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Haemato Oncology

The department of Haemato oncology looks after all the disease of blood and Lymphatics.  We cover Benign Haematology, Malignanat Haematology, Bleeding and thrombosis problems along with Bone marrow Transplantation.

We work alongside Medical, Radiation and surgical oncologists and share the infrastructure whose primary focus is solid tumors like Breast, colon, Lung etc.

We provide world class care mainly following UK based treatment approach and you will be provided with clinical letter addressing the issues discussed regarding Management plan.

Our Oncology department has six bedded dedicated Transplant unit on level 5 with spacious rooms which are microbiologically tested regularly and all are HEPA filtered.  We have dedicated Leukemia ward and Neutropenic ward, general ward and Chemotherapy day case area with good nurse patient ratio.

We have well established multidisciplinary Transplant team with trained nurses providing one to one care, on site aphaeresis machine, stem cell storage facility, Transplant Immunology lab with excellent support of transfusion lab along with world class qualified Transplant Consultants.

Our specialist have knowledge in laboratory medicine as well, along with clinical care provides a unique opportunity to combine clinical skills with cutting edge science in making diagnosis and choosing appropriate treatment plan and monitor progress in world class standards.

We frequently contribute to diagnosis and management in other specialties and in intensive care setting as blood disorders can present in various forms and at times diagnosis can be very difficult.

Treatment of blood cancers depends on particular type and can vary considerably from patient to patient.

We would risk stratify the cancer at the time of diagnosis to understand how the disease will behave on the long term which can influence treatment plan.

The treatment majority of the times are chemotherapy, rarely combined with Radiotherapy. There is limited role for surgery in Haematological Malignancies.

Many of our patients are surprised to hear in some cases treatment may not need to be started immediately. This is referred to as “watchful waiting “who needs periodic follow up and need for treatment can be in years.

 

Head & Neck Oncology

Head & Neck Surgery is a sub-specialty of cancer surgery that deals with the surgical management of cancer of the head & neck as well as other related tumors and conditions occurring in the region.

Some of the common conditions which are managed by the Head & Neck Surgeon are:

  1. Oral (mouth and tongue) cancer, tumors affecting the jaw
  2. Cancer of the throat (larynx and pharynx)
  3. Lumps affecting the thyroid gland and thyroid cancer
  4. Salivary gland (Parotid and submandibular gland) tumors
  5. Sinus cancer (maxillary, ethmoid etc) and tumors affecting the skull base
  6. Neck swellings (TB, lymphomas and other lymph nodal swellings and sarcomas)
  7. Orbital tumors
  8. Any other tumors and related conditions occurring in the Head & Neck region

Head & Neck cancers:

These cancers are generally referred to as life-style related cancers as they are due to certain habits and practices. Cancers of the mouth and throat (upper aero-digestive tract) are primarily caused by the habit of smoking or chewing tobacco and other related products and by excessive alcohol consumption. India has one of the highest incidence of Head & Neck cancer in the world (one-third of all cancers) due to the indiscriminate use of chewed tobacco in different forms.

The department offers screening for people addicted to tobacco as well as counseling and guidance to kick the habit.

Warning signals of Head & Neck cancer:

  1. A sore or ulcer in the tongue or mouth that does not heal within three weeks
  2. Persisting bleeding from the gums or mouth
  3. Nasal obstruction associated with bleeding from the nostril
  4. Change in voice and/or difficulty in swallowing beyond three weeks
  5. A painless lump in the thyroid or elsewhere in the neck
  6. A wart or mole which increases in size or changes in colour or starts bleeding

If any of these symptoms are present it is important to immediately see a doctor to rule out cancer.

Common surgeries performed:

  1. Composite resection for oral cancer
  2. Total and partial laryngectomy with voice restoration using latest voice prosthesis
  3. Surgery of the thyroidincluding Robotic thyroidectomy
  4. Minimal access Parathyroid surgery using intra-op PTH estimation
  5. Parotid and other salivary gland surgery
  6. Laser surgery for cancer of the larynx
  7. Skull base surgery for sinus and other advanced cancers and parapharyngeal tumors
  8. Reconstructive surgery of the Head & Neck including micro-vascular free flap technique
  9. Trans-oral robotic surgery (TORS) for tumors of the oro-pharynx
  10. Vascular tumors of the neck (carotid body tumors etc.)
  11. Surgery and reconstruction for skin cancers

Rehabilitation:

The department runs a very successful Laryngectomee Society for the rehabilitation of throat cancer survivors.

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The Head & Neck Team at Apollo Hospital, Hyderabad
Dr Umanath K. Nayak M.S., Fellow of the University of California, Davis
Associate Professor and Senior Consultant (Head & Neck, Skull Base and Robotic surgery)
Dr. Arsheed Hakeem M.S., DNB (ENT), FHNS Senior Consultant (Head & Neck, Endoscopic skull base and Trans-oral robotic surgery)
Dr. Rahul Buggaveeti M.S .(ENT), Mch (Head & Neck Surgery)
Consultant (Head & Neck, Micro vascular and Laser surgery)
Dr. Shobana Sekhar MDS, Fellowship in Head & Neck surgery
Junior Consultant (Head & Neck and Maxillo-facial surgery)
Shriram Ramamurthy M.S.,CCC-SLP (Speech pathology)
Speech and swallowing specialist
The Department offers a Fellowship program for the training of surgeons interested in a career in Head & Neck Surgery

Urological Oncology (Cancer)

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What is Urological Oncology?

Urological oncology is a sub-speciality of oncology that deals with cancer related to Urological organs. The different organs that come under this sub-speciality include:

• Kidney
• Prostate
• Bladder
• Adrenal gland
• Testis
• Penis

What is Cancer?

Cells are the basic building blocks of human tissue and organs. Cancer is a disease that results from abnormal uncontrolled growth and division of cells. Under normal circumstances, cells reproduce in an orderly fashion to replace old cells, maintain tissue health and repair injuries. However, when growth control is lost and cells divide too much and too fast, a cellular mass -or "tumour"- or cancer is formed.

Can we cure cancer?

Majority of the cancers can be cured if they are caught in early stages. This is especially true with respect to testicular and prostate cancers, which can be cured in almost 99% of the patients if caught early. However, the treatment needs to be a delivered through a multi-disciplinary team comprising of specialists from medical and radiation oncologists along with specialist cancer surgeons. There is is very good evidence to indicate that cancer outcomes are better from larger cancer treatment centres compared to individual small practices.

What are the symptoms of Urological cancer?

Haematuria: Presence of blood in the urine is one of the cardinal symptom of urological cancers. This could be blood that is visible to the naked eye or blood in the urine picked up on urine testing.

Urinary symptoms: Presence of urinary symptoms indicated a problem of either the bladder or the prostate gland. The symptoms include going to the toilet to pass urine frequently, needing to strain to pass urine, need to rush to the toilet to pass urine or urinary leakage.

Pain: Pain in the loin area (on either side of the backbone between the ribcage and hip bone) can be indicative of problem with the kidneys. Pain in the lower part of the abdomen, below the umbilicus which radiates to the penis or the testicles is an indication of problem with the prostate or bladder.

Feeling of a lump: Any lump (mass/growth) that is easily felt anywhere in the body needs a specialist doctors review and further investigations. Cancers related to urological organs can cause a palpable mass either in the loin area, lower abdomen or in the testicles. Any lump in the testicle needs urgent specialist review.

Non-healing ulcer on penis: All ulcers on the penis need review and further investigation by a specialist to rule out a cancer.

Urgent/Emergency symptoms: Patients who have sudden onset of back pain, which is not controlled with normal painkillers with/without weakness or unsteadiness in the legs, loss of control over either motions or urine should seek urgent clinical advice. These symptoms can be caused by compression of spinal cord by cancer spread to the spinal canal and these patients need emergency treatment.

What are the advantages of Precision oncology at Apollo:

The principle objective of the urological oncology team is to deliver a high quality precision oncology in a compassionate manner. The team comprises of diagnostic doctors (Radiology and histopathology), medical and radiation oncologists and organ specific cancer surgeons working in collaboration as a team and delivering state of art treatment as a standard of care. The holistic needs of the patient are taken into account before the tumour board discussion to device patient specific treatment plans.

The advanced technologies that are available at Apollo Cancer Institutes, Jubilee hills, Hyderabad that help the team deliver high quality precision cancer care include

• PSMA PET CT: For precision in Prostate cancer staging
• PET CT: For precision in urological cancer staging
• Tomotherapy: For precision in delivery of radiotherapy
• da Vinci Si Robot: For precision in cancer surgery
• Liquid Biopsy: For precision in diagnosis

In spite of all the technical advances, it is always the man/women behind the machine or the doctor who is operating the machine or robot who determines the outcome for the patient. At Apollo cancer institutes, we have highly qualified senior personnel involved at every step of decision-making, planning and delivery of treatment to ensure high quality of care is ensured as a standard.