Cancer Treatment—Premium Hospitals in India at your Convenience

Cancer mortality in India has been doubled from 1990 to 2016, and breast cancer is on the rise. According to the Indian Council of Medical Research (ICMR), it could further increase by 12% in the next five years. Now, this is the alarming data that needs to be discussed seriously in the upcoming years. 

The best hospitals in India for Cancer Treatment

Over the years, India has developed its cancer care facilities, but public cancer facilities are still inadequate. That is why this unfortunate disease causes mental, physical, and financial stress on the patients and family members. We are presenting a list of the best cancer hospitals in India that you could seek for good cancer treatment.

1. Fortis Malar Private Hospital 

Also known as Malar Hospital in Chennai, it is considered as one of the best multi-speciality cancer hospitals in the country. With a 25-year old legacy of providing premium-quality cancer treatment, Fortis Malar Hospital is constantly delivering innovative ways of treating cancer with the help of its qualified and experienced team of doctors. 

Benefits you get 

• Top-class blood cancer treatment
• An individualized treatment plan is provided by a multidisciplinary tumor board
• Comes with a success rate of 77% in radiation oncology
• You will be provided with a relationship manager for help

Address

No. 52, 1st Main Road, Gandhi Nagar, Adyar, Chennai, Tamil Nadu 600020

2. Tata Memorial Govt. Hospital

In most cases, cancer treatment is quite expensive. Acquiring a good treatment would take a lot of money. However, Tata Memorial Government Hospital comes with one of the least expensive cancer treatments with top-quality medical services in India. Established in 1941, this premium cancer treatment institute has also grown in terms of research and treatment over the years. 

Benefits you get

• Free Cancer Treatment 
• Less expensive
• Provides premium counseling for patients
• Avoids unnecessary tests
• Advanced treatment and extensive research on cancer treatment
• Offers digital Mammography, anesthesia delivery systems, and Surgical Microscopes

Address

Dr. Ernest Borges Road, Parel, Mumbai, Maharashtra 400012

3. Kidwai Memorial Institute of Oncology Govt. Hospital

Established in 1973, this hospital is considered one of the top cancer hospitals in India. It offers affordable and quality based cancer treatment. Here, anti-cancer drugs are sold 60% cheaper than the market price.  

Benefits you get

• Surgical instruments are disposed of using gamma radiation by radiation sterilization plant
• Counseling is provided to the patient and family members
• Advanced technologies like Clinac-1800 (Linear Accelerator)is used to treat cancer
• CCX-100 autoanalyzer with a gamma camera

Address

Dr. M.H, Marigowda Road, Bengaluru, Karnataka 560029

4. AIIMS (New Delhi)

AIIMS is one of the oldest public cancer hospitals in India. Three types of technologies, such as surgery, radiotherapy, and chemotherapy, are used for treating cancer at minimal rates. 

Benefits you get

• AIIMS department of oncology consists of 46 patent beds, 5 private wards, 3 major operation theatres
• Every year they perform 4000 minor and major cancer surgical procedures
• Teaching and research is being made on various cancers in order to provide doctors with better insight

Address

Sri Aurobindo Marg, Ansari Nagar East, New Delhi, Delhi 110029

5. Apollo Hospitals Private Hospital

Apollo Hospital offers comprehensive cancer treatment in the field of radiation and surgical oncology. This leading healthcare institute features advanced technologies to treat various cancers. 

Benefits you get

• With 125 surgical and radiation cancer specialists, it offers 9 world-class cancer centers in India
• Stem cells and bone marrow transplantation is being offered
• This premium health institute has completed over 55 successful robotic surgeries
• Personal guidance is provided to the patient and family members
• Affordable proton therapy that kills cancer cells is available here

Address

Plot No. 64, Vanagaram-Ambattur Road, Ayanambakkam, Kil Ayanambakkam, Chennai, Tamil Nadu 600095

6. Columbia-Asia Hospital

The department of surgical oncology of Columbia-Asia Hospital comes with advanced medical facilities that can be used for detecting the early as well as advanced stages of cancer. 

Benefits you get

• Screening is provided for various cancers like Colon cancer. 
• Guidance is provided to the patient and the family members
• Cancer treatments like gastrointestinal tract tumors, head and neck tumors, pediatric malignancies, etc. are being done here

Address

26/4 Brigade Gateway, Beside Metro, Malleshwaram, Bengaluru, Karnataka 560055

7. Basavatarakam Indo-American Cancer Hospital

Founded by N T Rama Rao in 1989, this premium health institute aims to provide accurate diagnosis and treatment for cancer patients at lower costs. Also, it offers reasonable charges for medication. 

Benefits you get

• Monitors patient condition and family condition carefully to help them
• This premium cancer institute comes with 9 operation theatres, 1 isolation room, 1 medical ICU, 6 linear accelerators, and 4 surgical ICUs.
• Experienced oncologists

Address

Road No. 10, IAS Officers Quarters, Nandi Nagar, Banjara Hills, Hyderabad, Telangana 500034

8. Yashoda Cancer Institute

Founded by Dr. G Surender Rao in 1989, Yashoda Cancer institute brings 16,000 new cancer patients every year. It always provides accurate cancer care and treatment. 

Benefits you get

• They can detect cancer in the early stage with their cutting-edge medical equipment
• Dedicated CT scan facility
• Best post-operative care is being provided by the surgical observation unit

Address

16 – 10 – 29, Nallakunta Cross Rd, Malakpet, Hyderabad, Telangana 500036

9. Adyar Cancer Institute

This Chennai-based government cancer care facility provides cancer treatment at a nominal cost. They also provide free lodging and boarding to almost 60% of patients.

Benefits you get

• Free and affordable cancer treatment
• Cancer treatment is provided to over 15,000 patients annually
• Cutting-edge technologies such as rapid arc therapy and linear accelerator are used

Address

W. Canal Bank Road, Gandhi Nagar, Adyar, Chennai, Tamil Nadu 600020

10. Rajiv Gandhi Cancer Institute and Research Centre

In 2017, the India Today Group awarded this cancer hospital the most trusted hospital in oncology. Their 360-degree cancer treatment and oncology services include bone marrow transplant, surgeries related to medical oncology.

Benefits you get

• For treating prostate cancer, they use SONABLATE 500 cutting edge technology 
• They have Fully equipped technology for treating lung cancer
• Reasonable medicine pricing

Address

Sir Chotu Ram Marg, Rohini Institutional Area, Sector 5, Rohini, New Delhi 110085

Disclaimer: This article is solely for informative purposes. We have no intention of promoting these hospitals and don’t urge the readers to solely avail treatment from the above-mentioned hospitals. Our intention is to inform readers about some of the services available in these top-notch hospitals.

Testicular cancer and its Treatment

What is Testicular Cancer? 

The testicular cancer occurs when cells in the testicle grow in order to form a tumor. This is rare. More than 90 % of testicular cancers develop in the germ cells, which involves in producing sperm. 

There are mainly a couple of types of germ cell cancers (GCTs), Seminoma & Non-seminoma. 

Seminoma: Seminoma generally grow slowly and respond very well to chemotherapy radiation therapy.

Non-seminoma: Although, Non-seminoma comparatively grows rapidly and is less responsive to those treatments.

This Non-seminoma has a few sub-types such as: choriocarcinomas, embryonal carcinomas, teratomas and yolk sac tumors. 

Apart from this, there are also rare testicular cancers that usually don’t form in the germ cells.

Leydig cell tumors develop from the Leydig cells, involved in producing the testosterone.

Sertoli cell tumors start from the Sertoli cells that support normal sperm growth.

Who is at Risk?

• Male with a father or brother who had testicular cancer. 
• Male with the history of testes that don’t drop prior to birth. 
• Male with germ cell neoplasia in situ (GCNIS). 

What are the Symptoms of Testicular Cancer?

Initially, the signs and symptoms of testicular cancer may be difficult to notice. Symptoms of a testicular tumor may include:

• A lump which may be painless in the testicle.
• Testicle swelling, with or without pain. 
• A feeling of weight in the testicles. 
• Pain in the testicle, groin or scrotum. 
• Changes or tenderness in the breast tissues of male. 

Interact with your doctor as soon as you notice any of these signs and symptoms. If you do have symptoms, your doctor performs a physical exam, an ultrasound and a tumor marker blood test.

You may be referred to a urologist for good care. Testicular cancer is not diagnosed with a standard biopsy (tissue sample) prior to the surgery.

The testicular cancer can be precisely diagnosed and staged after the tumor is surgically removed. At that point, your doctor will study the tissue in order to learn the exact type of cancer, where it is located and how aggressive it is.

What are the Stages of Testicular Cancer?

Stage 0: It can be considered as a warning that cancer could grow. 

Stage I (IA, IB, IS): This stage indicates that the cancer is found only in the testicle and has not spread to anywhere else in the body.

Stage II (IIA, IIB, IIC): In this stage the cancer has spread to 1 or more lymph nodes in the belly.

Stage III (IIIA, IIIB, IIIC): This stage shows the cancer has spread beyond the lymph nodes in the belly. Cancer may exist far away from the testicles, such as distant lymph nodes or the lungs.

Treatment of Testicular cancer: 

For treating testicular cancer a doctor's team, such as a urologist, oncologist or a radiation oncologist, will work together in order to find the precise treatment plan for each and every patient. The treatment plan will be based on the diagnosis as well as health of the particular patient. 

Surveillance is a specific way to look for the change with normal check-ups and is basically performed for men with Stage 0 as well as Stage I cancers.

In case your cancer gets worse, then the surgery in order to remove the testicle is the best treatment. After surgery, patients will be monitored to make sure they are well or not. 

Male patients with stage II & III testicular cancer may be recommended for comparatively more treatment, like radiation therapy, chemotherapy or the removal of tumors that have spread to the beyond lymph nodes. Radiation is preferred when the seminoma cells are detected, but in some non-seminoma cancer cells it is not effective. Chemotherapy is recommended for any testicular cancer that has spread beyond the testis, or if tumor markers rise after orchiectomy. 

On behalf of the diagnosis of testicular cancer, other surgical options can be recommended. Testis-sparing surgery (TSS) is basically an option for men or children who have a benign tumor. For Testis-sparing surgery, tumor markers must need to be negative.

A surgery known as RPLND (retroperitoneal lymph node dissection) is sometimes an option for male patients with cancers that may return. This surgery helps in order to remove the lymph nodes in the abdomen and must be performed by an experienced surgeon. 

Testicular cancer medication: 

In order to treat testicular cancer there are several drugs that are approved by the FDA (Food and Drug Administration). There are common drug combinations used in testicular cancer. The individual drugs used in combinations mainly are approved by FDA. However, the drug combinations usually are not approved but are widely used.

Bleomycin Sulfate: This medication is believed to work by preventing the making of DNA. The bleomycin IP 15 units is recommended to be given intravenously, by intramuscular injection, or under the skin. 

The common adverse reactions due to bleomycin injection include rash, fever, weight loss and vomiting.

Cisplatin: For patients with testicular cancer, cisplatin 50 mg chemotherapy medication should be given by injection into a vein. This platinum-based antineoplastic family of medicine functions in part by binding to DNA and inhibiting its replication. 

The common adverse reactions include vomiting, bone marrow suppression, hearing problems and kidney problems. 

Cosmegen (Dactinomycin): Dactinomycin, also known as actinomycin d, is a chemotherapy medication should be given by injection into a vein. It is shown to have the ability in order to inhibit the transcription. 

The common adverse reactions due to dactinomycin 0.5 mg include mouth ulcers, bone marrow suppression, vomiting, hair loss, infections, liver problems and muscle pains. 

Etopophos (Etoposide Phosphate): Etopophos a chemotherapy medication can be used either by mouth or injection into a vein. This topoisomerase inhibitor family of medication is believed in order to work by damaging DNA. 

The common adverse reactions include fever, low blood cell counts, hair loss, vomiting, loss of appetite and diarrhea. 

Ifex (Ifosfamide): Ifosfamide (IFO) a chemo drug should be administered by injection into a vein. This nitrogen mustard class of drug works by disrupting the duplication of the DNA as well as creation of the RNA. 

The common adverse reactions include hair loss, blood in the urine, vomiting, kidney problems and infections. 

Vinblastine Sulfate: Vinblastine a chemotherapy medication should be given by injection into a vein. Vinblastine believed to work by blocking cell division. 

The common adverse reactions include change in sensation, weakness, headaches, loss of appetite and constipation. 

Drug Combinations Used in Testicular Cancer: Drugs in combinations usually work better than single drugs because different drugs kill cancer cells in different ways.

Each of the drugs in this combination is approved by the FDA in order to treat cancer or conditions related to cancer.

BEP: BEP (Bleomycin, Etoposide Phosphate, Cisplatin). is used to treat:

• Testicular germ cell tumors that are malignant.

JEB: JEB (Carboplatin (JM8), Etoposide Phosphate, Bleomycin) is used in children to treat the following malignant extracranial germ cell tumors:

• Testicular germ cell tumors.

PEB: PEB (Cisplatin (Platinol), Etoposide Phosphate, Bleomycin) is used in children to treat:

• Testicular germ cell tumors that are malignant.

VeIP: VeIP (Velban, Ifosfamide, Cisplatin (Platinol), is used in order to treat:

• Advanced testicular cancer.

VIP: VIP (Etoposide (VP-16), Ifosfamide, Cisplatin (Platinol) is used to treat:

• Testicular cancer that is advanced. It is often recommended in those patients who cannot take bleomycin sulfate.

What is the Risk for Return?

Testicular cancer may come back but the chances are quite rare, at about 5 % or less. Apart from this, the risk of cancer growing in the other testicle is also quite less. Still, it is necessary to learn how to do a testicular self-exam. Also, regular follow-up visits with your urologist can be helpful.

How often, and for how long follow-up care is required is based on your diagnosis.

If your cancer returns, the healthcare provider will want to find and treat it quickly. Additional treatment options depend on the type of cancer and location.

Disclaimer: Above mentioned information is not a tool for the self-diagnosis or a substitute for professional medical advice. Please discuss with your urologists or health care provider about your health concerns. Always interact with a healthcare provider prior to starting or stopping any treatments, including medications.

Read:- Treatment of childhood liver cancer

Treatment of Childhood Liver Cancer

What is childhood liver cancer? 

It is when malignant cells start forming in the tissues of the liver. It is mostly determined by the symptoms like abdominal pain or a lump in the abdomen, swelling in the abdominal region, nausea, vomiting, and loss of appetite.

There are certain diseases, which act as risk factors for childhood liver cancer. They are: 

1. Aicardi Syndrome 
2. Glycogen storage disease 
3. Trisomy 18
4. Hemi hyperplasia

A CT scan, serum tumor marker test, or a complete blood count test can diagnose the condition. Other than that, abdominal X-ray, MRI, and biopsy are also helpful in this case.

Standard treatment procedures for Childhood Liver Cancer- 

1. Surgery 

Partial hepatectomy, liver transplant, or resections of metastases are the commonly approached options. Surgery is applicable in both advanced and primary cases. A number of tests are carried out before surgery to figure out the size of the primary tumor, the level of alpha-fetoprotein in blood, or whether there's more than one tumor. If the patient is eligible for a transplant, he/she will have to wait for an organ donor that matches the requirements. In some cases, chemotherapy is given before surgery to shrink the tumor. Surgical procedures have their own drawbacks, like the chance of infection, pain, or bleeding. However, doctors will calculate the risk factors and then go for it so that the patient's life is not put at high risk.

2. Watchful Observation 

It is also quite useful because there are changes in symptoms disappearing or changing at times. Doctors monitor the health of the patients carefully for a significant period before taking any action. It is also used for Hepatoblastoma, where the tumor has already been removed by surgery.

3. Chemotherapy

It is one of the most commonly prescribed treatment options that use drugs to kill cancer cells or stop their growth within the body. Drugs are either administered orally or intravenously into the bloodstream. Sometimes, combination chemotherapy also opts for better results (use of more than one anti-cancer drug at the same time)

There are multiple chemo drugs that are effective for childhood liver cancer. Some of them are stated as follows: 

1. Gemcitabine- Categorized as an ant metabolite, Gemcitabine is a cytotoxic chemotherapy drug that is either prescribed alone or with Docetaxel for better impact.
2. Oxaliplatin- For Hepatoblastoma, Oxaliplatin is given in combination with other anti-cancer drugs like Cisplatin and Vincristine. This platinum-based medication is given as an injection into the vein twice every 14 days.
3. Cisplatin- It is an antineoplastic cytotoxic chemotherapy drug that is classified as an alkylating agent. Being the most common platinum-based chemotherapy medicine, Cisplatin 50 mg has shown remarkable effects on the case of childhood liver cancer.
4. 5 Fluorouracil- This chemotherapy drug is also an antimetabolite that is available in the market as Fluorouracil cream and injection. While the cream or topical is used for treating skin cancer and similar conditions, in the case of childhood liver cancer, it is given as an injection.
5. Capecitabine- When administered in the body, Capecitabine gets converted to Fluorouracil to target the cancer cells and prevent them from forming new DNA. This is how Capecitabine 500 mg is helpful for destroying liver cancer cells in the body.

Chemotherapy has certain side effects like:

• Nausea and vomiting
• Hair loss 
• Mouth sores
• Loss of appetite 
• Fatigue 
• Diarrhea 
• Increased chances of infections
• Easily bruising and bleeding

4. Radiation Therapy 

There are two types of radiation therapy that are used for treating childhood liver cancer: External radiation therapy and internal radiation therapy. They are the use of high-energy X-rays or radioactive needles to destroy the cancer cells. The former is used to treat Hepatoblastoma that can't be dealt with surgical procedures. It is also used for relieving the symptoms at times.

The side effects of radiation therapy are: 

• skin color change in areas where the radiation beam is given 
• blistering and peeling of skin 
• loss of appetite
• diarrhea 
• nausea and vomiting

5. Ablation 

It is a process by which affected tissues are removed and destroyed. It's divided into two categories- radiofrequency ablation and percutaneous ethanol injection. Both are useful for treating recurrent Hepatoblastoma. Although serious complications are not seen in this treatment procedure, fever, liver infection, and abdominal pain have been noticed in some cases.

6. Targeted therapy

It is a new type of drug treatment that targets the cancer cells in the body to destroy them. It can aim at specific abnormalities or simply target the blood vessels to slow down the growth of malignant cells.

Certain important targeted therapy drugs are: 

1. Lenvatinib- Lenvima or Lenvatinib is first-line therapy for childhood liver cancer. It is administered orally that acts upon the cancer cells with its anti-angiogenic activities. Lenvatinib 4mg and Lenvatinib 10 mg target the blood vessels to destroy the cancer cells.
2. Sorafenib- Sorafenib 200 mg is a kinase inhibitor. It simply works by blocking the effect of abnormal proteins on the cancer cells or destroy them.
3. Regorafenib- This multikinase inhibitor is specifically known to target the VEGFR-TIE2 tyrosine kinase to stop the growth of cancer cells. The normal dosage is 160mg - four Regorafenib 40 mg tablets per day.

The common side effects of targeted therapy are diarrhea and constipation, shortness of breath, fatigue, dryness of skin, and cold-like symptoms. However, these aren't persistent and go away easily.

7. Immunotherapy

Here, the immune system of the patient is given a boost by the use of drugs like Atezolizumab to fight the cancer cells from within. 

Atezolizumab 60mg is a PD-L1 inhibitor that is used commonly for conducting immunotherapy in patients. It's given intravenously once at an interval of 2, 3, 4 weeks, depending on the condition.

Conclusion

Liver cancer cases that are connected to the Hepatitis B virus-like Hepatocellular Carcinoma can be approached with antiviral drugs. In some cases, patients also participate in a clinical trial. With the advancement of medical science, newer and better treatment methods are coming to the surface to cure childhood liver cancer with lesser side effects.

Inoperable Lung Cancer

                    

The phrase "Inoperable lung cancer" makes a lung cancer diagnosis even quite terrifying. But the cancer inoperable doesn't mean that it can not respond to any other type of lung cancer treatment. 

If any patients have been diagnosed with lung cancer, he'll or she'll surely want to know about several things, including what type of lung cancer I have, what are the treatment options, and about survival rates. And if your doctor has given you words that you have inoperable cancer, literally you’ll want to know about this frightening term as well.

Doctors specifically use the term “inoperable cancer” when they cannot operate with the intent in order to cure the cancer. Here, cancer can not be cured by surgery, rather some other lung cancer treatment options can be effective. 

Why Lung Cancer May Be Inoperable: 

Below mentioned are a few reasons why lung cancer might be termed inoperable:

• Your cancer has spread.
• The location of lung cancer. 
• The health of the patient.

When Inoperable lung cancer spreads to outside your lungs. It’s basically known as unresectable lung cancer.

Types of Inoperable Lung Cancer: 

Inoperable lung cancer basically categorized into two types, based on the size of the affected cells:

Non-small-cell lung cancer (NSCLC): Up to about 85% of lung cancer cases are NSCLC. It has three subtypes:

• Adenocarcinoma
• Squamous cell carcinoma
• Large-cell (undifferentiated) carcinoma.

Small-cell lung cancer (SCLC): This kind of cancer almost occurs due to cigarette smoking. Approximately 70% of cases are usually diagnosed after the cancer has spread. SCLC often grows faster than non-small cell lung cancer, meaning it responds well to radiation therapy and chemotherapy.

Treatment Options: 

In Inoperable lung cancer, you can't have surgery. But it doesn't mean that you can't do anything with your cancer. Several treatment options like radiation therapy, chemotherapy, targeted therapy, and immunotherapy are able to fight it, even when the operation can not be performed. 

Radiation therapy: Your healthcare provider uses high-energy X-rays or other radiation in order to kill cancerous cells or prevent them from growing. Patients with Non-Small Cell Lung Cancer, may direct the energy at a certain part of the body from the outside with the help of a machine (known as external) or implant the radioactive seed, wire, or needle in the body just near the cancer (known as internal). The external radiation therapy is often used for small cell lung cancer.

Chemotherapy: Several medications are able to kill cancerous cells or can prevent from dividing. You may be recommended pills in order to swallow or have injections.

Chemotherapy medications used in order to treat NSCLC. The chemo medications most used for NSCLC include:

• Cisplatin
• Carboplatin
• paclitaxel
• Albumin-bound paclitaxel (nab-paclitaxel, Abraxane)
• Docetaxel (Taxotere)
• Gemcitabine (Gemzar)
• Vinorelbine (Navelbine)
• Etoposide (VP-16)
• Pemetrexed (Alimta)

Targeted therapy: Targeted therapy basically uses medicines or antibodies that are able to attack specific cancerous cells. It leaves comparatively less harm to the healthy cells than either chemo or radiation. It’s mainly recommended for the NSCLC.

Several mutations are able to be treated with targeted therapy medicines. These include:

Tyrosine kinase inhibitors: Tagrisso (osimertinib), Tarceva (erlotinib 150 mg), and Iressa (gefitinib 250 mg), Ofev (nintedanib 150 mg), Gilotrif (afatinib 40 mg), Afinitor (everolimus 10 mg). 

ALK rearrangements: Xalkori (crizotinib), Zykadia (ceritinib), Alectinib (alencensa), and Alunbrig (brigatnib). 

ROS1 rearrangements: Xalkori (crizotinib), Lorbrena (lorlatinib), Rozlytrek (entrectinib), and Zykadia (ceritinib).

Immunotherapy: Immunotherapy is also known as biologic therapy. It helps in order to boost, direct or restore your immune system in order to fight cancer.

Checkpoint inhibitors:

• Atezolizumab (Tecentriq)
• Durvalumab (Imfinzi)
• Nivolumab (Opdivo)
• Pembrolizumab (Keytruda)

Bladder Cancer And Its Treatment

Bladder Cancer: Bladder cancer occurs when the healthy cells in the bladder lining change and grow in an uncontrolled way, forming a mass addressed as a tumor.

Urothelial carcinoma is known as the most common type of bladder cancer.

Squamous cell carcinoma, small cell carcinoma, and adenocarcinoma are often less common types.

Urothelial carcinoma also developed in the ureters, that bring urine from the kidney to the bladder, and responsible for spreading to the kidneys. Bladder cancer can also be described as the non-muscle-invasive or the muscle-invasive. 

Symptoms of Bladder Cancer

In bladder cancer, sometimes doesn’t have many signs or symptoms and is detected when a urine test is performed. Apart from this, most patients with bladder cancer do have some signs and symptoms. 

These symptoms can include:

• Blood in the haematuria 
• Changes in the bladder habits 
• Pain in one side of a lower abdomen or back.

What are the risk factors?

Studies represent that the people with certain risk factors have higher chances to develop bladder cancer. These factors include:

• Smoking
• Older age
• Being male
• Chemical exposure at work
• Chronic infections
• Long-term catheter use
• Previous cancer treatments
• Diabetes treatment
• Personal or family history

How Does Bladder Cancer Start And Spread: Inside the lining of a bladder is the urothelium, which is made of urothelial cells (also called transitional cells). If urothelial cells make the excess copies of themselves and grow out of control, this is a bladder cancer. 

After forming in urothelium, the tumors generally grow into the bladder wall. Then cancerous cells travel through lymph or blood in order to form new tumors in other parts of the body. This is known as metastasis. 

PHASES OF BLADDER CANCER: 

Patients with bladder cancer are grouped into 3 main categories, depending on the stage of cancer. Treatment goals as well as management of these groups are different. 

Non-muscle invasive bladder cancer: Stages 0 and 1 belong to the non–muscle-invasive. It is known as the early bladder cancer. In this, the tumor has not spread to the thick layer of the muscle in the bladder wall. The purpose of treatment for non-muscle-invasive cancer are to: 

• Decrease the risk of cancer coming back after it is being treated successfully. 
• Resist the cancer from progressing to an advanced stage.

Muscle-invasive bladder cancer: Basically stages 2, 3, and early stage 4 are the muscle-invasive. Local control therapy such as radiation or surgery, combined with the chemotherapy, is required in order to prevent the spread of cancerous cells away from the bladder. The purpose of the treatment for muscle-invasive cancer are to:

• Cancer's stage in order to confirm that it is muscle-invasive, but has not metastasized. 
• Determine the best local treatment options. 

Metastatic bladder cancer: In this, the cancer has spread to organs and lymph nodes far from the bladder. These cancers are difficult in order to cure. The major purpose of care for metastatic bladder cancer is to assist you live as comfortably as possible.

Diagnosing of Bladder Cancer: 

Diagnosis is performed with the help of several existing ways:

General Tests: General tests may include:

• blood and urine tests
• an internal examination: in this the healthcare provider slides a gloved finger into the rectum or vagina in order to know for anything unusual. 

Main Tests: In order to diagnose the bladder cancer, your doctor may arrange:

• an ultrasound: a scan that uses soundwaves to create pictures of your organs. 
• a cystoscopy: the doctor inserts a tube with a light and camera through the urethra to view the bladder; a flexible cystoscopy can be done with local anaesthetic, while a rigid cystoscopy is done under general anaesthetic in hospital and may include a biopsy. 
• MRI and CT scans: these basically involve an injection of dye into the body.

Further Tests: In order to check if cancer has spread to other parts of the body, you may have:

• a radioisotope bone scan
• x-rays 
• an FDG-PET scan

Treatment Options For Non-muscle Invasive Bladder Cancer: 

Once tumor found after close examination of the bladder, your doctor may choose to perform a transurethral resection of bladder tumor (TURBT) as a first step in your treatment. 

TURBT: It is generally the initial treatment for non-muscle invasive bladder cancer. It is basically a procedure which is used both for diagnosis as well as treatment. By using this procedure doctors remove the tumor which is generally reserved for the non-aggressive cancer.

Patients with the non-muscle invasive cancer located only in the bladder can be recommended in order to receive immunotherapy or chemotherapy drugs after a TURBT via intravesical therapy. There are numerous intravesical therapy bladder cancer treatment options:

Bacille Calmette-Guerin (BCG): This vaccine is an immunotherapy drug. This therapy is used in order to boost the body’s natural defenses to fight cancer. The onco-BCG is a first-line treatment for carcinoma that has not spread outside the bladder. It is effective in order to prevent bladder cancer recurrences following TURBT.

Mitomycin C: Mitomycin is basically a chemotherapeutic agent used to kill cancer cells. It is mainly given to patients at doctor’s offices, outpatient clinics or hospitals.

The mitomycin injection is easily absorbed into the bladder and has helped with preventing tumor recurrence. 

The mitomycin 40 mg has been used more often immediately after TURBT or sometimes within 24 hours after the initial TURBT treatment.

Thiotepa (Tepadina): Thiotepa is used as intravesical chemotherapy in bladder cancer. The thiotepa is recommended to be used prophylactically in order to prevent seeding of the tumor cells at the cystoscopic biopsy; as a therapeutic agent in order to prevent recurrence after cystoscopic resection of the bladder tumor (transurethral resection of bladder tumor) or as an adjunctive agent at the time of biopsy. 

Cisplatin: The cisplatin 50 mg specifically belongs to the platinum-based antineoplastic family of medications. It works in part by binding to the DNA and inhibiting its replication. 

Intercalating Agents (Doxorubicin, Valrubicin and Epirubicin): These agents are known for good absorption into the bladder, and systemic toxicity is very rare. Doses can vary from 3 times a week to once in a month.

Gemcitabine: This is used for more advanced bladder cancer. In patients who received previous therapy without cure, gemcitabine therapy may be helpful.

Atezolizumab: This medication is used for the locally advanced or metastatic urothelial carcinoma  after the failure of cisplatin-based chemotherapy.

The use of atezolizumab is considered as a first-line treatment for the metastatic bladder cancer in patients who can not receive cisplatin-based chemotherapy and have high levels of PD-L1. 

Laser-Ablation Therapy: This involves using a laser in order to burn cancer cells. Patients for this type of therapy have low-grade papillary tumors as well as a history of the low-grade, low-stage tumors.

List of ovarian cancer medications

Often detected in its later stages when it spreads to the stomach and pelvis, ovarian cancer is the type that occurs in the egg-producing female organs. While most cases do not have any symptom in the early stages, it becomes fatal and complicated to treat during the advanced stage. The very non-specific symptoms include loss of appetite and unusual weight loss. Patients who are experiencing a shift in bowel movement, discomfort in the pelvis area, and frequent urge to urinate need to consult a doctor immediately. 

Medications used for treating Ovarian Cancer

1. Melphalan

Melphalan is single-agent chemotherapy that is prescribed for the treatment of ovarian cancer in adults. It works by destroying the cancer cells and slowing down their further growth in the body. Melphalan 50 mg is given as an intravenous infusion over certain intervals. The dosage can be modified based on the condition of the patient. During the course of treatment, patients must avoid getting pregnant or breastfeeding. It can also interfere with the normal menstrual cycle. The average retail Melphalan price is $675.95, but one can get it at a wholesale rate from several pharmacies. 

2. Gemcitabine hydrochloride

This antineoplastic cytotoxic chemotherapy medication is given in combination with Carboplatin to treat ovarian cancer that has relapsed within 6 months of finishing the last treatment. It is administered intravenously once every 3 to 4 weeks as per the condition of the patient's demands. There are certain moderate side effects like skin rashes, itching, nausea, vomiting, diarrhea, and temporary hair loss that can be managed easily in the gap between two doses where the body is given time to recover.  

3. Carboplatin

It is prescribed in combination with Paclitaxel as an initial treatment of Ovarian Cancer. At this stage, cancer must still be restricted to the ovaries for the treatment to take effect fully. Carboplatin 450mg is infused intravenously once every 4 weeks. The infusion takes about 30 minutes, and then the patient needs to stay back at the hospital for a few hours to let the doctor monitor the immediate after-effects. Usually, 6 cycles of treatment (24 weeks) can yield results, but in certain advanced cases, it can continue longer. The carboplatin price for a single vial of 45mL is 2769 INR.  

4. Olaparib

For the treatment of advanced ovarian cancer, Olaparib is given in combination with other drugs like Bevacizumab to conduct maintenance therapy in patients. It is also effective for patients who have received 2 to 3 lines of chemotherapy prior to this. For refractory conditions, Olaparib is prescribed with Rucaparib to shrink the tumor. The medication is effective in patients where cancer has a specific genetic mutation – BRCA. 

5. Cisplatin

So far, Cisplatin qualifies as the most active drug for the treatment of Ovarian Cancer. It is a chemo drug that is administered intravenously at certain intervals (weeks). To treat advanced conditions, Cisplatin is also given at a high dose in combination with Vinblastine, Ifosfamide, and Etoposide. Before receiving Cisplatin 50 mg, your doctor will provide you with IV fluids for about 8 to 12 hours. For IP chemotherapy, the drug will be injected directly into the abdominal cavity. If you have a hearing impairment and bone marrow suppression, the medication can worsen the conditions. 

6. Niraparib

Patients who have responded fairly to platinum-based chemotherapy can benefit from this medication to slow down the progression rate of ovarian cancer. It is a highly selective oral PARP 1 and PARP 2 inhibitor that is also prescribed as maintenance therapy for recurrent conditions. The dosage for first-line maintenance treatment is determined based on the body weight and platelet count of the patient. For a supply of 100mg 30 capsules, the cost of Niraparib is $7588. 

7. Paclitaxel

It is prescribed in both primary and advanced stages of ovarian cancer. Doctors can also prescribe it with the chemo drug Carboplatin. It is administered as an infusion in the veins. Few patients can have allergic reactions as a result of this. To prevent that, your doctor can prescribe a few medications after transfusion. Paclitaxel 100 mg is given every 3 weeks, but the recent clinical studies show that it had worked more efficiently when the time span was reduced to one week. However, it entirely depends upon the extent of the disease. Paclitaxel price is 5000 INR for a vial of 16.7mL.

Final Words

Ovarian cancer has a better chance of getting completely cured if diagnosed and treated in the initial stages. As it spreads, the chances become slim, and the situation gets deadlier. So far, there have been different drug regimens for the treatment of this condition. Minor side effects are common and can be managed easily since they're not persistent.