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MULTI-DISCIPLINARY EXCELLENCE

Our approach to cancer care is best defined by our unique Cancer Management Teams (CMTs). We believe that cancer is a complex enemy; conquering it demands the coming together of the finest experts in specific cancer groups.

Each CMT, at the Apollo Proton Cancer Centre, is made up of specialists who straddle diverse disciplines like Surgery, Radiation & Medical Oncology, Pathology, Rehabilitation and several others. A CMT is further fortified by world-class support staff like nurses, dieticians, therapists and clinical trial coordinators. These experts play a pivotal role in drawing up the treatment blueprint based on vast experience, the unique needs of the patients and the collective expertise of the team.

Breast Cancer

Breast Cancer is the commonest cancer in women globally, as well as in India; incidence is rampant and ominous trends of accelerating the world over. Each year, more than 80,000 women in India develop breast cancer. Breast cancer is the uncontrolled growth of breast cells. Cancer occurs as a result of mutations, or abnormal changes in the genes responsible for regulating the growth.

Normally, the cells replace themselves through an orderly process of cell growth, healthy new cells take over as old ones die out. But over time mutations can 'turn on' certain genes and 'turn off ' others in a cell. The changed cell gains the ability to keep dividing without control or order, producing more cells just like it and forming a tumour. A tumour can be benign (not dangerous to health) or malignant (has the potential to be dangerous). Benign tumours are not considered cancerous: their cells are close to normal in appearance, they grow slowly, and they do not invade nearby tissues or spread to other parts of the body. Malignant tumours are cancerous. Left unchecked, malignant cells eventually can spread beyond the original tumour to other parts of the body.

Usually breast cancer either begins in the cells of the lobules; less commonly, breast cancer can begin in the stromal tissues, which include fatty and fibrous connective tissues of the breast. Over time, cancer cells can invade nearby healthy breast tissue and spread to the underarm lymph nodes and to other parts of the body.

When a woman finds an abnormal mass on examination or an abnormal area is detected by screening mammogram, a careful history and physical examination should be carried out. A thorough physical examination of the breast should be done by a doctor.

Breast cancer is considered to be a systemic disease to start with, in majority of the cases. This means that while the primary disease in the breast is obvious, there is the possibility of microscopic disease elsewhere; hence treatment is required for local area and distant sites. Local treatment is removal or destruction of the local tumour by either surgery or radiation. The treatment of distant sites is either by chemotherapy or hormonal treatment. Patients may need one form of treatment or call the four forms of treatment either simultaneously or in sequence.


Surgery

Surgery is the most common treatment for breast cancer; it involves the removal of the tumour and some surrounding healthy tissue during an operation.


Sentinel lymph node biopsy

At APCC, our surgery procedures includeSentinel Lymph Node Biopsy (SLNB) where the sentinel lymph node is identified, removed, and examined to determine whether cancer cells are present.


Breast Conservation Therapy

Breast Conserving Surgery (BCS) with radiation therapy is today standard therapy for low grade Breast Cancer. It is safe and preferred therapeutic procedure in all early detected breast cancers, because it provides the same level of overall survival as mastectomy.


Accomplishing a good cosmetic effect is of key importance when using BCS, balanced with width of excision, and achieving low local reoccurrence rate.

Mastectomy

 

Reconstructive surgery

Reconstructive surgery is an option for patients who have undergone a mastectomy. This is a surgery to re-create a breast using either tissue taken from another part of the body or synthetic implants.

 

Radiation Therapy

Radiation therapy may be used to treat breast cancer at almost every stage. Radiation therapy is an effective way to reduce your risk of breast cancer recurring after surgery.

For early stage breast cancer, radiation is directed only to the tumour bed cavity. Accelerated Partial Breast Irradiation (APBI) is attracting more attention from both physicians and patients as an alternative to adjuvant whole-breast irradiation in early stage breast cancer, suggesting similar in-breast recurrence rates as whole breast irradiation.

 

 

 

 

Late side effects

Once breast cancer treatment ends, most side effects of treatment go away. However, some long-term side effects and new health effects may occur months or even years after treatment ends. These late effects of treatment vary from person to person. Some of the late effects of radiation are

 

Immunotherapy for Lung Cancer

Proton radiation is a slowly emerging as powerful option for the treatment of breast cancer. Using the Braggs Peak phenomenon we ensure there is no exit dose and a significantly lower entrance dose than conventional X-rays; damage to critical tissue near the breast, like the lungs and heart, is dramatically reduced.

 

 

The data for proton therapy in breast cancers is still evolving and not routinely done. It is indicated on a case to case basis after detailed discussion with the oncologists.

 

Chemotherapy

In Chemotherapy, intense drug regimen is used to kill cancer cells. Usually more than two drugs are used; these drugs are given by injections. When chemotherapy is given after surgery and is called adjuvant chemotherapy and, in this setting, it is used to take care of microscopic disease elsewhere. When it is given before surgery it is called Neoadjuvant chemotherapy and in this setting the purpose is to reduce the size of a large tumour, and make it surgically removable. Whether it is adjuvant or Neo-adjuvant - it is administrated several times over a period of months with breaks between treatments.

 

Hormonal therapy

Hormonal therapy, alternatively known as endocrine therapy, is now a widely used treatment for most tumours that test positive for either estrogen or progesterone receptors. This type of tumour uses hormones to fuel its growth. Blocking the hormones can help prevent a cancer recurrence and death from breast cancer when used either by itself or after adjuvant or neoadjuvant chemotherapy.

 

Targeted therapy

In this treatment modality we start the process with a detailed investigation that covers tests to identify the genes, proteins, and other factors in the tumour. Post the results we target the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. These treatments are very focused and highly effective in blocking the growth and spread of cancer cells while limiting damage to healthy cells.

 

Rehabilitation

The treatment of breast cancer does not end with the treatment. That is just the end of chapter, and more importantly the start of another crucial one. At APCC, our focus is to help our patient get back to an active and confident life at the earliest. We believe that a robust support system that is there for our patients – emotionally, physically and spiritually – is a vital cog in the rehabilitation process.

We leverage our deep experience in integrated cancer care, the wide network of Apollo Cancer Survivors and the skills of a vibrant team to help chart the roadmap for our patients to reclaim their lives.

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