New trend: Cancer-ravaged organs being saved, not removed

NEW DELHI: In a heartening trend, doctors are now saving cancer-ravaged organs through innovative methods instead of removing them completely to ensure patients have a better quality of life. So even though health minister Ghulam Nabi Azad recently said in the Rajya Sabha that India is set to see a steady rise in cancer cases, doctors are gifting almost normal organs back to their patients. The organs thus salvaged range from breast, liver, larynx, eyes, bone, voice box and rectum.

"The trend now is to leave the afflicted organ in the body without compromising treatment," says Dr S V S Deo, associate professor, surgical oncology at AIIMS. "So, in the early stages of breast cancer now, we remove the tumour only, along with some side tissue, leaving the breast intact. We then do breast reconstruction. Earlier, we would remove the breast and lymph glands nearby."

The biggest beneficiary of preserving organs is the liver which has a tremendous regenerative capacity. Even if only 25% of the liver is healthy, it can be made whole through a new procedure called ALPPS (Associated Liver Partition and Portal vein ligation for Staged hepatectomy). This is done in advanced stages of cancer where even a transplant won't help, says Chennai-based Dr Mohamed Rela, a top liver transplant surgeon. "First, the liver and the portal vein supplying blood to it are divided into two. One part of the vein goes to the damaged part and the other to the healthy part. The former is tied up and gradually shrinks in size, while the other rapidly grows in size. After two weeks, the abnormal liver is removed," says Rela. The cost: Rs 10 lakh approx for ALPPS and Rs 20 lakh for a transplant.

For Kota-based Poonam, 57, ALPPS was a life-saver. "I used to have severe stomach pain and rapid loss of weight and was diagnosed with gall and liver cancer. I got ALPPS done in Bangalore. Now I can eat everything and my weight is normal," she says.

Similarly, in colorectal cancers, earlier, the rectum, sphincter mechanism (responsible for bowel movement) and the anus would be removed, making waste matter go out through an abdominal passage. This severely restricted the life of patients. "Today, the tumour in the rectum is shrunk through chemotherapy and radiation. Then the colon is joined to the anus keeping the sphincter mechanism intact," says Dr Basant Mahadevappa, hepatobiliary surgeon at HCG Cancer Hospital, Bangalore.

In the case of bone cancers earlier amputations used to be done. Today, tumours are shrunk through localized chemotherapy and the bone saved. In voice box cancers, too, the organ would be removed, making the patient speechless. Now, the voice box is preserved using laser, making the patient sound almost normal, says Deo.

Despite scepticism about whether these methods would completely eliminate cancer, many patients are opting to keep their organs intact, giving them a new lease of life.

A stitch in time...

Percentage of a cancerous organ which can be preserved in the early stages

Liver: 100

Bones: 60

Breast: 50

Eyes: 60

Larynx: 60

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