Live Discussion with Dr. Archit Pandit
Questions doctors asked during the Jivo Masterclass on Advanced Treatments in Gynaec Oncology, taught by Dr. Archit Pandit, Director - Surgical Oncology, Fortis Escorts Hospital, New Delhi, India, on . Written by Jivo Healthcare from the transcript of the session, drafted with AI assistance and edited by the Jivo team.
What is the cost range for laparoscopic surgery in gynaecologic oncology cases, recognising that it depends on the complexity of the surgery, and does the hospital offer chemoradiotherapy, IMRT and VMAT?
Asked by Dr. Mizi Kashweka, Zambia
Laparoscopic cancer surgery, whether a laparoscopic radical hysterectomy or a laparoscopic hysterectomy, usually costs around $5,000 to $5,500. We also very frequently perform surgery for endometriosis: these operations are very difficult and gynaecologists generally do not want to venture into them, so we receive many endometriosis referrals. Costs range from around $5,000 to $6,500. Fortis has radiation oncology: 3D-CRT, IMRT, IGRT, 3D arc therapy, CyberKnife, tomotherapy and brachytherapy. Beyond routine medical oncology, we have access to targeted therapy and immunotherapy, and India now has CAR-T cell therapy at one centre, one of the most advanced treatments in the world at present.
Answered by Dr. Archit Pandit
What is the utility of high-intensity focused ultrasound (HIFU) therapy for gynaecologic malignancies, is it available at your institution, and what does it cost?
Asked by Dr. William Gadaga, Zimbabwe
Focused ultrasound therapy is generally used for certain small fibroids. My own area of interest is malignancy, that is, cancer surgery, but focused ultrasound therapy is performed at Fortis, and the cost ranges from around $4,500 to $6,500.
Answered by Dr. Archit Pandit
What advancements has Fortis made for African patients with gynaecologic malignancies, what are the most recent and frequent surgical treatments you offer, and what is the estimated cost of each surgical option?
Asked by Dr. Zammenu, Ethiopia
There is no advancement that is particular to African patients. What I would suggest is that there is real scope for cancer vaccines, for HPV-related cancers of the cervix, vagina, vulva and oropharynx, to be spread across forums of African patients and African general practitioners. Vaccines for cervical and other cancers would be a very important topic of discussion and practice. In gynaecologic cancer surgery, the most important advancement is HIPEC (hyperthermic intraperitoneal chemotherapy), used for colon cancers, most frequently ovarian cancers, peritoneal and appendiceal cancers, rectal cancers and stomach cancers. Ovarian cancers are generally diagnosed at stage 3C or stage 4, when the cancer is already advanced, and these patients were frequently neglected, with no treatment available. Over the last 10 to 15 years HIPEC has come to the forefront: we now treat stage 3C and some stage 4 cancers, with tremendous improvement in certain ovarian cancers. The next advancement is robotic and laparoscopic cancer surgery for retroperitoneal lymph node dissection, endometriosis surgery, radical hysterectomy and pelvic node dissection. The further advancement is sentinel lymph node dissection. We no longer need to perform the full pelvic lymph node excisions we usually performed in many endometrial and cervical cancers: we identify the one lymph node to which the tumour spreads and remove it, instead of removing all the other lymph nodes and causing many side effects. The cost of these procedures usually varies from $5,000 up to $6,500 to $7,000. HIPEC surgery costs around $11,000 to $12,000.
Answered by Dr. Archit Pandit
Since HIPEC comes in from stage three onward, is it possible to operate on a patient with stage two cervical cancer using HIPEC or another technology?
Asked by Dr. William Gadaga, Zimbabwe
No. HIPEC is not for cervical cancer. It is used only for peritoneal, appendiceal, ovarian, colon and rectal cancers and some stomach cancers: these are the cancers in which HIPEC is beneficial. Among gynaecological cancers, ovarian and endometrial cancer are the only two in which HIPEC can be used. For cervical cancer we can go for surgery; from stage 2B onwards we go for chemotherapy and radiation therapy, followed by some form of immunotherapy.
Answered by Dr. Archit Pandit
How can general practitioners from Africa, meaning doctors on the medical rather than the surgical side, access specific course modules at Fortis?
Asked by Dr. William Gadaga, Zimbabwe
Doctors on the medicine side can come as observers. We cannot give you hands-on training, because in India hands-on training is generally given to foreign doctors who are surgeons or gynaecologists. We can give you an overview of cancer care across our preventive health checkups, medical oncology and surgical oncology. The best part is to be part of our tumour board: a round-table meeting where we take decisions, bring all the world literature to the table, and the whole board sits and discusses each and every case.
Answered by Dr. Archit Pandit
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In This Series: Advanced Treatments in Gynaec Oncology
- 1.Advanced Treatments in Gynaec Oncology
- 2.HIPEC for Ovarian Cancer, Keyhole Surgery and Sentinel Nodes
- 3.Early Detection of Gynaecological Cancer: Red Flags and BRCA
- 4.Live Discussion with Dr. Archit Pandit