SCREENING AND SURVEILLANCE SERVICES
Cancer management is not a one person’s responsibility. The society and the physician must join hands together for early diagnosis and treatment of cancers. Late referrals and patient ignorance of his symptoms are the main reasons for cancers presenting at an advanced stage where limited therapeutic options are available. We regularly hold camps and CMEs for educating primary care physicians and common man about the symptoms of various GI cancers and emphasizing the need for screening of GI cancers. With image enhanced endoscopy such as chromoendoscopy and narrow band imaging it is possible to pick early stage asymptomatic cancers , wherein they can be treated by endoscopy and translating to best patient outcomes. Elderly patients , those persons with risk factors for a particular cancer and persons with family history of cancer must volunteer for screening, for possibility of early stage cancer diagnosis.
- Some Key Features :
- 1. Dr Tarun Bharadwaj is the best cancer doctor in Bhopal who has extensive experience in managing patients suffering from stomach cancer.
- 2. High resolution endoscopy for early cancer diagnosis is now available in Bhopal.
- 3. Bhopal now has best cancer Doctor, Dr Tarun Bharadwaj who was trained in Japan in NBI technology which helps in early diagnosis of cancer.
1. Screening for Esophageal Cancer-
- Gastroscopy is performed with magnification narrowband imaging(M-NBI) to look for presence of area of demarcation , abnormal vessels, and brownish epithelium. The abnormal area is further interrogated by using chromoendoscopy with Lugol’s iodine to look for Lugol void areas. Early diagnosis of superficial esophageal squamous cell carcinoma(SESCC) is thus possible by Gastroscopy.
Risk Factors for Esophageal carcinoma (Persons with below mentioned risk factors are advised to undergo screening for early diagnosis of esophageal cancer).
- 1. Alcohol intake and smoking
- 2.Intake of Red/salted Meat
- 3.Presence of Achalasia cardia
- 4. History of upper aero-digestive tract squamous cell cancer
- 5.Radiation therapy following mastectomy
- 6. Obesity
- 7. Gastroesophageal reflux disease and Barrett’s esophagus
- 8. Family history of esophageal cancer
Patients are usually advised esophageal ESD for SESCC and esophagectomy (Removal of esophagus) for locally advanced cancers.
2. Screening for Gastric cancer-
- Gastroscopy is performed initially with white light to look for abnormal areas of discoloration (red or white). Subsequently all abnormal areas are closely interrogated with magnification Narrow band imaging (M-NBI) to diagnose and characterize early gastric cancer. Presence of demarcation line with abnormal microvascular or microsurface pattern is suggestive of early gastric cancer.
- Risk Factors for Gastric cancer-
- 1. Helicobacter Pylori infection
- 2. Diet high in salt intake and eating of processed meat
- 3.Eating of Fried/fatty foods and red meat
- 4.Cigaretter (Cigarette) smoking
- 5. Obesity
- 6. Family history of gastric cancer
Patients are usually advised gastric ESD for early gastric cancer and gastrectomy (Removal of stomach) for locally advanced cancers.
3. Screening for colorectal cancer-
- For average risk adults a one time colonoscopy starting at the age of 50 years is recommended. If the index colonoscopy is negative, next colonoscopy is advised after 10 years. Annual Fecal occult blood test(FOBT) is recommended in the interim. All FOBT patients are further evaluated by colonoscopy for presence of polyps or cancer. Colonoscopy with magnification Narrow band imaging (M-NBI) is performed to look for presence of poyps and cancer. Polyps are further characterized by NBI to decide if they can be removed endoscopically or by surgery.
- Risk Factors for Colorectal cancer-
- 1. Adenomatous polyps or sessile serrated adenomas(SSAp)
- 2.Family history (or personal history) of colorectal cancer
- 3. Inflammatory bowel disease such as Ulcerative colitis and Crohns colitis.
- 4.High fat, Low fibre diet.
- 5. Age more than 50 years
- 6. Eating of Red meat
All adenomas are removed endoscopically, few advanced polyps or frank cancer will require surgery with removal of colon.
4. Screening of other GI organs-
- 1. Screening for hepatocellular cancer (HCC, Liver cancer) in all patients with chroninc liver disease
- 2. Screening for Pancreatic cancer (in all patients with chronic pancreatitis)
- 3. Screening for gall bladder cancer(in all patients with gall bladder polyp with size more than 1 cm and with gallbladder stone)
Dr Tarun Bharadwaj is the best cancer doctor in Bhopal , who can diagnose and treat esophagus/stomach/colon cancer .