A Voice of Hope

Dr. Vineeta Goel (Director & HoD – Radiation Oncology, Fortis Hospital, Shalimar Bagh) speaks about the frustration and the fear that surrounds a cancer diagnosis. Through the platform “A Voice of Hope”, Fortis Cancer Institute aims to challenge these feelings of hopelessness with stories of grit and courage from cancer survivors themselves. Stay tuned with us for real survival stories from real people.

Expert Explains Various Causes Of Cancer

World Cancer Day 2023- Smoking, chewing tobacco, and betel nuts are risk factors known to cause cancer. Expert explains various causes of Cancer.

Cancer is a dreaded disease, and its incidence is increasing. In a special series, on World Cancer Day, the OnlyMyHealth editorial team talked to Dr Vineeta Goel, Cancer Specialist, Fortis Hospital, Shalimar Bagh, Delhi. Dr Goel has been treating and helping cancer patients live a healthy life for the last 25 years. Dr Goel talks in great detail about what different causes of cancer and approaches to deal with them. It is important to remain vigilant of these causes of cancer and prevent them as much as possible.

What Causes Cancer?

According to Dr Goel, “The causes of cancer are not fully known, but we know some risk factors that are associated with cancer development. Consumption of tobacco, betel nut, and smoking are all associated with the increased risk of several cancers, including mouth, throat and lungs. Avoid these substances to prevent cancers.” Sometimes mouth/tongue cancer can also occur due to constant trauma or friction by sharp teeth or ill-fitting dentures. Be aware and see your dentist if you have any such teeth to avoid cancer development.

Lifestyle-Related Causes Of Cancer

There are certain lifestyle factors like lack of physical exercise, sedentary life, obesity, and consumption of junk foods, which also increase the lifetime risk of developing cancer. There is a saying that “sitting is the new smoking”. This means lack of exercise or prolonged sitting is as harmful as smoking.

Genetic Causes Of Cancer

Few cancers run in families and are transferred through genes. According to Dr Goel, the extent of genetic cancer is only about 5%, while the rest 95% of cancers are not hereditary. It is important that people with a family history of cancer be more aware of this disease and do regular screening tests.

Approaches To Fight Cancer

It is important that we change our perception towards cancer. Dr Goel suggests three ways one can deal with cancer.

Prevention Of Cancer

Adding to the prevention of cancer, Dr Goel said, “Cervical cancer is common cancer in women but can be prevented by a vaccine. This vaccine is easily available in India. The vaccine is administered to girls after the age of 12 years, in two to three shots.” The risk of breast cancer reduces in women by breastfeeding and avoidance of prolonged use of oral contraceptive pills. Cancer of the liver is sometimes associated with Hepatitis B infection, and like cervical cancer, Hepatitis B vaccines are also available in the market.

Dr Goel recommended having a plant-based diet with more fresh fruits and vegetables instead of junk, processed foods, and meat. Additionally, one should not forget to indulge in regular physical exercise.

Cancer Screening

Many cancers cannot be prevented, but since they are common cancers, it becomes important to be aware of their symptoms and go for regular screening and health checkups. In today’s day and age, many people do regular checkups for heart disease, cholesterol, and blood sugar levels. One should include cancer screening tests in their health checkups as well.

Golden Rule For Timely Cancer Detection

If you have any symptoms like any ulcer, swelling, unexplained weight loss, reduced appetite, change in voice, difficulty in gulping food, difficulty in breathing, abnormal bleeding, or back pain persisting for more than three weeks, please consult your doctor to rule out the possibility of serious illness like cancer.

Our Attitude Determines Our Altitude

It is important that we change our perception towards cancer diagnosis and treatment. While concluding, Dr Goel said, “We need to change the pessimistic view that cancer cannot be cured. Modern medicine has made significant advancements that make cancer cure possible for the majority of patients. We should have an optimistic approach and think that cancer is just a comma in one’s life and not a full stop.”

Prevention, awareness, screening tests, early detection and optimism towards cancer diagnosis and treatment is the message that we should be spreading on this World Cancer Day.

Is Cancer Hereditary?

Is Cancer Hereditary? What Is A Family Cancer Syndrome? Get expert advice on Family cancer syndrome, also known as hereditary cancer syndrome.

Cancer occurs when there is an uncontrolled growth of cells which also has the potential to spread to other organs. It can occur in any part of the body when genes that govern our cell’s behaviour are altered and get misregulated. In a special series on World Cancer Day 2023, we talked to Dr Vineeta Goel, Cancer Specialist, Fortis Hospital, Shalimar Bagh, Delhi, who explained us about cancer and if it is hereditary. For the past 25 years, she has treated cancer patients and assisted them in leading healthy lives.

Is Cancer Hereditary?

If you have ever wondered if cancer is hereditary, the answer is mostly a “big no”. Although genetic alterations cause cancer, they are not always inherited. It is believed that only 5% to 10% of cancers are hereditary when someone inherits a genetic mutation. Some of the cancers that can be hereditary are breast cancer, prostate cancer, colon cancer, ovarian cancer and uterine cancer.

What Is A Family Cancer Syndrome?

Family cancer syndrome, also known as hereditary cancer syndrome, is a type of inherited disorder where the risk of developing specific cancers is higher than average. Mutations in specific genes handed down from parents to offspring are the root cause of hereditary cancer disorders. However, it must be noted that not every cancer that appears to be inherited is caused by family cancer syndrome. In some cases, family members may develop the same type of cancer because of the same environment or habits, such as tobacco use or exposure to air pollution. There is also the possibility of cancer running in the family if members of the family possess a variety of genetic variations that are each associated with a very small cancer risk.

Testing For Inherited Cancers

You may wonder if you need genetic testing to detect if you have inherited a genetic change. However, not everyone needs genetic testing if they have someone in their family who has or has had cancer. You should consult with a genetic counsellor to decide if you need to get tested for genetic testing. The doctor will ask you about your family history and medical records to determine if you need to get tested. The doctor will make you aware of the benefits, risks, and side effects of genetic testing. You should refrain from ordering the at-home genetic test, as it may have several drawbacks.

Signs That May Indicate Hereditary Cancer

  • Diagnosis of cancer at an early age
  • Many first or second-degree relatives with cancer.
  • If any member in your family has breast, uterine or ovarian cancer.
  • If any of your family members has rare cancers like sarcoma, pheochromocytoma, medullary thyroid cancer, or a male member has breast cancer.
  • Family member with multiple types of cancer

How sedentary lifestyle is making us vulnerable to cancer!

A sedentary lifestyle is basically a lifestyle where a person spends most of his/her time in one comfortable position

A sedentary lifestyle is basically a lifestyle where a person spends most of his/her time in one comfortable position and does not indulge in much physical activity. Medical experts claim that this kind of lifestyle has many sorts of health risks in general and increasing cancer cases are also reported which originate due to a sedentary lifestyle. In the past decade, the cases of obesity-related cancer have been on the rise and sitting, reclining, and lying down for hours at stretch is a new carcinogen, according to experts.

“World over incidence of cancer is increasing at an alarming rate. We all need to identify where in our lifestyles we are going wrong and correct it to prevent cancers in our present and future generations. An estimated 30-40% of cancers can be prevented through changes in modifiable lifestyle and environmental risk factors. We know for several years that consumption of tobacco either by chewing or smoking, alcohol and some viral infections are known risk factors for cancer. Recent studies have shown that physical inactivity, sedentary lifestyle and obesity are also emerging high risk lifestyle factors for cancers,” says Dr. Vineeta Goel – Director and HOD – Radiation Oncology, Fortis Hospital Shalimar Bagh.

According to many studies, risks of cancers like breast, colon (intestine), uterus, ovary, prostate, esophagus (food pipe), stomach and bladder can be reduced with higher level of physical activity.

“In the past 30–40 years, three main modifiable factors have emerged that are associated with an increased risk of cancer: physical inactivity, sedentary behaviour, and overweight or obesity. The incidence of obesity-related cancers is critically affected by dietary composition, physical activity, and sedentary practices. A key and effective measure in the prevention of cancer is to reduce the exposure to modifiable causes of cancer, such as physical inactivity,” says Dr. Sanjeev Kumar, Surgical Oncologist, HCMCT Manipal Hospitals, Dwarka.

It is very important to maintain optimum body mass index (BMI)/weight to reduce the risk of cancer and avoid the re-occurrence of cancer in survivors.

“Exercise has many positive biological effects on the body, some of which have been proposed to explain associations with specific cancers. These include lowering the levels of certain hormones (estrogen, growth factors, insulin ), reducing inflammation, improving immune system function, reducing transit time for food to travel through intestine and helping to keep a check on weight preventing obesity which has a direct link in development of many cancers,” says Dr Kumar.

Why being sedentary is a new carcinogen; offer tips to stay active.

Physical inactivity, sedentary behaviour, and overweight or obesity can raise our risk of cancer. Doctors on how to stay active and modify lifestyle.

Sedentary lifestyle is on rise due to increasing use of technology, decreasing physical activity and people moving or walking a lot less in general. This inactive lifestyle has far serious implications than it appears on surface and several studies suggest how it is linked to many kinds of cancer. Experts say that sitting, reclining, lying down for hours at stretch is a new carcinogen and can increase risk of cancer. The cases of obesity-related cancer are on rise in the past decades and to avoid this risk factor, making lifestyle changes that make you active can go a long way. (Also read: 5 exercises to improve heart health if you are leading a sedentary lifestyle)

“World over incidence of cancer is increasing at an alarming rate. We all need to identify where in our lifestyles we are going wrong and correct it to prevent cancers in our present and future generations. An estimated 30-40% of cancers can be prevented through changes in modifiable lifestyle and environmental risk factors. We know since several years that consumption of tobacco either by chewing or smoking, alcohol and some viral infections are known risk factors for cancer. Recent studies have shown that physical inactivity, sedentary lifestyle and obesity are also emerging high risk lifestyle factors for cancers,” says Dr. Vineeta Goel – Director and HOD – Radiation Oncology, Fortis Hospital Shalimar Bagh.

Strong evidence exists that higher level of physical activity reduce the risk of different cancers like breast, colon (intestine), uterus, ovary, prostate, esophagus (food pipe), stomach and bladder.

“In the past 30–40 years, three main modifiable factors have emerged that are associated with an increased risk of cancer: physical inactivity, sedentary behaviour, and overweight or obesity. The incidence of obesity-related cancers is critically affected by dietary composition, physical activity, and sedentary practices. A key and effective measure in the prevention of cancer is to reduce the exposure to modifiable causes of cancer, such as physical inactivity,” says Dr. Sanjeev Kumar, Surgical Oncologist, HCMCT Manipal Hospitals, Dwarka.

What is sedentary lifestyle

Sedentary lifestyle and physical inactivity has been linked with many cancers as per many studies.

“Sedentary behaviour means sitting, reclining, or lying down for extended periods of time. There is strong evidence that higher levels of physical activity are linked to lower risk of several types of cancer like breast cancer, uterine cancer, colon cancer, food pipe cancer, stomach cancer, bladder and kidney cancer. There is some evidence that physical activity is associated with a reduced risk of lung cancer,” says Dr Kumar.

How exercise and physical activity can prevent us from cancer

Dr Vineeta Goel says physical Exercise and maintaining optimum body mass index (BMI)/ weight can reduce risk of cancer in general population and prevent cancer re-occurrence in cancer survivors.

“Exercise has many positive biological effects on the body, some of which have been proposed to explain associations with specific cancers. These include lowering the levels of certain hormones (estrogen, growth factors, insulin ), reducing inflammation, improving immune system function, reducing transit time for food to travel through intestine and helping to keep a check on weight preventing obesity which has a direct link in development of many cancers,” says Dr Kumar.

“WHO recommends that adults should do either moderate intensity exercises for 150-300 minutes per week or vigorous/high intensity exercises for 75-150 minutes/week,” says Dr Goel.

Coffee Table Conversations With Cancer Patients? Much To Learn..

Every hardship in life makes one a much stronger person.

As an oncologist, when I meet some of my patients, I try to dig deeper to understand their perspectives on cancer, treatment, impact of close encounter with threat to life etc.

And every time I dig deeper, I learn something worth remembering and sharing.

Recalling one such meeting with a young 32 years old lady, college teacher by profession, treated for breast cancer. Upon her diagnosis of breast cancer, she took a sabbatical leave from college job to take care of her health and manage treatment. By the time she completed her breast cancer surgery, chemotherapy and radiation therapy, our lady had gained few extra kilos of body weight. Once she joined back her college job after many months of absent from work and while she had put on some weight-many of her colleagues asked if she was pregnant and was blessed with a baby. To this she wittily replied that –“I have been born again in last nine months-I have new hair, skin, nails and a new life”.

How true –I think almost all cancer patients especially breast cancer patients can relate to this.

Recently met another young lady who had completed her breast cancer surgery, chemotherapy and radiation therapy sometime back. I asked her how she was doing and how was life?

She said doctor this disease and its treatment has transformed me as a person. Cancer and its treatment shows you both life and death very closely. It has made me a much stronger and fearless person.

“C” (of cancer) has given me four new “G”s in my “new” life.

I have stopped keeping grudges and guilt.

I have more sense of gratitude and I am more giving by nature now.

Every day I try and live a better life then I was living before my diagnosis.

What a learning and journey from C to G !!

#Cancerfree #Guiltfree #Grudgefree #Gratitude #Giving #Newlife # Lifetransformation

Corona Pandemic And Perspectives For Cancer Patients

As I became an oncologist/cancer specialist and started seeing both life and death more closely, my perspectives on life have changed and evolved.

I have learned over years that life is fragile. Life is unpredictable. Yet life is beautiful. Life is to be lived and cherished.

I realized fragility of human body when I first saw a patient in terrible pain caused by a 5 millimeter kidney stone (it was too tiny to cause that enormous pain). I realized fragility of life when I saw a patient having brain hemorrhage and paralysis after a trivial fall at home. Human body and life is really fragile as aptly said by Sant Kabir that human life is like water bubble.

Growing up as doctor, I also learned that diseases and ailments are part of life. What scares me as a health care professional are diseases for which definitive treatment is still not discovered. I am not so much scared of diseases for which treatments are available.

And all my above mentioned believes on life have been re – affirmed by the present corona virus pandemic.

This pandemic almost came like an avalanche for which nobody in the entire world was geared up or prepared. Practically there is no treatment for this infection and all we can do is – prevent it from spreading. If the infection still sets in, we can only give supportive care like oxygen, fluids, ventilation and hope for the best.

When I see cancer patients and I see a tag on them of being “cancer survivor” – I am pained. This tag almost means that these men and women with cancer were not expected to survive this disease and have been fortunate to have somehow survived.

I am sorry, but as an oncologist, I refuse to accept such pessimism towards cancer. And I urge everyone – no cancer, ex cancer, present cancer communities– to reject this pessimism and tag of cancer survivor especially now when all of us are facing fragility of life in the present circumstances of Covid -19 pandemic.

Fortunately for majority of cancers, treatment and hope is there while for viral infections like Corona, treatment is not available.

Adding on, I recently met a young lady who was almost completing her treatment for breast cancer. She shared with me that in the present times of lockdown, her father called her up enquiring how she was coping up with the diagnosis and treatment. She in turn assured her father that she is young and her body is fit to withstand this tough treatment and he need not worry. She even added that thankfully she has got a disease for which treatment and cure is possible. Now that’s what I call as winning and positive attitude.

So, my dear friends let’s live and cherish our fragile lives with gratitude towards one and all and live life without any tags.

 

MY PERSONAL VIEWS

DR VINEETA GOEL

Associate Director Radiation Oncology Max Super Speciality Hospital, New Delhi

Why Is Cancer Detected In Late Or Advanced Stages?

Why is cancer detected in late or advanced stages? Why is there delay in diagnosing cancer? What can we do to catch it in early stages?

I recently saw one young man in his late 30s – he had persistent headache and pain in neck for almost a year- which he self-attributed to long working hours and desk job.

He would self-medicate himself with pain killers or analgesics. Incidentally his mom was admitted in hospital with typhoid fever. Since he was in the hospital, he thought of consulting a physician. Based on his history of long standing and severe pain – doctor ordered MRI brain and spine – which showed high grade advanced brain tumour going into spine/ neck. Fortunately, this tumour had not spread and was localized to brain, but had become very large in size. It was removed successfully with surgery and was then treated with radiation therapy.
Where did things go wrong? Why was there delay in diagnosis and what we could have done to pick it up early?
Cancer has no symptoms of itself which can be shared with the world to raise awareness of early cancer diagnosis. Some of the common symptoms of cancer are

  1. Unexplained weight loss
  2. Persistent loss of appetite
  3. Back pain (headache in our patient’s case)
  4. Difficulty in swallowing food
  5. Change in voice
  6. Cough
  7. Any swelling /ulcer
  8. Blood in urine/ stool / cough

Now let’s take example of back pain or cough – these are such common symptoms that almost everyone experiences them sometime.

But the key for early detection of cancer or any other serious health problem is that if any symptom is persisting beyond 3 -4 weeks then it needs to be adequately investigated- including investigations for cancer if suspected after basic investigations.
So the key to early diagnosis is -do not ignore any persistent symptom, consult your doctor and get yourself adequately investigated.

Perspectives For Cancer Patients

As I became an oncologist/cancer specialist and started seeing both life and death more closely, perspectives life have changed and evolved.

I have learned over years that life is fragile. Life is unpredictable. Yet life is beautiful. Life is to be lived and cherished.

I realized fragility of human body when I first saw a patient in terrible pain caused by a 5 millimeter kidney stone (it was too tiny to cause that enormous pain). I realized fragility of life when I saw a patient having brain hemorrhage and paralysis after a trivial fall at home. Human body and life is really fragile as aptly said by Sant Kabir that human life is like water bubble.

Growing up as doctor, I also learned that diseases and ailments are part of life. What scares me as a health care professional are diseases for which definitive treatment is still not discovered. I am not so much scared of diseases for which treatments are available.

And all my above mentioned believes on life have been re – affirmed by the present corona virus pandemic.

This pandemic almost came like an avalanche for which nobody in the entire world was geared up or prepared. Practically there is no treatment for this infection and all we can do is – prevent it from spreading. If the infection still sets in, we can only give supportive care like oxygen, fluids, ventilation and hope for the best.

When I see cancer patients and I see a tag on them of being “cancer survivor” – I am pained. This tag almost means that these men and women with cancer were not expected to survive this disease and have been fortunate to have somehow survived.

Fortunately for majority of cancers, treatment and hope is there while for viral infections like Corona, treatment is not available.

Adding on, I recently met a young lady who was almost completing her treatment for breast cancer. She shared with me that in the present times of lockdown, her father called her up enquiring how she was coping up with the diagnosis and treatment. She in turn assured her father that she is young and her body is fit to withstand this tough treatment and he need not worry. She even added that thankfully she has got a disease for which treatment and cure is possible. Now that’s what I call as winning and positive attitude.

So, my dear friends let’s live and cherish our fragile lives with gratitude towards one and all and live life without any tags.

MY PERSONAL VIEWS

DR VINEETA GOEL

Director and Head, Radiation Oncology Cancer Institute, Fortis Hospital, New Delhi

Cancer Treatment In Corona Virus Pandemic

These are certainly difficult times – we have Corona Virus infection on one side and cancer treatment on the other.

I am speaking this out as a radiation oncologist to correct some wrong notions

There are two categories of cancer patients:-

1. Ex Patients- Patients who completed cancer treatment >6 months back- they are almost like a normal person. Their risk of acquiring Corona Virus infection or getting into some complications if they get Corona Virus infection is only a shade higher than an otherwise normal person who never had cancer.

Example Lady A is 70 years old with diabetes and heart ds; no history of cancer- say her risk of acquiring corona Virus infection or getting some complication is appox 5%

Lady B is 70 years old with diabetes and heart ds; with breast cancer treated 1 year back- say her risk of acquiring corona Virus infection or getting some complication is appox7-10%

Lady C is 70 years old with no health problems with breast cancer treated 1 year back- say her risk of acquiring corona Virus infection or getting some complication is appox5%

So, don’t have unnecessary fears in your mind.

Take universal precautions of hand hygiene, social distancing.

Please do not visit hospital for minor problems, routine tests or follow ups.

If needed do telephonic consultation with your doctors via phone. You may take appointment through max website.

2. Current Patients – Patients who are on active cancer treatment with either surgery, chemotherapy, immunotherapy or radiation therapy anytime since last 3-4 months or who are currently on treatment. This group of patients have their immunity little or sometimes very low as compared to a non- cancer age and health profile matched individual. These cancer patients are more susceptible to acquire Corona Virus or any other infection. So, follow all universal hygiene precautions like hand washing, face mask, social distancing etc. even more thoroughly.

Please discuss with your oncologist regarding urgency of following cancer treatment protocol.

Remember for a patient cancer is just one type, for us oncologists, cancer has multiple types and moreover every patient and his/her health profile is different.

For us as oncologist two women with similar breast cancer are still different, they are not same. When we look at breast cancer we think of multiple factors like stage, lymph nodal involvement, ER/PR/Her2 N status, age, other health issues and so many other things.

We go through all this before coming out with treatment recommendations based on all these multiple factors.

Based on your age, general health and overall cancer disease profile, your oncologist will guide you for cancer treatment in this time of Corona Virus Pandemic.

To give you an example – Glioma is a type of brain tumour and is commonly treated by surgery and post – operative radiation therapy. But Gliomas have several types. For a certain type of gliomas your oncologist might tell you that despite of Corona epidemic, we must immediately start radiation and chemotherapy. While the same oncologist might suggest that for another glioma patient its ok to start treatment anytime between 1-3 months from surgery. So do not panic and don’t overthink/overjudge. If you are seeking these answers on Dr Google, be careful least you fail to correctly comprehend it.

Another common case scenario that I come across is that majority women with breast cancer need radiation therapy after surgery or chemotherapy. Generally, we prefer to start Radiation therapy after minimum 3 weeks gap from surgery or chemotherapy. But the range of safe time frame to start radiation therapy anytime between 3-6 weeks from last chemotherapy or surgery. Again, these are standard guidelines, its best to discuss with your oncologist with regards to specifically your case.

Similarly as a radiation oncologist, I see some patients with cancers of head and neck regions who come to me for radiation therapy. Please discuss your specific case with us to help you take correct decision regarding optimum timing of starting radiation therapy.

Radiation therapy by itself does not cause much suppression of body immunity or lowering of blood counts. Cancer itself causes a state of low immunity and increases chances of acquiring viral infections. Additionally, patients are generally required to come to hospital for several days to weeks for radiation therapy. Travelling to and back from hospital by itself increase chances of catching Corona virus infection.

No two-cancer patients or their risk of catching corona virus infection is similar, hence speak to your cancer specialist for best professional advice.

Have trust in your doctor’s recommendations. We are available to you for tele and video consultations, you may book appointment via Max Health care website.

In these tough times use everything judiciously including your phone consultation timings. We also recommend that please keep your relevant reports ready before starting tele consultation (similar to the way you carry all your reports with you when going to hospital).

Dr Vineeta Goel
Associate Director Radiation Oncology
Max Super Speciality Hospital, Shalimar Bagh, Delhi

Sedentary Lifestyle, Physical Inactivity and Cancers

World over incidence of cancer is increasing at an alarming rate. We all need to identify where in our lifestyles we are going wrong and correct it to prevent cancers in our present and future generations.

An estimated 30-40% of cancers can be prevented through changes in modifiable lifestyle and environmental risk factors.

We know since several years that consumption of tobacco either by chewing or smoking, alcohol and some viral infections are known risk factors for cancer.

Recent studies have shown that physical inactivity, sedentary lifestyle and obesity are also emerging high risk lifestyle factors for cancers.

Strong evidence exists that higher level of physical activity reduce the risk of different cancers like breast, colon (intestine), uterus, ovary, prostate, esophagus (food pipe), stomach and bladder.

Sitting is new smoking! It means that sitting is as bad for health as smoking is. We always knew that smoking is bad for health, but no one ever taught us that sitting is as bad for health as smoking is. And it is not often discussed that sedentary lifestyle can even increase risk of cancer.

Increase in urbanization, sedentary jobs and leisure time spent at computer or watching television or smartphones have further led to inactive lifestyle.

Physical activity changes internal milieu or environment of cells of our body. It improves our cell metabolism, hormonal balance, genomic stability etc. to protect cells from transforming into cancerous cells.

Physical Exercise and maintaining optimum body mass index (BMI)/ weight can reduce risk of cancer in general population and prevent cancer re occurrence in cancer survivors.

WHO recommends that adults should do either moderate intensity exercises for 150-300 minutes per week or vigorous/high intensity exercises for  75-150 minutes/week.

Let us all follow daily exercise regimen to prevent obesity and bad health including cancer associated with it.

Get physically active and prevent cancers!

# prevent cancers

# physical exercise and cancers

Support Group Program at Fortis Hospital

Support Group Program at Fortis Hospital (International Women�s Day)

We had a wonderful support group program at Fortis Hospital, Shalimar Bagh, for our women patients with cancer in alignment with recent International Women’s Day.

What a day full of positivity and enthusiasm it was!

Support group works like tonic, like oxygen for anyone who participates. Patients who have already completed their treatment journey become role model for people who are on their path of treatment.

It also gives moments of catharsis – sometimes people become emotional and start crying—but its Ok – we all need to sometimes cry our heart out and make it light.

Every person has something unique to share to manage some side effects of treatment like – hot flushes, constipation, nausea etc. And sharing these tricks on this platform certainly helps many others.

There were patients whom I saw laughing for the first time.

Overall, we all had a lovely day and created some magical memories.

Dont Fall For These 9 Myths If You are Trying To Quit Smoking

Quitting your smoking habit can be hard, and people fall back on multiple tropes to make it a success. But a doctor warns why you must never fall for these myths.

Most of you, when feeling down, nervous, anxious and even stressed, easily switch to smoking a cigarette, thinking that’s the only way to relax. Right? You’re not alone if you believe that smoking can relieve stress. There are many people who believe it. But sorry to break it to you, it’s a myth which people like to believe because it suits them!

Most of you, when feeling down, nervous, anxious and even stressed, easily switch to smoking a cigarette, thinking that’s the only way to relax. Right? You’re not alone if you believe that smoking can relieve stress. There are many people who believe it. But sorry to break it to you, it’s a myth which people like to believe because it suits them!

In fact, there are many myths around smoking
All of us are aware of the side effects of smoking. Even the cigarette pack screams loud that smoking is injurious to health. Still, we aren’t able to quit it. Some people get warned that quitting smoking immediately may lead to weight gain. There are more such myths people tend to believe.

But Dr Vineeta GoelDirector and Head of Department at Radiation Oncology, Fortis Hospital Shalimar Bagh, says smoking is the biggest avoidable risk a person can take. And yet, millions of people choose to take the risk every single day of their lives because of the false beliefs that smokers have about cigarettes that force them to continue smoking against their judgment.

However, if you want to say goodbye to cigarettes, it’s the time you face the reality.

Here are some myths and facts about smoking:

Myth 1: Filters make cigarettes safer
Fact: There are no studies to prove that filter cigarettes are indeed safer. But it is a myth people believe that filters make cigarettes safer than smoking non-filtered cigarettes. The fact is filters do not protect any individual from the chemicals present in cigarettes. In fact, Dr Goel says “They are designed to make smoke particles smaller, which makes nicotine easier to absorb.” And this increases the addiction.”

Myth 2: You’ll put on weight if you quit
Fact: Are you one of those who don’t want to quit smoking because it helps to burn calories, helping you lose weight? Well, the active component, the nicotine present in cigarettes helps boost energy consumption and reduce appetite, it is the same reason why you gain weight after quitting it. When you quit smoking your appetite is no longer suppressed and you may eat more which can lead to weight. However, weight gain is not the necessarily outcome of quitting smoking.

Myth 3: Smoking helps to relieve stress
Fact: Do you also smoke to handle your stress? If yes, it’s not going to help you out. But did you know that smoking doesn’t decrease stress, instead it can increase stress and tension? Yes, that’s true. According to Dr Goel, nicotine creates an immediate sense of relaxation. So people smoke in the belief that it reduces stress and anxiety. But this effect is not going to last forever, it’s temporary. In fact, this will increase your addiction to cigarette smoking.”

Myth 4: Occasional smoking won’t hurt you
Fact: You are wrong if you believe that occasional cigarette smoking is fairly harmless. Each time you smoke a cigarette, it can hurt your heart, lungs, and the cells throughout your body. Keep in mind that there is no safe form of tobacco and there is no safe level of exposure to tobacco smoke.

Myths 5: Electronic cigarettes are safer
Fact: There’s no safe form of tobacco. Not even e-cigarettes, also known as vaping. Just like cigarettes, e-cigarettes also contain nicotine and other toxic chemicals in the form of liquid and this is a harmful and addictive drug that can affect your health in many ways. “It can put an individual at a greater risk of developing lung cancer,” says Dr Goel.

Myth 6: Main risk to pregnant women who smoke is premature delivery
Fact: This is a known fact that smoking makes it harder for a woman to conceive and a woman is at higher risk of never becoming pregnant. Along with that not just premature delivery but smoking can also increase the risk of miscarriage, ectopic pregnancy, low birth weight, and cleft lip/palate.

Myths 7: Smoking relieves boredom
Fact: We have already busted a myth that smoking does not help you reduce your stress, instead it can actually increase your anxiety and tension. So trying smoking for your boredom relief may instantly relieve it but using cigarettes every time to get rid of that feeling may make you addicted to it.

Myth 8: Smokeless tobacco is healthier than cigarettes
Fact: “This is absolutely incorrect because smokeless tobacco is still tobacco, which provides nicotine along with other substances that are known to cause cancer,” says Dr Goel. While one is not inhaling it into the lungs, it is still being absorbed through the lining of the mouth and circulating through the bloodstream to all parts of the body.

Myth 9: My smoking (second-hand smoke) doesn’t affect anyone around me
Fact: Second hand smoking (SHS) also known as passive or involuntary smoking is equally risky. SHS can also increase your risk of lung cancer, heart attack or stroke, and other serious illnesses. So if you don’t want to quit it for yourself, quit it for your family or friends.

So don’t fall for these myths and quit smoking in a safer way!

Decoding Breast Cancer in Simple Language

What is Breast Cancer?

Cancer arising in breast tissues is called breast cancer. It tends to grow rapidly, continuously and spread to lymph nodes or other organs of the body.

Is every swelling/lump in breast be cancer?

Nope, all breast lumps are not cancerous. Nevertheless, one needs to get oneself tested and examined to rule out any cancer in a breast lump.

What should I do if I feel a swelling/lump in breast?

Don’t panic. Consult a doctor, get yourself examined and tested.

Is pain in breast, a symptom of cancer?

  • Cyclical breast pain before or after menstrual cycle is not related to breast cancer.
  • Majority breast cancers are painless. However sometimes in advanced stages breast cancer may be associated with pain.

Who is at risk of breast cancer?

  • Being women, itself is a risk factor for breast cancer or in other words every woman is at risk of breast cancer and this risk increases with advancing age.
  • It is more common in women who have their delayed pregnancy above the age of 30 years and who did not have their biological children.
  • Women who are overweight and physically inactive also carry higher risk.
  • Risk of developing breast cancer is also higher in women with history of cancer (Breast/ovary/Uterine/Prostate) in their families. It is important to note that of all breast cancers only 5-10% are related to genetic factors while rest are not.

Can Breast cancer occur in men also?

Yes, rarely breast cancer can occur in men.

Is incidence of breast cancer increasing in India?

Incidence of breast cancer is increasing in world as well as in India possibly due to change in lifestyle as well as availability of better tools to diagnose cancer.

What can I do to decrease my chances of developing breast cancer?

  • Living a physically active life with daily exercises, body weight management and balanced diet goes a long way in prevention of all cancers including breast cancer.
  • Early marriage, timely childbirth and breast feeding also helps reduce chances of breast cancer.

What should I do to keep a check on my breast health or timely detection of any breast abnormality including cancer?

  • Being aware about your breasts and doing monthly self-breast examination is least one can do.
  • After the age of 30 years, once in a year, one should see a doctor for clinical breast examination.
  • There are no standard guidelines for regular mammogram in India due to our large population base. One should get an annual mammogram starting at the age of 45.

What is Mammogram? Is there any MRI done for breast cancer diagnosis?

  • Mammogram is simply X ray of breast to detect any abnormality.
  • Sometimes additional Ultrasound or MRI of breast may be done after mammogram as problem solving tools.

Can Breast Cancer be cured? Is effective treatment available for breast cancer?

With timely detection in early stage, majority breast cancers can be cured through effective anti-cancer treatment.

Is biopsy safe for breast cancer? Can cancer spread faster after biopsy?

Biopsy is an essential test to confirm the diagnosis and type of cancer. It is a safe procedure and does not increase risk of spread of cancer.

Does every patient with breast cancer require removal of breast or mastectomy?

All patients with breast cancer do not require removal of breast or mastectomy. Majority patients can safely conserve/keep their breast with only removal of tumor after discussion with their cancer specialist.

What are the key changes in breast cancer treatment in last 10 years?

Awareness of breast cancer in public is one of the key changes.

Availability of safe and effective tests for diagnosis and treatment is the second key change. Together both these changes have translated into improved survival for cancer patients.

Do all patients with breast cancer require chemotherapy?

Not every patient with breast cancer requires chemotherapy. Some selected patients can avoid chemotherapy and be treated with hormonal and other targeted therapies in consultation with their cancer specialist.

Why do patients with breast cancer require radiation therapy?

Patients with breast cancer have reduced chances of local recurrence and better long-term disease control with use of radiation therapy.

Are there any newer and better radiation therapy treatments for breast cancer patients?

There are several advances in breast cancer radiation therapy using techniques like IMRT, IGRT, 4 D RT, ABC and APBI which have all increased safety and effectiveness of this treatment.

About the Author- Dr Vineeta Goel is Director and Head of Radiation Oncology at Fortis Hospital Shalimar Bagh and Vasant Kunj. She has over 20 years of experience in the field of Oncology and is trained from Tata Memorial Hospital, Mumbai. She has specialized training and expertise in treating breast cancer.

Coffee Table Conversations with cancer patients—Much to learn…

Every hardship in life makes one a much stronger person.

As an oncologist, when I meet some of my patients, I try to dig deeper to understand their perspectives on cancer, treatment, impact of close encounter with threat to life etc.

And every time I dig deeper, I learn something worth remembering and sharing.

Recalling one such meeting with a young 32 years old lady, college teacher by profession, treated for breast cancer. Upon her diagnosis of breast cancer, she took a sabbatical leave from college job to take care of her health and manage treatment. By the time she completed her breast cancer surgery, chemotherapy and radiation therapy, our lady had gained few extra kilos of body weight. Once she joined back her college job after many months of absent from work and while she had put on some weight- many of her colleagues asked if she was pregnant and was blessed with a baby. To this she wittily replied that – “I have been born again in last nine months- I have new hair, skin, nails and a new life”.

How true – I think almost all cancer patients especially breast cancer patients can relate to this.

Recently met another young lady who had completed her breast cancer surgery, chemotherapy and radiation therapy sometime back. I asked her how she was doing and how was life?

She said doctor this disease and its treatment has transformed me as a person. Cancer and its treatment shows you both life and death very closely. It has made me a much stronger and fearless person.

“C” (of cancer) has given me four new “G”s in my “new” life.

I have stopped keeping grudges and guilt.

I have more sense of gratitude and I am more giving by nature now.

Every day I try and live a better life then I was living before my diagnosis.

What a learning and journey from C to G !!

#Cancer Free # Guilt Free # Grudge free #Gratitude # Giving #new life # Life transformation

Celebrating Life ? Cancer Survivors Day

I stand humbled and inspired!

Every day as an oncologist, I get inspired by my patients and their families.

Today world is observing cancer survivor’s day. This day is observed to generate awareness about cancer treatment and optimism for people fighting this disease.

Few days back, I saw a patient in her late fifties who had undergone treatment for two different cancers. She had cancer of large intestine in her 40s and then cancer of uterus in her 50s. She shared with me that fighting cancer was a life transforming experience for her. She completely switched over to healthy diet and yoga. She has been running in Delhi half marathon every year for last more than 10 years. She is also an avid trekker and participates in all adventure sports.

I was filled with guilt as she was sharing all this as I don’t take as good care of my own health as she does.

I met another lady who also incidentally had defeated two cancers. She told me about her participation in the beauty pageant, car rally and that she is life coach as well.

I am a feminist, so please excuse me for sharing another story of a young woman. A beautiful young lady with breast cancer came to me for opinion regarding radiation therapy. This young bright lady was working in a MNC and shared with me that her cancer was diagnosed immediately after birth of her second child. She also mentioned that soon after her diagnosis, her younger sister got herself tested and was also diagnosed with breast cancer. I was little stunned after listening to her confident calm conversation. I enquired that life must have been really difficult with two sisters together going through cancer treatment. She laughed and said – “no things actually became easier. I am ahead of her in all treatments, so I keep guiding her from my personal experience. When I have my chemotherapy, she manages my kids and I take care of her family during her chemotherapy”. My mouth was shut after this positive narration.

At the same time, some patients come to us after completing their cancer treatment, complaining that their employers are not willing to get them back in their job. This is so inhuman.

Times have really changed. Cancer patients do not need sympathy from society.

Cancer has become a treatable and curable disease. Cancer patients demand right treatment, compassion, empathy and positive attitude of society and treatment.

Let us together celebrate life.

Prevent cancers by adopting a tobacco and alcohol free healthy life style.

Let us get our girls vaccinated to prevent cervical cancer.

Get our regular cancer screening done for early detection of cancer.

Let us all support anyone fighting cancer with positive and empathetic attitude.

Let Us Save Our Children And World From The Ills Of Tobacco

This is not a story, but a true incident. I am on oncologist and I treat patients with cancers of various kinds.
I saw this young 19 years old boy who had come to me with a diagnosis of lung cancer. When I am told that I am expected to see a patient with lung cancer, intuitively I start imagining a middle to old age man. But this patient was only 19 years old.

He was accompanied by his parents. His parents look absolutely lost, stunned and anxious when they came to take an opinion about radiation therapy. I also observed that while the parents looked very anxious, somehow the boy look very calm and quiet.

After examination and going through his case reports, I realized that this young man had stage three lung cancer and he would require a combination of chemotherapy and radiation therapy.

Although we doctors master the art of hiding our emotions and reactions, I was still nervous at the idea of treating such a young man with radiation therapy. I asked him quietly if he ever consumed tobacco or smoked cigarettes. He persistently refused ever using any form of tobacco or any other substance of abuse. After a brief examination and counselling about the treatment, the parents moved out of my OPD chamber. This boy quietly stayed back in the OPD. He on his own then confessed and accepted that he had been smoking cigarettes for last four years. I asked him that four years back, he must have been a school student and how could he get access to cigarettes. He shared that in school, tobacco, cigarettes etc. were available through some secret routes. He even requested me in hushed up tone that I should not share this information with his parents as they will not be able to face and accept it. My parental instincts forced me to ask him if he regretted his smoking habit. He regretfully nodded and accepted that he made a mistake and he did it under peer influence.

I want to ask you all—where as a society are we heading? We parents send our children to schools and colleges for studying while some of them loose track and get deviated in wrong directions.

  • World is going through one pandemic, and another is waiting and rising.
  • It is our moral duty to save our children and the world from tobacco.
  • There is only one way- this world needs “No Tobacco” movement by the people and for the people.

Stay away from myths and stay away from Cancer

If I had to replace word “cancer” with anything then I would to replace it with Hope, Courage, Optimism, and awareness.

Let us bust some of the myths associated with cancer.

  1. Myth – Cancer cannot be prevented.

Fact- Cancer can be prevented by following healthy diet (More plant base diet/vegetables/fruits and less of junk and processed food), healthy weight and daily physical exercises. Timely childbirth and breast feeding protects women against breast cancer. Give vaccines to girls between age of 15-25 years to prevent cervical cancer.

  1. Myth – Cancer cannot be diagnosed at early stage.

Fact– Cancer can be detected at an early stage by being vigilant about possible cancer symptoms and doing regular health checkups. Women should do PAP smear test, once every year, after the age of 40 years for early detection of cervical cancer. Women should also do Mammogram (X ray of Breast) every year after the age of 40 years for early detection of breast cancer. Men should do, blood test PSA once every year after the age of 40 years for early detection of prostate cancer.

  1. Myth – Cancer is genetic and runs in families.

Fact- Less then 5% cancers are genetic. Majority cancers do not run-in families.

  1. Myth-Doing biopsy or surgery can lead to spread of cancer.

Fact- Cancer does not spread by doing biopsy or surgery. Biopsy is essential for identifying whether cancer is present or not and type of cancer without which correct treatment cannot be started. Surgery is another important corner stone for curing majority cancers.

  1. Myth – Occasional smoking and alcohol does not lead to cancer.

Fact- Tobacco, betel nut, cigarette/bidi smoking and alcohol are associated with several cancers especially cancer of throat, mouth, lungs and liver.

  1. Myth – People don’t recover from cancer.

Fact- In last few years there are several advances in cancer treatment. More and more patients are now getting cured of cancer.

My final message for everyone is to not to get misguided.

Stay healthy and aware about cancer to detect it early.

#cancer myths # early cancer detection #cancer awareness

How To Prevent Cancer From Coming Back?

Cancer treatment often involves long and tough journey.

After completing cancer treatment, while patients and their families feel relieved at one end but at the same time somewhere the fear of cancer re occurrence starts haunting their hearts and mind.

My few suggestions to every cancer patient and their families to work towards preventing cancer from coming back are

  1. Complete your treatment as prescribed by your oncology team. Please do not leave your treatment incomplete at any point of time.
  2. Be regular on follow up and follow all investigations prescribed as recommended by your oncologists.
  3. Eat healthy diet with major portion of your diet coming from plant sources including vegetables, fruits, dry fruits etc. Avoid or limit meat, fried and processed food.
  4. Stay away from tobacco. If you were earlier a regular tobacco user and find it difficult to leave tobacco, please speak to your physician and seek medical help in stopping tobacco use.
  5. Avoid or limit alcohol intake.
  6.  Be regular in your physical activity regimen like yoga, walk etc. Immediately after cancer treatment completion many patients feel lack of energy or have neuropathies due to which the find it difficult to do walking, jogging etc. Don’t worry, gradually build up your exercise regimen and routine.
  7. Maintain healthy body weight. Many patients gain weight during cancer treatment as a result of either medication, over feeding or decreased physical activity. Try and loose this excess weight. There are several scientific studies which have proven that chances of cancer re occurrence are lesser in patients who maintain their body weight.

Listen to “her”. Her Choice Matters

Our whole life completely turns around when any family member has any major illness.

As an oncologist I see many women go through breast cancer treatment.

With this disturbing diagnosis of big “C” every family member is shaken and gets emotional.

Many a times, oncologist explains that doing breast conserving surgery ( retaining breasts and only removing tumour) is as safe as mastectomy ( complete breast removal surgery) for the patient.

This advice by oncologist is based on scientific evidence of trials with almost 20 years follow up of several thousand patients who underwent either breast removing or breast saving surgeries.

But family members are sometimes high on emotions and take self decision that breast removal surgery should be done to ensure maximum safety. Often woman who is actually the patient is not asked her choice.

In one such extreme case one lady in her 60’s had one sided early breast cancer but her son decided that he wants mastectomy for both sides for his mother( without genetic testing ) as he was concerned about his mother’ safety. Treating oncologists tried very hard to reasons out with him that breast removal surgery of normal breast is not required. Patient’s son did not agree and signed and made her mother also sign consent for mastectomy on both the sides.

Many of us watched this helpless situation with teary eyes.

I understand that cancer diagnosis comes as a shock.

Still let’ s make decisions with head on our shoulders and more importantly let the woman in discussion be a part of discussion and decision.

Her choice matters!

#breastcancer #breastconservation