Name: Ramesh Khanojia
Location: Mumbai
Question:What is the prognosis for thyroid cancer, and what factors can affect it?
Answer:The prognosis of thyroid cancer is usually good. The majority of thyroid cancers have survival and control rates upwards of 90%. In fact, some small cancers can have survival upwards of 99%. However, there are some cancers that are good cancers with this extremely good survival and some which are not so good. So, what makes the prognosis of thyroid cancer bad. Thyroid cancer is the only cancer where Age is an important prognostic factor. All those above the age of 45-55 have a more aggressive tumor.
The second is the stage with which the patient presents. If it is confined to the thyroid gland, it has a better prognosis than if it goes to the rest of the body. 3rd is the type of cancer or the grade of cancer. There are certain thyroid cancers which are more aggressive, and histology is more aggressive. The 4th important prognostic factor is the completeness of surgery. Very often surgery is done half-heartedly, the disease is left behind that can have an implication on the outcomes and the 5th prognostic factors is if the patient presents with thyroid cancer that has invaded local tissues such as the voice box, wind pipe or food pipe, these patients have poor prognosis.
Name: Sneha Ann
Location: Kolkata
Question:How important is early detection in improving the outcomes for thyroid cancer patients?
Answer:Early detection is useful for the majority of cancers. However, in thyroid cancer we do not go around looking for thyroid cancer by doing screening tests. WHO has given an advisory that routine ultrasounds, that is, sonography of the neck should not be done in asymptomatic patients to pick up thyroid cancer. The reason is many of us have small foci of thyroid cancer, which are largely asymptomatic and will never threaten our life or will need surgery in the lifetime. This was found when autopsies were conducted on people dying of other causes. 20 percent of people could have these small laboratory cancers as they are called within the thyroid gland. Therefore, we should not go around doing screening tests of the sonography for thyroid cancer.
The only thyroid cancer which is screened for is a variant of thyroid cancer called medullary thyroid cancer medullary thyroid cancer occurs from certain special cells in the thyroid. These cancers form about 09:55 percent of all thyroid cancers. These cancers are of 2 types, familial, which means it runs in families seen in 20%, and sporadic, which can just occur in an individual person in 80 percent. Finding out whether your cancer is familial is important and it is done by doing a special test. A genetic test called red proto onco gene on your blood, which will tell you whether this cancer is familial. Picking up these cancers early ensures a near complete cure rate close to 100%.
Name: Nirmal Sahadevan
Location: Chennai
Question:What are the typical symptoms of thyroid cancer, and does it get diagnosed?
Answer:Tyroid cancers are usually diagnosed with swelling. The patient will present with a swelling in the front of the neck or in the side of the neck if the cancer is spread to the lymph nodes. Sometime the cancer grows behind or backwards and involves the voice box nerve, that's the recurrent laryngeal nerve or involves the windpipe. In that case, the patient will present with hoarseness of voice or with the cough and sometime hemoptysis, that is, blood in the sputum.
Answer:If the cancer spreads to the food pipe, people might have difficulty in swallowing. Occasionally the cancer spreads to other parts of the body, such as the lung and the bones. Some people with small thyroid cancers could present just with bone swelling. It could be a big bump on the scalp that's on the head. It could be present in the spine; in which case you would have difficulty in walking & pain. It could be in the lungs, in which case they could be coughing, and again hemoptysis of blood in the sputum. However, the vast majority of cancers present locally with the swelling that could be in front of the neck or to the side of the neck.
Name: Anil Thomas
Location: Bangalore
Question:Can you explain the role of bone marrow and stem cell transplants in the treatment of certain blood cancers.
Answer:Bone marrow transplant is primarily used for high grade leukemias. It's also used for relapsed lymphomas. Stem cell therapy on the other hand is when your bone marrow is totally depleted with intensive chemotherapy and radio therapy. It’s kind of a transplant in itself that helps rejuvenate the bone marrow.
Name: Cyril Mathew
Location: Kollam
Question:Are there any promising new therapies or research developments in the field of blood cancer treatment?
Question:The new developments in the treatment of blood cancer are one- genetic. I wouldn't say genetic. I would say mutational understanding of certain genetic stroke mutational changes in the blood cancer so that we can target these specifically with certain drugs that act purely on these targets. The second is exciting new developments in the treatment which includes new drugs which are targeted drugs as well as immunotherapy, and the 3rd is recent advances in bone marrow transplant and Kar T cell therapy.
Name: Praveen Kumar
Location: Mumbai
Question:How does prostate cancer impact quality of life?
Answer:Prostate cancer affects the quality of life of patients. There are 3 main domains which are affected by prostate cancer. This could be because of the cancer itself, or it could be because of the side effects of treatment. The domains that are primarily affected as sexual function. Prostate is a male sex gland urinary function. They could have difficulty in passing urine, incomplete evacuation of the bladder, bleeding from the bladder, going frequency, urgency, and it also affects bowel function. That is, the number of times you pass your motions, particularly post treatment. Prostate cancer can also affect the quality of life. If it is a little advanced and goes to the bones, people can just present with intractable back pain and then prostate cancer is diagnosed.
Name: Anand Chacko
Location: Kerala
Question:What is the role of genetics and family history in the development of prostate cancer and should individuals with family history be screened separately?
Answer:Prostate cancer is known to be genetic or heritable. That means if someone has a first degree relative with prostate cancer, the risk increases if they have more than one relative with prostate cancer, the risk is 4 times more. There are certain genes that are known to be associated with this hereditary prostate cancer such as braka and various other kinds of genes. You inherit the gene, not the cancer. So even if some of them have this gene they may not get cancer. But given the increased risk, what must be done is that people with a family history need to start screening at a much earlier age and they need to be screened more frequently.
Name: Monish Sen
Location: Mumbai
Question:Are there any specific risk factors that make someone more susceptible to thyroid cancer symptoms and how can one reduce their risk?
Answer:There are no well-established risk factors for thyroid cancer. Thyroid cancer is very common among people who have taken radiation, particularly in childhood, either for a medical condition like a young child who has a lymphoma treated with radiation, or any other such condition, or for people who have grown up kids in areas of nuclear fallout such as Chernobyl and other things. Some thyroid cancers run in families as well. These are usually the medullary thyroid cancers, but even the well differentiated thyroid cancers can run with certain syndromes, such as what we call Carney syndrome, Cowden syndrome, but these syndromes generally manifest with other side effects, and that's how these cancers are diagnosed.
Name: Sharad Kumar
Location: Pune
Question:What are the most common early signs of thyroid cancer, and when should I be concerned if I experience them?
Answer:Thyroid cancer usually presents with swelling. The blood reports or thyroid function tests are usually normal. Whenever you have an abnormal thyroid function test, it usually is not a cancer. Very, very rarely could it be cancer, so all swellings of the thyroid with abnormal reports are usually treated medically. They could be thyroiditis, which is very common among middle-aged ladies. It could be a quieter which might need surgery for different indications. It could be thyrotoxicosis, which is excessive secretion of thyroid, which again rarely is operated on.
Name: Jeevan Singh
Location: Delhi
Question:How important is it to seek medical evaluation if I notice a lump in my neck or other potential thyroid cancer symptoms?
Answer:It is very important for you to seek medical advice if you get a lump in the neck. Lump in the neck, usually above the age of 40, particularly if the person is a smoker or tobacco user needs to be investigated if it is there for more than 03-04 weeks. Thyroid cancer lumps are usually in the center of the lower neck. When it gets a little more advanced, it spreads to the sides of the neck when it spreads to the limp glands. A good way of knowing whether the lump in your neck is a thyroid or not is to extend your neck, that is look towards the ceiling and swallow. If the lump moves up when you swallow, what we call moves up on deglutition, that is a thyroid lump. Such a patient needs to go for further investigations.
Name: Shilpa Raje
Location: Mumbai
Question:Could you explain the different types of thyroid cancer and their respective treatment approaches?
Answer:Thyroid cancers are of different types. 90% of them occur from the thyroid follicular epithelium and they are called follicular cell derived thyroid cancers. These are papillary thyroid 90% of the time, follicular cancers, mixed papillary and follicular. Basically, we call it a follicular variant of papillary thyroid cancer. These form 90% of thyroid cancers. 5 to 10% are what we call medullary thyroid cancers, and these appear from what we call the para follicular cells, not the thyroid follicles, but next to them they have parathyroid para follicular cells.
Answer:Then there are some aggressive variants of thyroid cancers which are poorly differentiated and anaplastic. The anaplastic sometime is very, very lethal, with patients not surviving more than 6 months, and the rare forms of thyroid cancer could be a lymphoma that occurs within the thyroid gland. The majority of thyroid cancers, barring lymphoma, if they are operable, need to have surgery as the initial first step. Surgery is done to remove all cross diseases with minimum mobility. Depending on the histology, the patient has to be decided on whether they need adjuvant or supplementary therapy, which could consist of radioiodine therapy, which is a nuclear treatment, external beam radiotherapy, and occasionally now some people need chemotherapy.
Name: PJ James
Location: Kottayam
Question:What are the recommended screenings and tests for prostate cancer, and at what age should men start considering them?
Answer:There are certain genes that are known to be associated with this hereditary prostate cancer such as braka and various other kinds of genes. You inherit the gene, not the cancer. So even if some of them have this gene they may not get cancer. But given the increased risk, what must be done is that people with a family history need to start screening at a much earlier age and they need to be screened more frequently.
Name: PJ James
Location: Kottayam
Question:What are the recommended screenings and tests for prostate cancer, and at what age should men start considering them?
Answer:There are certain genes that are known to be associated with this hereditary prostate cancer such as braka and various other kinds of genes. You inherit the gene, not the cancer. So even if some of them have this gene they may not get cancer. But given the increased risk, what must be done is that people with a family history need to start screening at a much earlier age and they need to be screened more frequently.
Name: Vishnu Ramachandran
Location: Kerala
Question:How often should men with a family history of prostate cancer or other risk factors consult a specialist for preventive care?
Answer:Prostate cancer is known to be genetic or heritable. That means if someone has a first degree relative with prostate cancer, the risk increases if they have more than one relative with prostate cancer, the risk is 4 times more. There are certain genes that are known to be associated with this hereditary prostate cancer such as braka and various other kinds of genes. You inherit the gene, not the cancer. So even if some of them have this gene they may not get cancer. But given the increased risk, what must be done is that people with a family history need to start screening at a much earlier age and they need to be screened more frequently.
Name: Neeraj
Location: Assam
Question:Can you explain the role of bone marrow transplantation in the treatment of blood cancers and who might be eligible for this procedure?
Answer:Bone marrow transplant is primarily used for high grade leukemias. It's also used for relapsed lymphomas. Stem cell therapy on the other hand is when your bone marrow is totally depleted with intensive chemotherapy and radio therapy. It’s kind of a transplant in itself that helps rejuvenate the bone marrow.
Name: Gayatri Devi
Location: Mumbai
Question:Are there any ongoing clinical trials or emerging therapies that show promise in the treatment of blood cancers that patients should know about?
Answer:The new developments in the treatment of blood cancer are one- genetic. I wouldn't say genetic. I would say mutational understanding of certain genetic stroke mutational changes in the blood cancer so that we can target these specifically with certain drugs that act purely on these targets. The second is exciting new developments in the treatment which includes new drugs which are targeted drugs as well as immunotherapy, and the 3rd is recent advances in bone marrow transplant and Kar T cell therapy.