IndiaMedToday Feb 2022 by IndiaMedToday

FEBRUARY 2022, VOLUME 6 ISSUE 02 `200 INDIA MED TODAY

Making a Difference in Cancer Care

FEBRUARY 2022

INTERVIEW

APPROACH

FEATURE

SPECIAL FEATURE

New Age Cancer Screening and Diagnosis

Oncology Management

Preventable Cancers in Females

Cancer Treatment Comes of Age in West Bengal

Edit Note

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February 2022 EDITORIAL Editor Neelam Kachhap Sub-Editor Abishek Raj editorial@ indiamedtoday.com

Need for Increased Funding

BOARD OF ADVISORS Dr Alexander Thomas Dr Girdhar Gyani

We all know about how higher incidences of cancer are in India.

Dr Prem Kumar Nair

With a handful of good institutions catering to the patients, hospitals

Dr Bhabatosh Biswas Dr Alok Roy

are overburdened and there is a long waitlist for patients who

Ramesh Kannan

need radiotherapy, chemotherapy etc.

With a majority of the hospitals based out of West and South India, patients are flocking to these centres in large numbers to get the best and most affordable treatment.

CONSULTING EDITOR Dr Libert Anil Gomes Dr Salil Choudhary Venkatesh Ganesh ART & PRODUCTION

Apart from this, the cost of treatment is on the higher side and many

ScreeTract | Shylesh

patients are forced to travel far to get treatment. The February edition

ADVERTISING Gunjan Chauhan gunjanc@indiamedtoday.com The Media Ant

covers the various aspects of cancer care and experts have opined about the tech innovations in cancer care Experts also pointed out how financial planning in a cost-effective manner, with the involvement of the health insurance industry, is an important dimension in cancer management.

help@themediaant.com

Though World Cancer Day is held every year on February 4, a lot more needs to be done in this

DIGITAL MARKETING

space. We need to have better infrastructure in cancer care while remembering the pricing factor

Vivek Nair Sales & Strategic Partnership Snehal Vajpayee snehal@indiamedtoday.com

too as it will help cancer patients in the long run. You could also write to us and let us know your views. Send in your letters to editorial@ indiamedtoday.

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Editor M Neelam Kachhap

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February 2022

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CONTENTS

Facebook

PULSE

INTERVIEW

IMPACT

Advances in Cancer Management: Immunotherapy

New Age Cancer Screening and Diagnosis

Evolution of Oncology Care During the Pandemic

UPFRONT

19 COVER STORY

Making a Difference in Cancer Care 4

February 2022

03 Editorial 05 Letters 06 News Roundup 26 Interview 29 Approach 30 Feature 32 Special Feature 35 Study 37 Event Report www.indiamedtoday.com

CHECKIT OUT ONLINE

Letters

he government’s focus on digitisation in healthcare should give rise to the integration of digital technologies such as AI/ML in equipment and digital data management

Suresh Vazirani, Founder Chairman, Transasia-Erba International Group of Companies

The budget brought disappointment in aspects of other essential services like domestic manufacturing of medical devices.The disappointment further ensued with lesser than anticipated, overall spending allocated to healthcare, which remains fundamental in infrastructural development of the same Dr Lalitha Reddy, Vice President, Telemedicine Society of India The planned increase in capital expenditure is likely to boost economic growth and employment. There is a thrust on macro-areas like digital, VC-ecosystem, ease of doing business and supportive measures for R&D and industry-academia collaboration with pharma included in the sunrise sectors. Sudarshan Alliance

Jain,

Secretary-General,

Indian

Pharmaceutical

The budget with its digital push in education and skilling for all shows that it has its heart in the right place. With digital registries of health providers and health facilities, unique health identifier for each individual will help to provide universal access to health facilities. Dr Prathap C Reddy, Chairman, Apollo Hospitals Group The allocation towards healthcare is not to the level we anticipated. Coming out of the shadows of the pandemic, it is most important to allocate at least 3 per cent of the budget to healthcare. Dr Azad Moopen, Founder CMD, Aster DM Healthcare

The Union Budget does not give any clear directions and has no blockbuster announcements. Harish Iyer, Head of Finance, Carestream India While there has been no significant announcement related to the diagnostics sector, it is encouraging to see the government focusing on the PPP model and digital health which will further ensure accessibility and availability of quality healthcare services in remote locations Dinesh Chauhan, CEO, CORE Diagnostics As expected, Budget 22-23 was a balanced effort to improve overall economic growth. Measures introduced in Budget 2022-23 will further strengthen the healthcare sector while focusing on prevailing challenges. Dr GK Velu, CMD, Trivitron Healthcare and Neuberg Diagnostics We were expecting the government to move forward on promised reforms and anticipated conducive measures to boost domestic manufacturing of medical devices. It is frustrating that against our expectations, the government has not included any measures to help end the 80-85 per cent import dependence forced upon India and an ever-increasing import bill of over Rs 46000 crore and promoting growth Indian Medical Device industry other than repeating last year’s assurance to end custom exemptions of products that can be made in India Rajiv Nath, Forum Coordinator, AiMeD

Tt is heartening that the Union Budget 2022 identifies genomics and pharmaceuticals as ‘sunrise’ sectors. This would enable well-rounded development beyond employment and access to enhanced industry efficiencies and competitiveness, which will go a long way in attracting increased investments in biopharmaceutical innovation

The budget has just focussed on mental health and the digitisation of the healthcare sector. Budget 22-23 seems very disappointing for the healthcare sector. India’s growth is estimated to be at 9.27 per cent and healthcare will play a major role in the boost. Strengthening of health infrastructure, speedy vaccination programme implementation has strengthened the Indian healthcare system.

Vani Manja, Country Managing Director, Boehringer Ingelheim India

Dr Alok Roy, Member, FICCI, Health Services Committee and Chairman Medica Group of Hospitals

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News Roundup PM inaugurates CNCI’s second campus in Kolkata Prime Minister Narendra Modi inaugurated the

second

campus

Chittaranjan

National Cancer Institute in Kolkata. The second campus of CNCI has been built at a cost of over Rs 540 crore, out of which around Rs 400 crores have been provided by the Union government and the rest by the West Bengal government, in the ratio of 75:25. The campus is a 460-bedded comprehensive cancer centre unit with cutting edge infrastructure for cancer diagnosis, staging, treatment and care.

.....inaugurates 11 medical colleges in TN The PM inaugurated 11 new medical colleges in Tamil Nadu through video conference. Union Minister Dr Mansukh Mandaviya, Dr L Murugan and Dr Bharati Pawar, Chief Minister Tamil Nadu MK Stalin were present on the occasion. The

new

medical

colleges

are

being

established at an estimated cost of about Rs 4000 crore, out of which around Rs 2145 crore has been provided by the Union government and the rest by the Tamil Nadu government. The districts in which the new medical colleges are being established are Virudhunagar, Namakkal, The

Nilgiris,

Nagapattinam,

Tiruppur, Dindigul,

Thiruvallur, Kallakurichi,

Ariyalur, Ramanathapuram and Krishnagiri.

Kochi’s Amrita Hospital nominated as Advanced Centre for Clinical Trials by ICMR The 1,300-bed Amrita Hospital in Kochi has been designated as Advanced Center for Clinical Trials (ACCT) by the Indian Council of Medical Research (ICMR), the country’s apex body for the formulation, coordination, and promotion of biomedical research. Amrita Hospital is among the only three hospitals in South India – and the only one from Kerala – to be nominated as ACCT by ICMR.

February 2022

Launch of HBOT unit at Narayana Health City

Narayana Health City sets up HBOT unit Narayana Health City recently launched a dedicated regenerative medicine with a hyperbaric oxygen facility at its campus. The department was inaugurated by John Shaw – Vice Chairman, Biocon in the presence of Dr Devi Shetty – Founder and Chairman, Narayana Health, Dr Kiran Mazumdar Shaw – Executive Chairperson and Founder, Biocon, Dr Paul C Salins – Medical Director and Sr. Vice-President, Mazumdar Shaw Medical Centre and Mr. Viren Shetty – Executive Director and Group COO, Narayana Health. The dedicated department will offer Hyperbaric oxygen therapy (HBOT), one of the most evolved, yet underutilised treatment options. In this modality, therapeutic administration of oxygen (100 per cent pure oxygen) is given in a pressurised environment.

Advent International to acquire controlling stake in Avra Laboratories Advent International has signed a definitive agreement with Dr AV Rama Rao, a distinguished scientist and his family to acquire a controlling stake in Avra Laboratories. Avra Laboratories is a science-driven organisation with a strong research and development (‘R&D’) team trained under the leadership of Dr

AV Rama Rao, which is focused on niche generic molecules as well as proprietary custom synthesis business for global pharmaceutical players. Over a long period of time, Avra Laboratories has forged many successful partnerships with innovator companies and strongly positioned itself as a partner of choice in manufacturing complex small volume molecules. Leveraging its in-house pool of scientific talent, Avra Laboratories has a long and consistent track record of high profitability and above industry margins.

HLM acquires 100% stakes in Care24 Care24, a leading home healthcare platform operating in Mumbai and Delhi, has been acquired by Human Life Management (HLM), a leading Japanese home medical support corporation. HLM, led by Yoshiki Sasaki, which has been a prime investor in Care24 from the past two years and holds multiple businesses in healthcare and other sectors. Care24 will extend its robust service delivery and agile technology platform for HLM and will cater to the evolving healthcare needs of the customers. Post the acquisition, HLM and Care24 will closely work together to scale and strengthen medical service offerings in India and additionally expand to other southeast countries like Thailand, Vietnam, Indonesia using Yushoukai’s deep

medical expertise and Care24’s superior software development and technology capabilities.

Digital A Plus Group of Companies launches OMNICONNECT360 Digital A Plus group of companies has launched OMNICONNECT360, a cutting edge solution providing their clients, and remote customers with a simplified, costeffective and integrated digital ecosystem. The feature is designed to effectively manage business marketing functions as well as scientific and brand communication of healthcare and life science companies. OMNICONNECT360 offers integrated multi-channel solutions with various modules of services to their audience. It is a one-stop solution that aims to reduce the time frame right from ideation, planning, development, deployment, execution to analytics.

ICMR approves KRIVIDA Novus RT-PCR kit KRIVIDA Novus RT-PCR kit, developed by Chennai-based KRIYA Medical Technologies in collaboration with ImmuGenix Bioscience, has received approval from ICMR (Indian Council of Medical Research). The kit detects the SARS-CoV-2 virus and also differentiates the Omicron variant from Delta and other variants. The test takes just about 45 minutes to detect the infection and determine the variant.

Inauguration of multi-organ transplant centre at Sparsh RR Nagar Unit, Mysore Road, Bengaluru

SPARSH Hospital launches multi-organ transplant centre SPARSH Group of Hospitals has launched a new multi-organ transplant centre at Sparsh RR Nagar Unit, Mysore Road, Bengaluru to offer comprehensive and multidisciplinary care to patients. Led by Dr Kumud Dhital, a globally renowned Heart and Lung Transplant Surgeon, SPARSH Multi-Organ Transplant Centre brings together a team of 50 highly experienced transplant specialists who will provide integrated care during every step of the transplant process. The 50-member multidisciplinary team at SPARSH encompasses a group of highly skilled and experienced doctors.

The launch event was inaugurated by Dr K Sudhakar, Minister of Medical Education and Health, Government of Karnataka.

Lupin signs promotional agreement with Exeltis on SOLOSEC Lupin Pharmaceuticals and Exeltis USA announced a promotional agreement for Exeltis to promote SOLOSEC along with Exeltis’ existing line of Women’s Health products, further enhancing value to OBGYNs and their patients. SOLOSEC is indicated for the treatment of Bacterial Vaginosis in adult women (a common vaginal infection) and Trichomoniasis in adults (the most common non-viral, curable sexually transmitted infection in the US.).

...signs first partnership agreement with Chinabased Foncoo Lupin has entered into a partnership with Shenzhen Foncoo Pharmaceutical Co (Foncoo). This is Lupin’s first partnership arrangement in China and reinforces Lupin’s commitment to bringing high quality generic and complex generic medicines to patients around the world.

Roche launches COVID-19 At-Home Test Roche Diagnostics India has launched COVID-19 At-Home Test. The over-theKRIVIDA Novus RT-PCR kit

counter test is intended to be used for

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News Roundup market from Sanzyme, a leading player in the probiotics and reproductive health segment in the country. The transaction is valued at Rs 628 crore and is expected to be completed in the next two weeks subject to customary closing formalities.

Bharat Biotech’s Krishna and Suchitra Ella and SII’s Cyrus Poonawala to receive Padma Bhushan At-Home Test kit the detection of SARS CoV-2 infection in individuals with symptoms suggestive of COVID-19 and is approved by ICMR. The company has already brought a wide range of COVID-19 testing solutions to the country including the gold standard RT-PCR test, a lab-based antigen test, and Rapid Antigen tests for professional use. Individuals can perform the self-test at home without special training or the supervision of a healthcare worker and expect results in 15 minutes. The test collects the sample from the front area of the nose instead of the nasopharynx, resulting in a simplified and more comfortable sampling procedure. The test will be available in e-pharmacies and local pharmacies and requires no prescription.

CSIR signs MoU with Institut Pasteur An MoU was signed recently between CSIR and Institut Pasteur with scope for cooperation in health research. CSIR and Institut Pasteur would be jointly researching and focusing on emerging and reemerging infectious diseases and inherited disorders and enable the delivery of effective and affordable healthcare solutions not only for the people of India and France but for the global good. The MoU provides for developing potential scientific and technological cooperation and networking in advanced and emerging areas of Human Health between scientists and institutes/laboratories of CSIR and Institut Pasteur and its international network.

The Government of India has announced the Padma Awards 2022. This year vaccine makers Bharat Biotech’s Krishna Ella and Suchitra Ella and Serum Institute of India’s Cyrus Poonawala will receive the Padma Bhushan. Dr Himmatrao Bawaskar and Dr Vijaykumar Vinayak Dongre, Dr Bhimsen Singhal, from Maharashtra, Dr Prokar Dasgupta from the UK, Dr Lata Desai from Gujarat, Dr Sunkara Venkata Adinarayana Rao, Andhra Pradesh, Dr Veeraswamy Seshiah from Tamil Nadu and Dr Kamlakar Tripathi from Uttar Pradesh will receive the Padma Shri in medicine. Dr Narendra Prasad Misra from Madhya Pradesh and Dr Balaji Tambe from Maharashtra will receive the award posthumously.

EIDO Healthcare collaborates with Thieme to enter Indian Thieme and EIDO are working together to improve patient education in India. The collaboration sees Thieme assume responsibility for sales and marketing activities in the Indian market for EIDO’s INFORM Consent Suite (ICS) – a collection of over 400 procedure-specific, patient education documents for informed consent in surgery – and EIDO’s digital consent solution. Thieme India is a well-established digital health service provider and partner for health information processes in the Indian clinical market. EIDO Healthcare, a British company, is already present in Europe, Australia, North America and Africa, and will expand its Asian operations through this collaboration.

JBCPL to acquire brands from Sanzyme for Rs 628 crores

AGI glaspac inaugurates manufacturing facility for speciality glass division

JB Chemicals & Pharmaceuticals Limited (JBCPL) will acquire brands for the Indian

AGI glaspac, a leading container glass

February 2022

bottle

manufacturer,

inaugrated

its

new manufacturing facility in Bhongir, Telangana. With an aim to cater to the growing demand in the speciality glass segment, the new 154 TPD (Tonnes per day) glass plant has initiated the production of clear glass products such as vials, nail polish bottles, etc. These clear glass products are primarily used for pharmaceutical products, premium spirits, food and beverages and also to make water bottles and candle jars. The facility will provide direct employment to 350+ people and will serve foreign markets along with the Indian markets.

IIT Madras, Krea University study suggests ways to boost medicine supply deliveries Indian Institute of Technology Madras and Krea University, Chennai, conducted a study that can help states boost medical deliveries. The study showed that fill rates of Tamil Nadu, Kerala, Odisha and Punjab could potentially rise to 53 per cent as compared to an average fill rate of 30.95 per cent. These four states were chosen for the study as they were the largest Indian states with the largest populations in the country. Essential medicine procurement in the Indian Public health system is undertaken by the State-level medical service corporations (MSC). Some states, such as Kerala, follow a centralised system, while others like Punjab. Tamil Nadu and Odisha follow a decentralised system, which is a mix of the two. The study found that despite the operational, logistic, and infrastructural challenges that exist in the current drug supply system, several measures can be undertaken by state governments to considerably ease the system and address the medicine shortage.

Granules India appoints Dr KVS Ram Rao as Joint MD and CEO Granules India Limited (GIL), announced the appointment of Dr KVS Ram Rao as Joint Managing Director and Chief Executive Officer (CEO) with effect from January 5, 2022. Dr Ram Rao has over two decades of experience in the pharmaceutical and chemical industries. Dr Ram Rao holds a bachelor’s degree in chemical engineering from Osmania University, Hyderabad and

Sanjeev Mishra and Razorpay founders. Existing investor Venture Catalysts has also participated in the current round. The funds raised will be used for expanding geographically to reach $900 mn in GMV, serving 1.5 million subscribers and patients to get quality medical and cosmetic treatments across the world.

Ram Mudaliar to lead AstraZeneca India’s CDI Division Dr KVS Ram Rao a master’s degree and PhD in chemical engineering from the Indian Institute of Science, Bangalore. He has over 29 years of experience in the field of manufacturing, R&D, business and customer service management. He worked as Executive Director & CEO for CSM Business of PI Industries. He played a significant role in Dr Reddy’s Laboratories Limited while working in various capacities from 2000 to 2018. He also worked with Jubilant Life Sciences and Gujarat Heavy Chemicals.

Apollo Hospitals collaborates with The Clinic by Cleveland Clinic Apollo Hospitals Group has announced a collaboration with ‘The Clinic by Cleveland Clinic’, to bring international second opinion services to their patients. Through this programme, doctors at Apollo can collaborate with leading medical experts at Cleveland Clinic to review complex cases and devise the most appropriate treatment plan. Anyone looking to seek an international second opinion can consult an Apollo consultant, and express interest in the service.

AstraZeneca India announced the appointment of Ram Mudaliar as the India lead of their Clinical Data & Insights (CDI) division. Mudaliar worked with AstraZeneca Canada, managing the delivery of the lung portfolio and leading oncology data management teams in the North American region and Europe. He has also worked as Interim Global Head of Oncology in Data Management for a brief period. Mudaliar’s appointment follows the launch of the CDI India division in October 2021. As CDI India Lead, Mudaliar will be responsible for establishing and expanding the CDI footprint in India, liaising with CDI global and local leaders to develop and implement strategic decisions for the India site. He is also responsible for ensuring the local planning and coordination relating to facilities and enabling support for the India team, connecting with Facilities Management, Human Resources, IT, Compliance, R&D Site Leadership and other functions as required.

Novo Nordisk India launches GLP-1 RA, Oral Semaglutide, to treat diabetes Novo Nordisk India launched the world’s first and only “peptide in a pill”, oral semaglutide, a gamechanger in diabetes management. Semaglutide, a GLP-1 receptor analogue (GLP-1 RA) – one of the drug classes to treat diabetes, till now was available only in the form of injections. This is the first time a GLP-1 RA has been developed in an oral formulation. Oral semaglutide is a co-formulation of GLP-1RA semaglutide with an absorption enhancer SNAC which protects semaglutide from undergoing degradation in the stomach like other peptides and enhances its absorption. Novo Nordisk invested 15 years of continuous research, innovation, and development to makethe oral formulation of semaglutide into a reality. Due to this scientific breakthrough, it received the Prix Galien Award in 2020, a prestigious award in the industry, for the best biotech innovation.

IHL Care launches Digital Health Centre India Health Link (IHL) – a medical device and wellness care company based out of a

Bengaluru, connected

committed ‘user

centric’

building

healthcare

ecosystem through its advanced digital

Cross Border Healthcare start-up Hospals raises $3.5 M Hospals, a cross border health benefits and travel platform that enables international patients to access healthcare across India, the UAE, Turkey and Thailand, announced part raise of its Pre-Series A investment from Inflection Point Ventures, 9Unicorns, Singapore-based Wavemaker and prominent angels like Kunal Shah,

Ram Mudaliar

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News Roundup platform and award-winning health station – “hPod”, has come up with a customised solution. IHL Care ‘Digital Health Centre’ is a first of its kind Integrated Heart Health Programme that complements Corporate Wellness, providing customised health solutions. The ‘hPod’ brought by IHL Care is a self-service ATM size health station. It is capable of screening (20+) essential vital parameters including key parameters like Blood Pressure, Temperature, Body Mass Composition, Pulse, SPO2, and ECG, without any paramedic assistance.

Glenmark receives ANDA approval for Metronidazole Vaginal Gel, 0.75% Glenmark Pharmaceuticals has received final approval by the United States Food & Drug Administration (US FDA) for Metronidazole Vaginal Gel, 0.75 per cent, the generic version of MetroGel-Vaginal Gel, 0.75 per cent, of Bausch Health US. Glenmark’s current portfolio consists of 173 products authorised for distribution in the US marketplace and 46 ANDA’s pending approval with the US FDA. In addition to these internal filings, Glenmark continues to identify and explore external development partnerships to supplement and accelerate the growth of its existing pipeline and portfolio.

Sai Life Sciences appoints Sauri Gudlavalleti as COO Sai Life Sciences, a leading global Contract Research, Development & Manufacturing Organization (CRO-CDMO), announced the appointment of Sauri Gudlavalleti as its Chief Operating Officer. Gudlavalleti will report to the CEO and MD, Krishna

Kanumuri and drive the company’s growth as a new generation, sciencedriven organisation. Gudlavalleti joins Sai Life Sciences from Dr Reddy’s Laboratories where he was heading Global R&D and Portfolio Management for small molecule API & Formulations, encompassing portfolio & strategy, development, technology transfer, CRO/ CDMO partnerships, IP, regulatory affairs and clinical affairs. Over his seven-year tenure there, he spearheaded a multifold increase in the R&D pipeline, significantly globalised the R&D efforts with an impetus on fast-growing emerging markets and brought about a pioneering transformation in R&D through data and analytics.

LaBelforte launches special purpose business entities – Covidrops and Covinhaler Pune-based LaBelforte, an Indian startup promoted by a Pune-based doctor, announced the launch of its special purpose business entities – Covidrops and Covinhaler to facilitate the development of immune optimising nasal and inhaled drug products. “Company’s target is to primarily facilitate co-development of Nasal sprays and Pocket Inhaler that are safe and effective ancillaries for both COVID-19 prophylaxis and therapy,’ said Dr Gaurav Raj Chhabra, Founder, LaBelforte, India.

Epigeneres Biotech raises $ 6M in Series B Funding

Medall to expand across South India Medall announced its plans to expand across South India. Apart from penetrating deeper into Tamil Nadu into Tier II and III cities, Medall will also be expanding into other South Indian states, viz, Karnataka, Andhra Pradesh, Telangana and Kerala. Positioned as a franchisee model, the centres will be in multiple formats comprising of collection centres, mini wellness centres, full-service centres, lab collection centres and Medall Care Centres. Medall plans to open about 300 – 400 centres across South India during the year.

MaxiVision appoints VS Sudheer as CEO Hyderabad-based MaxiVision Eye Hospitals group announced key leadership appointment to its strategic position for its pan India business. VS Sudheer has been appointed as Chief Executive Officer, for the whole MaxiVision Group. Sudheer has been working as Chief Operating Officer for the group for the last five years. The new appointment is his elevation of the position. Sudheer who has been with MaxiVision for the past five years has significantly contributed to the company’s annual revenues. He brings with him very strong expertise to team up and works with ophthalmologists of repute to deliver clinical excellence in all branches of the eye care segment.

Mumbai-based Epigeneres Biotech, the exclusive licensee in India of Singaporebased Tzar Labs, has raised $6 million in a Series B funding round. Lead investors in this round include Kotak Investment Advisors, Moez Daya (of Satya Capital), and

LetsVenture

Angel

Fund.

Other

investors include Ashish Kacholia, East River Advisors, One Decacorn, Nandita Advisors, and Chockalingam Valliappa, to name a few. With initial approvals in place, the latest round of investment will go towards expanding its lab facilities, scaling operations, and development of an AI platform to launch the service in India – a world first. And, continue bringing the best diagnostic technology to patients and Sauri Gudlavalleti

February 2022

providers.

VS Sudheer

in the Kasaragod district of Kerala, catering to patients from Malabar and Southern Karnataka. An initial investment of around Rs 140 crores have been earmarked for the new facility, which will include a 200-bed comprehensive tertiary care facility, with the option of expanding to a quaternary care facility in the future. The new Aster Hospital is expected to begin operations in 2024-25.

Sanjay Bapna joins MyHealthcare as Chief Commercial Officer MyHealthcare announced the appointment Direct RT-PCR Kit

BioGenex Life Sciences launches Direct RT-PCR Kit Hyderabad-based US-headquartered BioGenex Life Sciences has developed a RT-PCR kit for COVID-19 diagnosis, which detects COVID 19 caused by SARS COV 2 variants including Omicron plus other variants. The kit detects Omicron without RNA extraction in half the time than standard PCR DR. The National Institute of Biologicals(NIB), Noida, an ICMR designated lab, examined the performance of this kit and found that it performed with 100 per cent accuracy and 100 per cent sensitivity which means no false negatives or positives, which will significantly control the pandemic through accurate diagnosis. The kit detects the Omicron variant in half the time than the standard RT-PCR tests. The cost of the kit is Rs 150 plus taxes.

Dozee raises Rs 71 Cr Dozee, a pioneer in Contactless Remote

of Sanjay Bapna as its Chief Commercial to monitor patients continuously and to help doctors & nurses enhance patient care and clinical outcomes.

Dhoot Transmission launches health and wellness venture, Burge Electronics Dhoot Transmission Pvt Ltd (DTPL), a global automotive components manufacturer with a presence in six countries, has launched a venture christened Burge Electronics as it embarks on a diversification plan to establish its presence in the fast-growing health and wellness industry. Burge Electronics, which means guarantor in German, will roll out a series of world-class health and wellness products to deliver a truly healthy lifestyle. Banking on DTPL’s more than two decades of know-how in product development, manufacturing and distribution, Burge Electronics aims to disrupt the health and wellness industry with safe, affordable, advanced and innovative solutions.

Patient Monitoring (RPM) solutions, has

Officer. Bapna will be responsible for driving the business traction across all MyHealthcare

platforms,

including

its

AI offerings through institutional sales,

Sanjay Bapna strategic partnerships and other high growth revenue initiatives. With 30 years

Aster DM Healthcare to set up sixth hospital in Kerala with Rs 140 cr investment

time when the company has seen a strong

Aster DM Healthcare is strengthening its

Previously, Bapna has held key positions

adoption of its Remote Patient Monitoring

footing in the country by signing a 30-years

in multinational organisations such as L&T,

Solution for Hospitals, the Dozee Pro,

lease agreement to set up its sixth hospital

Hewlett Packard and Phillips where he has

which converts any bed into a Step-down

in the state of Kerala, adding to the existing

led large business units. He has worked

ICU at a fraction of cost in both public

14 hospitals in India. The hospital is being

with healthcare start-ups such as Doxper,

and private settings. The Dozee Pro has

set up by Malabar Institute of Medical

leading their corporate and institutional

been installed in over 6,000 beds in 300

Sciences (MIMS), a material subsidiary of

sales and building a successful growth

hospitals covering 40 districts across India

Aster DM Healthcare and will be situated

trajectory.

raised Rs 71 crore in an additional funding round led by Doordash’s Gokul Rajaram. The round also saw participation from existing investors Prime Venture Partners, 3one4 Capital, YourNest and other angel investors. The current funding comes at a

experience

across

healthcare

and

technology, Bapna brings in-depth industry expertise and learnings in building robust, scalable business solutions. A specialist in overall business strategy, he completed his engineering from NIT Kurukshetra.

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News Roundup

Johari Centre of Excellence

Johari Centre of Excellence opens at IIT Jodhpur Technology Park Johari Digital Healthcare Ltd (JDHL) launched the Johari Centre of Excellence (CoE) at the Indian Institute of Technology Jodhpur Technology Park. The collaboration is a step towards making India self-reliant in the manufacturing of medical devices. Prof Santanu Chaudhury, Director, IIT Jodhpur, Prof Sampat Raj Vadera, Deputy Director, IIT Jodhpur, Satyendra Johari, CEO & Founder and Nisha Johari, Co-Founders, Johari Digital Healthcare, and other dignitaries were present during the launch.

network for providing better patient care. Moreover, the partnership opens up new pathways for people to access ancient Ayurvedic Care which is India’s pride and heritage.RaphaCure is powered by Cognota Healthcare, which is a leading healthtech company with multiple cutting-edge digital solutions.

Bajaj Group partners with LV Prasad Eye Institute LV Prasad Eye Institute, as part of its undertaking

developing

various

Institutes of Excellence that focus on major causes of blindness, is partnering with the Bajaj Group for an Institute of Excellence and a Global Resource Centre for Retinal

RaphaCure partners with Madhavbaug

Diseases.

Leading digital healthcare services provider, RaphaCure on has entered into a strategic partnership with Madhavbaug (Vaidya Sane Ayurved Laboratories). The strategic tie-up is a game-changing event for the cardiac care space wherein technology will be leveraged to reach out to patients even in the remotest regions of the country. RaphaCure and Madhavbaug will not only play to each other’s core strengths but will also tap their combined

and Dr Prashant Garg, Executive Chair, LV

February 2022

The

MoU

formalise

the

partnership was signed between Shekhar Bajaj, CMD, Bajaj Electricals Limited (BEL) Prasad Eye Institute (LVPEI). Named as the Anant Bajaj Retina Institute in the loving memory of late Anant Bajaj, it will be an integral part of LVPEI. The Institute of

AliveCor’s KardiaMobile to alert people experiencing irregular heart rhythm symptoms AliveCor, the global leader in FDAcleared personal electrocardiogram (ECG) technology, announced that the National Institute for Health and Care Excellence (NICE) has issued Medical Technologies Guidance (MTG) recommending KardiaMobile as an option for detecting atrial fibrillation (AF) for people with suspected paroxysmal AF, who present with symptoms such as palpitations and are referred for ambulatory ECG monitoring by a clinician. KardiaMobile is the first personal ECG to be recommended by NICE for use within the National Health Service (NHS) in England and Wales.

IHH Healthcare India appoints Anurag Yadav as CEO

Excellence aims to enhance access to high-

Anurag Yadav has been appointed as the

quality retina care to several million more

Chief Executive Officer of IHH Healthcare

people through direct services of the LVPEI

India. Anurag joined IHH Healthcare in

network and the work of its alumni and

April 2017 as the Chief Financial Officer

partners, and through capacity building

(CFO) of its India Operations Division,

across India and other parts of the world.

where he oversaw the financial activities

Alkem Labs launches technology for diabetic foot ulcer mgmt in India

Anurag Yadav of IHH’s network of hospitals in India (excluding Fortis). As the newly promoted CEO, he will provide leadership and strategic direction to IHH Healthcare India, ensuring that it continues to deepen trust with patients, employees, and other stakeholders, in line with IHH’s vision to be the world’s most trusted healthcare services network. Yadav held senior leadership roles in Fortis Healthcare and Manipal Health Enterprises. With over 25 years of experience in business leadership, financial management, strategic planning, mergers and acquisitions and post-merger integration, Anurag is well-positioned to take IHH India to its next level of success.

Metropolis launches 3rd edition of MedEngage Scholarship prog Metropolis Healthcare has launched the 3rd edition of MedEngage Scholarship programme and is now inviting applications from the final year MBBS and MD/DNB students. Metropolis Healthcare launched the MedEngage program in 2018 to nurture medical students and help them contribute to healthcare research in the country by financially rewarding the deserving candidates and providing them with practical knowledge through our world-class laboratory and panel of experts on board. Metropolis conducted the scholarship programme successfully for the consecutive 2 years and has awarded more than100 students with scholarships worth up to 50 lakhs. In this year 2022, it intends to reward 150 students from across India through this scholarship programme.

Alkem Laboratories has announced to launch a unique patented technology for the treatment of Diabetic Foot Ulcer (DFU) in India. The solution would be based on disruptive 4D Bioprinting technology, which would be used to treat deep, nonhealing chronic wounds and is expected to be launched in the Indian market in the latter half of 2022 post regulatory approval. The advanced technology for DFU management has a high scope of preventing amputations in diabetic patients. This technology will be available at affordable rates to Indian patients at a time when there is no definitive treatment for DFU in India.

Intuitive India introduces remote learning technology for surgeons Intuitive India, the Indian arm of Intuitive, a global technology leader in minimally invasive care and the pioneer of roboticassisted surgery (RAS), has launched India’s first remote surgical case observation technology, ‘Intuitive Telepresence’ (ITP). The technology enables surgeons to learn from expert surgeons without the need for travel or time away from their busy practice. The ITP uses proprietary technology that enables real-time exchange of audio and video between the remote observer and the operating surgeon. Through this, observers can be virtually present in the operating room (OR) where a procedure with a da Vinci system is being performed. ITP technology is HIPPA (The Health Insurance Portability and Accountability Act) compliant which provides a secure platform for remote learning on da Vinci Robotic platform.

workflow, and enhances surgical decision making for a better overall customer experience and improved patient and economic outcomes.

BSV opens R&D centre in Airoli, Maharashtra Bharat Serums and Vaccines (BSV) to spur innovation and scientific research has opened a world-class R&D centre at Airoli, Maharashtra. The state-of-art centre was inaugurated by Rajesh Tope, Health Minister, Maharashtra. Also present at the event were Sanjiv Navangul, MD & CEO, BSV, Vishwanath Swarup, COO, India Business and Dr Jaby Jacob, Head, R&D. The R&D centre will endeavour to bring scientifically advanced biological, biotechnology products and novel drug delivery systems that deliver better patient outcomes in Women’s Health, Assisted Reproductive Technology and Critical Care & Emergency Medicines.

Dr (Col) Avnish Seth, VSM joins HCMCT Manipal Hospital, Dwarka HCMCT Manipal Hospitals has announced the appointment of Dr (Col) Avnish Seth as the Head of Gastroenterology & Hepatology. He will also drive all organ and tissue donation initiatives at Manipal Hospitals. Dr Seth has over 25 years of expertise in gastroenterology and liver diseases including many clinical landmarks first in his field and was honoured with the Vishisht Seva Medal by the President of India in 2009. Dr Avnish Seth and his team will strengthen the gastroenterology and hepatology programme and also the organ retrieval and transplant to provide the best possible care for patients in Delhi NCR.

J&J announces strategic partnership with Microsoft The Johnson & Johnson Medical Devices Companies (JJMDC) will collaborate with Microsoft to further enable and expand JJMDC’s secure and compliant digital surgery ecosystem. The Microsoft Cloud will help JJMDC realise its vision of driving innovation that advances skills, improve

Dr (Col) Avnish Seth

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News Roundup

Team at Kauvery Hospital Chennai transplantation unit

Kauvery Hospital Chennai expands heart and lung transplantation unit Kauvery Hospital Chennai, a unit of Kauvery Group of Hospitals, based out of Tamil Nadu, announced the expansion of their heart and lung transplantation unit by appointing Dr Kumud Kumar Dhital and Dr Srinivas Rajagopala. The team is headed by Dr Dhital, who is the Program Director of the Heart and Lung Transplantation unit. He is a cardiothoracic surgeon, specialised in heart and lung transplantation. The team also has Dr Rajagopala who is the Director of Transplant Pulmonology & Lung Failure Unit and a Senior Consultant in Interventional Pulmonology & Sleep Medicine.

Ophthalmic Research Biorepository in India opens at LV Prasad Eye Institute The Hyderabad campus (Kallam Anji Reddy Campus) of LV Prasad Eye Institute (LVPEI) in Hyderabad is now equipped with a

February 2022

state-of-the-art Ophthalmic Research Biorepository. LVPEI is the first institute in the country to have this facility. The facility has been set up with the generous support received from Prof Krothapalli Ravindranath, retired Dean, SV University, Tirupati. Prof Ravindranath is a long-term well-wisher and supporter of LVPEI. The Prof Krothapalli Ravindranath Ophthalmic Research Biorepository has been set up in the operational complex of the institute that is on par with international standards. The facility is well equipped with infrastructure required for cryopreservation (storage of ophthalmic tissues) as in -80°C, -20°C and 4°C freezers, liquid nitrogen for snap freezing and specially trained technical staff for handling the samples.

IIITH to develop screening tool to detect early oral cancer In a collaboration with Grace Cancer Foundation and BioCon Foundation, the International Institute of Information Technology Hyderabad (IIITH) is developing a screening tool to detect abnormal oral lesions before they progress into

advanced stages of cancer. This automated solution only requires a smart phone to help save lives. According to Grace Cancer Foundation’s CEO and Director, Dr Chinnababu Sunkavalli, the prognosis for oral cancer is usually poor since most patients are diagnosed in the advanced stages. Grace Cancer Foundation runs mobile camps, where it tries to conduct early cancer screening and detection, but the NGOs efforts are hindered by the inconsistent availability of skilled medical professionals, such as oncologists, who can perform exams and interpret x-ray findings on the spot.

Pulse

Advances in Cancer Management: Immunotherapy Immunosuppressive agents, cytokines, oncolytic viruses, cancer vaccines are all being developed to engineer the immune system to fight against cancer.

Cancer develops when cells in our body develop the potential to grow uninhibited. Ageing, changes in lifestyle, exposure to toxins all interact in a complicated manner leading to this change. The body’s immune system has an important role in preventing the cells Dr Arun R Warrier, Consultant- Medical Oncology, Aster Medcity, Kochi

from gaining the ability to proliferate without control and invade other organs by spreading through the bloodstream, which are the hallmarks of cancer. As

a result of this, patients with diseases like HIV cause immunosuppression to have a higher number of cancers. This weakening of the immune system in elderly persons without any risk factors increases their risk of developing cancers. Historically, Galen a renowned Greek physician, had documented the relationship between immune response and cancer. William Bradley Coley

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Pulse

who is known today as the Father of Immunotherapy described cancerous growths disappearing after skin infections. Such spontaneous remissions are extremely rare, occurring in 1 out of 60,000- 100,000 cases. Over the last 100 years, contributions from scientists all over the world were instrumental to understand the fascinating interplay between immune regulation and cancer. In 2018, the Nobel Prize was awarded to James Allison and Tasuku Honjo for their meticulous work on checkpoint molecules as potential therapeutic targets. Antibody-based therapies were the initial ones to be used for the treatment of cancer. Antibodies are made by the body to mark out cancer cells. In 1997, Rituximab, which targets the CD 20 antibody on lymphoma cells, became the first monoclonal antibody to be approved. In the last 25 years, lakhs of patients across the world were saved using Rituximab either alone or in combination with chemotherapy in various types of lymphomas. Trastuzumab, another monoclonal antibody against Her-2-receptor expressed in 25 per cent of breast cancers has also improved cancer outcomes for a significant number of patients. Cancer cells can protect themselves from the immune system by stimulating checkpoints. This helps them to hide from the protective cells of the body. Checkpoint inhibitors block these points, thus restoring the capacity of the body to fight against cancer. In 2011, Ipilimumab was the first such drug to be approved for the treatment of melanoma. In a short span of time, several other inhibitors of the PD-1 receptor or its ligands, PD-L1 and PD-L2, were approved worldwide. Nivolumab, pembrolizumab, atezolizumab, durvalumab, and avelumab all showed significant improvement in outcomes of several cancers. Elegant clinical trials were designed to monitor the efficacy in multiple cancers and based on them, they are approved for use in specific 16

February 2022

cancers. Notable among them are lung

Immunosuppressive agents, cytokines,

cancer, melanoma, bladder cancer and

oncolytic viruses, cancer vaccines are

colon cancer.

all being developed to engineer the

There is a scientific rationale for the use of these drugs, and they cannot be given for all cancers. In lung cancer, we can measure the PDL1 receptor expression on the lung cancer specimen after doing a biopsy. If the level of expression is more than 50 per cent, Pembrolizumab as a single drug is more effective than even chemotherapy. Meanwhile, for lung cancers that lose response to chemotherapy, these drugs can be used irrespective of PD L1 expression. A better understanding of such predictive

immune system to fight against cancer. CAR T cell therapy seems to be the one that may be used more frequently in near future. CAR T cell therapy involves the isolation of patient's T cells which are tumour-specific, modification and multiplication of those cells in the laboratory and then re-injection back to the patient circulation. Dramatic responses

chemotherapy

failed

patients have resulted in the approval of CAR T cell therapy in relapsed leukaemias and lymphomas.

markers is needed to ensure that those

In the future, immunotherapy drugs

who respond the best are offered

may

immunotherapy as these drugs are

adjuvant settings to prevent relapse of

expensive. A proportion of patients

the disease after curative treatment.

on these drugs can also develop side

Identifying

effects, so close medical monitoring is

who would benefit the most based

needed. A review of patient records has

on biomarker testing would be the

shown that almost 20- 30 per cent of

most challenging aspect. Rather than

advanced cancer patients who were

replacing chemotherapy, they will have

treated with these drugs survived,

a role along with chemo and other

compared to less than 5 per cent of

targeted agents in the continuum of

historical controls.

care for cancer patients.

used

the

subset

frequently

patients

Interview

New Age Cancer Screening and Diagnosis Cancer has become a major concern in today’s time. It is imperative for us to screen individuals in order to provide a comprehensive and holistic view of health. Dr Tausif Ahmed Thangalvadi, Medical Director, NURA, talks about how NURA can bring in a revolution in cancer care

Recently NURA has opened its firstever diagnostic centre in Bengaluru. Tell us more about the new centre and which all tests will be conducted at the centre? NURA is a premium AI-based Health screening centre and one of its kind Dr Tausif Ahmed Thangalvadi, Medical Director, NURA

in India. It is a collaboration between Fujifilm Healthcare Global & DKH group,

major organs and ailments like heart, lungs, kidney, bones, liver, cancer, COPD and other lifestyle diseases. • Gender-specific packages

health

screening

• No prior preparation or fasting is required, walk-in walk out in just 120 minutes

bringing the best of AI-enabled imaging

We screen the following diseases:

technology to improve one’s health

•

screening experience. Our screening service is designed to suit ones busy life. We want to secure the lives of people while providing accessible and high-quality healthcare. Our technology, process along AI deliver quick and accurate results, while always keeping one’s safety in mind. Our machines are minimally invasive and ergonomically designed to ensure one’s comfort. How NURA is different? •

Highest possible precision with AI

algorithms and doctor's interpretations •

Image-based technologies with best-

in-class equipment •

Comprehensive

package

covering

For Men

We screen for blood pressure, BMI, lung cancer, coronary heart disease, COPD, visceral fat analysis, osteoporosis/ bone mineral density, sarcopenia, full body composition, colon cancer, oral cancer, prostate cancer, diabetes, metabolic syndrome, kidney and liver health, gout, anaemia and general well-being. •

For Women

We screen for blood pressure, BMI, lung cancer, coronary heart disease, COPD, visceral fat analysis, osteoporosis/ bone mineral density, sarcopenia, full body composition, breast cancer, cervical cancer, colon cancer, oral cancer, diabetes, metabolic syndrome, kidney and liver health, gout, anaemia and general well-being.

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Interview

Which new technologies are being currently used at the centre? Fujifilm Healthcare’s vast data set of radiology images and decades of experience in the field has helped in developing advanced AI technologies that empower radiologists and doctors. Our AI allows them to read scans more efficiently and accurately, helping them make quick and intelligent decisions. AI technology makes the screening process safer by allowing us to use ultra-low doses of radiation. Sharper images have previously only been possible with larger doses of radiation. Our AI technology processes the lowdose scan and compares them to similar scans in Fujifilm’s vast library of imaging data. This enables us to sharpen the low-dose image and identify problems that would be missed by the naked eye. Cancer is a major area of focus at your centre. What are the new offerings you would like to provide in cancer care? Our objective is to screen an individual for comprehensive health. Cancer has become a major concern in today’s time. It is imperative for us to screen individuals in order to provide a comprehensive and holistic view of health. For lung cancer: At NURA, lung cancer screening is done through Ultra low dose CT scan equipment coupled with our AI technology. Through this, we are able to sharpen the quality of the ultralow dose scan to assist the doctor in early detection. For breast cancer: NURA digital mammography uses a flexible compression paddle which allows the machine to gently fit the natural curve of the breast, allowing the pressure to be dispersed evenly and lowering your discomfort. It does Accurate screening with 3D Imaging in a few minutes. For cervical cancer: A colposcope is used for taking images of the cervix area. The device has inbuilt AI software which gives an indication about any

February 2022

abnormalities. For oral cancer: A handheld device is used to take images of the Oral cavity by our dentist. Images are processed in our AI software to detect cancerous cells. Do you plan to provide new centres across the country? Yes, we are planning to open up more centres in other cities in the next one to two years. How cost-effective are these tests? Our packages are quite cost-effective. If the same set of tests and scans are done outside NURA, it might cost anywhere between Rs 40000-50000. Whereas, at NURA, we offer it as a single package costing Rs 15,000. What will be your growth plans for the next five years? Our mission is to provide affordable, accessible and accurate health screening services globally through NURA. In the coming five years, we would focus more on expanding our presence in prominent cities of India and a few other countries.

Cover Story

Making a Difference in Cancer Care

Closing the gap in cancer care one step at a time Team IMT

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Cover Story

C By 2030, it is estimated

ancer is a well-known term in India. Understandably as nearly 7-8 million people lose their battle with

adding to the growing mortality due to

the disease in India every year. Today

awareness about this ‘cancer care gap’

we all know at least one person who is

and ask for greater equity.

suffering from cancer or who is lost to

cancer. The 2022-2024 World Cancer Day campaign is designed to raise

This year the Union for International

that 75% of all premature

cancer.

deaths due to cancer

The cancer care landscape in India has

new three-year campaign for World

will occur in low- and

been very promising. A number of public

Cancer Day (Feb-4) to bring together

middle-income countries.

sector institutions like the Tata Memorial

individuals,

Hospital,

Cancer

governments around the world in an

Institute, Chennai have been the leaders in

effort to create awareness and help

not only providing latest cancer therapies

close the gap in cancer care.

Importantly, this care gap is not only between highand low-resource settings.

Cancer

Mumbai

and

Adyar

but also trained the best of doctors and nurses who went on to start premier institutes in different parts of the country.

Prof. Anil d’Cruz, President, Union for International Cancer Control, Director of Oncology, Apollo Hospitals, India.

February 2022

Control

(UICC)

launched

organisations

and

“By 2030, it is estimated that 75% of all premature deaths due to cancer will occur in low- and middle-income

The Indian government has focused on

countries. Importantly, this care gap

cancer prevention and control through

is not only between high- and low-

various programs, and instituted centers

resource

within most countries among different

excellence

along

with

regional

settings.

Disparities

exist

cancer centers. However, a number of

populations

socioeconomic factors along with stigma

or assumptions that encompass age,

and discrimination prevent many people

cultural contexts, gender norms, sexual

from accessing these services and thus

orientation, ethnicity, income, education

due

discrimination

The COVID-19 pandemic has deepened health inequities and created an even greater need for action to mitigate the adverse impact on cancer incidence and survival.

levels and lifestyle issues. These factors potentially reduce a person’s chance of surviving cancer – and they can and must be addressed,” said Prof. Anil d’Cruz, President of the Union for International Cancer Control, Director of Oncology at Apollo Hospitals, India.

colorectal and childhood cancers,” says Dr Miriam Mutebi, Member of the Board, Union for International Cancer Control and Consultant Breast Surgical Oncologist, Clinical epidemiologist and health systems researcher, Aga Khan University Hospital, Kenya.

According to UICC, the first year of the campaign will focus on acknowledging and addressing the social determinants of health that constitute barriers to equitable care.

The aim of the campaign is to help build efficient and widely accessible cancer services that will save countless individuals from a premature and often painful death.

The COVID-19 pandemic has caused

“As individuals, as communities, we can and must come together and break down barriers. We have achieved a lot in the last decade in cancer care and control around the world but not addressing inequities in society is slowing our progress. Closing the care gap is about fairness, dignity and fundamental rights to allow everyone to lead longer lives in better health,” Dr Cary Adams, CEO of the Union for International Cancer Control added.

significant disruptions to cancer services and exacerbated existing health inequities, with a high risk of seeing an increase in cancers diagnosed at a later stage and therefore cancer-related deaths. “The COVID-19 pandemic has deepened health inequities and created an even greater need for action to mitigate the adverse impact on cancer incidence and survival. Understanding and addressing the social determinants of health and their impact on cancer can considerably improve outcomes for at-risk populations, particularly for cancers that can be more easily detected and treated such as cervical, breast,

Greater equity in health care will also strengthen families and communities, benefit the economy with greater workforce participation and offer net savings to health budgets.

Dr Miriam Mutebi, Member of the Board, Union for International Cancer Control and Consultant Breast Surgical Oncologist, Clinical epidemiologist and health systems researcher, Aga Khan University Hospital, Kenya.

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Cover

Roots and Routes of Cancer The route of financial planning in a cost-effective manner, with the involvement of the health insurance industry, is an important dimension in cancer management

“It is our choices, Harry, that show

5.7 million people have died. Cancer

what we truly are, far more than

deaths per year are much more (About 10

our

million) and even higher than HIV/AIDS,

abilities"

said

Dumbledore

(JK Rowling) Whenever I feel down and defeated, this quote gives me new energy. Though Dr Vikas S Kavishwar, Consultant in Histopathology, GRL, Metropolis Healthcare

the world of Harry Potter is magical, it has its roots in the moral principles of our world and it stands on the route of Harry’s faith, irrespective of his abilities. Every day, when I look at

tuberculosis

combined.

can be prevented. Another third can be cured with proper routes of diagnosis and management. Unfortunately, the focus on COVID-19 management had roots of delay in the treatment of other diseases, including cancer. The theme for 2022-2024 is “Close the

if I had magical powers to read their

Care Gap”. Today 65 per cent of cancer

mind – where cancer has its roots

deaths are happening in the least

– before it takes a route towards a

developed parts of the world. Equitable

full-blown disease. Every cell has the

access to cancer prevention, diagnosis,

potential to turn into cancer but every

treatment and care can save lives and

mechanism is there in place to prevent

improve quality of life. PPPs could be

that occurrence. The natural choice of a

one practical route to achieve this goal.

so is it a limitation to fight abilities of cell or is it a wrong choice in the mind of cell…which transforms it into a cancer cell? – A million-dollar question with no satisfactory answer. During the COVID-19 pandemic, about

February 2022

and

More than one-third of cancer cases

cells under the microscope, I wonder

cell must be not to become cancerous

malaria

Today

public

sector

government

hospitals are flooded with patients but need to organise their resources. Corporate hospitals are well equipped and can deliver the best possible healthcare, however, the expenses are beyond the reach of many patients. The

cost involved gets augmented further when the tests get repeated in another hospital. We need to tackle the roots of all these issues. In India, out of about 1.1 million new cases reported every year, two-thirds are diagnosed at an advanced stage. Cancers of the oral cavity, lung and breast

are

mainly

responsible

for

morbidity and mortality. Traditionally, cancer management has been the teamwork of oncosurgeon, oncophysician offering chemotherapy and

radiation

medicine

expert

for

radiotherapy. With ongoing research, new routes of targeted and customized therapies

are

becoming

available.

Techniques like IHC, Flow cytometry, cytogenetics, tumour marker studies are an integral part of the diagnosis. Molecular testing for cancers in the brain, lung, breast and colon has become a part of cancer management protocols. Thus, the route of the cancer diagnosis also has become a team-work of histo pathologists,

haematopathologists,

micro biologist, genetic experts and

dedicated technicians. The team needs to get trained and to adapt as per the need. Digital Pathology was a classic example in COVID-19 pandemic, histopathologists who could not visit the laboratory had to learn to report on the digitized slide. Technology and expertise do not come free, but it is the need for time. Hence, the route of financial planning in a costeffective manner, with the involvement of the health insurance industry, is an important dimension in cancer management. COVID-19 has taught us to unite the strengths of roots and routes of the private and public sector, upgrade ourselves to face challenges, improve the delivery of the healthcare system and be compassionate with the sufferer. Let us carry on the same route for cancer patients… to turn on the light in the darkest of cancer times. As J.K.Rowling’s Dumbledore has already said… "Happiness can be found, even in the darkest of times, if one only remembers to turn on the light"

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Impact

Evolution of Oncology Care During the Pandemic While the oncology sector endured a shot in the light of the pandemic, it has not only bounced back but is also witnessing exponential growth and attention

The COVID-19 pandemic has forced the

deaths contribute 8 per cent of the total

healthcare industry and professionals to

number of adults’ death in the country.

concentrate their strength and prowess

In such a scenario, any halt in the

in managing the vast outbreak. It was perhaps, the need of the hour. Thanks to the dedication of healthcare workers and professionals, and to the industry Satyaki Banerjee, CEO, Medical Imaging, Trivitron Healthcare

at large, the world developed multiple vaccines protocols.

and

advanced

However,

while

treatment India

now comparatively better prepared to manage the pandemic wave, critical medical areas such as oncology had taken a hit initially. It is known that immune-compromised people are at a much higher risk of COVID-19 infection, and cancer patients usually fall into such category. Owing to the pandemic, the hospital visits

for

chemotherapy,

radiation

therapy and surgery for cancer were curtailed exponentially. Even the cancer screening facilities were toned down in order to focus the strength on the management

COVID-19.

fact,

during the first lockdown, as much as 69 per cent of healthcare institutions halted the screening. This consequently led to a low number of cancer patient registrations, a reduction of almost 56 per cent all over the country. This observation is critical as India sees an annual diagnosis of over 1.3 million cancer patients and an annual death of .85 million patients. In fact, cancer 24

February 2022

screening and treatment process will

prove to be devastating. However, with the pandemic getting into the first level of control; Hospitals were segregated as COVID and non-COVID hospitals. This allowed safe access for cancer patients to continue their treatment. At the same time, in large hospitals, COVID and nonCOVID areas were strictly demarcated in order to reduce contamination and maintain a COVID-free environment for cancer screening and treatment. In the sector of oncological diagnosis, there have been significant improvements. While the oncology sector endured a shot in the light of the pandemic, it has not only bounced back but is also witnessing exponential growth and attention. A key aspect of cancer diagnosis is Next-GenerationSequencing or NGS which provides vast insight into the genetic materials (DNA & RNA), helping healthcare experts

narrow down the origin as well as the level of cancer in the patients. The NGS market in India has been forecasted to grow at 19.6 per cent CAGR, touching $71 Million by 2028. A driving factor for the growth of NGS was the disruption of the supply chain during lockdown which prevented firms from importing (or exporting) crucial raw material needed for testing. This forced companies to invest in NGS which is far more userfriendly and does not require excess reliance on imported raw materials. Another important aspect when it comes to oncology care and treatment is advances made in Medical Imaging. There are multiple imaging modalities available to clinicians to diagnose, stage, and treat human cancer: Computed Tomography (CT Scan), Ultrasound (US), Magnetic Resonance Imaging (MRI), Single-photon Emission Computed

Tomography (SPECT), Positron Emission Tomography (PET), and optical imaging. Of these, CT, MRI, SPECT, and PET are capable

three-dimensional

(3-D)

detection of cancer anywhere in the human body. Major cancerous tumours are likely to be treated if they are diagnosed early. This is perhaps one of the strongest driving forces behind the expansion of

the

Medical

Mammography

Imaging

plays

segment.

particularly

important role when it comes to breast cancer diagnosis and imaging. Detected early the chances of complete cure is very high with a very good quality of life for the patient. Advanced digital mammography those

with

systems,

very

especially

sophisticated

AI-

enabled image processing systems are particularly effective in detecting very very early stage breast cancers. The COVID-19 spurred the development of

at-home

self-health

care,

even

in case of severe diseases. This was also adopted by the oncology sector. There has been an increased at-home treatment

and

extension

care

services for cancer patients, especially the ones for whom going to the hospital was deemed unsafe, and those who were at late-stage cancer. This has not only allowed firms and companies to expand their home-care services but has also helped patients to receive care from the comfort of their home, with their family members always around them. The market for home care is also expected to grow at a significant rate in the upcoming years. Government initiatives have contributed to enhancing the current infrastructure to guarantee the delivery of tailored healthcare even in tier ii/iii cities. Our healthcare system has been given the opportunity to be re-evaluated, and reformed in light of the pandemic. India's future lies in putting its focus on excellence, merging cutting-edge treatments with a team of doctors that provide patient-centric care.

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Interview

Cancer Continues to a Growing Burden in India Varian, headquartered in Palo Alto, California is primarily focused on cancer treatments such as radiation and diagnostics for the oncology field. Ashok Kakkar, Senior MD, Varian, has been with Varian for about a decade of his 34- year career in the medical technology vertical speaks to Venkatesh Ganesh about advances in cancer management in India TEAM IMT

He’s worked for GE Healthcare and Siemens, among others, while witnessing the

evolution

industry.

Aside

India’s from

healthcare

radiotherapy,

Kakkar says their portfolio includes advanced diagnostics based on artificial intelligence and machine learning to improve

overall

effectiveness

and

efficiency within oncology departments. In an interview with IndiaMedToday, Kakkar points out that conventional

allopathy currently relies on three approaches to cancer treatment, usually prescribed together: Surgery, chemotherapy and radiation. Further, on average, globally, 60 per cent of cancer patients have prescribed radiation. In India, a study by Tata Memorial in Mumbai indicates the number is 18 per cent, which is interpreted as insufficient access to radiation. With many cancer patients struggling just to survive and also being forced to travel long distances for treatment, what is Varian doing to address such challenges? We are a private institution and work with customers in both the private and public sectors. We are encouraging big private operators like Tata Trust, Tata Group, Apollo and Reliance, trying to educate them about the country’s need for oncology solutions and the opportunities that await. We are trying to work with them to establish hospitals in tier II and III locations. A few years ago, we signed a contract with Reliance to set up 20 such hospitals, all in tier II and III parts of Maharashtra, out of which five are already in place, and more are expected.

Ashok Kakkar, Senior Managing Director, Varian 26

February 2022

With Tata Trust, we entered an arrangement in Assam, along with the state government, to create a joint venture called Assam Cancer Care

is with private customers, only 20 per cent is government. Government share should increase, especially for a disease like cancer; things must be done fast, and in areas where it may not be very remunerating. Everybody wants to set up a hospital in big cities, but nobody wants to do it in the interior, that's where the shift is needed. Prices are reducing and radiation is, in the long term, one of the least expensive ways of treating cancer patients. If you compare India with the US and other developed markets, the treatment cost in India is 1/10th of what is charged elsewhere. But even that is remarkably high because it is not backed up by insurance. Even after Ayushman Bharat, our coverage is perhaps less than 40 per cent of people who are covered through third-party insurance. Foundation, which is 50 per cent funded by the state and 50 per cent by Tata Trust. We provided them with radiation and other technological solutions. In many cases, we directly engage with states like Madhya Pradesh, West Bengal and Tamil Nadu. Some of these states have purchased solutions directly, while some are now looking at a Public-Private Partnership (PPP) model like what Madhya Pradesh is planning in seven of their teaching hospitals, wherein they’ll have cancer facilities on a PPP model. Another problem faced in smaller locations is hospitals without oncology facilities. It’s said that patients can avail Ayushman Bharat, but then they don't have it. In such a scenario, how will Varian’s innovations and advancements redefine cancer care? Having the ability to network and connect facilities with technology in the absence of sufficient high-end, skilled resources at every location is important. Enabling proper knowledge sharing can greatly improve oversight,

quality and consistency in the delivery of healthcare services. Each cancer patient is different, you can’t use the same yardstick, protocol or treatment for everyone. Artificial intelligence and machine learning solutions have the potential to analyse a patient’s unique medical data and recommend treatment options. The doctor can always decide the best course of action, but this technology can help to improve the process if it is perceived as an integrated solution. Regarding general advancements in radiation, the linear accelerators previously used could provide 50-60 sittings; but today it’s possible to treat 150 patients per day in India. This is an example of why it’s crucial to design equipment with precision, simplicity and efficiency in mind. What about the cost? I think they are available and affordable; they are being deployed by a lot of hospitals. But in India, most private hospitals are at the forefront. Of the hospitals, 80 per cent are in the private sector, and 80 per cent of our business

The technology is available and affordable, but accessibility remains an issue. Allocating funds is not enough, holistic thinking is required to deploy technology appropriately. How was the radiotherapy industry affected by covid lockdowns? I think the significant impact has been delayed diagnosis and treatment. Hospitals shifted their focus to covid, while patients were simultaneously scared to visit hospitals. Some studies have revealed an increase in the growth of cancer because of treatment delays. Can you elaborate on the current situation with regards to cancer rates? I don't think we are doing enough from a prevention standpoint at all. For private hospitals, they treat sick patients. They are not in the business of healthcare; they are in the business of sick care. So, if patients get sick, it's business for them. We should be alarmed because earlier it was around 700,000 people getting cancer, then it went up to a million and now it is 1.5 million reported and it is only going up.

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Interview

At any point in time, we have 50 lakh, cancer patients. Who is responsible for creating awareness? If a patient gets diagnosed early, they have a better prognosis. If you diagnose cancer at stage III or IV, it is already late, more expensive to treat and the prognosis is poor. Awareness and education are imperative, creating a crucial role for government and NGOs. They can involve the private sector, all stakeholders, to create awareness. I feel that we need to create hope and not fear. But it's chicken and egg because if you don't have infrastructure closer to where patients live then they don’t have that possibility of even going in. We can be smarter and try to use technology and not wait for everything to come to us. Because of the impact of lockdowns on livelihoods, businesses, state government collections and such, state budgets are stretched thin. Is there anything that can be done to address this from a policy angle? The first thing at the policy level is awareness of the problem. I don't think there is enough understanding that they need to do something different. Much before this Ayushman Bharat scheme was announced, everybody used to say that even if we create infrastructure, how will people access it when they don't have the means to pay for it? And that led to this. So, there was a fair amount of realisation that something needs to be done to provide universal access. What is the radiotherapy utilisation in India right now, what’s the near-term potential? Globally, it's around 60 per cent, in India it's less than 20 per cent. Currently, in India, there are around 650 linear accelerators (radiation therapy machines) but these 650 are in 100 districts and not in all the 720 districts, so we must expand it. You can't play catch up unless and 28

February 2022

until you do something big, and that's where the government needs to act as a catalyst and run a programme, which would take care of this in a big way in the next five to 10 years. What are the key lessons, especially considering the setbacks of the past two years? I think the biggest lesson is there is no substitute for planning. Only reacting to a situation is never effective nor efficient as you end up spending more money. We have tremendous talent and ability in India with some of the best doctors, engineers and scientists plus the wherewithal and the technology, so there can be localised solutions. Are there studies on the economic impact of cancer in India? I think there are global studies, I don't think there are any studies like this here, but we are working with agencies to see if we can produce white papers on this.

Approach

Oncology Management The adoption of technology has improved the quality of survival as well as longevity

Neuro-oncology

Dr NK Venkataramana, Founder Chairman & Director Neurosciences, Brains Hospitals, Bangalore

has

evolved

such as 3D Imaging, MR Tractography,

big way for the last three decades.

image-guided

In the 1980s, the delay in diagnosis,

assisted neuro-navigation, ultra-sonic

lack of proper imaging had resulted

surgical

aspirations,

in patients with large brain tumours

bi-polar

and

causing complete visual loss, hearing

helped to precisely remove the tumours

loss,

paralysis

surgery,

computer-

radiofrequency

tumour

fluorescence

unconsciousness.

completely and safely regardless of the

Those days cerebral angiography was

location. This has improved the quality

the mainstay in diagnosis. In the 1990s

of survival as well as longevity and in

advent of CT scans and MRI at the dawn

many benign tumour cures.

of the new century has resolved many issues. Brain tumours were diagnosed early and even small tumours were detected easily.

Parallelly, advances in neuropathology, genetics

molecular

diagnosis

and

immune histochemistry have paved the way for tailormade therapies for select

In the 1980s the treatment options

individuals with specific tumours. The

were also very limited. Neurosurgery

delivery of radiotherapy has advanced

was known as macro neurosurgery

tremendously

with lots of limitations, leading to only

radiotherapy, stereotactic radiosurgery

partial removal of tumours. There were

with image guidance has contributed to

associated

the prolonged survival of the malignant

complications

brain

swelling, a significant insult to the surrounding neural tissue leading to unacceptable morbidity and mortality. The advent of micro neurosurgery made surgery precise and gross total removal of the tumours as well as preserving the surrounding nerves helped to improve the outcomes and quality of life of these patients. Adoption of technology subsequently,

called

Stereotactic

tumours. Gene

therapy,

immunotherapy

and

targetted therapies are going to be the future for the highly selected targetoriented treatment of brain tumours. Despite all the advancements, some of the malignant brain tumours such as Glioblastoma Multi-pharma poses severe challenges to neurosurgeons even today.

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Feature

Preventable Cancers in Females Every penny spent on preventive screening not only saves precious lives but also brings down the need for public expenditure to build cancer treatment infrastructure

The incidence of cancer is rising at an alarming rate. There were an estimated 14 lakh new cases of cancers in India in 2020. More women in India were diagnosed with cancers than men in 2020. Sangeeth Kini, Vice President, Hemogenomics

While it is a fact that a combination of genetic, environmental and lifestyle factors lead to the alarming rise of cancers every year, the question is whether we can do anything to prevent cancers with the help of simple health check-ups. In this article, I would like to dwell on two of the major cancers affecting women of our country; and the simple, easy and non-invasive ways to prevent those cancers.

Cervical cancer Cervical cancer is the cancer of cervix – the lower end of the uterus. This is one of the most preventable cancers. But unfortunately, India has the highest number of cervical cancer cases every year. More than 1,00,000 women are detected with cervical cancer and over 50,000 women die of this cancer every year in our country. Such is the severity of this cancer! Cervical cancers can be prevented through the HPV Vaccine if administered to girls in their adolescence. And the majority of the unvaccinated (even vaccinated) women can still prevent this cancer by undergoing a simple 30

February 2022

screening test called Thinprep LBC (liquid-based PAP) and HPV mRNA Testing. These tests are very simple to perform and are intended to identify women at risk of developing cervical cancer as well as to detect women with early-stage cervical abnormalities. By identifying and treating such women early on, cervical cancer can be prevented by reversing any earlystage pre-cancerous abnormalities or by stopping further the progression of cancerous abnormalities; thereby being able to save thousands of lives every year from progressing into full-blown cancer (carcinoma in-situ). Various studies have observed that regular cervical screening reduces the incidence rates of cervical cancer by a minimum of 50 per cent.

Breast cancer This is leading to cancer affecting women. In India, every year about 2.5 lakh women are diagnosed with breast cancers and about 80000 women lose their lives due to this cancer. Almost 70 per cent of breast cancer patients visit their doctor for the first time when they are already in the third or four stages of the disease. It is concerning to find that more women at younger ages are detected with breast cancers these days compared to the earlier time. It is estimated that by 2030, breast cancer would kill more women in India than any other disease.

Public health expenditure on cancer care Our government spends thousands of crores of rupees every year to treat cancer patients by building hospitals and

other

treatment

infrastructure.

While that would be of great help to the patients, it would make sense if a fraction of the total cancer care budget is spent on screening and prevention of various cancers. Screening and early detection would substantially reduce the incidence of cancers; consequently, the need to spend thousands of crores on

cancer

treatment

infrastructure

would also come down. Let me conclude by stating that when it comes to cancer care, the first and most desirable public health strategy must be to prevent through screening programmes to reduce the total number of cancer cases which in turn reduces the need to allocate a huge budget for cancer treatment infrastructure. Every A simple mammogram test is an answer to prevent advanced breast cancers by early detection of pre-cancerous abnormalities.

mammogram

can

detect pre-cancerous changes of the breast at least a few years before one can feel a lump or any other

penny spent on preventive screening not only saves precious lives but also brings down the need for public expenditure to build cancer treatment infrastructure. In other words, a penny spent on prevention saves many rupees on treatment by the government.

abnormality herself as part of selfexamination. By identifying the early pre-cancerous changes and by receiving timely treatment, a woman can almost completely get cured herself of this disease and lead a normal life. It is estimated that about 40 per cent of breast cancers can be prevented and lives could be saved if women undergo screening with a mammogram at least once in one to two years. Both the above screening methods –

cervical

cancer

screening

and

mammogram – can reduce the total incidence of these women’s cancers by 40-60 per cent which translates to saving about 60,000-90,000 lives every year in India.

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Special Feature

Cancer Treatment Comes of Age in West Bengal Woeful lack of advanced cancer treatment facilities in Bengal, but also a complete lack of faith in the existing ones forced many to travel to distant cities for affordable and quality treatments till things changed for good

It was my dream to become a cancer specialist. Right from the time I was studying for my MBBS, I knew that treating

cancer

patients

was

ultimate goal. As a student of MS at the Grant Medical College, Mumbai, I began visiting the Tata Memorial Centre, to Dr Sourav Datta, Director, Medica Cancer Projects

spend time with the doctors there and learn from them. After passing out, I joined the centre as an observer and was later selected as a Fellow. During my visits, I was often surprised to hear a fair amount of Bengali being spoken around me. I realised that a large number of patients (around 25 per cent) getting treated here were from Bengal. The hospital had even set up a dedicated desk with Bengali-speaking guest relation executives to guide the patients from Bengal. I began talking to these patients to find out why they felt compelled to travel to Mumbai for even the smallest of concerns. That is when I began understanding that the reason was not just the woeful lack of advanced cancer treatment facilities in Bengal, but also a complete lack of faith in the existing ones. This disturbed me, and when I discussed this with my mentor at Tata Memorial Prof Pankaj Chaturvedi, he told me that I should think of going back to Kolkata after a while and work towards improving the cancer care facility there. The opening of Tata Medical Centre at

February 2022

Rajarhat in Kolkata in 2011 was a giant leap in the region’s cancer treatment scenario. Though the hospital was not a unit of Mumbai’s Tata Memorial, the name Tata is associated with advanced cancer care the world over, and for patients in Kolkata, they finally had a facility in their backyard that they could trust. In 2015, inspired by our teachers at Tata Memorial, a group of oncologists trained at the Centre, who belong to this part of the country decided to take the significant step of moving to Kolkata to set up a facility focussed on ‘organ-specific cancer care’, the modern method of treating the cancer patients. Other metro cities like Mumbai, Delhi, Bengaluru, Chennai, started this organspecific cancer treatment long back, however, it was missing in Kolkata so far. Unfortunately, we failed to find any backers for this project among the big corporates in healthcare in the city initially. A relatively new cancer facility in Howrah finally agreed to our terms and our cancer care journey in this state began. Coincidentally, around this time a gradual change was taking place in the city in the area of cancer treatment with various healthcare units in the corporate, trust and government sectors beginning to beef up their cancer care facilities. It was an encouraging trend, as not just new cancer centres

about five DM medical oncologists in the city. Now the number has increased significantly with at least 10 more specialists having joined various centres, thus giving the field of medical oncology a big boost in the city. Bone marrow transplant, a treatment modality that was barely available a few years back, is now being offered by multiple corporate, trust and govt hospitals in the city. Nuclear medicine plays a major role in advanced cancer care. The city saw its first PET CT in 2013, the number has now gone up to 10.

were coming up, but existing facilities were

making

significant

additions

to their facilities. As a result of this, the past few years have seen major developments in all areas of cancer treatment. The change has been seen across the entire healthcare spectrum in the city – in Corporate, Government and Trust facilities. New public-private partnerships have been formed. Nowhere has this change been more visible than in the area of radiation oncology. Radiotherapy is an integral part of cancer treatment. A decade back, the city had only two advanced radiation therapy facilities (with linear accelerator), and that too was only in the corporate sector. Today there are 22, five of which are in government hospitals

and

seven

trust-run

facilities (including two in Chittaranjan National Cancer Institute – a CentreState collaboration), and the rest in various corporate set-ups. Apart from this, there are four tele-cobalt machines. The availability of advanced radiation therapy in the city has significantly increased in the last five years. Another

important

area

cancer

treatment is medical oncology. Till about five years back there were only

Radioiodine therapy is an essential component in the treatment of thyroid cancer. Unfortunately, this facility was not available in either government or corporate set-ups a few years back. Only one trust hospital offered radio-iodine therapy through VECC (Variable Energy Cyclotron Centre). This meant long waiting periods for patients, leaving most with no option but to travel to other states for treatment. Today, five centres in the city are offering this treatment. Apart from this, one centre in the city now also offers advanced nuclear medicine therapies like Alpha and DOTA. These advancements have benefitted the patients immensely as the need to travel to other states and faraway centres have decreased, thus increasing both accessibility and affordability. In the area of surgical oncology, Kolkata is gradually shifting its focus from general oncology to organspecific surgical care. This change is being seen in all sectors – among Trust hospitals at Tata Medical Centre, among Corporates at Medica Hospital and in the Government sector at Chittaranjan National Cancer Institute (new campus) and SSKM, have started this focused expertise-driven care. Advanced surgical procedures like HIPEC, microvascular free flap reconstruction, etc are routinely performed in various centres. In the area of robotic surgery, there have been significant leaps. The

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Special Feature

city’s first robot was introduced in the city in 2012 but was used mainly for non-oncology cases. Now the city has five surgical robots of which three centres are using these robots exclusively for cancer surgeries. An upsurge has also been seen in cancer-specific diagnostic facilities in the city with dedicated CT scans and MRI machines having been installed in multiple centres. Immunohistochemistry - an extremely important tool for cancer diagnosis - was barely available till a few years back. Now multiple hospitals are providing this facility regularly. Apart from the massive developments in the private sector, what is most encouraging is that the treatment for cancer is the biggest thrust area in the state government’s book today. Chittaranjan National Cancer Research Institute has recently started a modern cancer care facility in Rajarhat with 600+ beds. Apart from this, in collaboration with Tata Memorial Centre, Mumbai the Government of West Bengal is in the process of setting up two state-of-theart cancer care facilities in Kolkata (with SSKM – IPGMER Hospital) and in North Bengal (with North Bengal Medical College), to cater to the economically backward sections of the society in urgent need of advanced care. Though the buildings are not yet ready, Tata Memorial alumni have already started treating patients in the existing facilities voluntarily. Despite these significant advancements, there is still some lacuna that needs to be filled to enable the state to become a leader in cancer treatment not just in the country, but in the entire south-east Asian region, particularly given the high demand for such a facility in this region. The upcoming Cancer Care facility at Medica Hospital is aiming to fill this gap. Our super advanced cancer hospital will have a high-end radiation facility, PET CT, therapeutic nuclear medicine and the first bone bank in this region, among other modern facilities. Medica is also setting up an advanced lab with 34

February 2022

the latest pathological test facilities like immunohistochemistry, molecular pathology, flow cytometry, among other high-end investigative tests. In a first-of-its-kind endeavour in the country, Medica has recently announced a unique rehabilitation programme for cancer survivors. Medica group has decided to employ cancer survivors in the upcoming Medica Cancer Hospital, Kolkata as staff members in various areas of service delivery, a few already are on board. This will set an example for the rest of the country in the need for spreading the ambit of care beyond clinical treatment for cancer patients. The increasing number of facilities for the treatment of cancer in the state is a welcoming trend for cancer patients not just in West Bengal, but also people in the neighbouring states of Jharkhand, Bihar, Odisha and the North-east. This will

also

benefit

our

neighbouring

countries like Bangladesh, Nepal and Bhutan immensely. One can confidently predict today that West Bengal is set to become a destination in advanced cancer care for the entire region and South East Asia in the next two years.

Study

Progression of Alzheimer’s Disease May Be Delayed by Meditation Study indicates that simple meditation performed at home can alter the brain structure and increase grey matter in patients suffering mild cognitive impairment (MCI) and mild Alzheimer’s disease TEAM IMT

A new study, supported by the Department of Science and Technology (DST), and conducted by the International Institute of Information Technology Hyderabad (IIITH) in collaboration with the Neurology Department of Apollo Multispeciality Hospital, Kolkata, reveals that simple meditation performed at home can alter the brain structure and increase grey matter in patients suffering mild cognitive impairment (MCI) and mild Alzheimer’s disease.

researchers to seek alternative options for managing the disease.

The drugs presently available to treat Alzheimer’s do not possess any disease-modifying effects, but only give temporary relief of symptoms. The severity of impairment often worsens within five years in more than half of MCI patients, leading to an Alzheimer’s diagnosis. This has prompted

Methods and findings

Dr Amitabha Ghosh, Head of Neurology at Apollo Multispeciality Hospital, Kolkata and Dr Bapi Raju, Cognitive Science research centre at IIITH, together lead a joint research team with researcher Neha Dubey and Dr. Raju’s students, Madhukar Dwivedi and Aditya Jain Pansari to understand the effects of meditation on MCI and early Alzheimer’s patients.

The team assigned patients having MCI or early Alzheimer’s into Meditation and Control groups. Before beginning the study, MRI brain scans were taken from both groups. Patients in the Mediation group were advised to

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Study

meditate at home for 30 minutes each

Ghosh. Meditation increases one’s focus,

day in a quiet, sitting posture with help

causing

of audio instructions from a CD. After

from floating thoughts. The findings

six months, both groups again were

of increased grey matter in the frontal

given MRI brain scans, and the findings

area corroborate the fact that it

conscious

disengagement

revealed that patients in the Meditation group showed a marked increase in

is this area of the brain that involves

cortical thickness and volume of grey

attention, decisiveness and attaining

matter, particularly in the prefrontal

goals.

area of the brain, which coincided with a reduction in thickness in the posterior area of the brain.

kinds of networks that exist in the brain.

This study was conducted as part of DST’s Science And Technology of Yoga

“One is activated by attention or when

And Meditation (SATYAM) programme

focusing on a task, whereas the other

under its Cognitive Science Research

takes over when there is no specific task to perform and during mind wandering," he said, noting that the latter is part of the default mode network (DMN). The DMN is the network of brain regions active when a person is not consciously focusing on the outside world. Usually,

Initiative.

Apollo

Multispeciality

Hospital recruited patients according to neuropsychological assessments, while IIITH carried out image processing and analysis of the brain images. The team intends to follow up this study with a

we operate with a continual switch

larger number of participants for a

between the two networks. “However,

longer duration.

in patients with MCI or Alzheimer’s

“We

disease,

where

the

networks

degenerate, the switch does not always take place as efficiently. hence you find them losing attention, getting distracted and having memory lapses,” said Dr

February 2022

area indicates suppression of some of the nodal regions of the DMN.

Dr Amitabha Ghosh spoke about two

The reduced grey matter in the posterior

are

considering

applying

for

one more grant to make it a formal clinical trial so that meditation as an intervention can be registered as a treatment method,” says Dr Bapi.

Event Report

Need to Create Awareness on Cervical Cancer Experts deliberate on prevention mechanism for cervical cancer at a conference hosted by ASSOCHAM

ASSOCHAM, the apex industry body, organised a conference on 'Awareness and Prevention of Cervical Cancer' to honour and assist women who have either been diagnosed with it or are being treated for this health condition. Priyanka Chaturvedi, Member of Parliament (Rajya Sabha) was the guest of honour at the conference. “There are some issues that have taken priority over cervical cancer such as TB and COVID. If we intend to prioritise the need to eradicate cervical cancer this would go a long way. The challenges are that we need to address the stigma attached to pelvic examination, and build awareness amongst women in all strata,” she said. Dr Princess Nothemba (Nono) Simelela, Assistant Director-General and Special Advisor for Strategic Priorities, World Health Organization (WHO) stressed the need to be optimistic. She said, “We need to recognise global health complacency. We have tools to detect this cancer. We have to make sure these preventive tools reach everybody. These days there is more focus on profit than solidarity because the vaccine is expensive. Everyone needs to take responsibility. There are new technologies that can augment change. Women should come together to challenge and demand these

services. We need to make our demands political.” Dr Shalini Singh, Director, ICMRNational Institute of Cancer Prevention and Research, MoHFW, GOI, focussed on the need to spread awareness, which is lagging. She added, “Awareness and knowledge give us power and perception. It also gives us the selfconfidence to think from different levels. Ideally, all women should be aware of cervical cancer. Things like ‘where can I seek help?’ or ‘who can get affected’?” She explained that to eliminate cancer, the policymakers, medical fraternity, and community need to come together to raise awareness; create demand for primary prevention through vaccination and for screening and early detection. All these together shall fructify the goal of cervical cancer elimination. Narendra Varde, Managing Director India & Neighbouring Markets, Roche Diagnostics India informed that onefourth of cervical mortality comes from India. He further explained, “Cervical cancer is a common cause of death among women of reproductive age. Especially in India, cervical cancer accounts for 17 per cent of all cancer deaths among women between 30 and 69 years. These deaths can be prevented, provided cancer is detected

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Event Report

and treated in the early stages. WHO's three main pillars of Prevent, Screen, and Treat offer a comprehensive approach to cervical cancer elimination by 2030. India too needs a robust public health policy for prevention through HPV screening and vaccination.” Ravi Bhatnagar, Co-Chairperson, ASSOCHAM CSR Council, Director, External Affairs and Partnerships (SOA)–Reckitt shared that cervical cancer is the fourth-most frequent cancer in women worldwide, after breast cancer, colorectal cancer, and lung cancer, with around 500,000 new cases cropping up every year, as well as 300,000 deaths. Stressing on the fact that it can be cured, he informed that the Government of India (GOI) is also taking all possible measures and initiatives, through robust planning and strategic implementation framework, in this direction. The Ministry of Health has introduced Papanicolaou test (Pap smear screening), HPV-DNA test, and numerous programmes to promote a healthy lifestyle, generate awareness, and early detection. Bhatnagar also focussed on the need to create more awareness, vaccination, and preventive measures to erudite cancer. Dr S Shantha Kumari, President, The Federation of Obstetric and Gynaecological Societies of India FOGSI said that Pap smear screening examination should be made mandatory. She also stressed that the girls must be fully vaccinated with the HPV vaccine by the age of 15. Dr Radhika Srinivasan, Professor, and Head of Department of Cytology & Gynec. Pathology, PGIMER, Chandigarh, and Secretary, Indian Academy of Cytologists gave a presentation on cytology titled ‘Cytology for Cervical Cancer Screening - Is It Relevant Today?’ She also informed that “Cytology and HPV DNA testing are both available in India, we have moved from conventional to liquid-based cytology, saves time manpower and cytology detects the disease rather than the infection, we 38

February 2022

need to create an efficient system for the present and the future. She added that cytology, a primary screening test, is available and quite affordable, too. Dr Abhishek Shankar, Associate Professor, Department of Radiation Oncology, AIIMS, Patna; Associate Editor, APJCP; Associate Editor, SAJC, Editor in Chief, APJCC; Founder Secretary, ISCO explained that India needs a groundshot approach as well as a communitybased approach. For this, we need to create a good strategy as it's going to be difficult to do so. He further explained, “Let’s put our efforts together to achieve the WHO target of ‘Eliminate Cervical Cancer’ in near future. Mridu Gupta, CEO, Caped India informed that while cervical cancer is the fourthmost cancer in the world, in India, it's the second-most common disease, which claims the lives of women every eight minutes. She elaborated, “World

Health Organisation (WHO) has made an estimate that India will be cervicalfree in 2110, which is a very long time. We also fall short on many parameters and lack of information is a major problem, but it can be reduced if there are discussions on cervical cancer and if awareness encourages and increases the number of women to undertake to screen. We need to create strategies and conversations around it regularly.” Dr Rajesh Kesari, Founder, and Director, Total Care Control, Delhi-NCR, who moderated the session, highlighted that cervical cancer that affects the female gender is an infection due to human papillomavirus (HPV); it is the most common sexually transmitted infection and is responsible for the majority of cervical malignancies. However, cervical cancer can be cured if detected early and the conference aimed to create this awareness to eliminate it.

The Evolving Cybersecurity Landscape Remote working has increased cyberthreats. But even after the global pandemic is over, it’s going to be important to take actionable steps to combat the sizable security risks.

Customized MVISION Device-to-Cloud Suites MVISION Advanced

MVISION Premium

MVISION Complete

We Recommend:

Implement a cloud-based secure web gateway

1 2 3 4 5 6

Require multi-factor authentication to reduce risks of credential theft

Set policy in the cloud for routine device checks

https://www.mcafee.com/enterprise/en-us/assets/reports/restricted/rp-carr-wfh.pdf https://www.mcafee.com/enterprise/en-us/assets/reports/restricted/rp-carr-wfh.pd Source: https://www.darkreading.com/cloud/as-cloud-adoption-grows-dlp-remains-key-challenge/d/d-id/1335000 https://newsroom.ibm.com/2020-07-29-IBM-Report-Compromised-Employee-Accounts-Led-to-Most-Expensive-Data-Breaches-Over-Past-Year https://www.gartner.com/smarterwithgartner/is-the-cloud-secure/ https://media.nominet.uk/wp-content/uploads/2019/02/12130924/Nominet-Cyber_CISO-report_FINAL-130219.pdf

8 https://www.mcafee.com/enterprise/en-us/assets/reports/rp-cloud-adoption-and-risk-report-work-from-home-edition.pdf McAfee and the McAfee logo are trademarks or registered trademarks of McAfee, LLC or its subsidiaries in the US and other countries. Other marks and brands may be claimed as the property of others. Copyright © 2020 McAfee, LLC. 4619_0920 SEPTEMBER 2020

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