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Indian Med Guru
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Lymphoma Treatment in India
What is a Lymphatic System?

A lymphatic system is a complex network of tubes (lymphatic vessels), glands (or
lymph nodes) and other organs including the spleen. The vessels and glands hold
a fluid called lymph. The lymphatic system has a number of functions. It drains
waste products and excess fluid from different parts of the body and moves them
to the blood stream to be processed. It also conveys nutrients and cells. The
lymphatic system is also part of the immune system, or the body’s natural defence
against infection. The lymph carries white blood cells called lymphocytes, which
help us to fight infection. We have lymph nodes and lymphatic vessels throughout
our body. Often the lymph nodes are found in groups, particularly under the arms,
in the neck and in the groin.

What is Lymphoma?

Lymphoma is a cancer of the lymphatic system, the body's disease-fighting network. The lymph system is made up of many
cells and organs, including the lymph nodes, thymus gland, spleen, and liver. This system produces B-Cells and T-Cells
lymphocytes, which make up your body’s immune system. These are spread throughout your body, much like your blood
vessels. In lymphoma, lymphocytes start to multiply in an abnormal way and begin to collect in certain parts of the lymphatic
system, such as the lymph nodes. Since these cells travel between the lymphatic and circulatory system while fighting
infections and viruses, lymphomas are blood-related cancers. The affected lymphocytes lose their infection-fighting properties,
making you more vulnerable to infection.

What are the Causes of Lymphoma?

Cancer is ultimately the result of cells that uncontrollably grow and do not die. Normal cells in the body follow an orderly path
of growth, division, and death. Programmed cell death is called apoptosis, and when this process breaks down, cancer results.


What are the Risk Factors?

Scientists do not know exactly what causes lymphoma, but they have identified several potential risk factors.

    •   Genetics - Lymphoma can be the result of a genetic predisposition that is inherited from family members. It is possible
        to be born with certain genetic mutations or a fault in a gene that makes one statistically more likely to develop cancer
        later in life.

    •   Carcinogens - Carcinogens are a class of substances that are directly responsible for damaging DNA, promoting or
        aiding cancer. Exposure to certain pesticides, herbicides, and solvents such as benzene has been associated with
        lymphoma. Similarly, black hair dye has been linked to higher rates of NHL. When our bodies are exposed to
        carcinogens, free radicals are formed that try to steal electrons from other molecules in the body. These free radicals
        damage cells, affecting their ability to function normally, and the result can be cancerous growths.

    •   Other Medical Factors - As we age, there is an increase in the number of possible cancer-causing mutations in our
        DNA. The risk of NHL increases as we age, and HL is most common between ages 16-34 and 55 years and older.
        Additional medical conditions that have been associated with higher lymphoma rates include infection with HIV,
        human T-lymphocytic virus type 1 (HTLV-1), Epstein-Barr virus, Helicobacter pylori, or hepatitis B or C; autoimmune
        disease (such as lupus); diseases that require therapies that suppress the immune system; and any other
        immunodeficiency diseases.
What are the Symptoms of Lymphoma?
Following are some of the symptoms of lymphoma;

    •   Swollen, painless lymph nodes in the neck, armpits, or groin
    •   unexplained weight loss
    •   soaking night sweats
    •   coughing trouble
    •   breathing or chest pain
    •   fatigue
    •   feeling of fullness in the



What are the Diagnosis and Tests for Lymphoma?

    •   Physical examination: Swollen lymph nodes in your neck, underarms, and groin, and swollen spleen or liver are
        usually examined doctors. Chest x-ray test is done to check the swollen lymph nodes.
    •   Biopsy: Biopsy is the only sure way to diagnose Lymphoma
    •   Excisional Biopsy: Entire lymph node is removed to diagnose lymphoma.
    •   Incisional Biopsy: Only a part of Lymph node is removed to diagnose lymphoma.
    •   X-ray
    •   CT scan/CAT scan
    •   MRI (magnetic resonance imaging)
    •   Gallium scan
    •   PET (positron emission tomography) scan
    •   Laboratory tests: Blood tests and urine tests

What are the Types of Lymphoma?

There are two types of lymphoma: Hodgkin lymphoma (HL, also called Hodgkin's disease) and non-Hodgkin lymphoma (NHL).
Both HL and NHL can occur in the same places and have similar symptoms. Their differences are visible at a microscopic
level. Hodgkin lymphoma develops from a specific abnormal lineage of B cells. There are five subtypes of HL. NHL may derive
from either abnormal B or T cells, and its 30 subtypes are distinguished by unique genetic markers.

Hodgkin Lymphoma (HL) - Hodgkin lymphoma can arise anywhere in the body where lymphocytes are found. HL has
characteristics that differentiate it from all of the other types of lymphoma, most notably the presence of a cell called the Reed-
Sternberg cell. A Reed-Sternberg cell is a large, abnormal cell that does not protect the body from infection. When it
abnormally multiplies, it often forms a tumor within a lymph node and attracts inflammatory cells around it. While the cause is
unknown, certain factors have been shown to increase the risk of developing Hodgkin lymphoma. Treatment for Hodgkin
lymphoma may include chemotherapy and/or radiation therapy. In certain cases, bone marrow or stem cell transplant may be
recommended, especially if the disease does not respond to initial treatment or if it returns despite an initial response to
treatment.

Non - Hodgkin Lymphomas (NHL) - Non - Hodgkin's lymphoma is a general term for a large group of lymphatic cancers that
comprise approximately 90% of all diagnosed lymphomas. Hodgkin's disease contain specific cells called Reed-Sternberg
cells that are not found in patients with non-Hodgkin's lymphoma. Approximately 85% of all non-Hodgkin's lymphomas
originate in B-lymphocytes and are sometimes referred to as B-cell lymphomas. Non-Hodgkin lymphoma begins when a
lymphocyte (usually a B cell) becomes abnormal. The abnormal cell divides to make copies of itself. The new cells divide
again and again, making more and more abnormal cells. The abnormal cells don't die when they should. They don't protect the
body from infections or other diseases. The buildup of extra cells often forms a mass of tissue called a growth or tumor. In
general, the risk factors for non-Hodgkin lymphoma include the following: Weakened immune system Certain infections like
Human immunodeficiency virus, Epstein-Barr virus (EBV), Helicobacter pylori, Human T-cell leukemia/lymphoma virus type 1
(HTLV-1) and Hepatitis C.
What are the Stages of Lymphoma?

Once the diagnosis is confirmed, doctors "stage" the disease. Staging is how doctors
determine the extent of the disease, which affects treatment options.

   •    Stage I: The cancer is limited to one lymph node region or a single organ.

   •    Stage II: In this stage, the cancer is in two different lymph nodes or the cancer
        is in a portion of tissue or an organ and nearby lymph nodes. But the cancer is
        still limited to a section of the body either above or below the diaphragm.


 Stage III: When the cancer moves to lymph nodes both above and below the diaphragm, it's considered stage III. Cancer may
 also be in one portion of tissue or an organ near the lymph node groups or in the spleen.

 Stage IV: This is the most advanced stage of lymphoma. Cancer cells are in several portions of one or more organs and
 tissues. It affects not only the lymph nodes but also other parts of your body, such as the liver, lungs or bones.


 What are the various Types of Treatment available for Lymphoma?

 There are several factors that you will need to take into account when deciding on your treatment. They include patient’s age,
 stage of lymphoma, likely progression of lymphoma, sub-type of lymphoma and possible side effects of the treatments.

 Chemotherapy - Chemotherapy is a widely used treatment for lymphoma, often combined with radiotherapy. The type of
 chemotherapy you receive will depend on the type and stage of your lymphoma. If it is thought that your lymphoma is curable
 you will normally receive an aggressive treatment regime designed to kill all of the cancerous cells in your body. However, if a
 cure is unlikely, then a more moderate treatment regime may be used which can often provide long-term relief from symptoms.
 An aggressive chemotherapy regime will involve you receiving injections of chemotherapy (intravenous chemotherapy) while a
 more moderate regime will involve you taking chemotherapy tablets (oral chemotherapy).

 Radiotherapy - Radiotherapy is often used to treat stage 1 and 2 lymphomas, when the cancerous cells are located in only one
 part of the body. Treatment is normally given daily, over the space of 2-6 weeks. The radiographer will need to first carefully
 plan your treatment. This may involve one or several appointments, where the radiographer uses a machine to 'map' out the
 lymphoma and decide what parts of your body the radiotherapy should be directed at. This may involve making small marks
 on your skin with a kind of marker pen. Radiotherapy itself is painless, but it does have a number of common side effects.
 These can vary, depending on which part of your body is being treated. For example, if the affected lymph nodes are in your
 throat radiotherapy can lead to a sore throat, while treatment to the head can lead to hair loss.

 Monoclonal Antibody Therapy - Monoclonal antibodies are drugs that can ‘recognize’ and find specific cells in the body. These
 drugs can be designed to find a particular type of cancer cell in the body. The monoclonal antibodies attach themselves to the
 cancer cells and destroy them. There are different types of monoclonal antibody treatment. They can be used alone, with
 radiotherapy or with chemotherapy. A monoclonal antibody treatment is available for certain types of lymphoma. The treatment
 may be used as part of initial treatment or if the disease recurs. In lymphoma, monoclonal antibody treatment can be given in
 different ways.

 Steroids - Steroids are used to treat some cases of lymphoma, in combination with chemotherapy. It is believed steroids make
 the chemotherapy more effective. Steroids are given intravenously, usually at the same time as your chemotherapy. A short-
 term course of steroids, lasting no more than a few months, is usually recommended, as this limits the number of side effects
 you could experience. Some side-effects of steroids are increased appetite, sleeping problem, indigestion, increased energy
 levels, etc.
Transplants - Sometimes high doses of chemotherapy destroy the lymphoma cells and your bone marrow. To help your
bone marrow make new healthy blood cells, some stem cells may be taken with a special machine before chemotherapy is
given. These cells are then transplanted into the body. These transplanted cells will then find their way to the bone marrow
and restore it, so that it can build healthy new blood cells.


Benefits of Lymphoma Treatment:

Many people are frightened at the idea of having cancer treatments because of the side-effects that can occur. Although the
treatments can cause side effects, these can usually be well-controlled with medicines. The potential benefits of treatment of
Lymphoma vary depending upon the individual situation and stage of Lymphoma. Many people with Hodgkin lymphoma will
be cured with treatment. However, sometimes if the lymphoma has come back after initial treatment, any further treatment
may only be able to control it, leading to an improvement in symptoms and a better quality of life. The treatment increases
your body's natural ability to fight cancer. It does this by giving a boost to your immune system.


Lymphoma Treatment in India:

The phenomenon of medical tourism is rapidly spreading around the world and for many people in the US, UK and other
western countries. India has been their destination of choice for medical and health care. When you are being treated for
cancer, you want a physician who is familiar with your particular disease. Yet because many forms of lymphoma are rare it
can be difficult to find a doctor who has treated patients with the disease. In India most of the hospitals has a
multidisciplinary team that includes heamotologists, radiation and medical oncologists, pathologists, radiologists, nuclear
medicine physicians, nurses and other relevant health professionals. Indian hospitals offer the most advanced diagnostic
technologies and treatments available today. Indian doctors and hospitals have immense experience of handling lymphoma
cases. Indian hospitals are similarly ranked to those in the U.S. according to the world health organization. Physicians in
India are often known for their level of personal care and interaction with their patients.

Cities in India providing Lymphoma Treatment are as follows;




                          Mumbai                      Hyderabad                      Kerala
                            Delhi                        Pune                         Goa
                         Bangalore                      Nagpur                       Jaipur
                           Chennai                     Gurgaon                     Chandigarh


Cost of Lymphoma Treatment in India:

hospital A combination of many factors has lead to the recent increase in popularity of medical tourism in India which include
rising costs of healthcare in industrialized nations, ease and affordability of international travel, favorable currency exchange
rates in the global economy, rapidly improving technology and proven, superior internationally accredited standards of care.
International medical travelers are generally residents of the United States, Canada, Great Britain, Western Europe,
Australia and the Middle East that are attracted towards Indian medical industry. Following table gives you an idea about the
cost difference between India and other major countries;
ABOUT INDIA

Located in South Asia, bordered by Pakistan, Nepal, China and Bangladesh, India is South Asia's largest, sovereign,
democratic republic. India has an edge over other countries when it comes to offering comprehensive, cost-effective and
timely medical care: it also offers an exotic, adventure-filled or cultural -if you wish array of destinations to discover and
revel in for the travelers. Indian cities like Mumbai, Hyderabad, Goa, Bangalore, Nagpur, Kerala, Delhi, Pune, Jaipur,
Chennai, Gurgaon, and Chandigarh offers best medical tourism service.

Mumbai - Formerly known as Bombay, is the commercial & financial capital city of India. Mumbai is famous for many
things, including its thriving Bollywood film industry, teeming bazaars, colonial-style buildings, Art Deco structures and a
superb choice of restaurants, often being rated as the dining capital of India. The tourist district of Colaba in Mumbai is a
great place to start exploring this great city.

Hyderabad – Hyderabad city is a great place to visit in the state of Andhra Pradesh. The place has witnessed a
continuous growth for last many years. Hyderabad has become a tourist hotspot following ever increasing number of
tourists during past few years. Hyderabad has a well-founded reputation as one of the safest cities in the world.

Goa - The country's smallest state and famed for its colonial Portuguese and Catholic past, most tourists visit Goa for its
endless selection of sandy beaches and coastal attractions. Standing proudly next to the Arabian Sea, Goa is a
particularly compact state and often feels like a large town, being easy to travel. Around Goa, tourists will soon realize that
the state has much more to offer than simply stunning beaches, fishing, water scooters, windsurfing and scuba diving.

Bangalore - Beauty lies in the eyes of beholder and if you want to see one of the most beautiful places in India then
Bangalore is the word for it. Bangalore has earned sobriquets like 'Silicon Valley of India', 'Pub Capital of India', and 'City
of Gardens'. Pleasant climate with colorful gardens with lakes and glittering nightlife, Bangalore has made its own
attraction for travelers as one of the most charming cities in India,

Nagpur - Nagpur is the largest city in central India, but with its friendly atmosphere and dependable transportation, you’ll
instantly feel at home. The city of Nagpur has a well-built infrastructure, is a clean and affluent city which makes a good
jumping-off point for a series of trips into the far eastern corner of Maharashtra.

Kerala - Natural beauty, clean air and primordial greenery amidst the vast expanse of water and sky, typifies the state of
Kerala – better known as God's own country. Kerala is famous for its alternative medical therapies such as Ayurveda,
which help to rejuvenate and revitalize the body. The region is also home to India’s only virgin tropical rain forest – the
Silent Valley National Park, supporting an overwhelming range of life forms, many of which are highly endangered, and
endemic to this part of the planet.

Delhi - "Welcome to The Capital City of India - New Delhi" Delhi is famous as Capital city of India is located in North India.
Delhi is truly a symbol of the old and the new; a blend of ancient well preserved monuments and temples along with jam-
packed burger joints and up market shopping malls. Delhi has state of the art Hospitals and the best qualified doctors.

Pune - Once referred to as the Oxford of the east, Pune continues to be a stronghold for academics and culture. An array
of factors like availability of efficient and experienced doctors, comparatively low treatment costs, hospital facilities of
international standards and many more have made Pune one of the top destinations for medical tourism.

Jaipur - Jaipur is one of the most popular destinations on a tourist's itinerary. The magnificent forts, beautiful havelis and
colourful bazaars make Jaipur a popular tourist destination among tourists. Jaipur has pioneered health and medical
tourism in India.

Chennai - Chennai is one of the most developed urban centers in the Indian subcontinent. The city forms the capital of
Tamil Nadu state and is the fourth largest metropolitan city in India. They have some of the very best hospitals and
treatment centers in the world. Each hospital is equipped with state of the art facilities. The technology brought into
practice is the very latest, including robotic surgery.
Knee Replacement Surgery in India
                                      Knee replacement surgery also known as knee arthroplasty is procedure to replace the
                                      weight-bearing surfaces of the knee joint to relieve the pain and disability of
                                      osteoarthritis. It may be performed for other knee diseases such as rheumatoid arthritis
                                      and psoriatic arthritis. The procedure has been proven to help individuals return back to
                                      moderately challenging activities such as golf, bicycling, and swimming. Total knees
                                      are not designed for jogging, or sports like tennis and skiing (although there certainly
                                      are people with total knee replacements that participate in such sports). Knee
                                      replacement is a routine surgery performed on over 600,000 people worldwide each
                                      year. Over 90% of people who have had Total Knee Replacement experience an
                                      improvement in knee pain and function.



Knee Replacement Surgery Candidates
A person would be considered a candidate for knee replacement if there is:

    •   Daily pain
    •   The pain is severe enough to restrict work, recreation and ordinary activities of daily living
    •   Significant stiffness in the knee
    •   Significant instability (constant giving way) of the knee
    •   Significant deformity (knock-knees or bow-legs) that hinders normal function of the knee
    •   Damage from arthritic conditions, such as osteoarthritis, rheumatoid arthritis or post-traumatic arthritis


Success Rate of Knee Replacement Surgery:
Knee replacement surgery is recognized as a miracle of modern surgery. Most orthopedic experts consider replacement to be
the best method of handling arthritis in the knee. Knee replacements have literally put hundreds of thousands of Americans
back on their feet and allowed them to enjoy their golden years.


Knee Replacement Surgery Preparations:

    •   If you smoke, cut down or quit. Smoking changes blood flow patterns, delays healing and slows recovery.
    •   If you drink, don't have any alcohol for at least 48 hours before surgery.
    •   Ask your doctor for pre-surgical exercises. If you are having hip or knee replacement surgery, doing exercises to
        strengthen your upper body will help you cope with crutches or a walker after surgery.
    •   Your primary care physician or an internist will conduct a general medical evaluation several weeks before surgery.
        This examination will assess your health and your risk for anesthesia. The results of this examination should be
        forwarded to your orthopaedic surgeon, along with a surgical clearance.
    •   Shortly before your scheduled surgery, you will probably have an orthopedic examination to review the procedure and
        answer any last-minute questions.
    •   You may need to take several types of tests, including blood tests, a cardiogram, a urine sample and a chest X-ray.
    •   Advice your surgeon of any medical conditions you have and of all the medications you are taking. You may need to
        stop taking certain medications or your surgeon may recommend substitute medications until your surgery.
        Medications such as corticosteroids, insulin or anti-coagulants will need to be managed before and after surgery.

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Lymphoma Treatment India

  • 1. Indian Med Guru Indian Med Guru Your Medical Option in India IndianMedGuru Consultants Website : www.indianmedguru.com
  • 2. Lymphoma Treatment in India What is a Lymphatic System? A lymphatic system is a complex network of tubes (lymphatic vessels), glands (or lymph nodes) and other organs including the spleen. The vessels and glands hold a fluid called lymph. The lymphatic system has a number of functions. It drains waste products and excess fluid from different parts of the body and moves them to the blood stream to be processed. It also conveys nutrients and cells. The lymphatic system is also part of the immune system, or the body’s natural defence against infection. The lymph carries white blood cells called lymphocytes, which help us to fight infection. We have lymph nodes and lymphatic vessels throughout our body. Often the lymph nodes are found in groups, particularly under the arms, in the neck and in the groin. What is Lymphoma? Lymphoma is a cancer of the lymphatic system, the body's disease-fighting network. The lymph system is made up of many cells and organs, including the lymph nodes, thymus gland, spleen, and liver. This system produces B-Cells and T-Cells lymphocytes, which make up your body’s immune system. These are spread throughout your body, much like your blood vessels. In lymphoma, lymphocytes start to multiply in an abnormal way and begin to collect in certain parts of the lymphatic system, such as the lymph nodes. Since these cells travel between the lymphatic and circulatory system while fighting infections and viruses, lymphomas are blood-related cancers. The affected lymphocytes lose their infection-fighting properties, making you more vulnerable to infection. What are the Causes of Lymphoma? Cancer is ultimately the result of cells that uncontrollably grow and do not die. Normal cells in the body follow an orderly path of growth, division, and death. Programmed cell death is called apoptosis, and when this process breaks down, cancer results. What are the Risk Factors? Scientists do not know exactly what causes lymphoma, but they have identified several potential risk factors. • Genetics - Lymphoma can be the result of a genetic predisposition that is inherited from family members. It is possible to be born with certain genetic mutations or a fault in a gene that makes one statistically more likely to develop cancer later in life. • Carcinogens - Carcinogens are a class of substances that are directly responsible for damaging DNA, promoting or aiding cancer. Exposure to certain pesticides, herbicides, and solvents such as benzene has been associated with lymphoma. Similarly, black hair dye has been linked to higher rates of NHL. When our bodies are exposed to carcinogens, free radicals are formed that try to steal electrons from other molecules in the body. These free radicals damage cells, affecting their ability to function normally, and the result can be cancerous growths. • Other Medical Factors - As we age, there is an increase in the number of possible cancer-causing mutations in our DNA. The risk of NHL increases as we age, and HL is most common between ages 16-34 and 55 years and older. Additional medical conditions that have been associated with higher lymphoma rates include infection with HIV, human T-lymphocytic virus type 1 (HTLV-1), Epstein-Barr virus, Helicobacter pylori, or hepatitis B or C; autoimmune disease (such as lupus); diseases that require therapies that suppress the immune system; and any other immunodeficiency diseases.
  • 3. What are the Symptoms of Lymphoma? Following are some of the symptoms of lymphoma; • Swollen, painless lymph nodes in the neck, armpits, or groin • unexplained weight loss • soaking night sweats • coughing trouble • breathing or chest pain • fatigue • feeling of fullness in the What are the Diagnosis and Tests for Lymphoma? • Physical examination: Swollen lymph nodes in your neck, underarms, and groin, and swollen spleen or liver are usually examined doctors. Chest x-ray test is done to check the swollen lymph nodes. • Biopsy: Biopsy is the only sure way to diagnose Lymphoma • Excisional Biopsy: Entire lymph node is removed to diagnose lymphoma. • Incisional Biopsy: Only a part of Lymph node is removed to diagnose lymphoma. • X-ray • CT scan/CAT scan • MRI (magnetic resonance imaging) • Gallium scan • PET (positron emission tomography) scan • Laboratory tests: Blood tests and urine tests What are the Types of Lymphoma? There are two types of lymphoma: Hodgkin lymphoma (HL, also called Hodgkin's disease) and non-Hodgkin lymphoma (NHL). Both HL and NHL can occur in the same places and have similar symptoms. Their differences are visible at a microscopic level. Hodgkin lymphoma develops from a specific abnormal lineage of B cells. There are five subtypes of HL. NHL may derive from either abnormal B or T cells, and its 30 subtypes are distinguished by unique genetic markers. Hodgkin Lymphoma (HL) - Hodgkin lymphoma can arise anywhere in the body where lymphocytes are found. HL has characteristics that differentiate it from all of the other types of lymphoma, most notably the presence of a cell called the Reed- Sternberg cell. A Reed-Sternberg cell is a large, abnormal cell that does not protect the body from infection. When it abnormally multiplies, it often forms a tumor within a lymph node and attracts inflammatory cells around it. While the cause is unknown, certain factors have been shown to increase the risk of developing Hodgkin lymphoma. Treatment for Hodgkin lymphoma may include chemotherapy and/or radiation therapy. In certain cases, bone marrow or stem cell transplant may be recommended, especially if the disease does not respond to initial treatment or if it returns despite an initial response to treatment. Non - Hodgkin Lymphomas (NHL) - Non - Hodgkin's lymphoma is a general term for a large group of lymphatic cancers that comprise approximately 90% of all diagnosed lymphomas. Hodgkin's disease contain specific cells called Reed-Sternberg cells that are not found in patients with non-Hodgkin's lymphoma. Approximately 85% of all non-Hodgkin's lymphomas originate in B-lymphocytes and are sometimes referred to as B-cell lymphomas. Non-Hodgkin lymphoma begins when a lymphocyte (usually a B cell) becomes abnormal. The abnormal cell divides to make copies of itself. The new cells divide again and again, making more and more abnormal cells. The abnormal cells don't die when they should. They don't protect the body from infections or other diseases. The buildup of extra cells often forms a mass of tissue called a growth or tumor. In general, the risk factors for non-Hodgkin lymphoma include the following: Weakened immune system Certain infections like Human immunodeficiency virus, Epstein-Barr virus (EBV), Helicobacter pylori, Human T-cell leukemia/lymphoma virus type 1 (HTLV-1) and Hepatitis C.
  • 4. What are the Stages of Lymphoma? Once the diagnosis is confirmed, doctors "stage" the disease. Staging is how doctors determine the extent of the disease, which affects treatment options. • Stage I: The cancer is limited to one lymph node region or a single organ. • Stage II: In this stage, the cancer is in two different lymph nodes or the cancer is in a portion of tissue or an organ and nearby lymph nodes. But the cancer is still limited to a section of the body either above or below the diaphragm. Stage III: When the cancer moves to lymph nodes both above and below the diaphragm, it's considered stage III. Cancer may also be in one portion of tissue or an organ near the lymph node groups or in the spleen. Stage IV: This is the most advanced stage of lymphoma. Cancer cells are in several portions of one or more organs and tissues. It affects not only the lymph nodes but also other parts of your body, such as the liver, lungs or bones. What are the various Types of Treatment available for Lymphoma? There are several factors that you will need to take into account when deciding on your treatment. They include patient’s age, stage of lymphoma, likely progression of lymphoma, sub-type of lymphoma and possible side effects of the treatments. Chemotherapy - Chemotherapy is a widely used treatment for lymphoma, often combined with radiotherapy. The type of chemotherapy you receive will depend on the type and stage of your lymphoma. If it is thought that your lymphoma is curable you will normally receive an aggressive treatment regime designed to kill all of the cancerous cells in your body. However, if a cure is unlikely, then a more moderate treatment regime may be used which can often provide long-term relief from symptoms. An aggressive chemotherapy regime will involve you receiving injections of chemotherapy (intravenous chemotherapy) while a more moderate regime will involve you taking chemotherapy tablets (oral chemotherapy). Radiotherapy - Radiotherapy is often used to treat stage 1 and 2 lymphomas, when the cancerous cells are located in only one part of the body. Treatment is normally given daily, over the space of 2-6 weeks. The radiographer will need to first carefully plan your treatment. This may involve one or several appointments, where the radiographer uses a machine to 'map' out the lymphoma and decide what parts of your body the radiotherapy should be directed at. This may involve making small marks on your skin with a kind of marker pen. Radiotherapy itself is painless, but it does have a number of common side effects. These can vary, depending on which part of your body is being treated. For example, if the affected lymph nodes are in your throat radiotherapy can lead to a sore throat, while treatment to the head can lead to hair loss. Monoclonal Antibody Therapy - Monoclonal antibodies are drugs that can ‘recognize’ and find specific cells in the body. These drugs can be designed to find a particular type of cancer cell in the body. The monoclonal antibodies attach themselves to the cancer cells and destroy them. There are different types of monoclonal antibody treatment. They can be used alone, with radiotherapy or with chemotherapy. A monoclonal antibody treatment is available for certain types of lymphoma. The treatment may be used as part of initial treatment or if the disease recurs. In lymphoma, monoclonal antibody treatment can be given in different ways. Steroids - Steroids are used to treat some cases of lymphoma, in combination with chemotherapy. It is believed steroids make the chemotherapy more effective. Steroids are given intravenously, usually at the same time as your chemotherapy. A short- term course of steroids, lasting no more than a few months, is usually recommended, as this limits the number of side effects you could experience. Some side-effects of steroids are increased appetite, sleeping problem, indigestion, increased energy levels, etc.
  • 5. Transplants - Sometimes high doses of chemotherapy destroy the lymphoma cells and your bone marrow. To help your bone marrow make new healthy blood cells, some stem cells may be taken with a special machine before chemotherapy is given. These cells are then transplanted into the body. These transplanted cells will then find their way to the bone marrow and restore it, so that it can build healthy new blood cells. Benefits of Lymphoma Treatment: Many people are frightened at the idea of having cancer treatments because of the side-effects that can occur. Although the treatments can cause side effects, these can usually be well-controlled with medicines. The potential benefits of treatment of Lymphoma vary depending upon the individual situation and stage of Lymphoma. Many people with Hodgkin lymphoma will be cured with treatment. However, sometimes if the lymphoma has come back after initial treatment, any further treatment may only be able to control it, leading to an improvement in symptoms and a better quality of life. The treatment increases your body's natural ability to fight cancer. It does this by giving a boost to your immune system. Lymphoma Treatment in India: The phenomenon of medical tourism is rapidly spreading around the world and for many people in the US, UK and other western countries. India has been their destination of choice for medical and health care. When you are being treated for cancer, you want a physician who is familiar with your particular disease. Yet because many forms of lymphoma are rare it can be difficult to find a doctor who has treated patients with the disease. In India most of the hospitals has a multidisciplinary team that includes heamotologists, radiation and medical oncologists, pathologists, radiologists, nuclear medicine physicians, nurses and other relevant health professionals. Indian hospitals offer the most advanced diagnostic technologies and treatments available today. Indian doctors and hospitals have immense experience of handling lymphoma cases. Indian hospitals are similarly ranked to those in the U.S. according to the world health organization. Physicians in India are often known for their level of personal care and interaction with their patients. Cities in India providing Lymphoma Treatment are as follows; Mumbai Hyderabad Kerala Delhi Pune Goa Bangalore Nagpur Jaipur Chennai Gurgaon Chandigarh Cost of Lymphoma Treatment in India: hospital A combination of many factors has lead to the recent increase in popularity of medical tourism in India which include rising costs of healthcare in industrialized nations, ease and affordability of international travel, favorable currency exchange rates in the global economy, rapidly improving technology and proven, superior internationally accredited standards of care. International medical travelers are generally residents of the United States, Canada, Great Britain, Western Europe, Australia and the Middle East that are attracted towards Indian medical industry. Following table gives you an idea about the cost difference between India and other major countries;
  • 6. ABOUT INDIA Located in South Asia, bordered by Pakistan, Nepal, China and Bangladesh, India is South Asia's largest, sovereign, democratic republic. India has an edge over other countries when it comes to offering comprehensive, cost-effective and timely medical care: it also offers an exotic, adventure-filled or cultural -if you wish array of destinations to discover and revel in for the travelers. Indian cities like Mumbai, Hyderabad, Goa, Bangalore, Nagpur, Kerala, Delhi, Pune, Jaipur, Chennai, Gurgaon, and Chandigarh offers best medical tourism service. Mumbai - Formerly known as Bombay, is the commercial & financial capital city of India. Mumbai is famous for many things, including its thriving Bollywood film industry, teeming bazaars, colonial-style buildings, Art Deco structures and a superb choice of restaurants, often being rated as the dining capital of India. The tourist district of Colaba in Mumbai is a great place to start exploring this great city. Hyderabad – Hyderabad city is a great place to visit in the state of Andhra Pradesh. The place has witnessed a continuous growth for last many years. Hyderabad has become a tourist hotspot following ever increasing number of tourists during past few years. Hyderabad has a well-founded reputation as one of the safest cities in the world. Goa - The country's smallest state and famed for its colonial Portuguese and Catholic past, most tourists visit Goa for its endless selection of sandy beaches and coastal attractions. Standing proudly next to the Arabian Sea, Goa is a particularly compact state and often feels like a large town, being easy to travel. Around Goa, tourists will soon realize that the state has much more to offer than simply stunning beaches, fishing, water scooters, windsurfing and scuba diving. Bangalore - Beauty lies in the eyes of beholder and if you want to see one of the most beautiful places in India then Bangalore is the word for it. Bangalore has earned sobriquets like 'Silicon Valley of India', 'Pub Capital of India', and 'City of Gardens'. Pleasant climate with colorful gardens with lakes and glittering nightlife, Bangalore has made its own attraction for travelers as one of the most charming cities in India, Nagpur - Nagpur is the largest city in central India, but with its friendly atmosphere and dependable transportation, you’ll instantly feel at home. The city of Nagpur has a well-built infrastructure, is a clean and affluent city which makes a good jumping-off point for a series of trips into the far eastern corner of Maharashtra. Kerala - Natural beauty, clean air and primordial greenery amidst the vast expanse of water and sky, typifies the state of Kerala – better known as God's own country. Kerala is famous for its alternative medical therapies such as Ayurveda, which help to rejuvenate and revitalize the body. The region is also home to India’s only virgin tropical rain forest – the Silent Valley National Park, supporting an overwhelming range of life forms, many of which are highly endangered, and endemic to this part of the planet. Delhi - "Welcome to The Capital City of India - New Delhi" Delhi is famous as Capital city of India is located in North India. Delhi is truly a symbol of the old and the new; a blend of ancient well preserved monuments and temples along with jam- packed burger joints and up market shopping malls. Delhi has state of the art Hospitals and the best qualified doctors. Pune - Once referred to as the Oxford of the east, Pune continues to be a stronghold for academics and culture. An array of factors like availability of efficient and experienced doctors, comparatively low treatment costs, hospital facilities of international standards and many more have made Pune one of the top destinations for medical tourism. Jaipur - Jaipur is one of the most popular destinations on a tourist's itinerary. The magnificent forts, beautiful havelis and colourful bazaars make Jaipur a popular tourist destination among tourists. Jaipur has pioneered health and medical tourism in India. Chennai - Chennai is one of the most developed urban centers in the Indian subcontinent. The city forms the capital of Tamil Nadu state and is the fourth largest metropolitan city in India. They have some of the very best hospitals and treatment centers in the world. Each hospital is equipped with state of the art facilities. The technology brought into practice is the very latest, including robotic surgery.
  • 7. Knee Replacement Surgery in India Knee replacement surgery also known as knee arthroplasty is procedure to replace the weight-bearing surfaces of the knee joint to relieve the pain and disability of osteoarthritis. It may be performed for other knee diseases such as rheumatoid arthritis and psoriatic arthritis. The procedure has been proven to help individuals return back to moderately challenging activities such as golf, bicycling, and swimming. Total knees are not designed for jogging, or sports like tennis and skiing (although there certainly are people with total knee replacements that participate in such sports). Knee replacement is a routine surgery performed on over 600,000 people worldwide each year. Over 90% of people who have had Total Knee Replacement experience an improvement in knee pain and function. Knee Replacement Surgery Candidates A person would be considered a candidate for knee replacement if there is: • Daily pain • The pain is severe enough to restrict work, recreation and ordinary activities of daily living • Significant stiffness in the knee • Significant instability (constant giving way) of the knee • Significant deformity (knock-knees or bow-legs) that hinders normal function of the knee • Damage from arthritic conditions, such as osteoarthritis, rheumatoid arthritis or post-traumatic arthritis Success Rate of Knee Replacement Surgery: Knee replacement surgery is recognized as a miracle of modern surgery. Most orthopedic experts consider replacement to be the best method of handling arthritis in the knee. Knee replacements have literally put hundreds of thousands of Americans back on their feet and allowed them to enjoy their golden years. Knee Replacement Surgery Preparations: • If you smoke, cut down or quit. Smoking changes blood flow patterns, delays healing and slows recovery. • If you drink, don't have any alcohol for at least 48 hours before surgery. • Ask your doctor for pre-surgical exercises. If you are having hip or knee replacement surgery, doing exercises to strengthen your upper body will help you cope with crutches or a walker after surgery. • Your primary care physician or an internist will conduct a general medical evaluation several weeks before surgery. This examination will assess your health and your risk for anesthesia. The results of this examination should be forwarded to your orthopaedic surgeon, along with a surgical clearance. • Shortly before your scheduled surgery, you will probably have an orthopedic examination to review the procedure and answer any last-minute questions. • You may need to take several types of tests, including blood tests, a cardiogram, a urine sample and a chest X-ray. • Advice your surgeon of any medical conditions you have and of all the medications you are taking. You may need to stop taking certain medications or your surgeon may recommend substitute medications until your surgery. Medications such as corticosteroids, insulin or anti-coagulants will need to be managed before and after surgery.