A leading Onco-surgeon and expert, Dr Sujay Susikar, Consultant at Kauvery Hospital, Chennai, is raising the benchmark in the treatment of cancer with experience, knowledge, skill, commitment and compassion. Excerpt from the discussions with Dr Susikar, brought to you to read, mull and adopt a healthy lifestyle to keep cancer away.
India is at par with any country in the world when it comes to advancements in surgery. Most of the developments are actually happening in India. Robotic and laparoscopic surgeries, which are part of minimally invasive surgeries, made its advent in India some 15-20 years ago. In fact, the latest version of robots, have permeated more in India, and the most experienced surgeons are today actually from India. Today, its availability and accessibility is manifold catering to a larger population as compared to 15 years ago. Surgery is now very standardised. For example for oncology, we know the principles of surgery are well-defined, and it’s the same for any other speciality. Super specialty surgery facilities may not be available in every part of the country, but it is available in most part of the country such as in every metro city e.g., Chennai.
Onco-surgery is done for all solid organs except blood cancer. For all cancers, surgery is the best option to permanently remove the cancerous tissues and halt its progression, making it one of the most important aspect of curing a cancer. For cancer patients in stages 1 and 2, we do we try to downsize the tumour, which by then has affected other parts of the body, with the support of therapies like chemo or radiation. With advancements, stage 4 cancer has come under the purview of surgery even though the cancer has spread all over the body. Cancers of the breast, ovary, uterus and colon, however, can be controlled effectively with very good drugs, which are now available, enabling us to operate precisely once rest of the tissues have been cured.
Today, Kauvery Hospital has all the advanced facilities, techniques and necessary equipment to treat all cancers, under one roof. The most advanced robots, state-of-the-art labs, radiation and chemo therapy units, and laparoscopic facility, are complete super speciality units in themselves. At times, we practice as a group, where after a surgery, we use the help of specialists from other disciplines. The team is formed based on the organ and what cancer we are treating for better outcomes.
For example, after removal of cancerous tissues of the breast, plastic surgeons, help in reconstruction of the breast, whereas oral-maxillofacial surgeons do the reconstruction of the soft tissues after head and neck onco surgery.
I believe that there is always room for improvement in the speciality of surgery as in robotic surgeries, nano technology, finer advancements, and more of 3D reconstructions and simulations enabling us to access deep parts of the organs and reduce the damage of surrounding tissues while removing the tumour. These advancements will help us to approach the precise critical areas of cancer and help us to plan in advance using 3D simulation, raising the probability of success in the surgeries that we do.
The average ratio of cancer in India is 1:25, of which 1:20 are women. Because of lifestyle changes breast and endometrial cancers figure among the top cancers in women. The biggest impediment that we face is diagnoses of the exact cause of cancer and its unprecedented surge, which still remains elusive. But our hopes and efforts are pinned on early detection that can increase chances of quick recovery as compared for a relatively advanced case. For example, if breast cancer is detected early, chemo therapy can be avoided altogether, reduces morbidity, and mastectomy can be prevented. Also, patients get ample advantage of retaining their organs, avoid exposure to toxic treatments and get away with less of every side effect in the entire treatment. To tackle spread of cancer raising awareness and to know what can be the earliest signs and symptoms of cancer and identifying the needy who are in pre-cancerous stage is critical. For example, smokers, tobacco chewers with predisposition for oral cancer can be prevented from turning cancerous with early detection. While, in the insitu stage of cervix or the uterus, we are able to treat and prevent them from becoming full-blown cancers. Because we now know that cervical cancer is caused by human papilloma virus, there are vaccines for the female gender against this virus, which also prevents oral cancers.
A major factor is lifestyle changes, which is observed to be different in each generation and it also holds true for the present generation. Also, longevity poses a challenge with people living to a ripe old age making them susceptible to cancer.
Fat content in the body i.e., abnormal BMI or obesity is also a major trigger for cancer in the present generation as compared to their predecessors. Increase in environmental pollution, use of plastic, which has increased sharply in the last 20-30 years, can also be carcinogens leading to malignant tumours.
My advise is to try to go back to nature like how our forefathers lived some 3-4 generations ago. Time your body clock with nature, increase physical activity, avoid processed foods, cut down fat consumption, increase intake of natural fibres and eat more green vegetables.
Maintain the correct ratio between fat and carbohydrate versus protein versus fibre, which unfortunately is drastically skewed.
A large-scale cervical cancer screening and immunization programme is being promoted by Kauvery Hospital among women, and girls who are in the puberty stage for which we are visiting clusters to identify such cases. Ideally, immunization is best done before young women are exposed to sexual activity. In the west 13 years is concerned to be the right age for the immunization against cervical cancer, but in India it can go up to 18-20 years. Those who are vaccinated for cancer of the cervix, it will also help prevent cancer of the throat and growth of warts.
In oncology, we start with a handicap of lack of public information about the latest treatment available, including complete cure in early stages, which means dealing with and counselling flabbergasted patients and their families. In most cases, once a person is diagnosed with cancer they are scared of coming forward for treatment fearing that death is imminent and it’s a painful slow death. Once a patient come to Kauvery Hospital, a dedicated team takes complete charge of the situation assuaging their fears by informing them about the possibilities of cure, that surgery is painless, recovery is quick and one can lead a good life, which negates all the negative feelings they harbour. They then go for surgery with confidence. We also encourage patients to interact with those who have been treated and are leading a normal life.
Minimal access surgery is targeted to relieve the patient at the earliest from the hospital. Patients who have a positive outlook are the ones who respond best to treatment and recover faster than the rest.
Longevity depends on the stage of the cancer in which a patient comes to us. Today, surgery of breast and uterine cancers give about 95-97 percent cure. The longevity of cancer patients in Chennai is a high 97 percent. We have also had patients with stage four breast cancer live up to 10- 15 years after undergoing surgery. Not all but many cancers are curable with present day advancements, but they turn hormone receptor positive with the right diagnosis and right sequencing of treatment giving the desired results. With the support of Electronic Medical Records (EMR), followups, reminders for check-up and keeping in touch with our patients has improved accessibility and communication.
Kauvery Hospital has a big network of hospitals and robotic surgeons in Chennai and in other towns within the state where we go to do complex surgeries, on call. CMEs are organised regularly and we also collaborate where physicians from other hospitals come to train for more specialised work. Our objective is to consistently improve the quality of lives, improve recoveries, and make it very quick and easy for a patient, in our speciality of Onco-surgery, which means carrying out all major and extensive surgeries that are exacting in time and energy for the surgeon and the patient as well. With new advancements, we are trying to minimise recovery time, where even after destructive surgeries, we want them to come back as normal as possible as they were before the surgery. I am confident that our team will achieve what it has set out to.
The vision and mission of Kauvery Group of Hospitals is largely guided by philanthropic intent to benefit the society and we strive to fulfil this objective with commitment and compassion.
Dr Sujay Susikar Consultant at Kauvery Hospital, Chennai
Courtesy – OUTLOOK Magazine dated May 11, 2024
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai (Alwarpet & Vadapalani), Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.
Chennai Alwarpet – 044 4000 6000 • Chennai Vadapalani – 044 4000 6000 • Trichy – Cantonment – 0431 4077777 • Trichy – Heartcity – 0431 4003500 • Trichy – Tennur – 0431 4022555 • Hosur – 04344 272727 • Salem – 0427 2677777 • Tirunelveli – 0462 4006000 • Bengaluru – 080 6801 6801
