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'No one understands head and neck cancers better'
As medicine progresses, how relevant would surgery continue to be?
Surgery is like any business venture;it is shrinking at one end and increasing in other areas. So, the net result is that surgery is still allimportant. When I was a resident doctor in KEM Hospital over two decades back, we would operate on one or two patients with peptic ulcers every week. Now, we no longer operate for peptic ulcers as drugs can completely take care of it. Drugs have also made surgery vanish from the treatment for benign prostrate cancer and enlargement. There is no doubt that continuous research has made surgical interventions disappear in some cases. However, in the case of solid cancers, which account for about 80 per cent of the cancers, surgery is needed despite drugs. There is nothing on the horizon that can reverse the effects of a solid tumour. Drugs can shrink the cancer, but surgery is definitely needed in such cases.
It is not only drugs that have come up, even surgery has evolved a lot over the years...
The main theme of surgery these days is to improve access without increasing the incision. The focus is also on saving limbs and tissues. We strive hard to ensure that women don't have to lose their breasts completely due to cancer. We work towards conserving their breasts while ensuring that the cancer doesn't return. Similarly, we have cut down the need for limb amputations in bone cancer by 70 per cent. At Tata Memorial Hospital, we work on conserving a patient's voice box instead of removing it. Even if we need to remove the box, we rework things in such a manner that the patient continues to speak in his own voice.
What's your view on Indian expertise in surgery?
There is no doubt about our expertise. No one can understand head and neck cancers and surgically treat them better than us. We have the largest series in this cancer and hence the expertise. Ditto in the fields of oesophageal and breast cancers. In the next seven to eight years, we will have standardised treatment drawn up for all forms of cancer. The world will, in fact, look towards evidence from India on treatment of cancers.
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