitch said, individuals can proactively protect their oral health, prevent potential issues, and ensure a radiant smile for years to come.
Dr. Shay Markovitch has more than 20-years of experience in general and cosmetic dentistry. Dr. Markovitch is also a certified Invisalign® and Lumineers® provider. Thanks to his skills, Dr. Markovitch has helped give many people their confidence back through beautiful smiles. To learn more about Dr. Shay Markovitch and what he can do for you, book an appointment today at >>> https://pelhamfamilydentalarts.com/.
