1. Welcome Dr. Shambhavi and thank you for agreeing to this interview. Will you please introduce yourself?
I'm a Radiation Oncologist by profession and a humanitarian by nature. I come with a dream of helping people overcome and deal with the deadly disease of cancer.
2. What made you choose radiation Oncology as your stream of specialization?
I have always had a fascination for oncology since I entered medicine. When I took up the stream for my specialization, I honestly did not realize the havoc this disease had created. I'm just thankful that I chose it amidst other options.
3. Medical facilities in rural areas for cancer are quite expensive. What initiatives can the government take up?
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Medical facilities in rural areas are certainly poor. There is a dire need to open cancer centers in these areas. A lot of these centers are already underway as per government announcements. However, it will still not be enough to tackle the growing incidence of cancer. The Government can accelerate it by judicious use of funds and privatizing the process, by incentivizing corporations to spend the CSR funds in this sector
4. How is lifestyle related to cancer?
Lifestyle plays a major role in recent times. Every single action throughout our day determines our lifestyle and thereby affects the outcomes we face because of it. A good lifestyle comprises the basic discipline of mindful eating, getting some form of physical activity, 7 hours of sound sleep and staying away from psychoactive substances like tobacco and alcohol. A healthy state of mind is always an added bonus, but sadly available to a minuscule percentage of people. As of today, obesity, stress, excessive use of tobacco and alcohol, late marriages and childbirth, and consumption of processed food are all manifestations of a changing paradigm of lifestyle and are probable answers to the rising incidence of cancers.
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5. What are your recommendations on dietary habits to help avoid cancer?
Ensure that your diet is always full of vegetables, and fruits with a portion of whole grains. Vitamins C and E, lycopene, and beta carotene are potent antioxidants that fight against oxidative stress to the body which in turn protects against various diseases including cancer. Yellow orange fruits and vegetables are rich sources of beta-carotene. Tomatoes, watermelon and grapefruits are great sources of Lycopene. Vitamins C and E are found in oranges, lemons, guavas, nuts and seeds. Red meat should be consumed as little as possible. Good sources of protein are eggs, fish and dairy. There's enough evidence to state that a diet high in meat and fats contributes to colon cancer. Avoid processed and smoked food as and when possible and eat fresh home-cooked food as the staple base diet. A word of caution- antioxidants supplements must always be taken in moderation and after consultation with your clinician.
6. How helpful is exercise?
About 81% of adolescents and one-fourth population of adults do not meet the recommendation for physical activity by WHO. Physical activity of 150-300 minutes of moderate-intensity or 75-150 minutes of vigorous intensity is typically recommended by WHO for adults on a weekly basis. There's strong evidence that exercise has a protective effect against various cancers. Maintaining a healthy weight is the first and foremost advantage of exercise and this itself keeps most diseases at bay. Exercise also keeps inflammation and sex hormones in check and is a great way to keep our immune system working.
7. How about the influence of hereditary factors on cancer?
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About 10% of cancers may be attributed to an inherited genetic mutation. The biology and profile of such tumors are different. A few examples are breast, ovary and colon cancers.
Thus it becomes imperative to conduct surveillance and identify high-risk cases. Signs pointing towards hereditary cancer are cancers in first-degree relatives, rare types of cancers and early age of diagnosis.
8. What is your advice to smokers and tobacco addicts?
Tobacco is the single greatest cause of cancer in India. India has the most number of oral cancers in the world because of rampant tobacco use. Tobacco in every single form is dangerous, be it smokeless or in chewing/snuffing type. Every single whiff/puff of a cigarette is a step closer to developing cancer. Please seek help in getting rid of addictions. Pharmacotherapy in the form of FDA-approved medications can aid in fighting this problem. Nicotine replacement vis-a-vis lozenges and chewing gums are commonly available in markets and can mark your first step to quitting. Behavior interventions (counseling) are extremely useful too. Combining pharmacotherapy with behavioral therapy may actually yield the best results. But then willingness is always the first step.
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9. What are the latest technological advancements in cancer treatment?
Novel therapies such as gene therapy and stem cell therapy are being studied but are yet to be approved by FDA. We now have a few CAR- T cell therapy centers in India. Pertaining to radiation therapy: most urban hospitals of India are well equipped with state-of-the-art advanced equipment to provide a standard of care to cancer patients. Conventional linear accelerators are available in most hospitals. Tomotherapy/ cyberknife is capable of delivering more conformal doses and they are available at certain cancer centers. MR linear accelerators are a notch better in terms of real-time, more conformal treatment for certain cancers. However, very few centers have access to this machine and its technology. Particle therapy is available presently only in two centers in India. It has the huge advantage of sparing normal tissues in comparison to other forms of radiation therapy. Artificial intelligence is a thrilling advancement in the field of medicine. It is being used to assess the tumor response and for individualizing treatment plans.
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10. What are the warning signs to watch out for?
Look out for any signs and symptoms that may be out of the ordinary. Any persistent form of lump or swelling, nonhealing ulcers, altered bowel habits, and bleeding are some of the warning signs that need to be looked into.
Most importantly, when you discover anything abnormal in your body, do not feel hesitate in seeking medical help.
11. What is your message to the people on World Cancer Day?
Our body is the greatest gift we receive and taking care of it is one of our biggest responsibilities. Only when we are in a sound body and mind, can we contribute to a healthier, better society and a nation. Minor lifestyle changes will go a long way in protecting us against a myriad of ailments. In the words of William Shakespeare 'Our bodies are our gardens- our wills are our gardeners'.
