#Wilms Tumor Treatment In India
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Comprehensive Kidney Cancer Treatment in Delhi: A Beacon of Hope for Patients
Kidney cancer, also known as renal cancer, refers to the uncontrolled growth of cells in the kidneys, which can lead to tumor formation. With a rise in cases globally, Kidney cancer treatment in delhi has evolved significantly, offering better survival rates and improved outcomes. Delhi, India’s capital city, is home to several leading medical institutions that provide state-of-the-art treatment for kidney cancer. These hospitals combine advanced technology, skilled oncologists, and comprehensive treatment plans to offer patients the best possible care.
In this article, we explore the treatment options available for kidney cancer in Delhi and why the city is an ideal destination for patients seeking world-class medical care.
Types of Kidney Cancer
Kidney cancer generally falls into several types, with Renal Cell Carcinoma (RCC) being the most common, accounting for around 85% of cases. Other types include Urothelial Carcinoma, Wilms Tumor (mostly in children), and Renal Sarcoma. Early detection is key to effective treatment, as treatment plans differ depending on the cancer’s type, size, stage, and the patient's overall health.
Symptoms of Kidney Cancer
Kidney cancer symptoms may often go unnoticed in the early stages, which is why regular check-ups are vital for those at risk. However, when symptoms appear, they may include:
Hematuria (blood in the urine)
Persistent pain in the back or side
Unexplained weight loss
A lump or swelling in the abdomen
Fatigue and general weakness
If any of these symptoms are experienced, it is crucial to consult a doctor promptly for diagnosis and treatment.
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Best Pediatric Urologist in Delhi | Dr. Prashant Kumar Jain
Dr. Prashant Kumar Jain: Best Pediatric Urologist in Delhi
Discover expert pediatric urology care with Dr. Prashant Kumar Jain, the best pediatric urologist in Delhi. With years of experience and a compassionate approach, he provides exceptional treatment for children's urological issues.
Pediatric Urology
Congenital defects and diseases in the urinary tract or genitals of your child has to be identified early and rectified sooner. Unattended conditions put your child into various complications for rest of their life. The urinary tract includes the kidneys, ureters, and the bladder while the genital system includes the reproductive organs. Many of these conditions can now be diagnosed during antenatal period and this permits to properly counsel the parents regarding the natural course of the problem, management and finances involved. Also most of these conditions can be treated by using various endoscopic techniques avoiding any large morbid incisions of open surgery. Consultation of a pediatric urologist becomes essential when you notice any abnormalities in your child’s organs and system.
Best pediatric urologist in India
Pediatric urologists are the specialised experts who can diagnose, treat and administer your child related urinary and genital conditions. You may find the best solution for your child’s problem through the best pediatric urologist in India.
Finding out the real problem in your child is not always easy. Children cannot exactly indicate what is troubling them. They do not know to answer medical questions correctly, and they are not at all cooperative during medical tests. The best pediatric urologist in India has the experience in handling the children patiently and in treating the children after a thorough examination and precise diagnosis. He also uses state-of-the-art facilities and specialised equipment. Your child is treated in a very comfortable and fearless environment by the best pediatric urologist in India.
Conditions requiring treatment
The pediatric urologist would diagnose as your childi’s affected by one of the below conditions, although this list is not exhaustive –
Hypospadias: This is a congenital condition, where the urinary opening (urethra) is on the underside of the penis instead of being at the tip.
Epispadias: This is a congenital condition, where the urinatory opening (urethra) is on the top of the penis instead of being at the tip. In girls, the urinatory opening is towards the clitoris or even belly area.
Chordee: This is also a congenital condition, where the penis usually curves downwards. This could also be accompanied by Hypospadias.
Undescended Testis: this is a condition in which the testis does not descend down to there normal position in scrotal sacs.
Vesicoureteral reflux: This is an abnormality of urinatory function where flow of urine from the bladder reverts to the ureters (tubes which connect kidneys and bladder).
Pelvi-Ureteric Junction Obstruction: This is a blockage between the kidney pelvis and draining pipe(ureter) which can affect the kidney functions.
Posterior Urethral Valve: This is a condition in which a valve in the urinary passage obstructs the urinary flow.
Balanoposthitis: This is the inflammation in both the penis head and the foreskin, caused by yeast or fungal infections or any other reasons.
Renal and Adrenal tumor: Wilms tumor and Neuroblastoma
Symptoms requiring pediatric urologist’s consultation
Some of the abnormalities are thoroughly visible, whereas many of the symptoms need to be observed in your child during his normal course of a day. Below are few symptoms you need to know –
Urinary opening located not at the right spot
Abnormalities in the shape of genitals
Unusual skin tethering
Poor urinary stream
Persistent urge to urinate
Passing urine frequently in small amounts
Complaining of pain or burning sensation during urinating
Hesitancy to urinate
Blood in urine
Cloudy or strong-smelling urine
Lump or pain in abdomen
Complications of ignoring the symptoms
Repercussions of postponing the doctor appointments are serious than you think. Children tend to indicate their problems, only if it is impossible to bear up the pain any more. As responsible parents, we need to be vigilant and wise enough to spot the doubtful symptoms. Complications of ignoring the symptoms are unimaginable. This includes –
Abnormal curvature of the penis
Problems in learning to use toilets
Possibility to develop pyelonephritis during pregnancy of a girl child once grown up
Kidney scarring or failure
Hypertension or blood pressure
What types of treatments are given by the best pediatric urologist in Delhi?
Diagnosis and treatment of conditions that require a surgery
Surgical reconstruction of the urinary tract and genital abnormalities
Diagnosis and treatment of kidney stone disease
Surgical administration of tumors and problems of the bladder, kidney and testis
Evaluation and treatment of urological tract conditions diagnosed before birth
Things to do before consulting the best pediatric urologist in Delhi
Precise diagnosis and effective treatment depends on your commitment and choice of the best pediatric urologist. Before making the appointment, here are the things to do –
Note down all the signs and symptoms of your child that you doubt necessitating treatment
Get your child’s medical history on other health problems and recent reports
Think of your family’s medical history that you feel the child could have inherited
Doctor prescriptions of any medications that your child is taking
Quick questions and clarifications to know from your doctor
Our doctors are committed to give the best treatment that your child requires. It is your responsibility to make an urgent appointment with a consultant, once you notice any symptoms of genitals or urinary tract disorders in your child. Be sure your child is taken to the best pediatric urologist in India, who possesses the greatest expertise, comprehensive training and extensive experience treating children.
Conclusion:
Dr. Prashant Kumar Jain stands out as the best pediatric urologist in Delhi, renowned for his expertise and dedication to children's health. His commitment to providing personalized care ensures that young patients receive the highest standard of treatment in a supportive environment. Parents seeking reliable urological care for their children can trust Dr. Jain's experience and compassionate approach.
Category : Pediatric Urology
#best pediatric urologist#best pediatric urologist in Delhi#Best pediatric urologist in India#Epispadias#Hypospadias#Posterior Urethral Valve#Vesicoureteral Reflux
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Dr. Gaurav Kharya: A Leader in Pediatric Hematology and Oncology
In the realm of pediatric hematology and oncology, few names shine as brightly as that of Dr. Gaurav Kharya. With over 20 years of experience, he has become an internationally acclaimed bone marrow transplant surgeon, renowned for his pioneering work in haploidentical transplants for sickle cell disease (SCD). His remarkable career is marked by the successful performance of over 1,000 transplants, including more than 100 specifically for SCD patients in just the last seven years. This achievement stands out as the highest by any individual doctor in India.
Commitment to Patient Care
Dr. Kharya’s clinical proficiency extends beyond just transplants; he specializes in treating various blood disorders and pediatric cancers. He offers consultations at several esteemed hospitals across India, including Rainbow and Balaji Hospitals in Bhopal and Petals Children Hospital in Raipur. His dedication to his patients is not confined to the borders of India; Dr. Kharya holds international OPDs in countries such as New Zealand, Vietnam, Myanmar, Uzbekistan, Nigeria, Uganda, Kenya, and Zimbabwe, ensuring that children around the globe have access to his expertise.
At the heart of Dr. Kharya's practice is a robust team available 24/7, dedicated to managing pediatric emergencies swiftly and efficiently. This commitment underscores the urgency and importance of timely medical intervention in treating young patients.
Understanding Pediatric Cancers
Pediatric cancers are less common than adult cancers, but their impact can be profound. The treatment approach often involves a combination of surgery, chemotherapy, radiation therapy, and increasingly, innovative immunotherapies. The goal is to tailor these treatments to effectively eliminate specific types and stages of cancer.
Surgical Interventions
Surgery remains one of the most effective treatments for pediatric cancers, particularly for solid tumors like Wilms tumor (a type of kidney cancer) and certain brain tumors. The aim is to excise as much of the cancerous tissue as possible. However, meticulous planning is essential to minimize potential damage and long-term effects on a child's development.
Chemotherapy
Chemotherapy, which employs drugs to eradicate cancer cells, plays a crucial role in post-surgical treatment and in managing diffuse cancers such as leukemia. Children often tolerate higher doses of chemotherapy than adults, but these treatments must be carefully administered to mitigate severe side effects, which can impact growth, organ function, and increase the risk of secondary cancers later in life. Pediatric oncologists must tailor treatment plans with precision.
Radiation Therapy
Radiation therapy utilizes high-energy particles or waves to destroy cancer cells. While effective, there is significant concern regarding its long-term effects on children's growth and the risk of developing secondary cancers. Advances in precision techniques, such as proton therapy, allow for targeted treatments that minimize exposure to surrounding healthy tissues.
Innovative Treatments: Targeted Therapies and Immunotherapies
Targeted therapies are a promising advancement in cancer treatment, designed to focus on specific genes, proteins, or tissue environments that contribute to cancer's growth and survival. Immunotherapies, particularly CAR T-cell therapy, have shown remarkable success in treating certain types of pediatric leukemia, harnessing the body's immune system to combat cancer cells.
An Interdisciplinary Approach
The treatment of pediatric cancers requires a collaborative approach, involving pediatric oncologists, surgeons, radiation oncologists, trained nurses, and psychologists to provide holistic care for the child and their family. This comprehensive care model addresses both the physical and emotional aspects of cancer treatment, managing acute and long-term side effects while supporting the psychological well-being of the child.
The Importance of Early Diagnosis
One of the most critical factors in successfully treating pediatric cancers is early diagnosis. Most childhood cancers are highly curable if treated promptly by a specialized pediatric oncologist. Over the past three to four decades, the success rate of treating these cancers has dramatically increased from 10-20% to an impressive 90%.
Conclusion
Dr. Gaurav Kharya exemplifies the dedication and expertise required to navigate the complexities of pediatric hematology and oncology. His contributions to research and clinical practice, particularly in developing cell and gene therapy products in India, continue to push the boundaries of what is possible in treating young patients with blood disorders and cancer. Through his unwavering commitment to patient care and innovation, Dr. Kharya is not only changing lives but also shaping the future of pediatric oncology.
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Kidney Cancer Treatments in Bangalore | Worldofurology
Kidney Cancer Treatments in Bangalore: Advanced Options at World of Urology
kidney cancer treatments in Bangalore, or renal cell carcinoma (RCC), is a growing concern worldwide, and its prevalence in India is no exception. With the increasing number of cases, the demand for advanced and effective treatment options is crucial. Bangalore, known for its cutting-edge healthcare facilities, is at the forefront of providing world-class kidney cancer treatments. Among the leading institutions, World of Urology stands out for its comprehensive approach to managing kidney cancer, offering state-of-the-art treatments, personalized care, and expert consultation.
Understanding Kidney Cancer
Kidney cancer begins in the kidneys, two bean-shaped organs responsible for filtering waste from the blood and producing urine. The most common type of kidney cancer is renal cell carcinoma (RCC), which accounts for about 85% of all cases. Other types include transitional cell carcinoma, Wilms' tumor (commonly seen in children), and renal sarcoma.
Kidney cancer often goes undetected in its early stages due to the absence of symptoms. However, as the disease progresses, patients may experience symptoms like blood in the urine, persistent back or side pain, unexplained weight loss, fatigue, and a lump in the abdomen. Early detection and timely intervention are critical for successful treatment outcomes.
Kidney Cancer Treatment Options
The treatment of kidney cancer depends on various factors, including the stage of the disease, the patient's overall health, and the specific characteristics of the tumor. In Bangalore, World of Urology offers a range of advanced treatments tailored to meet the unique needs of each patient. Some of the primary treatment options include:
SurgerySurgery is the most common and effective treatment for kidney cancer, especially in the early stages. The goal of surgery is to remove the tumor while preserving as much kidney function as possible. World of Urology specializes in various surgical techniques, including:
Nephron-Sparing Surgery (Partial Nephrectomy): This procedure involves removing only the tumor and a small margin of healthy tissue, preserving the rest of the kidney. Nephron-sparing surgery is ideal for patients with small tumors or those with only one functioning kidney. The experts at World of Urology employ advanced techniques, including robotic-assisted surgery, to ensure precision and faster recovery.
Radical Nephrectomy: In cases where the tumor is large or has spread to surrounding tissues, a radical nephrectomy may be necessary. This procedure involves removing the entire kidney, along with the surrounding fat, adrenal gland, and nearby lymph nodes. Despite the loss of a kidney, patients can lead a normal life with one functioning kidney
Minimally Invasive ProceduresMinimally invasive procedures offer patients the benefits of reduced pain, shorter hospital stays, and quicker recovery times. At World of Urology, several minimally invasive techniques are available, including:
Laparoscopic Surgery: This procedure involves making small incisions through which a laparoscope (a thin tube with a camera) and surgical instruments are inserted to remove the tumor. Laparoscopic surgery is less invasive than traditional open surgery and offers faster recovery.
Robotic Surgery: Utilizing the da Vinci Surgical System, robotic surgery allows for greater precision and control during kidney cancer surgery. The surgeon operates the robotic arms from a console, enhancing accuracy and minimizing the risk of complications.
Cryoablation: This technique involves freezing the cancer cells using a cryoprobe, which is inserted through the skin directly into the tumor. Cryoablation is suitable for small tumors and is performed under imaging guidance, ensuring accuracy.
Targeted TherapyTargeted therapy is a form of cancer treatment that uses drugs to target specific molecules involved in the growth and spread of cancer cells. Unlike traditional chemotherapy, which affects both cancerous and healthy cells, targeted therapy focuses on cancer cells, reducing side effects. World of Urology offers advanced targeted therapies, including:
Tyrosine Kinase Inhibitors (TKIs): TKIs block the action of enzymes called tyrosine kinases, which play a key role in cancer cell growth. Drugs like sunitinib, sorafenib, and pazopanib are commonly used in the treatment of advanced kidney cancer.
mTOR Inhibitors: These drugs, such as everolimus and temsirolimus, inhibit the mTOR pathway, which is involved in cell growth and proliferation. mTOR inhibitors are often used when TKIs are no longer effective.
VEGF Inhibitors: Vascular Endothelial Growth Factor (VEGF) inhibitors, like bevacizumab, work by preventing the formation of new blood vessels that supply the tumor with nutrients. This helps in slowing the growth of the cancer.
ImmunotherapyImmunotherapy is a revolutionary approach that harnesses the body's immune system to fight cancer. By boosting the immune response or targeting specific immune checkpoints, immunotherapy can help control and even eliminate cancer cells. World of Urology provides cutting-edge immunotherapy options, such as:
Checkpoint Inhibitors: Drugs like nivolumab and pembrolizumab block proteins that prevent immune cells from attacking cancer cells. By inhibiting these checkpoints, the immune system can effectively target and destroy cancer cells.
Cytokine Therapy: This involves using proteins, such as interleukin-2 (IL-2), to enhance the immune system's ability to fight cancer. While cytokine therapy can be effective, it may also have significant side effects, so careful monitoring is essential.
Radiation TherapyWhile kidney cancer is generally resistant to radiation, it may be used in certain situations, such as when the cancer has spread to other parts of the body (metastasis) or to relieve symptoms like pain. Advanced radiation techniques, including stereotactic body radiation therapy (SBRT), are available at World of Urology to deliver precise doses of radiation to the tumor while minimizing damage to surrounding healthy tissues.
Clinical Trials and ResearchWorld of Urology is actively involved in clinical trials and research, offering patients access to the latest experimental treatments and therapies. Participating in a clinical trial can provide patients with new treatment options that are not yet widely available. The expert team at World of Urology carefully evaluates each patient's eligibility for clinical trials and provides comprehensive information to help them make informed decisions.
Why Choose World of Urology for Kidney Cancer Treatment?
World of Urology in Bangalore is a leading center for urological care, renowned for its expertise in kidney cancer treatment. The multidisciplinary team of urologists, oncologists, radiologists, and surgeons work together to develop personalized treatment plans tailored to each patient's unique needs. Key advantages of choosing World of Urology include:
Advanced Technology: World of Urology is equipped with the latest medical technology, including robotic surgery systems, advanced imaging techniques, and state-of-the-art radiation therapy equipment, ensuring precise and effective treatment.
Experienced Specialists: The team at World of Urology comprises highly experienced and skilled specialists who are leaders in the field of urology and oncology. Their expertise ensures the best possible outcomes for patients.
Comprehensive Care: From diagnosis to treatment and follow-up care, World of Urology provides a comprehensive approach to kidney cancer management. Patients receive holistic care that addresses not only their medical needs but also their emotional and psychological well-being.
Patient-Centered Approach: World of Urology is committed to providing compassionate care that prioritizes the patient's comfort and well-being. The team works closely with patients and their families to ensure they are informed and supported throughout their treatment journey.
Doctors
Dr. Mohan Keshavamurthy
Dr. Shakir Tabrez
Dr. Sreeharsha Harinatha
Dr. Basavaraj Neelgar
Dr. Karthik Rao
Dr. Mohan B A
Dr. Premkumar Krishnappa
Dr. Niti Raizada
Dr. Santosh Kumar Subudhi
Dr. Rubina Shanawaz Z
Dr. Ramesh H
Dr. Vishal
Dr. Kunal Sharma
Services
RAVH
Robotic Pyeloplasty
Sacral Colpopexy
Robotic Radical Prostatectomy
Penile Prosthesis
Kidney Transplant
Urinary Incontinence Treatment
Nephron Sparing Surgery
Get In Touch
Phone:+91-998-660-7455
Email:[email protected]
Address:No 156, Orchard Grande, 4 th Cross, 8th B-Main
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Kidney Cancer Treatment in India for Foreigners
Kidney cancer is known as renal cell cancer. Nowadays kidney cancer is most common in India. It starts inside the kidney, where blood is filtered. Kidney cancer is a harmful disease that attacks the healthy cells of the kidneys. It can be dangerous in the last stages. Our kidneys are two bean-shaped organs. Cancerous cells start to grow uncontrollably and form tumors in the kidneys. This tumor can extend beyond the kidney. Some cells can detach and spread to other parts of the body. In adults, renal cell carcinoma is a very common type of kidney cancer. Other less common types of kidney cancer can happen. Surgery is the most preferable treatment for different kidney diseases. A kidney cancer patient may have these symptoms, a lump can be felt in the abdomen, fatigue and unexplained weight loss, anemia, passing of blood in urine, unexplained fever for lasts weeks, etc. There are many types of kidney cancer.
Renal cell carcinoma - renal cell carcinoma has three main types clear cell, renal cell cancers, and papillary chromophobe
Urothelial carcinoma - this type is used to be called transitional cell cancer (TCC) of the kidney or ureter. It can change shape and stretch. The renal pelvis is the place of the kidney where urine collects.
Sarcoma - This is a rare type of soft tissue sarcoma of the kidney. This means the cancer started in the connective tissue muscles, nerves, fat, blood vessels, and fibrous tissue of the kidney.
Wilms tumor - this is a type of kidney cancer that can affect children. It is different from kidney cancer in adults.
Lymphoma
This type of kidney cancer can develop in both kidneys. In rare cases, kidney lymphoma can start as a tumor in the kidney.
The cancer spreads outside the kidney, to distant parts of the body, such as the liver, lungs, or bones.
Kidney Cancer Treatment Cost in India
Kidney cancer treatment costs in India are much lower than in other countries. The accurate cost is based on the diagnostic test, cost-affecting factors are doctor experience, selected hospital, accommodation, post-surgery care, etc. The average cost of kidney cancer treatment in India starts from 3600 USD and goes up to 7500 USD.
Best Kidney Cancer Treatment Doctors in India
Finding the best doctor for kidney cancer treatment can be crucial but India has several kidney cancer treatment surgeons. These doctors have years of experience in medical technology and work in reputable hospitals. They offer cutting-edge treatments and compassionate care, giving hope to numerous patients. Some best doctor's names are include:
Dr VineetGovinda Gupta (DM Medical Oncology–Gold Medalist, renal cancer specialist)
Dr.ArunHalankar (Nephrologist, MBBS, MD, Fellowship, USA)
Dr. Raghunath S.K (consultant and director of the uro-oncology and robotic surgery department)
Dr Pradeep Bansal (Kidney Transplant & Cancer Specialist)
Dr. Deepak Dubey (HOD & Chairman of Urology Department and Renal Transplantation)
Dr.SureshAdvani (Memberships of (ISO) Padma Shri and Padma Bhushan winner
Top Kidney Cancer Treatment Hospitals in India
India has many best hospitals for kidney cancer treatment. Now India is known globally for advanced medical technology of kidney cancer treatment. They provide radiofrequency ablation (RFA), cryoablation, radiation therapy, targeted drug therapy, immunotherapy, and chemotherapy as per the stage of cancer and the patient's overall health. Some of the best kidney cancer treatment hospitals' names are given below:
Tata Memorial Hospital (Mumbai)
Devasya Hospital (Ahmedabad )
All India Institute of Medical Sciences (AIIMS) (New Delhi)
Fortis Memorial Research Institute (FMRI) (Gurugram)
Rajiv Gandhi Cancer Institute & Research Centre (New Delhi)
Apollo Hospitals (Chennai)
Medanta- The Medicity (Gurgaon)
Al AfiyaMedi Tour is a leading medical tourism company in India. We offer medical tourism services such as finding the right doctor, the right hospital, and cost estimation etc. Some of the main countries are Bangladesh, South Africa, Egypt, Uganda, Zambia, Sudan, Dubai, Namibia, Iraq, Kenya, Saudi Arabia, Ethiopia, Nigeria, and so on. We provide free medical assistance for TURP surgery cost, lung cancer treatment, blood cancer treatment cost, the best hospital for heart valve replacement, arthroscopic surgery, bone marrow transplant cost, best liver transplant hospital, cosmetic andplastic surgery, heart surgeryliver transplant cost, top knee replacement surgeons, etc.
Source:https://alafiyameditour1.blogspot.com/2024/05/kidney-cancer-treatment-in-india-for.html
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Pediatric cancers encompass a range of malignancies that occur in children and adolescents. Some common types include:
Leukemia: The most common type of cancer in children, leukemia affects the blood and bone marrow, leading to abnormal production of white blood cells.
Brain and Central Nervous System (CNS) Tumors: These tumors can develop in different parts of the brain and spinal cord, impacting functions controlled by these areas.
Neuroblastoma: Arising from immature nerve cells, neuroblastoma usually occurs in infants and young children and can develop in various parts of the body, often the adrenal glands.
Wilms Tumor: A kidney cancer primarily affecting young children, Wilms tumor typically presents as a mass or swelling in the abdomen.
Lymphoma: Both Hodgkin and non-Hodgkin lymphomas can occur in children, affecting the lymphatic system.
Rhabdomyosarcoma: This type of cancer forms in soft tissues, such as muscles, and commonly occurs in the head and neck area, genitourinary tract, or extremities.
Retinoblastoma: A rare eye cancer that usually affects young children, retinoblastoma originates in the retina.
Osteosarcoma: The most common type of bone cancer in children and adolescents, osteosarcoma develops in the bones, often around the knee or in the upper arm.
Ewing Sarcoma: Another type of bone cancer, Ewing sarcoma typically arises in the bones or soft tissues around them, such as the pelvis, legs, or arms.
Hepatoblastoma: A rare liver cancer primarily affecting infants and young children.
These are just a few examples, and pediatric cancers can manifest in various other forms. Treatment approaches depend on the type, stage, and location of the cancer, as well as the child's overall health and other factors.
The dosage of radiation therapy given to pediatric patients with cancer depends on various factors, including the type of cancer, its stage, location, the child's age, overall health, and individual treatment plan. Pediatric radiation oncologists carefully consider these factors to determine the optimal dosage that effectively targets cancer cells while minimizing damage to healthy tissues and organs.
Radiation therapy doses for pediatric patients are typically measured in Gray (Gy), which represents the amount of radiation energy absorbed by tissues. The total dose and the fractionation schedule (the number of treatments and their frequency) are tailored to achieve the best treatment outcomes with the least possible long-term side effects.
Pediatric radiation therapy often employs techniques to minimize radiation exposure to healthy tissues, such as intensity-modulated radiation therapy (IMRT), proton therapy, and image-guided radiation therapy (IGRT). These technologies help deliver precise radiation doses to the tumor while sparing surrounding healthy tissues.
The specific dosage and treatment regimen are determined by the pediatric radiation oncologist in collaboration with the multidisciplinary care team, which may include pediatric oncologists, surgeons, radiologists, and other specialists, based on the child's individual circumstances and the goals of treatment. Close monitoring and follow-up care are essential to assess treatment response and manage any side effects that may arise during and after radiation therapy.
Treatment approaches are often tailored to each child's individual condition and may involve a multidisciplinary team of healthcare professionals to optimize outcomes and minimize long-term side effects. Close monitoring and follow-up care are crucial to assess treatment response and address any emerging issues during and after treatment.
Get the best treatment for cancer and full body health checkup at the best hospitals in India.
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Wilms Tumor
A Wilms’ tumour is a type of kidney cancer that usually affects young children. It is also known as a ‘Nephroblastoma’. Wilm’s tumour is the most common type of kidney cancer in children but is very rare.
The treatment for Wilms’ tumour usually includes surgery and may also include chemotherapy and radiotherapy. The outcome is usually very good and most children diagnosed with Wilms’ tumour will survive long-term.
A Wilm’s tumour is thought to come from very specialised cells that are involved in the development of kidneys. The specialised cells usually develop into normal kidney cells. If something goes wrong and some of the cells stayimmature then they grow out of control and develop into a Wilms’ tumour.
Wilms’ tumours are often divided into two main groups. The cells in each group look very different when looked at under a microscope. The appearance of cells under the microscope is called histology. The two types are:
Wilms’ tumour with favourable histology. Most Wilms’ tumours have favourable histology. This means that the cells have some similar features to normal kidney cells. Wilms’ tumours with favourable histology have an excellent chance of being cured with treatment.
Wilms’ tumour with unfavourable histology. Unfavourable histology means that the cells are completelyabnormal. This is called anaplasia. The cancer is less likely to be cured if there are lots of cells with anaplasia.
Wilms’ tumours usually only affect one kidney (unilateral). However, it can affect both kidneys (bilateral) in about 1 out of every 20 children who are diagnosed with Wilms’ tumour.
In most children, the causes of Wilms’ tumour are unknown. In about 1 in 100 children with Wilms’ tumour, another family member will also have Wilms’ tumour. This is because these children have inherited an abnormal gene from one of their parents. The abnormal gene increases the risk of Wilms’ tumour.
The most common symptom is a swelling in the abdomen which is gradually increasing in size and is felt by the parent one fine day. Other symptoms may include:
Blood in urine.
High temperature (fever).
Loss of appetite with nausea and vomiting.
Loss of weight.
A number investigation are done to diagnose a Wilms’ tumour and also for staging. An abdominal ultrasound scan is usually the first thing that is done. This is followed by an MRI scan and/or a CT scan of the abdomen and chest. These scans help to show exactly where the tumour is and whether it has spread to other parts of the body.Other tests will include blood tests to see how well the kidneys are working (kidney function tests) and to test for anaemia.
The stage of a cancer is used to describe the size of the cancer and whether it has spread to other parts of the body. This helps in deciding the treatment.
After examining the whole tumour under the microscope, Wilms’ tumours can be divided into a number of risk groups. The treatment following surgery will depend on these risk groups. The three main risk groups are known as low risk, intermediate risk and high risk.
Most Wilms’ tumours are in the ‘intermediate-risk’ group. So-called ‘low-risk’ tumours require less treatment after surgery than intermediate-risk tumours. ‘High-risk’ tumours need more treatment after surgery than ‘intermediate-risk’ tumours. The treatment will depend on a number of factors, including how the cells appear under the microscope (histology) and the stage of the tumour. Treatment usually includes an operation (surgery) and may also include chemotherapy and radiotherapy.
Surgery
All children with Wilms’ tumour will require surgery. Based on the imaging the surgeon decides for initial surgery or chemotherapy. The aim of surgery is to remove the whole of the tumour with the affected kidney (nephrectomy). However, in case of bilateral tumour or tumour in a solitary kidney, the tumour is removed leaving as much normal healthy kidney as possible.
Chemotherapy
Chemotherapygiven before surgery is known as neoadjuvant chemotherapy and is given to to shrink the size of the tumor and allow for complete surgical removal. Further chemotherapy may be needed after surgery, especially for Intermediate and ‘high-risk’ Wilms’ tumours, this is called adjuvant chemotherapy. Adjuvant chemotherapy helps to reduce the risk of the cancer coming back.
Radiotherapy
Not all children with Wilms’ tumour need radiotherapy. Radiotherapy may occasionally be used to shrink tumours that are too large to remove by surgery. Radiotherapy can also be used when tumours have spread elsewhere in the body.
Follow-up
After treatment for Wilms’ tumour your child will need regular check-ups to look for any return of cancer or for problems following treatment.
Outcome
The outcome for Wilms’ tumour is very good for all children, whatever their tumour stage. With treatment, 9 out of every 10 children diagnosed with Wilms’ tumour survive long-term. Most of the children with cancer that has spread to other parts of the body (metastatic disease) also survive long-term.
When one kidney is removed, the other will be able to work normally and can take over the work of the other kidney. Very few children with Wilms’ tumour have long-term kidney problems.
Tags = best pediatric urologist in delhi, best pediatric urologist in india, best pediatric surgeon in delhi, best pediatric surgeon in india, Wilms Tumor Treatment In India
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What Gastrointestinal Cancers develop in Young Children?
Childhood is the most beautiful of all life's seasons! But not every child is lucky enough to enjoy their childhood care-free. For children fighting the battle of cancer, the young years can be difficult. It is important to remember that early diagnosis and timely medical treatment can help in saving the child and curing them of cancer.
To spread awareness regarding pediatric cancer, promote the benefits of early diagnosis, and raise funds for families dealing with childhood cancer, India observes September as Childhood Cancer Awareness Month.
Childhood Cancer: Understanding the Menacing Problem
Every year, 300,000 children are diagnosed with cancer. It is 3-4% of total annual cancer cases detected globally. If we consider the Indian statistics, doctors diagnose 40,000-50,000 childhood cancer cases every year. Although 70-90% of pediatric cancers are curable, the estimate suggests that 70% of kids in India die due to:
1. Lack of awareness
2. Late detection and diagnosis
3. Inability to access medical facilities
4. High treatment cost
5. Unavailability of supportive care.
What Types of Gastrointestinal Cancers develop in Children?
The most common pediatric cancers are leukemia, brain, and spinal cord tumors, neuroblastoma, retinoblastoma, bone cancer, Wilms tumor, lymphoma, etc. When it comes to gastrointestinal cancer, surgical gastroenterologists often witness hepatoblastoma and pancreatoblastoma in children.
1. Hepatoblastoma: Malignant Liver Cancer among the Young
Hepatoblastoma is a type of liver cancer occurring in infants, toddlers, and children. It is a rare type of cancer that often affects children under the age of 3-4 years. GI surgeons have noticed that hepatoblastoma usually does not spread to other parts of the body.
Although the exact cause of the disease is unknown, experts pinpoint genetics. Beckwith-Wiedemann syndrome, familial adenomatous polyposis, glycogen storage diseases, and Aicardi syndrome increase the risk of hepatoblastoma in young children. If a baby is born with low weight, it can affect the risk of developing the disease.
Are there any Symptoms of Hepatoblastoma?
The signs of hepatoblastoma vary depending on the size of the tumor. However, one must look for the following symptoms:
a. Lump/swelling in the belly area
b. Enlargement of veins in the abdominal area
c. Pain in the abdomen
d. Trouble in eating and loss of appetite
e. Fatigue and unexplained weight loss
f. Nausea and vomiting
g. Fever
h. Jaundice
i. Itchy skin
If you notice any of the symptoms of hepatoblastoma, consult a surgical gastroenterologist immediately. The doctor can diagnose the disease after a physical examination, blood tests, ultrasound, tumor biopsy, CT scan, and MRI scan. The patient may have to undergo liver resection surgery, chemotherapy, and radiation therapy to treat hepatoblastoma. After the treatment, regular follow-ups are crucial.
2. Pancreatoblastoma: Rare Pancreatic Malignancy in Children
Malignant pancreatic tumors are different in children than those seen in adults. Additionally, they have better clinical outcomes in the younger population. Surgical gastroenterologists, oncologists, and other health care providers have noticed pancreatoblastoma almost exclusively in young children (age range: up to 9 years).
Pancreatoblastoma, pancreaticoblastoma, or infantile-type carcinoma of the pancreas is the most common type of pancreatic tumor in younger children. It causes less than 0.2% of pediatric cancer-related deaths in children. It means early detection and early medical treatment can help the child fight the disease successfully.
What are the Symptoms of Pancreatoblastoma?
Although the disease can be asymptomatic, parents and primary caregivers of the child must look for the following signs:
1. Abdominal pain and swelling
2. Fatigue and lethargy
3. Anorexia and weight loss
4. Diarrhea
5. Nausea and vomiting
Predominantly, the male children among the Asian population are affected by pancreatoblastoma. Doctors believe that congenital cases of the disease have some link to Beckwith-Wiedemann syndrome.
The surgical gastroenterologist will recommend tests: sonography, CT scan, MRI scan, etc., to diagnose pancreaticoblastoma. After a successful diagnosis, the young patient may need surgical pancreatic resection to remove the tumor.
Treatment, Care, and Support is Necessary
Childhood cancer can affect the young patient physiologically as well as emotionally. With immediate medical treatment, the emotional support of a counselor or support group is essential to help the child and family members.
To fight against the terrible disease, children need to undergo regular medical screening. Additionally, we need more childhood cancer awareness, better medical infrastructure, and improved public health strategies to avoid losing our future generation.
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Pediatric Tumors (wilms tumors, neuroblastoma, hepatoblastoma etc)
A Wilms’ tumour is a type of kidney cancer that usually affects young children. It is also known as a ‘Nephroblastoma’. Wilm’s tumour is the most common type of kidney cancer in children but is very rare.
The treatment for Wilms’ tumour usually includes surgery and may also include chemotherapy and radiotherapy. The outcome is usually very good and most children diagnosed with Wilms’ tumour will survive long-term.
A Wilm’s tumour is thought to come from very specialised cells that are involved in the development of kidneys. The specialised cells usually develop into normal kidney cells. If something goes wrong and some of the cells stayimmature then they grow out of control and develop into a Wilms’ tumour.
Wilms’ tumours are often divided into two main groups. The cells in each group look very different when looked at under a microscope. The appearance of cells under the microscope is called histology. The two types are:
Wilms’ tumour with favourable histology. Most Wilms’ tumours have favourable histology. This means that the cells have some similar features to normal kidney cells. Wilms’ tumours with favourable histology have an excellent chance of being cured with treatment.
Wilms’ tumour with unfavourable histology. Unfavourable histology means that the cells are completelyabnormal. This is called anaplasia. The cancer is less likely to be cured if there are lots of cells with anaplasia.
Wilms’ tumours usually only affect one kidney (unilateral). However, it can affect both kidneys (bilateral) in about 1 out of every 20 children who are diagnosed with Wilms’ tumour.
In most children, the causes of Wilms’ tumour are unknown. In about 1 in 100 children with Wilms’ tumour, another family member will also have Wilms’ tumour. This is because these children have inherited an abnormal gene from one of their parents. The abnormal gene increases the risk of Wilms’ tumour.
The most common symptom is a swelling in the abdomen which is gradually increasing in size and is felt by the parent one fine day. Other symptoms may include:
Blood in urine.
High temperature (fever).
Loss of appetite with nausea and vomiting.
Loss of weight.
A number investigation are done to diagnose a Wilms’ tumour and also for staging. An abdominal ultrasound scan is usually the first thing that is done. This is followed by an MRI scan and/or a CT scan of the abdomen and chest. These scans help to show exactly where the tumour is and whether it has spread to other parts of the body.Other tests will include blood tests to see how well the kidneys are working (kidney function tests) and to test for anaemia.
The stage of a cancer is used to describe the size of the cancer and whether it has spread to other parts of the body. This helps in deciding the treatment.
After examining the whole tumour under the microscope, Wilms’ tumours can be divided into a number of risk groups. The treatment following surgery will depend on these risk groups. The three main risk groups are known as low risk, intermediate risk and high risk.
Most Wilms’ tumours are in the ‘intermediate-risk’ group. So-called ‘low-risk’ tumours require less treatment after surgery than intermediate-risk tumours. ‘High-risk’ tumours need more treatment after surgery than ‘intermediate-risk’ tumours. The treatment will depend on a number of factors, including how the cells appear under the microscope (histology) and the stage of the tumour. Treatment usually includes an operation (surgery) and may also include chemotherapy and radiotherapy.
Surgery
All children with Wilms’ tumour will require surgery. Based on the imaging the surgeon decides for initial surgery or chemotherapy. The aim of surgery is to remove the whole of the tumour with the affected kidney (nephrectomy). However, in case of bilateral tumour or tumour in a solitary kidney, the tumour is removed leaving as much normal healthy kidney as possible.
Chemotherapy
Chemotherapygiven before surgery is known as neoadjuvant chemotherapy and is given to to shrink the size of the tumor and allow for complete surgical removal. Further chemotherapy may be needed after surgery, especially for Intermediate and ‘high-risk’ Wilms’ tumours, this is called adjuvant chemotherapy. Adjuvant chemotherapy helps to reduce the risk of the cancer coming back.
Radiotherapy
Not all children with Wilms’ tumour need radiotherapy. Radiotherapy may occasionally be used to shrink tumours that are too large to remove by surgery. Radiotherapy can also be used when tumours have spread elsewhere in the body.
Follow-up
After treatment for Wilms’ tumour your child will need regular check-ups to look for any return of cancer or for problems following treatment.
Outcome
The outcome for Wilms’ tumour is very good for all children, whatever their tumour stage. With treatment, 9 out of every 10 children diagnosed with Wilms’ tumour survive long-term. Most of the children with cancer that has spread to other parts of the body (metastatic disease) also survive long-term.
When one kidney is removed, the other will be able to work normally and can take over the work of the other kidney. Very few children with Wilms’ tumour have long-term kidney problems.
Tag = best pediatric urologist in India, best pediatric surgeon in Delhi, best pediatric surgeon in India, best pediatric urologist in Delhi
For More Information Visit http://www.pedsurgerydelhi.com
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Best Pediatric Urologist In Delhi, India - Dr Prashant Jain
Pediatric Urology
Congenital defects and diseases in the urinary tract or genitals of your child has to be identified early and rectified sooner. Unattended conditions put your child into various complications for rest of their life. The urinary tract includes the kidneys, ureters, and the bladder while the genital system includes the reproductive organs. Many of these conditions can now be diagnosed during antenatal period and this permits to properly counsel the parents regarding the natural course of the problem, management and finances involved. Also most of these conditions can be treated by using various endoscopic techniques avoiding any large morbid incisions of open surgery. Consultation of a pediatric urologist becomes essential when you notice any abnormalities in your child’s organs and system.
Best pediatric urologist in India
Pediatric urologists are the specialised experts who can diagnose, treat and administer your child related urinary and genital conditions. You may find the best solution for your child’s problem through the best pediatric urologist in India.
Finding out the real problem in your child is not always easy. Children cannot exactly indicate what is troubling them. They do not know to answer medical questions correctly, and they are not at all cooperative during medical tests. The best pediatric urologist in India has the experience in handling the children patiently and in treating the children after a thorough examination and precise diagnosis. He also uses state-of-the-art facilities and specialised equipment. Your child is treated in a very comfortable and fearless environment by the best pediatric urologist in India.
Conditions requiring treatment
The pediatric urologist would diagnose as your childis affected by one of the below conditions, although this list is not exhaustive –
Hypospadias: This is a congenital condition, where the urinary opening (urethra) is on the underside of the penis instead of being at the tip.
Epispadias: This is a congenital condition, where the urinatory opening (urethra) is on the top of the penis instead of being at the tip. In girls, the urinatory opening is towards the clitoris or even belly area.
Chordee: This is also a congenital condition, where the penis usually curves downwards. This could also be accompanied by Hypospadias.
Undescended Testis: this is a condition in which the testis does not descend down to there normal position in scrotal sacs.
Vesicoureteral reflux: This is an abnormality of urinatory function where flow of urine from the bladder reverts to the ureters (tubes which connect kidneys and bladder).
Pelvi-Ureteric Junction Obstruction: This is a blockage between the kidney pelvis and draining pipe(ureter) which can affect the kidney functions.
Posterior Urethral Valve: This is condition in which a valve in the urinary passage obstructs the urinary flow.
Balanoposthitis: This is the inflammation in both the penis head and the foreskin, caused by yeast or fungal infections or any other reasons.
Renal and Adrenal tumor: Wilms tumor and Neuroblastoma
Symptoms requiring pediatric urologist’s consultation
Some of the abnormalities are thoroughly visible, whereas many of the symptoms need to be observed in your child during his normal course of a day. Below are few symptoms you need to know –
Urinary opening located not at the right spot
Abnormalities in the shape of genitals
Unusual skin tethering
Poor urinary stream
Persistent urge to urinate
Passing urine frequently in small amounts
Complaining of pain or burning sensation during urinating
Hesitancy to urinate
Blood in urine
Cloudy or strong-smelling urine
Lump or pain in abdomen
Complications of ignoring the symptoms
Repercussions of postponing the doctor appointments are serious than you think. Children tend to indicate their problems, only if it is impossible to bear up the pain any more. As responsible parents, we need to be vigilant and wise enough to spot the doubtful symptoms. Complications of ignoring the symptoms are unimaginable. This includes –
Abnormal curvature of the penis
Problems in learning to use toilets
Possibility to develop pyelonephritis during pregnancy of a girl child once grown up
Kidney scarring or failure
Hypertension or blood pressure
What types of treatments are given by the best pediatric urologist in Delhi?
Diagnosis and treatment of conditions that require a surgery
Surgical reconstruction of the urinary tract and genital abnormalities
Diagnosis and treatment of kidney stone disease
Surgical administration of tumors and problems of the bladder, kidney and testis
Evaluation and treatment of urological tract conditions diagnosed before birth
Things to do before consulting the best pediatric urologist in Delhi
Precise diagnosis and effective treatment depends on your commitment and choice of the best pediatric urologist. Before making the appointment, here are the things to do –
Note down all the signs and symptoms of your child that you doubt necessitating treatment
Get your child’s medical history on other health problems and recent reports
Think of your family’s medical history that you feel the child could have inherited
Doctor prescriptions of any medications that your child is taking
Quick questions and clarifications to know from your doctor
Our doctors are committed to give the best treatment that your child require. It is your responsibility to make an urgent appointment with a consultant, once you notice any symptoms of genitals or urinary tract disorders in your child. Be sure your child is taken to the best pediatric urologist in India, who possess the greatest expertise, comprehensive training and extensive experience treating children.
For More Info. (http://www.pedsurgerydelhi.com/)
Tag = best pediatric urologist in India, hypospadias surgery in delhi, best pediatric surgeon in india
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Getting A Clear Perception Of Kidney Cancer
Kidney cancer is cancer that shapes in tissues of the kidneys. Similar to other vital organs in the body, sometimes the kidneys can develop cancer. The most common type of kidney cancer in adults is renal cell carcinoma which starts in the cells that line the little tubes inside your kidneys. Children are more probable to develop a type of kidney cancer named Wilms' tumor.
Early Detection Of Kidney Cancer
Kidney cancer hardly ever brings about problems in its initial stages. However, as a tumor develops, you can observe blood in your urine or feel accidental weight loss or back pain that does not getaway. Besides, kidney cancer cells could extend beyond your kidneys to neighboring organs and more distant places in the body. Nevertheless, if kidney cancer is identified and cured early, the possibilities for a comprehensive improvement are good. Early detection of kidney cancer is significant. As with most types of cancer, the earlier the tumor is revealed, the better a patient's possibilities for survival. Tumors found out at an initial stage frequently react well to treatment.
Some Common Symptoms Of Kidney Cancer
There are different symptoms which indicate cancer. These symptoms differ according to the type of cancer and the body part which has been hit. Top cancer hospitals in India use the following diagnostic methods:
• Lab tests - Lab tests of the blood, urine or other fluids measure the high or low level of certain substances that can be of cancer. They are an important diagnostic tool but not foolproof. • Nuclear scan - a small amount of radioactive material is injected known as a tracer. There is a machine called scanner which measures the radioactivity. It creates pictures of bones or organs and gets rid of radioactive substances in a quick span. • Pet scan - In this test, you will receive an injection of a tracer. The collection of tracers is the body is shown as a 3-D picture. • Biopsy - in some cases, doctors use a biopsy to diagnose some types of cancer. A part of the tissue of the body is removed and looked under the microscope by a pathologist. This tissue sample is either removed by a needle or with an endoscope. Surgery may also be needed.
Some of the best oncology hospitals in India use minimally invasive surgery methods for treating cancer. Some of the ways are –
• Laparoscopic surgery - this surgery is done with the help of a thin tube which is known as a laparoscope. Only small incisions are required which in dealing with cancer of Kidney, prostate, and ovaries. • Laser surgery - In this treatment, an optical fiber is inserted into a tumor. Then, a narrow beam of high-intensity light is used to remove cancerous tissue from the body. • Cryosurgery - cryosurgery is used to treat external tumors such as those which are present in the skin. Abnormal cells are killed off by freezing them with the help of liquid nitrogen. • Endoscopy - an endoscope is a thin flexible tube with an attached camera that allows the surgeon to see inside of the body. It may either be inserted into the mouth, rectum or vagina.
Reference
Dr. AK Saini is the best-known urologist in the region of Delhi-NCR. To know more about his services and treatment lines provided by him, you should meet him in person at his clinic Excel Advance Urology center for Kidney Treatment in Delhi.
Content Source : https://draksainiurologistindelhi.weebly.com/blog/getting-a-clear-perception-of-kidney-cancer
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Nephrectomy Cost in India | Request a Quote | Vaidam
Nephrectomy is a surgical procedure that involves removing the damaged part or all of the diseased kidney. This procedure is performed to treat severe kidney disease, kidney cancer, Wilm’s tumor or any form of traumatic injury. Every year, people all over the world come to India because the nephrectomy cost in India varies between $3,000 to $19,000.
Contact Vaidam Health for more information, budget-friendly treatment plan, medical visa availability and more! Call at +91-9650001746 or email at [email protected]!
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Wilms’ Tumor Treatment Market Research Study including Growth Factors, Types and Application by regions from 2019 to 2025
“The recent report, Wilms’ Tumor Treatment Market determines the market potential of the Wilms’ Tumor Treatment industry and the concentration of prominent manufacturers for the forecast period, 2019 to 2025. Apart from this, the study finds out the avenues for access to the market segment and sub-segments for several newly approved products and services. The market intelligence report further focuses on understanding the target customer (preferences, customers and influencers), the brands (product design, pricing, sale and positioning).
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The report also presents the market competitive landscape and a corresponding detailed analysis of the major vendor/key players in the market.
The key players covered in this report:
• The major manufacturers covered in this report Exelixis Inc NanoSmart Pharmaceuticals Inc Recombio SL Selvita SA
• Geographically, this report studies the top producers and consumers, focuses on product capacity, production, value, consumption, market share and growth opportunity in these key regions, covering North America Europe China Japan Southeast Asia India
• On the basis of product, this report displays the production, revenue, price, market share and growth rate of each type, primarily split into Cabozantinib s SEL-12034 Racotumomab Others
• On the basis of the end users/applications, this report focuses on the status and outlook for major applications/end users, consumption (sales), market share and growth rate for each application, including Hospital Clinic Others
• Key Stakeholders Wilms’ Tumor Treatment Manufacturers Wilms’ Tumor Treatment Distributors/Traders/Wholesalers Wilms’ Tumor Treatment Subcomponent Manufacturers Industry Association Downstream Vendors
This report studies the global Wilms’ Tumor Treatment market status and forecast, categorizes the global Wilms’ Tumor Treatment market size (value & volume) by manufacturers, type, application, and region. This report focuses on the top manufacturers in North America, Europe, Japan, China, and other regions (India, Southeast Asia).
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Which trends are likely to contribute to the development rate of the Wilms’ Tumor Treatment industry during the forecast period, 2019 to 2025?
What are the future prospects of the Wilms’ Tumor Treatment industry for the forecast period, 2019 to 2025?
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Pain & Palliative Medicine Rotation
I spent Weeks 4 and 5 with the Pain & Palliative Medicine Department. It was an opportunity to engage with issues pertaining to end-of-life care and to see how culture and class influence medical decision-making for patients with terminal illness. Palliative medicine is a relatively new sub-specialty in India; it didn’t become its own distinct department at St. John’s until 2008. Most low- and middle-income countries, India included, still have little access to palliative care. The St. John’s website describes the philosophy of Palliative Medicine as follows 1:
“Palliative Medicine is a multidisciplinary approach to specialized medical care for people with life-limiting illnesses. It focuses on providing people with relief from the symptoms, pain, physical stress, and mental stress of the terminal diagnosis. The goal of such therapy is to improve quality of life for both the person and their family.”
As such, the focus is on holistic symptom management (esp. pain management) and improving quality of life, rather than on curative interventions – a concept that several attendings remarked is still difficult for patients and families in India (or in the U.S., for that matter…) to accept. Palliative Medicine is a consultative service for the most part, and a majority of the terminal inpatients we rounded on were cancer patients. Still, approx. 80% of the caseload consisted solely of pain management for non-terminal patients – an indication, according to our attending Dr. T, that palliative care is still under-utilized as a service.
The nature of the specialty means that witnessing tragedy is inevitable: a 38 year old lady battling Stage IV ovarian cancer for years and finally succumbing; a small 6 year old boy with an aggressive form of metastatic Wilm’s tumor; colon cancer causing bowel obstruction and extreme abdominal pain; lung cancer making breathing difficult. The families by and large handled their adversity with grace, and I was often moved to see them advocate for their loved ones so adamantly – to ensure that pain and suffering would be minimized even if a cure was elusive or impossible.
Pain management was an important aspect of daily rounds; a lot of care was taken to ensure that dosages of pain meds (usu. opioids) were appropriately titrated. The Palliative team followed the so-called ‘WHO Ladder’ for pain management, whereby pain meds would be escalated from non-opioids (ex. NSAIDS, paracetamol) to weak opioids (ex. tramadol) to strong opioids (ex. morphine, fentanyl) in a stepwise fashion. Given the seriousness of the current opioid crisis in the U.S., this made me wonder about how opioids and other drugs were regulated in India. According to one of the attendings, the Indian Narcotics Bureau designates only certain hospitals as being able to prescribe strong opioids. And within each institution, only Registered Medical Practitioners (RMPs) who have received special training/certification can prescribe opioid medications. Kerala has the most opioid-dispensing institutions (~100-150), with North India having significantly fewer (only a few dozen, according to Dr. T). Bangalore has eight, of which St. John’s is one. There is an interesting tension between wanting to minimize patient exposure to the risk of narcotic dependence on the one hand whilst also striving to ensure that patients have appropriate access to pain meds on the other. A few patients we saw had actually come to St. John’s from out-of-state because they couldn’t otherwise obtain prescriptions for oral morphine 2 to manage their chronic pain 3.
Complicating things further, Dr. T also noted that titrating pain meds was sometimes frustrating because many of the pharma companies that produce generic meds aren’t strictly regulated and have questionable quality assurance. As a result, you can’t always be certain whether a particular drug/pill contains the full listed dose. Thus, if a patient doesn’t respond to a particular dosage/regimen, it’s often unclear whether it’s due to lack of efficacy or whether the pill the patient was given simply doesn’t contain the proper dose. One patient who was given tramadol in its generic form continued to complain of persistent pain; instead of upping the dose, Dr. T decided to try switching to a brand name formulation, and the patient’s pain immediately came down. Referring to some of the generic formulations of commonly prescribed oral pain meds, Dr. T wryly mused, “Is it chalk powder? It could be chalk powder. We don’t know.” On top of all this, the Indian government actively applies pressure on MDs to prescribe generics as a cost-saving measure, to the consternation of doctors, who argue that they cannot possibly provide optimum care if they can’t even be sure of the contents of the generics they are pressured to prescribe.
This got me wondering about how generics were regulated in the U.S., given that many of the generic meds that we prescribe and use are manufactured and sourced abroad in places like India. How does the U.S. ensure that our own markets aren’t flooded with questionable generics? I did some quick digging, and it seems that in order for foreign manufacturers to export their product to the U.S., they have to pass muster with the FDA’s Drug Quality Sampling and Testing Program 4. According to Consumer Reports: “...inspectors from the U.S. and India have ramped up efforts to make sure that plants in India making the drugs exported to the U.S. adhere to the strict manufacturing standards and regulations required by the FDA” 5. As much as we love to collectively complain about inefficient government bureaucracy, these revelations have made me grateful that we have institutions in place to ensure the public interest, as a check on rapacious private commercial practices.
Maybe the biggest takeaway from this rotation was how starkly it underscored inequalities in healthcare access. Unless a patient is very wealthy, healthcare (and esp. care for terminal illness) is often financially ruinous. Every citizen has access to free care at government hospitals, of course, but the general consensus is that these public facilities are under-resourced, under-staffed, and sub-par in terms of care quality. Many patients who can afford to do so therefore seek care at private facilities like St. John’s, where they pay out-of-pocket for every service rendered. Services can be abruptly halted if bills aren’t promptly paid. One patient with Stage III cervical cancer had her chemo and IV pain meds discontinued because of unpaid bills totalling 80,000 Rs. The mother of the aforementioned boy with metastatic Wilm’s tumor had apparently sold land and taken out loans to fund the treatment of her son, only to find out that the tumor was incurable. How she will manage financially after her son passes is unclear. In a market-based, for-profit system like India’s, are there ways to ensure greater healthcare equity and to make access less dependent on individual or familial wealth? 6
++++++++++++++++
[1] See: http://www.stjohns.in/Departments/Palliative%20Medicine/Overview ↩︎
[2] An interesting factoid: oral morphine is ridiculously cheap here – only ~1-2 Rs per pill! ↩︎
[3] Although the question of whether and to what extent opioids should be used to manage chronic pain in the first place is a contentious one. ↩︎
[4] See: https://www.fda.gov/Drugs/ScienceResearch/ucm407277.htm ↩︎
[5] See: https://www.consumerreports.org/cro/news/2014/04/are-generic-drugs-made-in-india-safe/index.htm ↩︎
[6] As with healthcare in the U.S., the problems and their solutions are, in part, a function of politics and political will. India spends less than 2% of its GDP on healthcare, and there is no robust system of health insurance to ensure high quality healthcare for all of its citizens. Certainly greater public sector investment in healthcare could be part of the solution. ↩︎
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Wilms Tumor Treatment In India done by our best pediatric urologist in india
Wilms Tumor
A Wilms’ tumour is a type of kidney cancer that usually affects young children. It is also known as a ‘Nephroblastoma’. Wilm’s tumour is the most common type of kidney cancer in children but is very rare.
The treatment for Wilms’ tumour usually includes surgery and may also include chemotherapy and radiotherapy. The outcome is usually very good and most children diagnosed with Wilms’ tumour will survive long-term.
A Wilm’s tumour is thought to come from very specialised cells that are involved in the development of kidneys. The specialised cells usually develop into normal kidney cells. If something goes wrong and some of the cells stayimmature then they grow out of control and develop into a Wilms’ tumour.
Wilms’ tumours are often divided into two main groups. The cells in each group look very different when looked at under a microscope. The appearance of cells under the microscope is called histology. The two types are:
Wilms’ tumour with favourable histology. Most Wilms’ tumours have favourable histology. This means that the cells have some similar features to normal kidney cells. Wilms’ tumours with favourable histology have an excellent chance of being cured with treatment.
Wilms’ tumour with unfavourable histology. Unfavourable histology means that the cells are completelyabnormal. This is called anaplasia. The cancer is less likely to be cured if there are lots of cells with anaplasia.
Wilms’ tumours usually only affect one kidney (unilateral). However, it can affect both kidneys (bilateral) in about 1 out of every 20 children who are diagnosed with Wilms’ tumour.
In most children, the causes of Wilms’ tumour are unknown. In about 1 in 100 children with Wilms’ tumour, another family member will also have Wilms’ tumour. This is because these children have inherited an abnormal gene from one of their parents. The abnormal gene increases the risk of Wilms’ tumour.
The most common symptom is a swelling in the abdomen which is gradually increasing in size and is felt by the parent one fine day. Other symptoms may include:
Blood in urine.
High temperature (fever).
Loss of appetite with nausea and vomiting.
Loss of weight.
A number investigation are done to diagnose a Wilms’ tumour and also for staging. An abdominal ultrasound scan is usually the first thing that is done. This is followed by an MRI scan and/or a CT scan of the abdomen and chest. These scans help to show exactly where the tumour is and whether it has spread to other parts of the body.Other tests will include blood tests to see how well the kidneys are working (kidney function tests) and to test for anaemia.
The stage of a cancer is used to describe the size of the cancer and whether it has spread to other parts of the body. This helps in deciding the treatment.
After examining the whole tumour under the microscope, Wilms’ tumours can be divided into a number of risk groups. The treatment following surgery will depend on these risk groups. The three main risk groups are known as low risk, intermediate risk and high risk.
Most Wilms’ tumours are in the ‘intermediate-risk’ group. So-called ‘low-risk’ tumours require less treatment after surgery than intermediate-risk tumours. ‘High-risk’ tumours need more treatment after surgery than ‘intermediate-risk’ tumours. The treatment will depend on a number of factors, including how the cells appear under the microscope (histology) and the stage of the tumour. Treatment usually includes an operation (surgery) and may also include chemotherapy and radiotherapy.
Surgery
All children with Wilms’ tumour will require surgery. Based on the imaging the surgeon decides for initial surgery or chemotherapy. The aim of surgery is to remove the whole of the tumour with the affected kidney (nephrectomy). However, in case of bilateral tumour or tumour in a solitary kidney, the tumour is removed leaving as much normal healthy kidney as possible.
Chemotherapy
Chemotherapygiven before surgery is known as neoadjuvant chemotherapy and is given to to shrink the size of the tumor and allow for complete surgical removal. Further chemotherapy may be needed after surgery, especially for Intermediate and ‘high-risk’ Wilms’ tumours, this is called adjuvant chemotherapy. Adjuvant chemotherapy helps to reduce the risk of the cancer coming back.
Radiotherapy
Not all children with Wilms’ tumour need radiotherapy. Radiotherapy may occasionally be used to shrink tumours that are too large to remove by surgery. Radiotherapy can also be used when tumours have spread elsewhere in the body.
Follow-up
After treatment for Wilms’ tumour your child will need regular check-ups to look for any return of cancer or for problems following treatment.
Outcome
The outcome for Wilms’ tumour is very good for all children, whatever their tumour stage. With treatment, 9 out of every 10 children diagnosed with Wilms’ tumour survive long-term. Most of the children with cancer that has spread to other parts of the body (metastatic disease) also survive long-term.
When one kidney is removed, the other will be able to work normally and can take over the work of the other kidney. Very few children with Wilms’ tumour have long-term kidney problems.
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Pediatric Urology
Congenital defects and diseases in the urinary tract or genitals of your child has to be identified early and rectified sooner. Unattended conditions put your child into various complications for rest of their life. The urinary tract includes the kidneys, ureters, and the bladder while the genital system includes the reproductive organs. Many of these conditions can now be diagnosed during antenatal period and this permits to properly counsel the parents regarding the natural course of the problem, management and finances involved. Also most of these conditions can be treated by using various endoscopic techniques avoiding any large morbid incisions of open surgery. Consultation of a pediatric urologist becomes essential when you notice any abnormalities in your child’s organs and system.
Best pediatric urologist in India
Pediatric urologists are the specialised experts who can diagnose, treat and administer your child related urinary and genital conditions. You may find the best solution for your child’s problem through the best pediatric urologist in India.
Finding out the real problem in your child is not always easy. Children cannot exactly indicate what is troubling them. They do not know to answer medical questions correctly, and they are not at all cooperative during medical tests. The best pediatric urologist in India has the experience in handling the children patiently and in treating the children after a thorough examination and precise diagnosis. He also uses state-of-the-art facilities and specialised equipment. Your child is treated in a very comfortable and fearless environment by the best pediatric urologist in India.
Conditions requiring treatment
The pediatric urologist would diagnose as your childis affected by one of the below conditions, although this list is not exhaustive –
Hypospadias: This is a congenital condition, where the urinary opening (urethra) is on the underside of the penis instead of being at the tip.
Epispadias: This is a congenital condition, where the urinatory opening (urethra) is on the top of the penis instead of being at the tip. In girls, the urinatory opening is towards the clitoris or even belly area.
Chordee: This is also a congenital condition, where the penis usually curves downwards. This could also be accompanied by Hypospadias.
Undescended Testis: this is a condition in which the testis does not descend down to there normal position in scrotal sacs.
Vesicoureteral reflux: This is an abnormality of urinatory function where flow of urine from the bladder reverts to the ureters (tubes which connect kidneys and bladder).
Pelvi-Ureteric Junction Obstruction: This is a blockage between the kidney pelvis and draining pipe(ureter) which can affect the kidney functions.
Posterior Urethral Valve: This is condition in which a valve in the urinary passage obstructs the urinary flow.
Balanoposthitis: This is the inflammation in both the penis head and the foreskin, caused by yeast or fungal infections or any other reasons.
Renal and Adrenal tumor: Wilms tumor and Neuroblastoma
Symptoms requiring pediatric urologist’s consultation
Some of the abnormalities are thoroughly visible, whereas many of the symptoms need to be observed in your child during his normal course of a day. Below are few symptoms you need to know –
Urinary opening located not at the right spot
Abnormalities in the shape of genitals
Unusual skin tethering
Poor urinary stream
Persistent urge to urinate
Passing urine frequently in small amounts
Complaining of pain or burning sensation during urinating
Hesitancy to urinate
Blood in urine
Cloudy or strong-smelling urine
Lump or pain in abdomen
Complications of ignoring the symptoms
Repercussions of postponing the doctor appointments are serious than you think. Children tend to indicate their problems, only if it is impossible to bear up the pain any more. As responsible parents, we need to be vigilant and wise enough to spot the doubtful symptoms. Complications of ignoring the symptoms are unimaginable. This includes –
Abnormal curvature of the penis
Problems in learning to use toilets
Possibility to develop pyelonephritis during pregnancy of a girl child once grown up
Kidney scarring or failure
Hypertension or blood pressure
What types of treatments are given by the best pediatric urologist in Delhi?
Diagnosis and treatment of conditions that require a surgery
Surgical reconstruction of the urinary tract and genital abnormalities
Diagnosis and treatment of kidney stone disease
Surgical administration of tumors and problems of the bladder, kidney and testis
Evaluation and treatment of urological tract conditions diagnosed before birth
Things to do before consulting the best pediatric urologist in Delhi
Precise diagnosis and effective treatment depends on your commitment and choice of the best pediatric urologist. Before making the appointment, here are the things to do –
Note down all the signs and symptoms of your child that you doubt necessitating treatment
Get your child’s medical history on other health problems and recent reports
Think of your family’s medical history that you feel the child could have inherited
Doctor prescriptions of any medications that your child is taking
Quick questions and clarifications to know from your doctor
Our doctors are committed to give the best treatment that your child require. It is your responsibility to make an urgent appointment with a consultant, once you notice any symptoms of genitals or urinary tract disorders in your child. Be sure your child is taken to the best pediatric urologist in India, who possess the greatest expertise, comprehensive training and extensive experience treating children.
Tags: best pediatric urologist, best pediatric urologist in Delhi, Best pediatric urologist in India, Epispadias, Hypospadias, Posterior Urethral Valve, Vesicoureteral Reflux
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