Oncology in India

Oncology is the branch of medicine that focuses on the research, prevention, diagnosis, and treatment of cancer. A medical professional who specializes in diagnosing and treating people with cancer is called an oncologist.

An oncologist can design a treatment plan based on detailed pathology reports that shows the type of cancer the patient has, how much cancer has developed, how fast the cancer is likely to spread, and what parts of the patient's body are involved.

The field of oncology has three main areas, which include:

• Medical oncologists use chemotherapy, hormonal therapies, and other types of targeted treatments to treat cancer. Most people think of medical oncologist as their primary cancer doctor. Medical oncologists help monitor and maintain patients' well-being, as well as helping patients manage side effects. Often patients follow up with their medical oncologist once their treatment is complete.
• Surgical oncologists perform the surgical removal of the tumor and surrounding tissue. They will help patients prepare for and recover from any surgical procedure they undergo during their cancer treatment. If your primary doctor suspects that you have cancer, a surgical oncologist is likely one of the first doctors you see. Surgical oncologists can perform biopsies, which involves removing a small tissue sample to be checked for cancer cells.
• Radiation oncologists treat cancer using radiation therapy. They use high-energy photon beams to target and destroy cancer cells. Approximately one-half of all cancer patients will undergo radiation treatment during their cancer care.

Because most cancers are treated with a combination of therapies, you could see two or all three different oncologists during the course of your treatment.

Besides the three main areas, there are also several other areas of oncology. These include:

• Pediatric oncologists diagnose and treat cancer in children. Some types of cancer appear more often in children and teenagers, such as leukemia, brain tumors, osteosarcoma, and Ewing’s sarcoma. Some pediatric oncologists focus on conducting research on childhood cancers, while others specialize in certain types of cancer.
• Gynecologic oncologists treat cancers that affect women, such as cancer of the ovary, cervix, uterus, vagina, and vulva. Additionally, they also treat complicated gynecological conditions that are not cancerous, such as fibroid tumors and endometriosis.
• Hematologist-oncologists diagnoses and treats blood cancers, such as lymphoma, leukemia, and myeloma. They may also specialize in the management of solid tumors.

Oncologists usually work with a variety of other medical professionals, including pathologists, diagnostic radiologists, oncology nurses, and oncology social workers. They may also work with doctors from other areas of medicine, such as neurologists, dermatologists, or urologists.

What does Oncology Involve?

There are many types of procedures to treat cancer. The types of procedures that you receive will depend on the type of cancer you have and how advanced it is. Some people who have cancer will only have one treatment. However, most people have a combination of treatments, such as surgery with radiation therapy and/or chemotherapy. Below are the types of procedures to treat cancer:

Chemotherapy

Chemotherapy is a type of treatment that uses drugs to kill cancer cells in the body and prevent them from growing. The drugs can prevent cell division, target the food source of the cancer cells’ (the hormones and enzymes the cells need to grow), and trigger apoptosis (a process in which cancer cells kill themselves).

• Chemotherapy drugs can be given in several different ways, including.
• Oral – taken in a pill or capsule form.
• Intravenously – through an infusion into a vein.
• Shots – injected with a needle.
• Topical – applying creams or gels into the skin. This type is used to treat certain types of skin cancer.

Chemotherapy drugs can also be given directly to cancer or directly to an area of the body, such as the abdomen or central nervous system.

Immunotherapy

Immunotherapy, or biologic therapy, boosts your body’s natural defenses to fight cancer. It uses substances made by your own body, or in a laboratory, to improve or restore your immune system function. It can stop cancer from spreading to other parts of the body, stop or slow the growth of cancer cells, and help your immune system work better at destroying cancer cells.

There are several types of immunotherapy to treat cancer, including immune checkpoint inhibitors, T-cell transfer therapy, monoclonal antibodies, treatment vaccines, and immune system modulators. Different types of immunotherapy may be given in different ways, such as intravenous (IV), oral, intravesical (directly into the bladder), or topical.

Targeted therapy

Targeted therapy uses drugs that are designed to specifically “target” cancer cells without affecting normal cells. It targets the cancer’s specific proteins, genes, or other tissue environment contributing to cancer survival and growth. These proteins and genes are found in cancer cells or in cells related to cancer growth.

The targeted drugs can block or turn off chemical signals that tell cancer cells when to divide and grow, stop making new blood vessels that feed cancer cells, change proteins within the cancer cells so the cells die, trigger the immune system to kill cancer cells, and carry toxins in the cancer cells to kill them.

• There are two types of targeted therapy:
• Small-molecule drugs, which is given through pills or capsules that you swallow
• Monoclonal antibodies, which are given through a needle in a blood vein.

Radiation Therapy

Radiation therapy uses intense energy beams to kill cancer cells and shrink tumors. It most often uses X-rays, but other types of energy, such as protons may also be used.

Radiation therapy can be done in two ways:

• External-beam radiation therapy – this type of radiation therapy delivers radiation from a machine outside the body. You will lie on a table, and the machine (called a linear accelerator) moves around you to deliver radiation from several different angles. It is a quick and painless procedure.
• Internal radiation therapy – also called brachytherapy, involves both temporary and permanent placement of radioactive sources in the body. During the placement of the radioactive sources, you will be given anesthesia.

Hormone therapy

Hormone therapy stops or slows the growth of cancer that uses hormones to grow. It works by blocking your body’s ability to produce hormones or interfere with how hormones behave in your body. It can reduce the chance that cancer will return by stopping or slowing its growth, as well as preventing or reducing symptoms in men with prostate cancer.

Hormone therapy is usually used to treat breast and prostate cancer. It can be taken in many ways, including orally, through an injection, and surgery.

Stem Cell Transplant

People whose blood-forming stem cells are damaged by the very high doses of radiation therapy or chemotherapy can undergo stem cell transplant to restore the cells. Blood-forming stem cells are vital since they grow into different types of blood cells that you need to be healthy. The stem cells will be given to you through an IV catheter. The process is very much like receiving a blood transfusion.

Surgical treatment

Surgical treatment for cancer is a procedure to remove cancer from your body. There are many types of surgeries to treat cancer, which differ based on the part of the body that requires surgery, the purpose of the surgery, the amount of tissue to be removed, and your preference. In general, the surgery can be open or minimally invasive.

• During open surgery, one large incision is made to remove the tumor, some healthy tissue, and some nearby lymph nodes.
• During minimally invasive surgery, a few tiny incisions are made instead of a large one. These incisions are made to insert a laparoscope (a long, thin tube with a camera on its end) and special surgical tools. The laparoscope allows your surgeon to see the inside of the body, and the surgical tools are used to remove the tumor and some healthy tissue.

How Long Should I Stay in India?

For chemotherapy, radiation therapy, immunotherapy, hormone therapy, and targeted therapy, the treatment schedule may vary. You may have treatment every day, week, or month. It may also be given in a cycle, which is a period of treatment followed by a period of rest to give your body a chance to recover. For surgical treatment, you may need to stay in the hospital for a few days, and you need to stay in India for at least 10 to 14 days. Your oncologist and/or medical tourism team will advise you on the length of stay in India.

What's the Recovery Time?

The type of procedure you undergo determines the recovery period. While you may be able to get back to your normal routine within 10 days after laparoscopic surgery, you may need to wait around 6 weeks to fully recover from open surgery. Your oncologist will give you a detailed recovery timeline.

What About Aftercare?

You will be given instructions on how to take care of yourself. Your surgeon or nurse will explain how to control your pain, how to take care of your wound, activities you can and cannot do, and how to spot signs of infections. You may also need to talk to a dietitian to help with eating problems caused by the treatment. You will need to attend follow-up checkups to monitor your condition.

What's the Success Rate?

Cancer survival has improved significantly due to constant advancement and improvements in the field of oncology, including improvement in treatments and screening (allowing for earlier diagnosis). Still, you need to be aware of the risks, such as infection, bleeding, nerve damage, fatigue, nausea, vomiting, and hair loss.

Are there Alternatives to Oncology?

There is no other alternative than to see an oncologist when it comes to cancer treatments. Some people may choose to undergo meditation, hypnosis, and acupuncture as well, usually to relieve the stress, anxiety, and pain that cancer can bring.

Oncology in and around India

About India

As the largest country in South Asia and the seventh-largest in the world, India is home to over one billion inhabitants. This extremely diverse country boasts one of the world’s fastest-growing economies and with its 38 JCI accredited facilities, it’s considered a prime destination for Medical Tourism. India welcomes an ever-increasing number of medical tourists each year, many of which travel for Oncology procedures. Its low-cost medical procedures draw tourists from all over the world, particularly Western and Middle Eastern countries. Highly specialized doctors speak English and the vast majority are trained in the UK or the US, with heart surgery procedures being especially common in India. Local accreditation bodies include the Indian Healthcare Federation, the Indian Medical Tourism Council, the Ministry of Health and Family Welfare, and the National Accreditation Board for Hospitals & Healthcare Providers (NABH)

Popular Parts of India

Home to around 1.3 billion people, India is the second-most populous country in the world, with its multi-ethnic society, spiritual beliefs, architecture, and diverse wildlife.

• Delhi is brimming with colorful modern life and is steeped in history. It is known to have the best food in the world such as Mughalai curries and chaat (vegetarian street food). Visit the Red Fort and witness the fascinating structure influenced by Islamic, Hindu, Persian, and Timurid traditions.
• Mumbai is the most cosmopolitan city in India. Home to Bollywood, India’s film industry, the city has a lot to offer. Stroll around the Gateway of India, shop in Colaba Causeway, watch the sunset in Marine drive, or visit Siddhivinayak Temple and learn about its cultural history.
• Kolkata (Calcutta) was once the capital city of India. It is a perfect blend of the past and the present. The city has charming colonial-era architecture, dynamic suburbs, and the amazing Bengali cuisine. Tourists can discover the creativity of Kurmatuli Idol-makers and visit the incredible Victoria Memorial.
• Jaipur is known as “The Pink City,” it is chaotic, vibrant, and historical.  The city, along with Delhi and Agra, is a part of the Golden Triangle that contains the biggest attractions in India. There are many beautiful buildings inside this city, but the most visited one is the Amer/Amber Fort that dates back to Raja Man Singh. It is a World Heritage Site and it offers amazing views of the city.
• Agra is where the magical Taj Mahal stands. The UNESCO World Heritage Site is as astounding as people describe it to be. Mehtab Bagh is another must-visit attraction; it offers the most scenic spot in the city and located just across the river from the Taj Mahal. Agra Fort, located northwest of the Taj, is one of India’s most historic structures.

Weather and Climate in India

There are four climatological seasons in India.

• Summer or pre-monsoon season starts in March and ends in May. April or May is the hottest month. The average temperature is around 23 to 42 °C.  
• Monsoon or rainy season lasts for three months from June to September. The season is usually humid and rainy. South India usually receives more rainfall.
• The post-monsoon or autumn season starts from October to November. The sky is usually cloudless.
• Winter occurs from December to February. December and January are the coldest months in the country with an average temperature of 10 to 15 °C and climb steadily from February. This is the peak season for tourism.

The best time to visit India is in the month of March or October when the weather is warm and sunny.

Getting Around in India

Indira Gandhi International Airport is the busiest airport in the country and is located in Delhi. The airport serves domestic and international flights. It connects the city with almost every country around the world and serves budget airlines such as Air Asia India, Go Air, and IndiGo. There are three other main international airports in Mumbai, Chennai, and Bengaluru.

The most affordable way to travel around the city is by bus although it can be very crowded. Buses are very reliable and fast. Airport taxis are available as a quick, easy, and hassle-free transportation mode especially for tourists who carry big baggage.

The best way to get around India is by train. Trains are everywhere and quite affordable with many different classes. The most popular class for travel is the Sleeper Class. It is best to purchase train tickets online.

Buses are a nice option for short-distance travel. Some of the buses can be very uncomfortable but there are luxury buses with air conditioning. Tourists can purchase tickets online, in the station, or even on the buses.

Taxis are relatively affordable, but tourists have to bargain. Tourists can ask the taxi driver to use the meter but the drivers will usually say it’s broken. It is advised to ask your hotel or hostel how much a taxi should cost before getting in one to avoid getting ripped off by taxi drivers. Rickshaws (Tuck-Tuks) are cheaper than taxis, but you also have to bargain. Hiring a car is not recommended due to the lack of respect for traffic laws and the chaos on the roads. Uber is available.

Tourist Visas in India

All visitors need to obtain and apply for a visa to enter India, except the citizens of Nepal and Bhutan. Visa on Arrival is available for citizens of Japan and South Korea. The country provides an online visa application. e-Visa is available for 150 nationalities and valid for  60 days. It is a double-entry visa. There is also a six-month tourist visa for longer trips.

Passport must be valid for at least 180 days after your entry to India and should have at least two blank pages.

Additional Information

1. Local Currency: the official currency is the Indian rupee (INR). 1 USD is equivalent to 70 INR.
2. Money & Payments: ATMs are widely available. Currencies such as US dollars, euros, and pounds sterling are easy to change throughout the country. Credit and debit cards are accepted in some shops, restaurants, and hotels. Always carry cash because many places still accept cash only. Service fees are sometimes added to the bills automatically in restaurants if it’ 10% tip is reasonable. Taxis and rickshaws do not expect a tip but it is good to tip drivers who are honest.
3. Local Language: There are many languages spoken in India including Hindi, Bengali, Telugu, Marathi, Tamil, Urdu, Gujarati, and Punjabi. English is understood by many people especially those in the tourism area and major cities.
4. Local Culture and Religion: India is very diverse and multicultural. Hinduism is the largest religion with 79.8% of the population practicing the religion. Islam, Christianity, Sikhism, and other religions are also practiced.
5. Public Holidays: India celebrates several major religious holidays. The country has numerous annual festivals such as Holi, Ganesh Festival, Diwali, and Onam.