siliconindia | | November 20199includes a genomics study and im-munology study. This combined with advanced molecular imaging can give us a near perfect situation of the sta-tus of the disease along with the right mode of treatment. This may involve, for instance, limited surgery, radical surgery, precision radiation, chemo-therapy, biotherapy or immunothera-py, based on the patient's presentation and markers.When we talk about surgery for instance, in the past, we did exten-sive surgery. But today, we employ target surgery. In breast cancer cases, there is no longer a need of mastec-tomy. Instead, we do a lumpectomy and analyse further to provide the best treatment. Today, with state of the art facility and the right technology available, we can achieve 90 percent disease-free survival in breast cancer cases and match the world standards.Taking radiation for instance, in the past, we did radiation as a pal-liative treatment - pre-operative or post-operative treatment or in cases where surgery was not possible. But today, there is no palliative care. Ra-diation, even in metastasized cases, or advanced cases can be given not just to treat the disease, but also to cause an immunological response to other parts of the body. This has emerged as a matter of great interest in the field of medicine where radiation along with immunotherapy may become the answer when it comes to treating ad-vanced cases. Today, using radiosur-gery, we can treat tumours faster and more accurately, focussing only on the tumour rather than on tissues. For example, multiple lesions in the brain can be treated without causing any harm to the larger part of the brain.The integration of `Digital Pa-thology' for an expert opinion on the biology of the tumor enables us to identify specific molecular defects, establish new biomarkers and ensure accurate diagnosis. This also helps us to rationalize the treatment decision, prognosticate the disease and moni-tor the response in patients. Through Digital Pathology, doctors can now use Next Generation Sequencing (NGS) of the cancer genome from biopsy of the tissue and the tumour DNA from the blood sample to arrive at accurate results. `Radio genomics' is playing a significant role in under-standing genetic variation associated with response to radiation by analys-ing radio-sensitivity index (RSI) and correlate between cancer imaging fea-tures and gene expression. As experts we believe that there has to be a significant change in treat-ing cancer and research is the first step to help us do that. We can cite many examples of patients who have bene-fited from the application of genom-ics research to their treatment. We need to move from a symptom-based approach to cancer care that gives us limited choices in treatments to a more gene/biochemical pattern-based approach so that we can offer patients personalized cancer medicine em-powered by genomics. When we treat cancer this way, it not only improves treatment outcomes for the patients, but also helps to significantly bring down the overall cost.Thus, the success of `Genomic Medicine' can already be seen in clin-ical practice. Since the publication of Human genome project in 2000, inte-gration of many cost effective diag-nostic platforms, there has been a sig-nificant increase in our understanding of the biology of each cancer, making the disease highly treatable. Cancer is no more a deadly disease, but consid-ered as a chronic lifestyle disease if the cure is done in proper way i.e. the right way the first time. Radiation, even in metastasized cases, or advanced cases can be given not just to treat the disease but also to cause an immunological response to other parts of the body
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