This Presentation provides information about the segmentation of oncology market worldwide, Global Oncology market analysis along with Indian Oncology market.
This presentation covers the following information - Indian Government initiatives,Market Challenges,Market Drivers and SWOT Analysis.
Hans E Grossinklaus, MD, Director, Section of Ocular Oncology & Pathology at Winship Cancer of Emory University presents the Specialized Program of Research Excellence (SPORE) Update: Uniting to Advance Ocular Melanoma Research at the 2016 CURE OM Patient & Caregiver Symposium.
This Presentation provides information about the segmentation of oncology market worldwide, Global Oncology market analysis along with Indian Oncology market.
This presentation covers the following information - Indian Government initiatives,Market Challenges,Market Drivers and SWOT Analysis.
Hans E Grossinklaus, MD, Director, Section of Ocular Oncology & Pathology at Winship Cancer of Emory University presents the Specialized Program of Research Excellence (SPORE) Update: Uniting to Advance Ocular Melanoma Research at the 2016 CURE OM Patient & Caregiver Symposium.
Basic information for discussion with a healthcare professional is provided here together with some background:
• An enlargement or the presence of tumors in the gland below a man’s bladder that produces fluid for semen ie, the prostate, may suggest benign prostatic hyperplasia (BPH) or prostate cancer
o Almost 8% of new cancer cases worldwide are attributed to this highly curable disease (proportion of patients surviving after 5 years = 98.9%)
o In the USA alone, prostate cancer is the most common non-skin cancer, diagnosed more often in African-American (1 in 5 cases) than white men (1 in 6 cases)
o Prostate cancer is strongly correlated with age, starting at about 50 years old and rising over the ensuing decades
o While debates over under- or over-treatment of prostate cancer continue, it is clear that management of the disease costs the USA an aggregate annual loss in productivity of $3.0 billion
o Moreover, prostate cancer is the third-leading cause of cancer-related deaths in the USA, mainly due to advanced or metastatic disease
nside Myriad. At Myriad, our goal is to make a difference in patients' lives and our work has been guided by this mission throughout the Company's history. ... Since 1991, Myriad has invested heavily in educating patients and healthcare professionals about the role genes and proteins play in disease.
The presentation begins with a brief history of how cancer epidemiology evolved, and what is the status at present. After describing the burden of the disease of cancer globally and in India, the presentation includes a brief description of Cancer causes and prevention including screening activities. It also talks about the national Cancer Registry Program, NPCDCS and NCCP.
An introduction to week 1 of a free online course on enhancing prostate cancer care, delivered by Sheffield Hallam University in the UK (Oct-Nov 2014). Week 1 focuses on diagnosis.
Running head INEFFECTIVE CANCER TREATMENTS LEADING TO DEATHS1.docxcowinhelen
Running head: INEFFECTIVE CANCER TREATMENTS LEADING TO DEATHS 1
INEFFECTIVE CANCER TREATMENTS LEADING TO DEATHS 18
Ineffective Cancer treatments leading to deaths
Name
Course
Tutor
Date
Abstract
The main focus of the report will be to research on the various methods through which cancer can be treated with a keen eye on why some methods are ineffective and lead to death. A discussion on different cancer treatment will be done followed by the types of cancer that cause millions of death today. Presentation of answers to the research questions will be done in line with ineffective cancer treatment methods. Relevant literature review will be conducted and used to support the claims of ineffective cancer treatments. Lastly, recommendations on the best cancer treatment will be done.
Introduction
Cancer is an ailment caused by the unrestrained division of abnormal cells in the body. The cancer cells are malignant meaning they can spread from the origin to distant organs and tissues. The disease can be genetically hereditary hence can be crossed over from one generation to another. Some of the forms of cancer treatment include targeted therapy, hormone therapy, chemotherapy, precision medicine, surgery, immunotherapy, and stem cell transplant. Some of the common types of this disease include lung, liver, stomach, and bowel cancers.
Cancer is also called as malignancy which means abnormal cells growth. More than 100 types of cancer are found in this world today, including breast cancer (widely spread among women), skin cancer (found in the person of almost every age), lung cancer (common among smokers), colon cancer, lymphoma and prostate cancer. Each kind of cancer has varying symptoms. Cancer differs with respect to the cell it affects first. The uncontrollable division of cells harm the body and form lumps and the masses of tissues which are known as tumors. The tumor grows in size and sometimes even intervene the digestive system, circulatory system, excretory system and nervous system. In the case of leukemia, cancer inhibits the normal blood functioning which is caused due to the abnormal cell division into the blood stream. Cancer also causes the systems of the body to secrete hormones that alter the body functioning. Tumors that do not grow and remain limited to one spot are considered to slightly less harmful and benign. The sign of the more dangerous and malignant cells is:
1. The harmful cancerous cells move from one spot to another throughout the body using blood as a medium and invade the organs and the healthy tissues of the body.
2. These cells grow and divide rapidly, they make blood vessels of their own which are used by them in the process of feeding, called as angiogenesis.
Then comes a stage is known as metastasized in which the tumor spread successfully to the other parts of the body, penetrating into the healthy tissues of the body and damaging them badly. The process is known as metastasis. It cause ...
Survivorship Care and Care Plans: Transforming Challenges into OpportunitiesCarevive
Dr. Carrie Stricker attended last month's Arizona Cancer Survivorship Care Plan Summit in Phoenix Arizona. The summit was a joint effort between the Arizona Cancer Coalition , the Arizona Department of Health Services, and the Susan G. Komen® Central and Northern Arizona.
Comprehensive Cancer Control (CCC) Programs work in their community to promote healthy lifestyles and recommended cancer screening, educate people about cancer symptoms, increase access to quality cancer care, and enhance cancer survivors' quality of care. The Arizona Department of Health Services developed the Arizona Cancer Coalition for dedicated individuals, professionals, and cancer survivors to address the priorities outlined in the Arizona Cancer Control Plan. These priorities include prevent cancer, detect cancer early, elevate cancer treatment, galvanize quality of life/survivorship care networks, and catalyze research.
Susan G. Kamen® Central and Northern Arizona is one of 120 Affiliates around the world dedicated to combating breast cancer at every front. Its service area encompasses all of central and northern Arizona, including Apache, Coconino, Gila, La Paz, Maricopa, Mohave, Navajo, Pinal and Yavapai counties. Through events like the Susan G. Kamen Phoenix Race for the Cure®, the Affiliate has invested more than $26.4 million in local breast health and breast cancer awareness projects in central and northern Arizona, and breast cancer research.
This summit served as a forum for clinicians, nurses, program planners, and public health professionals within Commission on Cancer (CoC) accredited hospitals to learn about survivorship care plans and address the implementation of standard 3.3 of CoC accreditation.
Field of oncology has evolved since many decades! This presentation will demonstrate how oncology had evolved. Special focus is on current radiation oncology and surgical oncology practices along with principles of oncology.
Understanding Uterine Cancer Treatment Optionsbkling
Join Dr. Bhavana Pothuri, gynecologic oncologist at NYU Langone Medical Center, as she breaks down the different types of uterine cancer treatments available to patients based on their particular diagnosis. Learn about new research and treatment updates, options for when cancer recurs, side effects, and more.
Mirfin Mpundu, Executive Director of the Ecumenical Pharmaceutical Network describes the organization's efforts to partner to address anti-microbial resistance and chronic diseases.
Basic information for discussion with a healthcare professional is provided here together with some background:
• An enlargement or the presence of tumors in the gland below a man’s bladder that produces fluid for semen ie, the prostate, may suggest benign prostatic hyperplasia (BPH) or prostate cancer
o Almost 8% of new cancer cases worldwide are attributed to this highly curable disease (proportion of patients surviving after 5 years = 98.9%)
o In the USA alone, prostate cancer is the most common non-skin cancer, diagnosed more often in African-American (1 in 5 cases) than white men (1 in 6 cases)
o Prostate cancer is strongly correlated with age, starting at about 50 years old and rising over the ensuing decades
o While debates over under- or over-treatment of prostate cancer continue, it is clear that management of the disease costs the USA an aggregate annual loss in productivity of $3.0 billion
o Moreover, prostate cancer is the third-leading cause of cancer-related deaths in the USA, mainly due to advanced or metastatic disease
nside Myriad. At Myriad, our goal is to make a difference in patients' lives and our work has been guided by this mission throughout the Company's history. ... Since 1991, Myriad has invested heavily in educating patients and healthcare professionals about the role genes and proteins play in disease.
The presentation begins with a brief history of how cancer epidemiology evolved, and what is the status at present. After describing the burden of the disease of cancer globally and in India, the presentation includes a brief description of Cancer causes and prevention including screening activities. It also talks about the national Cancer Registry Program, NPCDCS and NCCP.
An introduction to week 1 of a free online course on enhancing prostate cancer care, delivered by Sheffield Hallam University in the UK (Oct-Nov 2014). Week 1 focuses on diagnosis.
Running head INEFFECTIVE CANCER TREATMENTS LEADING TO DEATHS1.docxcowinhelen
Running head: INEFFECTIVE CANCER TREATMENTS LEADING TO DEATHS 1
INEFFECTIVE CANCER TREATMENTS LEADING TO DEATHS 18
Ineffective Cancer treatments leading to deaths
Name
Course
Tutor
Date
Abstract
The main focus of the report will be to research on the various methods through which cancer can be treated with a keen eye on why some methods are ineffective and lead to death. A discussion on different cancer treatment will be done followed by the types of cancer that cause millions of death today. Presentation of answers to the research questions will be done in line with ineffective cancer treatment methods. Relevant literature review will be conducted and used to support the claims of ineffective cancer treatments. Lastly, recommendations on the best cancer treatment will be done.
Introduction
Cancer is an ailment caused by the unrestrained division of abnormal cells in the body. The cancer cells are malignant meaning they can spread from the origin to distant organs and tissues. The disease can be genetically hereditary hence can be crossed over from one generation to another. Some of the forms of cancer treatment include targeted therapy, hormone therapy, chemotherapy, precision medicine, surgery, immunotherapy, and stem cell transplant. Some of the common types of this disease include lung, liver, stomach, and bowel cancers.
Cancer is also called as malignancy which means abnormal cells growth. More than 100 types of cancer are found in this world today, including breast cancer (widely spread among women), skin cancer (found in the person of almost every age), lung cancer (common among smokers), colon cancer, lymphoma and prostate cancer. Each kind of cancer has varying symptoms. Cancer differs with respect to the cell it affects first. The uncontrollable division of cells harm the body and form lumps and the masses of tissues which are known as tumors. The tumor grows in size and sometimes even intervene the digestive system, circulatory system, excretory system and nervous system. In the case of leukemia, cancer inhibits the normal blood functioning which is caused due to the abnormal cell division into the blood stream. Cancer also causes the systems of the body to secrete hormones that alter the body functioning. Tumors that do not grow and remain limited to one spot are considered to slightly less harmful and benign. The sign of the more dangerous and malignant cells is:
1. The harmful cancerous cells move from one spot to another throughout the body using blood as a medium and invade the organs and the healthy tissues of the body.
2. These cells grow and divide rapidly, they make blood vessels of their own which are used by them in the process of feeding, called as angiogenesis.
Then comes a stage is known as metastasized in which the tumor spread successfully to the other parts of the body, penetrating into the healthy tissues of the body and damaging them badly. The process is known as metastasis. It cause ...
Survivorship Care and Care Plans: Transforming Challenges into OpportunitiesCarevive
Dr. Carrie Stricker attended last month's Arizona Cancer Survivorship Care Plan Summit in Phoenix Arizona. The summit was a joint effort between the Arizona Cancer Coalition , the Arizona Department of Health Services, and the Susan G. Komen® Central and Northern Arizona.
Comprehensive Cancer Control (CCC) Programs work in their community to promote healthy lifestyles and recommended cancer screening, educate people about cancer symptoms, increase access to quality cancer care, and enhance cancer survivors' quality of care. The Arizona Department of Health Services developed the Arizona Cancer Coalition for dedicated individuals, professionals, and cancer survivors to address the priorities outlined in the Arizona Cancer Control Plan. These priorities include prevent cancer, detect cancer early, elevate cancer treatment, galvanize quality of life/survivorship care networks, and catalyze research.
Susan G. Kamen® Central and Northern Arizona is one of 120 Affiliates around the world dedicated to combating breast cancer at every front. Its service area encompasses all of central and northern Arizona, including Apache, Coconino, Gila, La Paz, Maricopa, Mohave, Navajo, Pinal and Yavapai counties. Through events like the Susan G. Kamen Phoenix Race for the Cure®, the Affiliate has invested more than $26.4 million in local breast health and breast cancer awareness projects in central and northern Arizona, and breast cancer research.
This summit served as a forum for clinicians, nurses, program planners, and public health professionals within Commission on Cancer (CoC) accredited hospitals to learn about survivorship care plans and address the implementation of standard 3.3 of CoC accreditation.
Field of oncology has evolved since many decades! This presentation will demonstrate how oncology had evolved. Special focus is on current radiation oncology and surgical oncology practices along with principles of oncology.
Understanding Uterine Cancer Treatment Optionsbkling
Join Dr. Bhavana Pothuri, gynecologic oncologist at NYU Langone Medical Center, as she breaks down the different types of uterine cancer treatments available to patients based on their particular diagnosis. Learn about new research and treatment updates, options for when cancer recurs, side effects, and more.
Mirfin Mpundu, Executive Director of the Ecumenical Pharmaceutical Network describes the organization's efforts to partner to address anti-microbial resistance and chronic diseases.
Gain a deeper understanding of uterine and endometrial cancer symptoms, diagnosis, treatment options, and current research trends with Dr. Jason D. Wright, Division Chief of Gynecologic Oncology at New York-Presbyterian/Columbia University Medical Center. This webinar is a collaboration with the Foundation for Women's Cancer.
How general internists can participate in the continuum of care for patients with cancer. (Talk given at Internal Medicine Grand Rounds, St. Elizabeth Hospital, General Santos City, 10 Feb 2021.)
Real-World Treatment Patterns in Relapsed/Refractory Multiple Myeloma Patient...Howard Friedman
Goal: To describe patient characteristics, treatment patterns, and survival outcomes in RRMM patients with at least two prior lines of therapies, including lenalidomide (LEN), and at least one PI, in the real-world setting in Turkey.
Politics behind $100 billion cancer industry worldwideRafay Munawar
Following are the facts included in PPT:
Politics behind $100 billion cancer industry worldwide.
Different approaches of cancer treatment and their success ratio
& prevention of cancer through natural foods
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Approach to Young, High Risk AML patients with Limited Resources
1. Approach to
Young, High Risk AML
patients with Limited
Resources
Dr. Hemant Malhotra,
MD, FRCP (London), MNAMS, FUICC, FICP, FIMSA
Professor of Medicine &
Head, Division of Medical Oncologist
SMS Medical College & Hospital, Jaipur.
Email: drmalhotrahemant@gmail.com
6. Disclaimer
• No significant conflict of interest to
declare related to this presentation
• Views expressed by me in this
presentation are essentially mine
and my perspective of the problem
7. WARNING !!!!
• The following presentation may contain
contents and/or issues which may be
upsetting and/or disturbing to a section
of the audience!!
• Viewer discretion is advised while
attending this session!!
8. Talk Outline
• Some India-specific Issues
• AML - Overview
• AML in India
• AML in resource limited setting
• The Future
9. India - Population & Problems
• 1.20 billion people (estimated 2011)
• 15% of the world‟s population
• 2nd most populous country after China
• Increasing at the rate of 1.7% annually
• Likely to overtake China in the middle of this century
• Rapidly aging population – presently 40% younger that
15 yrs.
• Senior citizens expected to increase by 274% by year
2040. India will have 20% of the world‟s senior citizens
by 2040.
• No social system of medicine
• 10 to 15 % have access to medical insurance – 85 to
90% „out-of-pocket‟ payment
11. Cancer in India
• 1 million new cases detected every year
• 3-3,50,000 die each year due to cancer
• 500 % increase in cancer in India by 2025
(280% due to ageing & 220% due to
tobacco use)
12. Oncology Care in India:
Best to the non-existent
• Oncology setups in Metros - Matching
best international standards
• Good hospitals with trained oncologists
in category A & most category B cities
• Radiotherapy dept in most medical
college hospitals
• No/minimal presence at district/village
level hospitals
24. High Risk AML in
Young patients with
Limited Resources
Standard aggressive induction
chemotherapy followed by 3/4
cycles of Consolidation
chemotherapy with HD Ara-C or
Allogenic HSCT in 1st remission
29. AML in India
• Remission rates: 60 to 70%
• 2 year DFS: 10 to 30% (more in children)
• Total cost of Standard 3+7 Induction CT
followed by 3 to 4 HD Ara-C (including
supportive care): INR 3,00,000/- to
5,00,000/- (USD: 6,000/- to10,000/-)
• Approximate cost of Allogenic HSCT: INR
7,00,000/- to 10,00,000/- (USD: 14,000 to
20,000)
31. Leukemia Lymphoma Clinic,
Birla Cancer Center, SMSMC&H, Jaipur
1992 to 2010 Data
N=1348
94
366
29486
234
334
AML ALL CML CLL HD NHL
32. Jaipur AML Data
• N= 94
• Median age: 48 years
• 22 patients less that 20 years of age
• Only 16 out of 94 received standard-of-care
chemotherapy
• Majority not eligible for standard-of-care
chemotherapy b/o:
– Financial constrains
– Lack of supportive care (no blood and/or platelet
donors)
– Logistic issues
– Co-morbidities
33. AML in India
• Less than 30% of patients eligible for standard-
of-care treatment aggressive treatment
• Less than 5% of patients receive allogenic SCT
• Majority not eligible for standard-of-care
chemotherapy b/o:
– Financial constrains
– Lack of supportive care (no blood and/or platelet
donors)
– Logistic issues
– Co-morbidities
34. AML in India
• Options for the patient who are not
eligible for standard aggressive CT:
– Best Supportive Care
– Low-dose, metronomic chemotherapy
– Innovative approaches (e.g. arsenic for
APML)
– Other novel combinations: e.g. targeted
agents (FLT3 I) with chemotherapy -
standard/metronomic, other combinations
– Clinical trials
38. To study the efficacy and toxicity of low
dose, metronomic chemotherapy in
patients of AML who are not candidates
for standard-aggressive chemotherapy
THE METRONOMIC CHEMOTHERAPY OF AML: (PEM)
Prednisolone 40 mg/m2/day,
Etoposide 50 mg/m2/day and
6-MP 75 mg/m2/day
Given orally on out-patient basis continuously for 21 days every month
Prospective Single-arm Study at SMSH, Jaipur
N= 25
39. “When administered, as in the schedule published here, it is associated with minimal
toxicity and is well tolerated. After remission induction, it can be administered on an
outpatient basis; this, in combination with the absence of conventional toxicities of
chemotherapy such as grade 3/4 neutropenia and mucositis, makes it significantly less
expensive to administer. In our setting, administration of an ATRA plus chemotherapy
regimen is associated with expenses of approximately $15 000 to $20 000, while this
single-agent As2O3-based regimen is associated with expenses of approximately $3000
to $5000.”
42. Conclusions:
• AML Rx in a resource-constrained setting is a
major challenge
• No easy answers
• All out efforts to increase infra-structure and
provide medical insurance/other funding for
diagnosis & Rx (including supportive care &
HSCT) at least for the young patient with AML
• Role of metronomic Rx
• Role of targeted agents
• Region-specific clinical trials needed to
address local issues
![Sawai Man Singh [SMS]
Medical College Hospital](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)