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Breast cancer and radiation therapy
Radiation therapy is a common treatment modality for breast cancer, often used in conjunction with surgery and chemotherapy. It involves the targeted use of high-energy X-rays or other forms of radiation to destroy or damage cancer cells in the breast and nearby lymph nodes. Radiation therapy may be recommended after breast-conserving surgery (lumpectomy) to reduce the risk of local recurrence. For some patients, radiation may also be indicated after a mastectomy, depending on factors like tumor size, lymph node involvement, and cancer stage. External beam radiation is the most common type of radiation therapy for breast cancer, administered over several weeks with daily sessions. Radiation can lead to side effects such as skin redness, fatigue, and breast discomfort, but these are typically temporary and manageable. Accelerated partial breast irradiation (APBI) is an option for select patients and involves a shorter course of focused radiation therapy.
About the Speaker
Dr. Bhavin Visariya
Radiation Oncologist, HCG ICS Khubchandani Cancer Centre
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Biosimilars and Cancer Supportive Care
Biosimilars are biological products that are highly similar to and have no clinically meaningful differences from an existing approved reference biologic drug. In cancer supportive care, biosimilars have become increasingly important for managing various aspects of cancer treatment, including supportive therapies. One significant application of biosimilars in cancer supportive care is in the management of chemotherapy-induced neutropenia. Neutropenia, characterized by low levels of neutrophils (a type of white blood cell), is a common side effect of chemotherapy that can increase the risk of infections. Biosimilar versions of granulocyte colony-stimulating factors (G-CSFs), such as filgrastim and pegfilgrastim, are used to stimulate the production of neutrophils and reduce the duration and severity of neutropenia.
Medical management of GI Neuroendocrine tumor
The medical management of gastrointestinal neuroendocrine tumors (NETs) involves a tailored approach based on the tumor's grade, stage, and specific hormonal secretion patterns. Somatostatin analogs, such as octreotide and lanreotide, are commonly used to control symptoms related to hormone hypersecretion and to stabilize tumor growth. For well-differentiated NETs with advanced disease, targeted therapies like everolimus and sunitinib may be considered to inhibit mTOR and tyrosine kinase pathways, respectively. Peptide receptor radionuclide therapy (PRRT) with agents like lutetium-177 DOTATATE has shown efficacy in certain cases. Systemic chemotherapy, often with streptozocin-based regimens, may be employed for poorly differentiated or aggressive tumors. Close monitoring through imaging studies, biomarker assessments, and multidisciplinary collaboration between oncologists, endocrinologists, and surgeons is essential for an integrated and individualized approach to the medical management of GI neuroendocrine tumors. Additionally, patient education and support are crucial components to address the chronic nature of this condition and optimize the patient's overall well-being.
Management of Malignant Biliary Strictures
The management of malignant biliary strictures involves a multidisciplinary approach aimed at relieving obstruction, improving quality of life, and potentially extending survival. Endoscopic retrograde cholangiopancreatography (ERCP) with stent placement is a common intervention to alleviate biliary obstruction. Metal stents are preferred over plastic stents for their durability and longer patency. In cases where ERCP is not feasible, percutaneous transhepatic biliary drainage may be employed. Systemic chemotherapy or radiation therapy may be considered as part of a comprehensive treatment plan, particularly in cases where the malignancy is unresectable. Surgical resection remains the curative option when feasible. Palliative care plays a crucial role in managing symptoms and enhancing the overall quality of life for patients with advanced disease. Close collaboration among gastroenterologists, oncologists, interventional radiologists, and surgeons is essential for the optimal management of malignant biliary strictures.