Narayana Health Care, Delhi

Introduction: Liver cancer is a formidable adversary, claiming the lives of thousands of people every year. However, there is a glimmer of hope on the horizon in the form of liver transplantation. This medical procedure, which involves replacing a cancerous liver with a healthy one, has the potential to offer a second chance at life for those battling this deadly disease. In this blog, we will explore the relationship between liver cancer and transplants, shedding light on the lifesaving combination that has given hope to many. A. Understanding Liver Cancer a. The Nature of Liver Cancer Before delving into the role of liver transplantation in treating liver cancer, it's essential to understand the disease itself. Liver cancer, also known as hepatocellular carcinoma (HCC), is a malignancy that originates in the liver cells. b. Silent Progression and Early Detection Challenges It is often associated with chronic liver diseases such as cirrhosis, hepatitis B, and hepatitis C. Liver cancer typically progresses silently, with symptoms appearing at advanced stages, making early detection challenging. B. The Role of Liver Transplantation Liver transplantation has emerged as a critical treatment option for individuals with advanced liver cancer. Here's how it works: 1. Selecting Suitable Candidates Not every patient with liver cancer is a suitable candidate for transplantation. To be considered, the cancer must meet specific criteria, including size and number of tumors and the absence of tumor invasion into blood vessels or other organs. Additionally, the patient's overall health and the severity of their liver disease are assessed. 2. Pre-Transplant Therapy: Some patients undergo treatments like local ablation (destroying the tumor with heat or cold) or transarterial chemoembolization (delivering chemotherapy directly to the tumor) to control tumor growth and reduce the risk of cancer recurrence post-transplant. 3. Transplant Surgery: When a patient is deemed eligible, a suitable donor liver is obtained, and the transplant surgery is performed. The cancerous liver is removed, and the healthy donor liver is implanted in its place. 4. Post-Transplant Care: After the surgery, patients require lifelong immunosuppressive medications to prevent organ rejection. They also undergo regular follow-up examinations and imaging to monitor for cancer recurrence. C. Benefits of Liver Transplants for Liver Cancer Patients 1. Improved Survival Rates: Liver transplantation offers the best chance of long-term survival for patients with early-stage HCC compared to other treatments. 2. Elimination of Cancer: Removing the cancerous liver eliminates the tumor, reducing the risk of recurrence compared to treatments that leave the diseased liver in place. 3. Improved Quality of Life: Post-transplant, patients can experience an improved quality of life, as they are no longer burdened by the debilitating effects of liver cancer and cirrhosis.Reduced Cancer-Related Symptoms: Symptoms such as abdominal pain, jaundice, and fatigue often improve or disappear entirely after a successful transplant. D. Challenges and Considerations While liver transplantation for liver cancer is a beacon of hope, it comes with its own set of challenges and considerations: 1. Limited Donor Organs: The availability of donor organs is limited, leading to long waiting lists for transplant candidates. 2. Eligibility Criteria: Strict eligibility criteria mean that not all liver cancer patients can benefit from transplantation. 3. Immunosuppression: Lifelong immunosuppressive medications increase the risk of infections and other complications. 4. Cancer Recurrence: While transplantation reduces the risk of recurrence, it is not entirely eliminated, and careful monitoring is essential. Certainly, let's explore the topic of liver transplantation for liver cancer in more detail, including recent advancements, the importance of early detection, and the need for increased awareness. E. Advancements in Liver Transplantation for Liver Cancer Over the years, significant advancements in surgical techniques, immunosuppressive medications, and post-transplant care have greatly improved the outcomes of liver transplantation for liver cancer patients. Some notable developments include: 1. Living Donor Transplants: In cases where deceased donor organs are scarce, living donor liver transplantation has emerged as a viable option. A healthy individual donates a portion of their liver to the patient, and both the donor and recipient livers regenerate, allowing for successful transplantation with reduced waiting times. 2. Precision Medicine: Advances in precision medicine have led to tailored treatment plans for liver cancer patients. Molecular profiling of tumors helps oncologists choose the most effective therapies, including targeted therapies and immunotherapies, before and after transplantation. 3. Post-Transplant Surveillance: Regular surveillance through imaging techniques such as MRI and CT scans, along with tumor marker testing, helps detect cancer recurrence at an early, treatable stage. Timely intervention is crucial to improving long-term survival rates. F. Importance of Early Detection Early detection of liver cancer plays a pivotal role in the success of transplantation. Unfortunately, liver cancer is often asymptomatic in its initial stages, making routine screenings essential, especially for individuals at higher risk due to underlying liver diseases. Common risk factors for liver cancer include: Chronic hepatitis B or C infections. Cirrhosis, often caused by excessive alcohol consumption or non-alcoholic fatty liver disease (NAFLD). Obesity and metabolic disorders. Exposure to aflatoxins or other environmental toxins. Regular screenings can detect liver cancer at an early, potentially curable stage when transplantation is most effective. Patients diagnosed at advanced stages may not be eligible for transplantation and may have limited treatment options. G. The Need for Increased Awareness Increasing awareness about liver cancer and the potential benefits of liver transplantation is critical. This includes educating the public, healthcare providers, and at-risk individuals about: The risk factors associated with liver cancer. The importance of regular check-ups and screenings for those at risk. Available treatment options, including transplantation, for eligible patients. The role of organ donation and the need for more registered organ donors to address the shortage of donor livers. Government initiatives, healthcare organizations, and advocacy groups can work together to promote liver cancer awareness campaigns and organ donation drives, ultimately saving lives and reducing the burden of this devastating disease. Conclusion In conclusion, liver transplantation for liver cancer represents a powerful treatment option that can offer hope and extended life to individuals facing this challenging diagnosis. With ongoing advancements in medical science, early detection efforts, and increased awareness, we can continue to improve the outcomes and accessibility of this lifesaving procedure for those in need.

IntroductionThe field of chest medicine, also known as pulmonology, is of paramount importance in today's world. As respiratory health concerns continue to rise, the expertise of chest specialists becomes increasingly vital. India is home to some of the world's most renowned chest specialists who have made significant strides in the diagnosis, treatment, and prevention of respiratory diseases. In this blog, we will introduce you to the top 10 chest specialists in India, celebrated for their dedication, expertise, and innovations in respiratory health. 1. Dr. Arun Chowdary Kotaru Dr. Arun Chowdary Kotaru is a Respiratory/ Pulmonology specialist with 9 years of experience. He passed out as the best going student from AFMC, Pune and is an enthusiastic and vivid clinician with patient-centric management. He is currently associated with Artemis Hospitals, Gurugram as a Consultant-Respiratory/ Pulmonology & Sleep Medicine. Dr. Kotaru completed his MBBS from GSL Medical College, Rajamahendravaram, and post-graduation in Respiratory Medicine from AFMC, Pune. He also holds a DNB in Respiratory Medicine. He is an active member of the Indian Chest Society (ICS). Dr. Kotaru's clinical focus is on Pulmonary Hypertension, Sleep, and Interventional Pulmonology. He is capable of performing all the latest pulmonary interventions available to date, including Bronchoscopy, Bronchoalveolar lavage, Transbronchial lung biopsies, Transbronchial needle aspiration, Thoracoscopy and pleural biopsy, and Endobronchial ultrasound + TBNA. Dr. Kotaru is the recipient of several awards, including the AFMC Gold Medal in the specialty of Respiratory Medicine and the Best Paper Presentation Award in NAPCON 2015, Jaipur. He is committed to providing the best possible care to his patients with his vast experience and expertise. Awards AFMC Gold Medal in the speciality of Respiratory Medicine Best paper presntation award in NAPCON 2015, Jaipur 2. Dr. Avi Kumar Dr. Avi Kumar joined the prestigious institution through Delhi PG Medical Entrance Examination 2006 and underwent a three year postgraduate residency programme in pulmonary medicine. Dr Kumar is extensively trained in - Intensive respiratory care unit:Mechanical ventilation (Siemens Servo-i), non invasive ventilation ( Respmed BiPAP and CPAP machines), intensive care monitoring, chest tube drainage, pleurodesis, arterial blood gas analysis and other critical care activities. Sleep laboratory:Diagnostic Polysomnography, Split Night Polysomnography with CPAP titration, Multiple Sleep Latency Testing (MSLT) and Maintenance of Wakefulness Testing (MWT). Pulmonary function laboratory:Computerized lung function testing that include spirometry, lung volume estimation by helium dilution method, diffusion studies by CO single breath method, bronchodilator response, exercise bronchoprovocation testing and histamine challenge testing. Fibreoptic Bronchoscopy and Autofluorescence Video Bronchoscopy:Bronchoscopic visualization of tracheobronchial tree, bronchoalveolar lavage(BAL), endobronchial and transbronchial lung biopsy(EBLB and TBLB) and transbronchial needle aspiration(TBNA) for various respiratory disease. 3. Dr. Gyanendra Agrawal Dr. Agrawal has a rich experience of managing a wide variety of critically ill patients especially those with respiratory ailments. He has done more than 1200 flexible bronchoscopies and about 300 medical thoracoscopies. Dr.Gyanendra Agarwal is an esteemed member of the Indian Society of Critical Care Medicine (ISCCM)Indian Society of Critical Care Medicine (ISCCM) and National College of Chest Physicians. Areas Of Specialization Interventional Pulmonology including EBUS. NIV assisted Bronchoscopy. Whole Lung Lavage. ECMO. Current Experience Working as Senior Consultant at Jaypee Hospital, Noida. 4. Dr. Prashant Saxena Fellowship training was completed by Dr. Prashant Saxena at Westmead & Liverpool Hospitals in Sydney, Australia. He has extensive knowledge of interventional pulmonary medicine and critical care. Additionally, he has received training in interventional pulmonary medicine from Greece, thoracoscopy from France, and paediatric bronchoscopy from Italy. He also holds the prestigious European Diploma in Intensive Care (EDIC, Europe), Fellow College of Chest Physicians (FCCP, USA), and European Diploma in Adult Respiratory Medicine (EDARM, Europe). Dr. Prashant has clinical expertise in the treatment of critically ill patients as well as the management of a variety of respiratory conditions, such as TB, Asthma, COPD, chronic lung diseases, Allergy, Respiratory Failure, Lung Fibrosis, Pulmonary Hypertension, smoking cessation, Sarcoidosis, and lung cancer. He is also an authority in sleep problems and interventional bronchoscopy. Dr. Saxena is dedicated to giving his patients the most comprehensive critical care he can. He has devised straightforward yet efficient infection prevention bundle routines as a result of his particular focus in infection control, which have greatly decreased the occurrence of hospital-acquired infections. In order to stop the development of antibiotic resistance, reduce avoidable hospital-associated illnesses, and lower treatment costs, he also devised and executed an antibiotics stewardship programme in the hospital. Treatments: Complicated Lung diseases management Bronchoscopy Chest Disease Treatment Pulmonary Function Test (PFT) Insomnia Treatment Interstitial Lung Disease Treatment Sleep Study Respiratory Tract Infection Lung Cancer Treatment Tuberculosis (TB) Treatment Lung Fibrosis Sleep Apnea Sarcoidosis Sleep Related breathing Disorder 5. Dr. M.S.Kanwar Dr. M.S.Kanwar has 45 years of experience in handling Critical Care, Acute and Chronic Respiratory diseases like Asthma, COPD Allergies, Lung Infections, Interstitial Lung Fibrosis, Sarcoidosis, and Lung Cancer. He is a Pioneer in Sleep Medicine in India and started this field for the first time in a big way in 1995 when he set up Asia's Largest and State of the Art Sleep Lab at Indraprastha Apollo Hospital, New Delhi. His team had done the largest Sleep studies in the country and he gets referrals for Sleep consultation from abroad also. His research papers on Sleep Apnea have been presented in the world conferences on Sleep Medicine. He is involved in training the Lung Transplant staff as well as in spreading the awareness on this cutting edge technology among physicians and the general public because this is a new life-saving modality in severely crippled Lung Failure cases. With 48 years of experience in these domains, Dr. M.S. Kanwar is a pulmonologist and specialist in tuberculous and chest diseases in Sarita Vihar, Delhi. At the Indraprastha Apollo Hospitals in Delhi's Sarita Vihar, Dr. M.S. Kanwar sees patients. In 1974, he earned his MBBS from Guru Nanak Dev University. In 1979, he earned his MD in tuberculosis and respiratory diseases/medicine from the same institution. In 1982, the National Board of Examinations awarded him membership in the National Academy of Medical Sciences (Respiratory Diseases). Fellowships / Memberships a) Fellowship training in Echocardiography University of Alabama, Birmingham(USA) in 1994, USA. b) Fellowship training in Pulmonary & critical care Mayo clinic in 1993-1994, USA. c) Fellowship training in Sleep medicine Mayo clinic in 1993-1994, USA. d) Clinical Observership Training in LUNG TRANSPLANT University Hospital Network(UHN), TGH, TORONTO in Sept. 2019, CANADA. e) FCCP American College of Chest Physicians since 1992, USA. f) FAMS (One Year Fellowship, Cardiology) University of Vienna since 1995, Austria. g) Fellow ISDA Indian Sleep Disorder Association since 2001, India. h) Fellow ISCCM Society of Critical Care Medicine since 2002, India 6. Dr. Mrinal Sircar Dr. Mrinal Sircar is a Senior Consultant in the Department of Oncology at Fortis Hospital in Noida, India. He is a well-regarded medical oncologist with over two decades of experience in the field of cancer treatment and care. Dr. Sircar has completed his MBBS and MD in Internal Medicine from the prestigious All India Institute of Medical Sciences (AIIMS) in New Delhi. He also holds a DNB in Medical Oncology from the National Board of Examinations, New Delhi. Dr. Sircar specialises in the treatment of various types of cancers, including breast cancer, lung cancer, gastrointestinal cancers, and lymphoma. He has expertise in chemotherapy, targeted therapy, and immunotherapy. He also has extensive experience in the management of cancer-related pain and palliative care. Dr. Sircar is actively involved in clinical research and has published several papers in national and international medical journals. He is also a member of various medical societies and associations, including the American Society of Clinical Oncology (ASCO) and the European Society for Medical Oncology (ESMO). Patients have praised Dr. Sircar for his compassionate and patient-center care, his thorough explanations of medical conditions and treatment options, and his ability to make patients feel comfortable and at ease during their appointments. He is dedicated to providing his patients with the best possible outcomes and ensuring that they receive personalized care that meets their unique needs. 7. Dr. Manoj Kumar Goel Dr. Manoj Kumar Goel is one of the eminent Pulmonologists and Critical Care Specialists, having rich experience of latest treatment of respiratory diseases. Dr Kumar is well versed with most modern procedures in Pulmonology but also excels in Advanced Therapeutic Pulmonary Interventions to treat blocked airways. Dr. Goel is also an expert in Sleep Medicine. Awards He has received National Award from National college of Chest Physicians for research in Pulmonary Interventions. Areas Of Interest Asthma COPD Bronchitis Chronic Cough Respiratory Allergy and Infections Interstitial Lung Disease Lung Fibrosis Environmental disorders 8. Dr Nikhil Modi Dr, Nikhil Modi is Presently Working as a Consultant in the Department of Respiratory, Critical care and Sleep medicine at Indraprastha Apollo Hospital, New Delhi.. He has been previously associated with premier institutes like Maulana Azad Medical college and V.P. Chest institute New Delhi. He has a vast experience in dealing with all types of respiratory ailments including sleep disorders, with extensive exposure of fibreoptic bronchoscopy and other chest related procedures and managing all types of critically ill patients. He has a vast experience and specialized training related to: Intensive care unit Sleep laboratory and polysomnography Pulmonary function laboratory Fibreoptic Bronchoscopy and Auto fluorescence Video Bronchoscopy Allergy skin testing and immunotherapy for aeroallergens Tobacco cessation clinic Cardiopulmonary exercise testing Cardiopulmonary rehabilitation clinic 9. Dr. Ammaiyappan Palaniswamy Dr. Ammaiyappan Palaniswamy Chockalingam is a Pulmonologist in Adyar, Chennai and has an experience of 21 years in this field. Dr. Ammaiyappan Palaniswamy Chockalingam also practices at Dr. Ammaiyappan's Chest Clinic in Adyar, Chennai, Arka Center for Hormonal Health Pvt Ltd in Adyar, Chennai and Fortis Malar Hospital in Adyar, Chennai. He completed MBBS from Annamalai University in 1997,Diploma in Tuberculosis and Chest Diseases (DTCD) from Madras Medical College, Chennai in 2002 and MD - Tuberculosis & Respiratory Diseases/Medicine from Madras Medical College, Chennai in 2015. He is a member of Indian Medical Association (IMA). Some of the services provided by the doctor are: Pulmonary Function Test (PFT),Polysomnogram/Home Sleep Study, Lung Function Tests/Spirometry, Treatment Of Obstructive Sleep Apnea and Decortication etc. 10. Dr. S. R. Goyal Dr. S. R. Goyal has worked extensively in the field of Respiratory Medicine, Tuberculosis, Immunology, Sleep Medicine & Critical Care. Armed with impeccable qualifications & perspicacious diagnostic abilities, has his keen interest in Interventional Pulmonology and works tirelessly towards taking this field to new heights. He aims to soon start a successful & sustainable Lung Transplantation Program with the collaboration of Thoracic Surgery team in order to provide benefit to those with end-stage lung diseases such as COPD, ILD, BRONCHIECTASIS etc. He has presented his work at multiple academic forums on National &International levels such as NAPCON, TESCON, PULMOCON, ICONIC, Indian Science Congress (ISC) & European Respiratory Society World Congress (ERS). Trained in the technique of Rigid Bronchoscopy & Thoracoscopy under Dr. David Breen from Ireland in 2014. He also underwent advanced Interventional Pulmonology cum Thoracic Ultrasonography workshop at ERS, Munich, Germany where he learned the techniques of Endo Bronchial Ultrasound (EBUS - Linear & Radial Probe) plus Endo Bronchial Stent placement. He received training in Sleep Medicine (Diagnosis plus Management) at Pmocrit - All India Institute of Medical Sciences (AIIMS), India. Certified in Diagnosis & Management of Respiratory Allergy(Immunology) - Vallabhbhai Patel Chest Institute, New Delhi, India. BLS-ACLS service provider: American Heart Association (AHA) - 2017.AwardsBest Paper Award: World TB Day - 2012Dr. C. N. Devianagam National Best Paper Award for the oral paper: NAPCON - 2013First Rank at TB Quest State Quiz: World TB Day - 2013Best Research Paper: Indian Science Congress - 2013Best Interactive Case Report (Oral) - 2014Best Paper Award: International Conference on insights & management of COPD (ICONIC) - 2014Gold Medal in Pulmonary Medicine: SRM University Convocation - 2014Rashtriya Gaurav Award Medicine: India International Friendship Society - 2015Top Three Pulmonology Teams of South Asia: British Medical Journal (BMJ) South Asia Awards - 2015Conclusion:Respiratory health is a cornerstone of overall well-being, and these top chest specialists in India exemplify excellence in the field of pulmonology. Their dedication to advancing respiratory care, research, and patient well-being is commendable. If you or a loved one are facing respiratory concerns, seeking consultation and treatment from these distinguished specialists can be a crucial step towards achieving and maintaining optimal respiratory health. Trust in their expertise, and breathe easy knowing your respiratory health is in the hands of the best. Read more: Providing Specialized Care for Patients with Chest Disorders