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Reports |
CPAA's Dr. Shubha Maudgal was invited to attend Project LEAD organized by the National Breast Cancer Coalition Fund at Madrid from June 20-26. Here is her report. Project LEAD (Leadership, Education and Advocacy Development) is an innovative science programme designed to train breast cancer activists. Dr. Shubha Maudgal was one of 35 participants from 25 countries chosen from 80 applications received from all over the world to attend the programme which was held in Madrid, Spain from 20th-26th June, 2004. The intensive 5-day course is designed to help activists effectively influence research and public policy in all the forums where breast cancer research decisions are made. The curriculum included lectures and study sessions on cell biology, cancer microbiology, genetics, cancer epidemiology and critical appraisal of research design. The National Breast Cancer Coalition Fund (NBCCF) is a grassroots organization dedicated to ending breast cancer through the power of action and advocacy. More than 600 organisations and tens of thousands of people bring their power and voice to NBCCF's network. The coalition is committed to ensuring that breast cancer advocates are involved in all policy and research decisions affecting breast cancer. NBCCF has successfully spearheaded the effort to increase government spending for breast cancer research in the US. Project LEAD was started in 1995 with the intention of empowering advocates all over the world by providing them with the tools to hold their own in a discussion regarding breast cancer research. Since then 1000 persons have been trained in the course. This was the first time the course was offered outside the United States. This was done as a result of requests by international advocates and in consultation with international and US based scientific organizations and advocacy groups from all over the world. The faculty for Project LEAD was drawn from international academic and research institutions including the University of Hamburg, Germany; Guy's and St. Thomas Cancer Centre, UK; University of Oslo, Norway; the Cochrane Collaboration, Spain; Brown University, US. Participants came from Argentina, Australia, Bangladesh, Cyprus, Croatia, England, Estonia, France, Germany, India, Italy, Namibia, Nigeria, Pakistan, Poland, Romania, South Africa, Spain, Ukraine and Venezuela and represented breast cancer organizations working in the field. The sessions started every day with a moment of silence in memory of participants who had succumbed to breast cancer and ended with motivating messages from past attendees. The first lecture related to the basic science and biology of cancer, the differences between benign and malignant growths and the mechanism of metastasis. The principles of genetics and inheritance, types of common disorders and their detection were covered. The structure of DNA, RNA and proteins and flow of information between the three was explained. A clinical overview of the anatomy, physiology and function of the healthy breast, common problems and the diagnosis, staging and treatment options for breast cancer were taught. The importance of understanding diagnostics, preventive and treatment options for breast cancer and ensuring that they are grounded in scientific evidence was stressed. Mutations or alterations in DNA and their consequences at the molecular and at the individual level were explained. These concepts and that of the oncogene and tumour suppressor gene were used to define how breast cancer occurs. The course also covered the principles of epidemiology, breast cancer statistics worldwide. Such terms as incidence prevalence and mortality were elucidated. A lecture was also given on risk and protective factors for breast cancer and predictive and prognostic factors. A great deal of emphasis was placed on setting up research work, the difference between cohort and case control studies. Clinical trial practice, purpose, randomization and endpoints were explained. A useful topic was how to find information from the internet. The programme directed us to constantly question the accuracy of facts we had previously taken for granted. By providing a meeting ground for people working towards a common goal all over the world, it helped to highlight both the similarities and differences in problems faced. All the alumni will now stay in touch and share each other's successes and failures. In future we will be able to draw from each other experiences and move closer to a solution to the question of how to stop breast cancer. Talk on Brain Tumours by Dr. R. Jalali As a part of our efforts to update our knowledge on cancer related subjects, Dr. Jalali, radiation oncologist at Tata Memorial Hospital, was invited to address a group of CPAA employees and volunteers from different NGOs and hospitals at Pikale Nursing Home, Mahim. The topic of the talk was "Brain Tumours." The brain consists of different kinds of tissues and cells and different types of benign and malignant tumors, which start in these cell and tissue, vary in prognosis and treatment. Infiltrating astrocytomas, which start in astrocytes are graded as low grade (slowest growing), intermediate grade, or high grade. Oligodendrogliomas start in brain cells called oligodendrocytes. Ependymomas arise from the ependymal cells that line the ventricles and may block the exit of cerebrospinal fluid from the ventricles causing the ventricle to become very large - a condition called hydrocephalus. Tumors of the brain differ from tumors in other parts of the body, the most deadly aspect of which is its ability to spread throughout the body. Brain tumors can spread to other parts of the Central Nervous System (CNS), but they almost never spread to other organs, however they can interfere with functions of the brain that are essential for life. Brain tumours are initially suspected because of the symptoms they cause which occur gradually and become worse over time. Sometimes these symptoms happen suddenly, like a stroke. Tumors within any part of the brain may cause pressure to rise within the skull. Increased pressure within the skull may cause headache, nausea, vomiting, or blurred vision. Headache is a common symptom of brain tumor, occurring in about 50% of children with brain tumors. In some children increased intracranial pressure causes crossed eyes and double vision or even visual loss. If a brain tumour is suspected, the doctor will take a complete medical history and perform a physical examination to evaluate the brain function of the patient and if a significant brain problem is present, he or she will usually order one or more imaging studies, such as the CT (computed tomography) scan and the MRI (magnetic resonance imaging) scan which will show a brain tumor in almost all cases and in addition, will tell the doctors exactly where it is located. However, a definite diagnosis of brain cancer is made only by removing some of the cancerous tissue for examination under the microscope. Tissue for diagnosis may be obtained by a neurosurgeon, who surgically opens the skull and removes as much of the tumor as possible. Alternatively, in a procedure known as stereotactic biopsy, a small piece of tissue is removed using a thin needle carefully guided to the tumor with the help of a CT or MRI scan and a computer and examined under a microscope to determine exactly what type of tumor is present. Examination of the cancerous tissue is usually necessary to determine the chances of survival and the best treatment. Brain tumors may be treated by surgery, radiation therapy or chemotherapy or a combination of these treatments is used. Treatment must be approached individually to give the greatest chance of cure and minimize long-term side effects. Generally, the first step is for the neurosurgeon to remove as much of the tumor as he or she can. Surgery alone or combined with radiation therapy may cure some tumors. Surgery is aimed at reducing the amount of tumor that needs to be treated by radiation or chemotherapy, improving the results of these treatments and some of the symptoms. Radiation from an external source focused precisely on the tumor is called external beam radiation. This is similar to a diagnostic x-ray except that the dose is much greater, the treatments last longer and are given over a period of a few weeks. Radiation may also be given by placing radioactive material directly within the tumor, called interstitial radiotherapy or brachytherapy. Because high doses of radiation therapy can damage a child's normal brain tissue, the radiation oncologist must deliver high doses of radiation to the tumor with the lowest possible dose to normal surrounding brain areas. Techniques such as 3D treatment planning (conformal radiation) and stereotactic radiosurgery (with a "gamma knife" or a linear accelerator) have been developed to spare normal tissue Radiation tends to be most effective against rapidly growing cells. As a result, high-grade tumors tend to be initially more responsive to radiation than low-grade tumors. Up to one half of all medulloblastomas, which are very common in children, and virtually all germinomas are cured by radiation therapy. Unfortunately, most brain tumors are not cured by radiation. Brain stem gliomas cannot usually be removed surgically unless they occur as a localized tumor. Most often they infiltrate throughout the brain stem. Since the brain stem is vital to life, a neurosurgeon cannot remove these infiltrating tumors and they are usually treated only with radiation. Chemotherapy is sometimes added. Chemotherapy uses anticancer drugs that are delivered into a vein (IV) or taken by mouth. In brain cancers sometimes the drugs may be given directly into the ventricles or into the spinal canal below the spinal cord. These drugs are generally used only for high-grade cancers, and are often given together with or following surgery and radiation therapy. Some of the chemotherapy drugs used to treat brain tumors include cyclophosphamide, melphalan, lomustine (CCNU), carmustine (BCNU), etoposide, thiotepa, cisplatin, carboplatin and vincristine. These drugs may be used singly or in various combinations, depending on the specific type of brain tumor. Dr. Jalali concluded the highly informative talk by mentioning that for further information the reader can access the website braintumourindia.com. CPAA would like to thank Dr. Jalali for taking time out from his busy schedule to share this useful information with us. Iva
Athavia delivered awareness lectures at Bharat Seva Sangh and at Mapkhan
College for 250 students. Mrunal Marathe spoke to over 150 persons at
lectures organized by TMH for the Nursing Association of Oncology, Vatsalay
and at IC Colony, Borivli. Maya Lele, a student in the US, spent her summer
vacation as a volunteer with CPAA, helped to develop an awareness lecture
specially targeting school students. The lecture, presented by her and
Alka Kapadia, was greatly appreciated by students of JB Vaccha, Don Bosco
and Avabai Petit Schools. Over 600 children attended the lectures. Prevention
and Early Detection
28 camps and OPDs were held during the month of June and 11 during July. Camps were held at Bombay Dyeing, Patalganga (8 camps); Mulund West, Child Eye Care Charitable Trust, Malad and Dahisar, Surya Niketan Hospital, Uttan, Parle Bisleri, Shiv Sena, Sewree (2 each). An ENT check up was arranged at Naigaon Police. A total of 482 people, 315 males and 167 females were screened in the camps and clinics in June and 501 people, 345 males and 156 females in July. 317 people were advised follow up. 14 OPDs and clinics were held during June and 4 during July. 164 males and 299 females were screened. 148 people were advised follow up. Two women were detected with breast cancer during the two months at our Naigaon Clinic. A 43-year-old lady is undergoing primary chemotherapy at Cama Hospital while a second lady was operated on by CPAA's panel doctor and will start her chemotherapy at Tata Memorial Hospital. The Diagnostics services team would like to convey their gratitude to Unity Charitable Trust who donated a cassette player for our playgroup at Ernest Borges Home.
The Smt. Lila Kishanchand Shahani Clinical Diagnostic Centre screened 287 persons during June and 350 persons during July. 1485 tests were performed, out of which 1172 were pathology tests. 215 sonography, 62 x-ray and 27 mammography investigations were carried out. 9 ECGs were performed.
During June 202 people were examined, of whom 22 had come for the first check-up and 180 for renewal check up. Rs. 72,561 was disbursed towards the 4 claims settled. During July 51 people were examined, out of whom 29 had come for the first check-up and 22 for renewal check-up. Rs. 2,05,037 was disbursed against the 4 claims made. 214 claims have been settled to date and over Rs.72 lakhs has been disbursed. Three policyholders were detected with cancer during the two months. A 61-year-old man, diagnosed with non-Hodgkins Lymphoma, underwent treatment at Hinduja Hospital. A 74-year old man was diagnosed with prostate cancer and is undergoing treatment at Hinduja Hospital. A 53-year old man was diagnosed with cancer of the pancreas. One of our policyholders expired. [Top] Patient Care
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PATIENT CARE AND REHABILITATION (SUMMARY) |
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|
|
Dec |
Jan |
Feb
|
Mar
|
Apr
|
May
|
Jun
|
July
|
|
Total
no. of patients aided |
917 |
1048 |
1129
|
1151
|
851
|
1175
|
997
|
774
|
|
Ambulance
service availed |
801 |
650 |
507
|
735
|
646
|
5
|
701
|
422
|
|
Visits
(hospital + home) |
813 |
8 |
6
|
6
|
80
|
29
|
94
|
108
|
|
Total
aid given (Rs lakhs) |
3.69 |
2.49 |
2.42
|
2.34
|
2.79
|
2.52
|
2.26
|
2.32
|
|
Medicine
(Rs lakhs) |
2.26 |
2.10 |
2.40
|
2.10
|
2.39
|
2.21
|
2.07
|
2.09
|
|
Patient
stipend (Rs lakhs) |
1.92 |
1.91 |
1.70
|
2.08
|
1.74
|
1.97
|
1.84
|
1.90
|
996
patients and 774 patients were aided, counseled and given guidance at
our locations in Mumbai-Smt. Panadevi Dalmia Cancer Management Centre;
at Nair Hospital Radiation Centre; Cama & Albless, Wadia and Tata Memorial
Hospitals; and at Bharat Sevashram Sangh in June and July respectively.
Over 1100 patients availed of ambulance facilities, including 93 patients
who availed of the stretcher service for long distances. 218 home and
institutional visits were made. 24 of our patients expired.
At Tata Memorial Hospital: Room No. 189, Golden Jubilee Block
Palliative
Care Unit at Tata Memorial Hospital
Mrunal Marathe counseled 34 patients, 21 males and 13 females during the months of June and July. 8 cases of head and neck, 4 of abdominal cancer, 10 cases of leukemia and 12 other cases were seen.
Mrunal met the teenage mother of a 3-year-old child suffering from retinoblastoma. Her husband had left her to deal with the illness on her own. During the counseling session, the information the girl requested was not about the child but how to apply for a passport. She confessed that she was tired of struggling and wanted only to leave India and find a job in the Middle East. She had no idea of what she would do there and only wanted an escape route from the realities of her present situation.
At Bai Jerbai Wadia Hospital for Children
23 new patients were registered during each of the months of June and July. 962 patients attended follow up of whom 1050 patients are undergoing chemotherapy. 65 patients were counseled. Vinaya Chacko visited 13 patients in their wards. 7 group meetings were held. 60 patients were given packets of Complan and 65 packets of biscuits were distributed. 30 children were given toys
64 patients were counseled and given guidance by Iva Athavia during June and 89 patients during July. 197 ward visits were made. 53 patients were provided guidance regarding alternative therapy. 10 terminally ill patients were referred to Shanti Avedana Ashram. 110 persons attended group meetings on diet and hygiene. Rs. 32,447 was donated towards treatment.
Nair Hospital (Radiation Department)
83 patients were counseled and given guidance at the Counseling Cell at Nair Hospital Radiation Department by Iva Athavia during June and July. 34 ward visits were made. 7 terminally ill patients were referred to Shanti Avedana Ashram. 22 patients were given information about alternative forms of medicines. Rs. 31,206 was donated towards treatment and our volunteers raised a further Rs.21,128.
Counseling at Bharat Sevashram Sangh
Iva
Athavia also counsels patients at Bharat Sevashram Sangh, Vashi every
Friday evening. 106 patients were counseled and guided during June and
July. 67 group meetings on radiation, diet and hygiene were organised.
21 patients were given information regarding alternative treatment.
[Top]
"Can I Help You?" Desk at Tata Memorial Hospital's Private OPD
Jennifer Quadros mans the "Can I Help You?" desk at Tata Memorial Hospital's Private OPD Registration Counter area every day from 9-12. During June and July Jennie helped 667 patients. She provided information on various kinds of cancers to almost 3000, helped over 1500 in filling up forms and gave literature on cancer to 929 patients. CPAA has also provided newspapers for the benefit of patients waiting in the registration area. Almost 2000 patients made use of the facility. 74 patients were given chocolates. Many patients have expressed their gratitude for Jennie's cheerful, smiling presence.
The Rehabilitation Centre adopted 5 new patients during the months of June and July. 220 patients and their family members were given assistance. 22 cases of mastectomy were attended and breast prostheses were provided. Over 500 patients were given rations worth over Rs.52,809. Rs.25,000 was spent on teachers' salaries, for patient education and vocational training. Rs.2.34 lakhs were spent on patients' wages and Rs.50,000 was spent on welfare activities, conveyance and diet supplements during the two months.
Cancer Patients
Aid Association Monthly Review is compiled by Dr. Shubha Maudgal and printed
by Mr. Suresh Mishra at Saraswati Printing Press
Please
write in with your comments to: Smt. Panadevi Dalmia Cancer Management
Centre, Anand Niketan, King George V Memorial,
Dr. E. Moses Road, Mahalaxmi, Mumbai-400 011
Phone: 24924000, 24928775, Fax: 24973599,
Email: webmaster@cpaaindia.org