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FORERUNNERS HEALTHCARE CONSULTANTS PVT. LIMITED Website : www.forerunnershealthcare.com


Cancer Surgery in India Cancer is a class of diseases in which a cell, or a group of cells display uncontrolled growth through division beyond the normal limits, invasion that intrudes upon and destroys adjacent tissues, and sometimes metastasis, which spreads the cells to other locations in the body via lymph or blood. These three malignant properties of cancers differentiate them from benign tumors, which are self-limited, and do not invade or metastasize. Most cancers form a tumor but some, like leukemia, do not. The branch of medicine concerned with the study, diagnosis, treatment, and prevention of cancer is oncology. What is Cancer Surgery? Cancer surgery — an operation to repair or remove part of your body to diagnose or treat cancer — remains the foundation of cancer treatment. Your doctor may use cancer surgery to achieve any number of goals, from diagnosing your cancer to treating it to relieving the symptoms it causes. Cancer surgery may be your only treatment, or it may be supplemented with other treatments, such as radiation, chemotherapy, hormone therapy and biological therapy.

Purpose of Cancer Surgery Cancer surgery may be used to achieve one or more goals. The basic reason is to remove cancer present in certain tissues or organs, Sometimes surgery is used to improve your quality of life rather than to treat the cancer itself. Surgery is often combined with other cancer treatments, such as chemotherapy and radiation. Whether you opt to undergo additional cancer treatment depends on your type of cancer and its stage.

Medical Conditions of Cancer • • • • • • • • • • • • • • • • •

AIDS-related Cancer Bone Cancer Brain Tumors Breast Cancer Colorectal Cancer Gastrointestinal Cancer Gynecologic Cancer Head and Neck Cancer Leukemia Liver Cancer Lung Cancer Lymphoma Pancreatic Cancer Prostate Cancer Skin Cancer Spinal Cord Tumor Urologic Cancer


Types of Caner Surgery The types of cancer surgeries are listed here: Preventive (prophylactic) Surgery: is done to remove body tissue that is likely to become cancer (malignant), even though there are no signs of cancer at the time of the surgery. For example, pre-cancerous polyps may be removed from the colon. Sometimes it is used to remove an entire organ when a patient has an inherited condition that puts them at a much higher risk for having cancer some day. For example, some women with a strong family history of breast cancer are found to have a change (mutation) in the DNA of a breast cancer gene (BRCA1 or BRCA2). Because their risk of getting breast cancer is high, these women may want to consider prophylactic mastectomy. This means the breasts are removed before cancer is found.

Diagnostic Surgery: This type of surgery is used to sample tissues to find out if cancer is present or what type of cancer it is. The diagnosis of cancer is made by looking at the cells under a microscope. There are many ways to get a sample of cells from an area that looks like it may be cancer. These are described in the section, "Surgery to diagnose and stage cancer." Staging Surgery: is done to find out how much cancer there is and how far it has spread. The physical exam and the results of lab and imaging tests are used to figure out the clinical stage of the cancer. But the surgical stage (also called the pathologic stage) is usually a more exact measure of how far the cancer has spread. Examples of surgical procedures commonly used to stage cancers, like laparotomy and laparoscopy, are described in the section, "Surgery to diagnose and stage cancer." Curative Surgery: is done when a tumor is found in only one area, and it is likely that all of the tumor can be removed. Curative surgery can be the main treatment for the cancer. It may be used alone or along with chemotherapy or radiation therapy, which can be given before or after the operation. Sometimes radiation therapy is actually used during an operation. (This is called intraoperative radiation therapy.) Debulking (cytoreductive) Surgery: is done to remove some, but not all, of the tumor. It is done when removing the entire tumor which would cause too much damage to an organ or nearby tissues. In these cases, the doctor may take out as much of the tumor as possible and then try to treat what's left with radiation or chemotherapy. Debulking surgery is commonly used for advanced cancer of the ovary and some lymphomas. Palliative Surgery: This type of surgery is used to treat problems caused by advanced cancer. It is not done to cure the cancer. It can also be used to correct a problem that is causing discomfort or disability. For example, some cancers in the belly (abdomen) may grow large enough to block off (obstruct) the intestine. If this happens, surgery can be used to remove the blockage. Palliative surgery may also be used to treat pain when the pain is hard to control by other means. Supportive Surgery: This is done to help with other types of treatment. For example, a vascular access device such as a PortA-Cath or Infusaport, that can be surgically placed into a large vein. The port can then be used to give treatments or draw blood, instead of putting needles in the arms. Restorative (reconstructive) Surgery: This type of surgery is used to improve the way a patient looks after major cancer surgery, or to restore the function of an organ or body part after surgery. Examples include breast reconstruction after mastectomy or the use of tissue flaps, bone grafts, or prosthetic (metal or plastic) materials after surgery for head and neck cancers. For more information on these types of reconstructive surgeries, you can read Breast Reconstruction after Mastectomy and Oral Cavity and Oropharyngeal Cancer. They can be read online or you can get a copy by calling our toll-free number.


Common Cancer Surgery Procedures: Cryosurgery: Unlike certain cancer treatments which rely on heat to destroy tumours, cryosurgery uses extremely cold temperatures to destroy cancer cells. It can be used both inside and outside the body and is particularly effective in the treatment of certain types of skin cancers. It relies upon the process of producing extremely cold temperatures using liquid nitrogen or argon gas in order to destroy diseased or abnormal tissue. The freezing temperature results in the formation of ice crystals in the diseased tissue which causes abnormal cells to tear apart. It works by circulating argon gas or liquid nitrogen which results in a ball of ice crystals forming around the probe which then freezes the affected cells. After cryosurgery has been completed, then eventually the frozen tissue thaws and it is then absorbed by the body naturally. One of the key benefits of cryosurgery is that it is far less invasive than other forms of treatment as well as producing far fewer side effects. It’s also a far less expensive treatment to administer. Bone Marrow Transplant: is often used to cure several different types of diseases including certain cancers. It can be particularly effective in cancer treatment for leukemia, lymphoma, severe aplastic anemia, and multiple myeloma and certain solid tumour cancers such as ovarian or breast cancer. However, it is not always the best treatment for everyone who may suffer from any of these diseases. The marrow transplant is transferred into the bloodstream using a central venous catheter and is a similar type of procedure to that of a blood transfusion. During this process, the stem cells start to make their way into the patient’s own bone marrow and begin reproducing to establish healthy, new blood cells. It may be necessary to undergo blood transfusions and, in some cases, it might be imperative to be confined in a sterile environment for a time. Vomiting, nausea, diarrhoea and feelings of extreme weakness are also some of the possible side effects although they are not all experienced by every patient. Lumpectomy: is the surgical removal of the breast tumor (the "lump") and some of the normal tissue that surrounds it. Lumpectomy is a form of “breast-conserving” or "breast preservation" surgery. There are several names used for breast-conserving surgery: biopsy, lumpectomy, partial mastectomy, re-excision, Quadrantectomy, or wedge resection. Technically, a lumpectomy is a partial mastectomy, because part of the breast tissue is removed. But the amount of tissue removed can vary greatly. Quadrantectomy, for example, means that roughly a quarter of your breast will be removed. Make sure you have a clear understanding from your surgeon about how much of your breast may be gone after surgery and what kind of scar you will have. The advantages of lumpectomy from the emotional and personal point of view are obvious – there is no loss of the breast, and the tissue expands after the lumpectomy so that the appearance of the breast is similar. There is no need for breast reconstruction and the operation is much less rigorous, so recovery times are shorter. Microscopically Controlled Surgery: It is predominantly used in the treatment of skin cancer in a number of situations. These can include where a tumour occurs in a particular area of the body where it is not able to be cured effectively using other treatment methods or where cancer cells have been previously treated but the cancer has returned. It is often the preferred method for treatment on areas such as the eyelid, nose or ear where a surgeon only wishes to remove the diseased tissue yet leave as much of the skin surrounding it untouched, yet it can also be used on the hand, scalp and genitalia. Perhaps even more importantly, This surgery does not rely on visual inspection to judge the extent of the problem which means that you’ll never be left with a situation where insufficient tissue is taken which leaves part of the tumour behind nor does it allow for overcompensation where too much tissue is taken. The procedure is carried out in stages whereby a little tissue from an initial layer will be surgically removed with a scalpel then more may be removed if necessary. Surgery for Gall Bladder Cancer: If you have gall bladder cancer, you have a tumour in the gall bladder, a small gland just behind the liver that usually produces bile. This fluid is released into the intestine to help digest fats in the food that you eat. Gall bladder cancer overall is quite rare but it is difficult to diagnose at a very early stage, so it tends to be discovered later, when treatments are not so effective. The operation involved in removing the gall bladder is a fairly major procedure that always needs a general anaesthetic and a stay in hospital. One of the main treatments for gall bladder cancer is surgery to try to remove all of the cancerous tissue. If the cancer is at a relatively early stage, the tumour is only present in the gall bladder itself and removing this completely can remove virtually all of the cancer. The operation to take out the gall bladder is called a cholecystectomy and this can either be done by open abdomen surgery or using a keyhole technique that involves laparoscopy. The aim is to remove the gall bladder, the bile duct and all the nearby lymph nodes to try to remove the tumour and a good margin of healthy tissue all around it.


Surgery for Prostate Cancer: is a very common cancer in men over 65 but is not often a cause of early death. Many men live with prostate cancer for years, and may die of an unrelated cause. It tends to be a slow growing cancer, although some forms can be more aggressive. The treatments available depend on the stage of the cancer and how aggressive it is. In the early stages, when the cancer is confined within the prostate gland and does not seem to be a threat, it is sensible not to rush into treatments straight away. Your doctor will possibly recommend watching and waiting, while your condition is carefully monitored over a period of months. If it is right in your case, your medical team may advise that your prostate gland is removed completely to prevent the cancer from spreading elsewhere in the body. This type of operation is called a radical prostatectomy and it can be carried out using open abdominal surgery, or a keyhole technique. Surgery for prostate cancer can be followed up by radiotherapy, either by external beam, or from tiny radioactive ‘seeds’ that are implanted in your body near to where the prostate gland has been removed.

Preparing for the Surgery Before having surgery, find out all you can about the benefits, risks, and side effects of the operation. You may want to ask your doctor the following questions. The answers may help you feel more comfortable with your decision. • • • • • • • • • • • • • • •

Why am I having this operation? What are the chances of its success? Is there any other way to treat this cancer? Other than my cancer, am I healthy enough to go through the stress of the surgery and the drugs used to do it (anesthesia)? Are you certified by the American Board of Surgery and/or Specialty Surgery Board? How many operations like this have you done? What is your success rate? Are you experienced in operating on my kind of cancer? Exactly what will you are doing in this operation? What will you are taking out? Why? How long will the surgery take? Will I need blood transfusions? What can I expect after the operation? Will I be in a lot of pain? Will I have drains or catheters? How long will I be in the hospital after the surgery? How will my body be affected by the surgery? Will it work or look different? Will any of the effects be permanent? How long will it take for me to recover enough to go back to my usual activities? What are the possible risks and side effects of this operation? What is the risk of death or disability with this surgery? What will happen if I choose not to have the operation? What are the chances that the surgery will cure my cancer? Do I have time to think about my options or get a second opinion?

After Surgery After surgery care can involve many different factors, depending on the type of surgery, the patient, and the amount of rehabilitation needed. Nearly every type of surgery requires some sort of after surgery care. If an individual has surgery on an extremity, they will need assistance prior to and upon their return home. If a patient has had surgery which requires further bed rest, it is critical that there is someone available around the clock, to aid the patient convalescing. Your health care team will give you specific directions for your recovery, such as how to care for any wounds, what foods or activities to avoid and what medications to take. Advance Cancer Surgery Electrosurgery: is a procedure which involves applying a high frequency electrical current to destroy cancerous cells. It is most commonly used to treat skin cancer but can also be used in the treatment of certain oral cancers. There are a number of different electrosurgical devices which can be used for tissue cauterization. However, Electrosurgery, itself, uses an alternating current to directly apply heat to the tissue whilst the tip of the probe remains relatively cool. On the other hand, other electrocautery devices work by using heat conduction via applying a direct current from a hot probe. Electrosurgery is the most commonly used to treat cancers on the skin’s surface at its outermost layer and also to treat new skin cancers. They are also used to treat both basal and squamous cell carcinoma.


Cancer Surgery in India India has recognized as one of the most important destination for cancer surgery. Many patients from their advanced countries come to India for a nice blend of top-class medical expertise at attractive prices is helping more and more Indian corporate hospitals to bring more and more foreign patients, including from the developed nations for high end surgeries pertaining to various disease including the cancer. The Indian oncology hospitals provide quality treatment to patient all across the globe. In order to help you and your dear ones on the fast track to recovery and revival, company provides unique medical tourism packages for your convenient travel to India for medical treatment. The Indian Oncologists are excelled in dealing various cancer surgeries, and most of them have to their credit International fellowships and International Board Certification. Personalized care and attention is provided with value added services besides results of world class standard at a very low cost affordable to all sections of society. The various cancer surgeries in India are available at various hospitals in the following cities with latest amenities and state-of-art-facilities. Mumbai

Hyderabad

Kerala

Delhi

Pune

Goa

Bangalore

Nagpur

Jaipur

Chennai

Gurgaon

Chandigarh

The compassion shown by our Doctors – along with evidence based and innovative cancer treatments, comprehensive education and research-based prevention of common cancers – have earned Indian hospitals the gratitude of cancer patients and their families. Undoubtedly they have emerged as new leaders in the field of medical services and strive to maintain that position.

Cancer Surgery Cost in India India offers outstanding Cancer surgical services at 60-80% less than prevailing USA or UK rates. Even with travel expenses taken into account, the comprehensive medical tourism packages still provide a savings measured in the thousands of dollars for major procedures. A cost comparison of various medical treatments can give you the exact idea about the difference:

Medical Treatment Bone Marrow Transplant Liver Transplant Heart Surgery Orthopedic Surgery Cataract Surgery

Procedure Cost (US$) United States India 2,50,000 30,000 3,00,000 60,000 30,000 6,000 20,000 6,000 20,000 5,000


ABOUT INDIA Located in South Asia, bordered by Pakistan, Nepal, China and Bangladesh, India is South Asia's largest, sovereign, democratic republic. India has an edge over other countries when it comes to offering comprehensive, cost-effective and timely medical care: it also offers an exotic, adventure-filled or cultural -if you wish array of destinations to discover and revel in for the travelers. Indian cities like Mumbai, Hyderabad, Goa, Bangalore, Nagpur, Kerala, Delhi, Pune, Jaipur, Chennai, Gurgaon, and Chandigarh offers best medical tourism service. Mumbai - Formerly known as Bombay, is the commercial & financial capital city of India. Mumbai is famous for many things, including its thriving Bollywood film industry, teeming bazaars, colonial-style buildings, Art Deco structures and a superb choice of restaurants, often being rated as the dining capital of India. The tourist district of Colaba in Mumbai is a great place to start exploring this great city. Hyderabad – Hyderabad city is a great place to visit in the state of Andhra Pradesh. The place has witnessed a continuous growth for last many years. Hyderabad has become a tourist hotspot following ever increasing number of tourists during past few years. Hyderabad has a well-founded reputation as one of the safest cities in the world. Goa - The country's smallest state and famed for its colonial Portuguese and Catholic past, most tourists visit Goa for its endless selection of sandy beaches and coastal attractions. Standing proudly next to the Arabian Sea, Goa is a particularly compact state and often feels like a large town, being easy to travel. Around Goa, tourists will soon realize that the state has much more to offer than simply stunning beaches, fishing, water scooters, windsurfing and scuba diving. Bangalore - Beauty lies in the eyes of beholder and if you want to see one of the most beautiful places in India then Bangalore is the word for it. Bangalore has earned sobriquets like 'Silicon Valley of India', 'Pub Capital of India', and 'City of Gardens'. Pleasant climate with colorful gardens with lakes and glittering nightlife, Bangalore has made its own attraction for travelers as one of the most charming cities in India, Nagpur - Nagpur is the largest city in central India, but with its friendly atmosphere and dependable transportation, you’ll instantly feel at home. The city of Nagpur has a well-built infrastructure, is a clean and affluent city which makes a good jumping-off point for a series of trips into the far eastern corner of Maharashtra. Kerala - Natural beauty, clean air and primordial greenery amidst the vast expanse of water and sky, typifies the state of Kerala – better known as God's own country. Kerala is famous for its alternative medical therapies such as Ayurveda, which help to rejuvenate and revitalize the body. The region is also home to India’s only virgin tropical rain forest – the Silent Valley National Park, supporting an overwhelming range of life forms, many of which are highly endangered, and endemic to this part of the planet. Delhi - "Welcome to The Capital City of India - New Delhi" Delhi is famous as Capital city of India is located in North India. Delhi is truly a symbol of the old and the new; a blend of ancient well preserved monuments and temples along with jampacked burger joints and up market shopping malls. Delhi has state of the art Hospitals and the best qualified doctors. Pune - Once referred to as the Oxford of the east, Pune continues to be a stronghold for academics and culture. An array of factors like availability of efficient and experienced doctors, comparatively low treatment costs, hospital facilities of international standards and many more have made Pune one of the top destinations for medical tourism. Jaipur - Jaipur is one of the most popular destinations on a tourist's itinerary. The magnificent forts, beautiful havelis and colourful bazaars make Jaipur a popular tourist destination among tourists. Jaipur has pioneered health and medical tourism in India. Chennai - Chennai is one of the most developed urban centers in the Indian subcontinent. The city forms the capital of Tamil Nadu state and is the fourth largest metropolitan city in India. They have some of the very best hospitals and treatment centers in the world. Each hospital is equipped with state of the art facilities. The technology brought into practice is the very latest, including robotic surgery.


Patients Testimonial:

Mr. Jeff Nwaeke, Nigeria Cancer Surgery for his father

Hi, It was the most incredible thing I had, seeing my father of getting away from the clutches of the menace called Cancer though his Malignant Cancer Tumor Surgery in India. This is Mr. Jeff Nwaeke from Nigeria. At the outset, a big thanks to our medical consultant Forerunners Healthcare group. I was really happy to see the arrangements the guys from Forerunner’s did for us, moreover, the doctors, the hospitals, were excellent. We met the surgeon who was suppose to treat my father, he was aware of my father’s case and comforted us his tender voice, and assured us to have the best treatments. The day soon came for my father’s Malignant Cancer Tumor Surgery in India. The surgeon adopted the robot-assisted surgery for my father’s Malignant Cancer Tumor Surgery.

Mr. Agha, Pakistan Breast Cancer Surgery for his wife

I am very happy with the treatment I got for my breast cancer surgery in India. The surgeon was very nice and caring. He made me very much comfortable with the treatment. I am very much thankful to Forerunners Healthcare Consultants for their help and support in arranging my breast cancer surgery in India with the best medical facilities and treatment in India. I got my surgery arranged with the best medical facilities and services in India. In India, we were received by a customer relations officer of the company. He took us straight to the hospital where I was supposed to get my surgery done in India.

Mrs. Caroline Johnson, Nigeria Blood Cancer Treatment

My name is Caroline from Nigeria. I came for my BMT surgery in India at Mumbai. To start with I had leukaemia. Because of the absolute impossibility of paying for a BMT surgery (Bone Marrow Transplant)for Leukaemia without insurance in the Nigeria I planed to find another option, I found Forerunners Healthcare in India website it was a solution for my budget and it has changed my life. The BMT surgery for leukaemia in India was painless for me. The treatment was very effective, the nursing and the support staff were all trained, kind and infinitely caring. I have the joy of facing the future with freedom of mobility and a wonderful on going connection to new friends. It would not have been possible without BMT surgery for leukaemia in India and of course not to forget Forerunners Healthcare India's help and guidance.


Knee Replacement Surgery in India Knee replacement surgery also known as knee arthroplasty is procedure to replace the weight-bearing surfaces of the knee joint to relieve the pain and disability of osteoarthritis. It may be performed for other knee diseases such as rheumatoid arthritis and psoriatic arthritis. The procedure has been proven to help individuals return back to moderately challenging activities such as golf, bicycling, and swimming. Total knees are not designed for jogging, or sports like tennis and skiing (although there certainly are people with total knee replacements that participate in such sports). Knee replacement is a routine surgery performed on over 600,000 people worldwide each year. Over 90% of people who have had Total Knee Replacement experience an improvement in knee pain and function.

Knee Replacement Surgery Candidates A person would be considered a candidate for knee replacement if there is: • • • • • •

Daily pain The pain is severe enough to restrict work, recreation and ordinary activities of daily living Significant stiffness in the knee Significant instability (constant giving way) of the knee Significant deformity (knock-knees or bow-legs) that hinders normal function of the knee Damage from arthritic conditions, such as osteoarthritis, rheumatoid arthritis or post-traumatic arthritis

Success Rate of Knee Replacement Surgery: Knee replacement surgery is recognized as a miracle of modern surgery. Most orthopedic experts consider replacement to be the best method of handling arthritis in the knee. Knee replacements have literally put hundreds of thousands of Americans back on their feet and allowed them to enjoy their golden years.

Knee Replacement Surgery Preparations: • • • •

• • •

If you smoke, cut down or quit. Smoking changes blood flow patterns, delays healing and slows recovery. If you drink, don't have any alcohol for at least 48 hours before surgery. Ask your doctor for pre-surgical exercises. If you are having hip or knee replacement surgery, doing exercises to strengthen your upper body will help you cope with crutches or a walker after surgery. Your primary care physician or an internist will conduct a general medical evaluation several weeks before surgery. This examination will assess your health and your risk for anesthesia. The results of this examination should be forwarded to your orthopaedic surgeon, along with a surgical clearance. Shortly before your scheduled surgery, you will probably have an orthopedic examination to review the procedure and answer any last-minute questions. You may need to take several types of tests, including blood tests, a cardiogram, a urine sample and a chest X-ray. Advice your surgeon of any medical conditions you have and of all the medications you are taking. You may need to stop taking certain medications or your surgeon may recommend substitute medications until your surgery. Medications such as corticosteroids, insulin or anti-coagulants will need to be managed before and after surgery.


Cancer Surgery in India