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Irish Times
5 days ago
- Health
- Irish Times
‘They saved my life': Trinity St James's Cancer Institute is recognised for care, research and education
Dubliner Niamh Walsh was working as a cook in a creche in April last year when she noticed her left leg was about 4cm wider than her right one. She had no other symptoms and when her GP referred her to the city's St James's Hospital she did not think anything was wrong. Following an ultrasound, she was told she had a mass of around 28cm in her pelvic area. Ms Walsh was diagnosed with ependymoma of the ovary – an extremely rare type of ovarian tumour. READ MORE She underwent an eight-hour open surgery, chemotherapy and, 11 weeks ago, had a preventive hysterectomy, in which her uterus was removed to reduce the chance of the cancer returning. 'I'm an only child, so this was a really big time for my parents being told out of the blue last year that their daughter has a really rare form of cancer that requires extreme operations and chemo after,' Ms Walsh (30) said. The diagnosis was a shock to her, too, she said. She is now trying to process everything she's been through over the past year. 'Still to this day, I cry about it,' she says. 'If I hadn't had that hysterectomy I could have heard it was back in the other ovary. I'm a very anxious person and the last thing I wanted was to be told the cancer was back.' On Wednesday, the Trinity St James's Cancer Institute (TSJCI) announced it has become the first cancer unit in Ireland to be accredited as a comprehensive cancer centre – a specialised institution recognised for advanced research and a broad range of cancer services. The Organisation of European Cancer Institutes (OECI) decided the Dublin base met or exceeded robust standards in cancer care, research and education. Prof Maeve Lowery, academic director of the TSJCI, said this designation would allow the hospital to bring improvements in patient-centred care. 'This carries an international weight. So it's about international benchmarking recognised across Europe and the US that shows certain standards of integration of academic activities like research, education, with clinical care. The real goal of it is to achieve more treatment options, better treatment options for patients,' she said. Prof Lowery said the hope was this designation would provide greater access for patients to novel treatments and clinical trials, an area in which Ireland had traditionally been viewed as lagging behind. 'It's the big issue within Ireland at the moment, there's a lot of disparity. The patients we treat here – we're a public hospital – and our patients are among the lowest socio-economic in the country. So it's really important that in the public system we're providing the best we can in terms of novel treatment,' she said. Minister for Health Jennifer Carroll MacNeill said the announcement marks a 'significant advancement' in cancer care for Ireland. 'Comprehensive cancer centres like TSJCI bring an additional focus on research and training which can expand the treatment options available for patients now and into the future,' she said. This is particularly true for patients such as Ms Walsh, who have rarer forms of cancer and for whom the diagnosis can feel devastating. If it were not for the kindness from the team of clinicians who treated her, Ms Walsh said she 'wouldn't have gotten through it'. 'My type of cancer, if I hadn't have had that operation when I did, it would have spread. This hospital saved my life,' she said. 'After this whole thing, I'm seeing a different side to myself. I used to be a very shy person, but now I'm trying to get out there. I'm trying to just enjoy life, because you've got to enjoy it while we can.'
The Hindu
7 days ago
- Health
- The Hindu
Tackling emerging threats to tobacco control
Tobacco control continues to remain a significant a public health challenge. Adding to the existing hurdles are new and emerging threats that are challenging conventional regulatory approaches. Experts say there are growing concerns over the increased and easy access to tobacco products, especially among the young. The digital space is one of the biggest concerns for doctors and activists who have been working in tobacco control for several years, as early initiation means longer and lasting impacts on one's health. There is an urgent need for better strategies to address these emerging threats, they say. According to the World Health Organization, an estimated 37 million children aged 13 to 15 years worldwide use tobacco. Tobacco use has to be prevented among the youth, stresses Surendran Veeraiah, professor and head, Psycho-oncology and Resource Centre for Tobacco Control, Cancer Institute (WIA), Chennai. 'Initiation happens due to reasons such as curiosity and peer pressure. Policy-makers have to focus on these areas to safeguard the youth from industry tactics. The Cigarettes and Other Tobacco Products Act (COTPA) clearly prohibits the sale of tobacco to persons under the age of 18 and within 100 yards of educational institutions. The law is there but implementation is still a challenge,' he said. Warnings on big and small screens While scenes in movies and television programmes mandatorily carry an anti-tobacco warning, newer challenges have emerged, he said, adding: 'The anti-tobacco health warnings are mandated on the silver screen. But now, we have come across videos of smoking on social media sites with zero warnings. How are these emerging challenges going to be addressed, especially considering the reach that social media has among the young?' S. Cyril Alexander, State convenor, Tamil Nadu Peoples' Forum for Tobacco Control added that though it was mandatory for OTT streaming platforms to display anti-tobacco warnings, not all platforms were implementing the 2023 notification. 'Some OTT platforms have implemented the rule, while others have not. We have been closely following the issue and are continuously raising it with the authorities as these platforms are reaching several children,' he said. Digital challenges This is not all. Newer challenges have emerged in the past few years. 'Consumers and products have become advanced but the enforcement is unable to keep pace. So, we are in reverse gear. Now, marketing of tobacco products is happening in the digital space, on social media and on WhatsApp,' said Mr. Alexander. He added that tobacco products including e-cigarettes are ordered online and directly delivered to the customers. 'For instance, once we register on the product website, details are sought on Whatsapp. Once the online payment is made, the product is delivered directly to the customer. With more online platforms in play, accessibility to tobacco products has been easier,' he said. Mr. Alexander added that his organisation has been studying digital marketing applications and have also lodged complaints. 'Tamil Nadu is the only State with a valid Section 5 of COTPA (Cigarette and Other Tobacco Products Act) committee to take action against direct and indirect advertising but the committee is not functional. We need to go forward and ensure proper enforcement along with strengthening online surveillance. We cannot continue to use conventional methods of monitoring,' he said. Dr. Veeraiah said that tobacco use is directly linked in one way or other to multiple non-communicable diseases such as cancers, diabetes, hypertension and cardiac ailments. Not to forget lung diseases caused by tobacco use. 'Smoking can affect the digestive system too. It can cause bowel changes and can also affect the skin and eyes. The younger the age of initiation, the more will be the problems as they grow,' he said. A public health official said that a multi-pronged strategy was required for tobacco control. 'There needs to be a high level of awareness. Restriction of sales is crucial as we are facing the problem of use of tobacco products among school students. We also need to look at the commercial aspect and monitor the advertisement of tobacco and increase the warning labels on the packets,' he said.
The Hindu
10-06-2025
- Health
- The Hindu
Doctors raise the importance of HPV vaccination to prevent cervical and a few other cancers
Vaccinating girls aged nine to 14 years against the Human Papillomavirus (HPV) is crucial for prevention of cervical cancers and a few other cancers. But equally important is vaccinating boys against HPV for a number of reasons, according to doctors. There are three reasons why boys should also be vaccinated against HPV, Jayashree N., gynaecologic oncologist and associate professor, Cancer Institute (WIA), said. 'First, it can cause cancers in men too. Secondly, they could transmit the virus to women, and thirdly, there is no screening test for men.' Somu Sivabalan, consultant Paediatrician and Pulmonologist, Rainbow Children's Hospital, explained that HPV being a sexually transmitted infection, it could spread from men. It could cause genital warts and precancerous changes. 'The primary target for HPV vaccination are girls aged nine to 14. Boys of the same age group are the secondary target for the vaccination,' he said. The doctors, who spoke at 'Conquer HPV and Cancer Conclave 2025', stressed that HPV was not limited to cervical cancer alone. It was associated with cancers of the vulva, vagina, anus in women and cancers of the penis, anus and oropharynx in men. The conclave was organised in Chennai on Tuesday as a part of a nationwide public health initiative led by Serum Institute of India. Dr. Jayashree said that vaccination and screening are the two pillars to prevent cervical cancers. Countries such as Australia, New Zealand, Canada, United States of America as well as European countries had an HPV vaccination programme as a result of which the incidence of cervical cancers has reduced, she said. Discussing the safety of the vaccine, Dr. Jayashree noted that Cancer Institute had administered 3,500 doses of the vaccine so far, and there had been no side effects. B. Sarath Balaji, senior Paediatric Pulmonologist and associate professor, Institute of Child Health, said that except for mild pain, redness in the site and mild fever, there had been no major side effects. He added that there was greater awareness among parents in cities about the vaccine. S. Vijaya, head of department and professor, ESIC Medical College and Hospital, Chennai, stressed the importance of taking time to counsel parents about the importance of the vaccine. Members of the Federation of Obstetric and Gynecological Societies of India were involved in creating awareness and training for doctors. Kavitha Sukumar, associate professor, Surgical Oncology, Institute of Obstetrics and Gynaecology, said screening for cervical cancer is simple. 'We have HPV DNA testing and pap smear. Now, self testing kits are also available,' she said.
India Gazette
07-06-2025
- Politics
- India Gazette
Uttarakhand CM Dhami inaugurates, lays foundation stone of 27 projects in Nainital worth Rs 126 crore 69 lakhs
Nainital (Uttarakhand) [India], June 7 (ANI): Uttarakhand Chief Minister Pushkar Singh Dhami inaugurated and laid the foundation stone of 27 development projects of Nainital district worth about 126 crore 69 lakhs in a program organised at Lalkuan, Nainital on Saturday. These projects include schemes related to education, road, medical, irrigation, sewerage, urban development, beautification and destitute cow protection. During this, 9 schemes were inaugurated at a cost of 25.93 crores and foundation stone were laid for 18 schemes at a cost of 100.76 crores. The Chief Minister said in his address that these projects will strengthen the infrastructure of the area and provide better facilities to the citizens. Appreciating the nationwide development work being done under the leadership of Prime Minister Narendra Modi, he said that India is becoming a leader in every field including defence, science, sports and infrastructure today. He mentioned the changing power and resolve of the country, referring to 'Operation Sindoor', the abolition of Article 370 and the construction of a rail bridge in Kashmir. The Chief Minister said that in order to make Nainital district an ideal district, projects like Mental Hospital, Cancer Institute, Ayush Hospital, Open Gym, Ambedkar Park, Ring Road, Bypass Road, Astro Park, Pollinator Park and Sports University are being implemented rapidly. Waste Management and Sewerage Management schemes have been started to make Haldwani a clean and green city, while multi-storey parking is being constructed to overcome the problem of jam. Efforts like the Jamrani Multipurpose Dam Project and Industrial Smart City in Khurpiya will give long-term benefits to the Terai region. The Chief Minister said that the state government is fully committed not only to development but also to protect cultural identity and social harmony. Strict steps have been taken against conversion, love jihad, land jihad etc. Uttarakhand is the first state in the country to implement Uniform Civil Code and the country's strictest anti-copying law has also been implemented here. Concrete efforts are being made under the 'Gau Sanrakshan Kanoon' for the protection of cows. The Chief Minister said that the state government has adopted a policy of 'zero tolerance' against corruption, and more than 200 corrupt people have been sent to jail in the last three years. He appealed to the public that all citizens will have to participate in the development journey to make Uttarakhand the leading state of the country. Reconstruction of 11 damaged canals in Okhalkanda, District Ayurvedic Bhawan in Bhimtal, Malla Sufi-Rusani-Digad-Kafuwa Lodhia Motor Road in Ramgarh, Malli Sethi Lift Irrigation Scheme in Betalghat, Construction of vehicle parking and OT for animals in Veterinary Hospital in Haldwani, Veterinary Hospital Building in Kaladhungi, Construction of Gaushala (Phase-1) in Gangapur Kabdwal, Government Polytechnic Building in Ramnagar and Renovation of Rehabilitation Centre in Pandey Navad Haldwani. Flood protection work in Indira Gandhi Sports Complex, construction of damaged canals in Fatehpur, Kamaluwaganja, Gunipur, Paniyali and Bachhinagar, Polytechnic building in Kotabagh, construction of tube well in Rampur Chakluwa, development of Kainchidham complex, repair of tourist accommodation house in Bhawali, construction of tourism office building in Nainital, reconstruction and improvement of rural motor roads, development of Jhidapani waterfall, construction of tube wells at various places, Rajpura and Parvatiya Mohalla sewerage schemes in Haldwani, construction of cowshed (phase-2) in Lalkuan and renovation work of library in Government Girl's Inter College Haldwani. (ANI)
The Hindu
03-06-2025
- Health
- The Hindu
Cancer is on the rise in India: could air pollution be a factor?
Over the past decade or so, air pollution has been increasingly spoken about in India, particularly in the context of the deterioration of air quality across large parts of the country, especially in the winter months. The air we breathe is known to be linked to respiratory illnesses and even cardiac disease, but now, experts say, there is also a strong association with a disease that is a rising burden in India: cancer. The scale of the cancer burden in India Cancer numbers are rising, and rising fast in India. The Indian Council of Medical Research-National Cancer Registry Programme has projected that the number of cancer cases in the country will spike from 14.6 lakh in 2022 to 15.7 lakh in 2025. Approximately one in nine people in India is expected to face a cancer diagnosis during their lifetime, the ICMR estimates. Cancer ranks second when it comes to non-communicable diseases that cause deaths in India. Lung cancer is the second-most common cancer among men in India, and also figures amongst the top five when it comes to women. Globally, it is the leading cause of cancer-related deaths, accounting for the highest mortality rates among both men and women. Over the past two decades, doctors say there has been a concerning pattern emerging in India: a rise in the number of non-smoking lung cancer cases. Traditionally, lung cancer has always been associated with smoking (which continues to remain the major risk factor) and its incidence has always been lower in India, compared to the West, says Kumar Prabhash, head, solid unit medical oncology, at Tata Memorial Hospital, Mumbai. 'Smoking rates have always been higher in the West and lower in India, and this was reflected in the lung cancer numbers. A large number of cases were associated with smoking, both in the West and India, in the past. Now however, and this is what we have been seeing over the past several years, there is a marked difference: a significant proportion of the lung cancer cases in India are in never smokers,' he says. Estimates vary, but several doctors agree that up to 30% of lung cancer cases that are now being seen are in those who have never smoked. At the Cancer Institute, Adyar, Chennai, two separate studies, one from 2012 and one from 2017, reflected this trend. In the first study, says Arvind Krishnamurthy, head of surgical oncology at the institute, researchers analysed patient data from 258 cases between 2003 and 2007, and found nearly 40% of the patients were non-smokers. In the second study, analysing data from 495 patients who came in during 2014-15, the non-smoking cases were over 55%,' he says. There are other factors that are also playing out in this pattern, the histology (the way cancer cells and tissues appear under a microscope) of the cancers for instance, is different: while most smokers present with squamous cell carcinoma, in non-smokers the usual presentation is adenocarcinoma, mirroring a global trend in the rise of adenocarcinoma, says Dr. Krishnamurthy. Age-wise, as with all cancers, patients in India are about a decade younger than those in the West, says Dr. Prabhash. Another concerning factor is that among women, the non-smoking lung cancers are higher than in men. The shift, doctors say, points to the urgent need to look beyond smoking and tobacco exposure for causes of lung cancer. Could air pollution be behind the rise? There is no doubt, says Krithiga Shridhar, head, Cancer Epidemiology Unit, Centre for Chronic Disease Control, New Delhi, that both outdoor (ambient) air pollution in general, and particulate matter (PM) in particular, are Group 1 carcinogens, meaning that there is sufficient evidence based on human studies that they have the potential to cause cancer. Indoor (household) air pollution, meanwhile, is classified as a group 2 carcinogen, meaning the evidence is probable. According to Swiss tech company IQAir's 2024 World Air Quality Report, India ranked as the fifth-most polluted country in the world with an annual average PM 2.5 concentration of 50.6 micrograms per cubic metre, against the World Health Organization's recommendation of 5, and higher than India's National Ambient Air Quality Standards of 40. 'The causal links are very well established between air pollution and lung cancer. The majority of evidence, however, is from settings where air pollution is low. From India, the evidence is still emerging,' Dr. Krithiga says. Doctors point out that while at present they can state that there is a strong association between air pollution and lung cancer, more definitive evidence is needed from the country to establish it as a cause. A 2022 research paper in the Indian Journal of Medical Research that described the epidemiology, and clinical profile of lung cancers in India, based on data from the National Cancer Registry Programme also notes this trend, and the potential role of indoor and outdoor air pollution. 'Compared to GATS (Global Adult Tobacco Survey) -1 (2009-2010), the prevalence of tobacco use has decreased in GATS-2 (2016-2017). Hence, there is an increasing recognition of the role of air pollution in the causation of lung cancer. According to recent findings of the National Non-Communicable Disease Monitoring Survey, almost half (48.5%) of the adults reported exposure to second-hand smoke at home, workplace or travel,' the paper states. Another contributor may be indoor (household) air pollution, particularly among women, say experts. The burning of solid fuels and biomass for cooking could be behind this. 'Even though the use of solid fuels for cooking has declined with most households switching to gas, their use in the past may be a factor, as lung cancer has a long latency period and generally presents a couple of decades after the exposure to the cause,' says Dr. Prabhash. Even in the northeast, says Ravi Kannan, director, Cachar Cancer Hospital and Research Centre, Assam, where the burden of cancer overall is the highest in India and where tobacco and alcohol use are major risk factors, the etiology (cause) of lung cancers is beginning to change, reflecting the larger Indian trend. 'Tobacco continues to remain a major cause of lung cancers here, but this is slowly shifting. The Northeast has always been one of the cleanest regions of India, but air pollution is beginning to be felt here as well. Also, in tribal communities, the fire is always kept burning, which could be a contributing factor, and while these traditional ways of life are changing now, it will take time for the impact of the change to be felt,' he says. Air pollution may not be the only factor however: a research paper published last year in The Lancet Regional Health - Southeast Asia, 'Uniqueness of lung cancer in Southeast Asia', states that occupational exposure to asbestos, chromium, cadmium, arsenic, coal-based products, as well as genetic susceptibility and pre-existing lung disease, could all be contributing, and these are all factors that need to be researched says Dr. Prabhash. The challenges of diagnosis and treatment Lung cancer has one of the highest mortality rates when it comes to cancers in India. Its diagnosis, however, is often late. Primarily, says Partha Pratim Medhi, assistant professor, radiation oncology, AIIMS Guwahati, this is because its symptoms are nonspecific – cough, chest pain and shortness of breath are seen with other conditions as well. 'Even in X-Rays, very few healthcare professionals will first suspect lung cancer,' he says. Dr. Prabhash adds that in India particularly, doctors are more prone to suspect tuberculosis first, potentially delaying the diagnosis. The 2022 research paper states that 'close to half of the patients had a distant spread of disease at the time of presentation in our analysis. Similar findings have been reported by studies from other Indian settings where most of the patients had Stage IV disease at the time of diagnosis.' Of 10 patients he sees in a month, says Dr. Medhi, there is perhaps one who has lung cancer that is in stage 1 or 2. Four are perhaps in stage 3, and the remaining five in stage 4. 'By this time the cancer has metastatised, spreading to the bones, brain, liver and other parts, which is why survival rates are low,' he says. While diagnostic facilities have improved over the years, with molecular testing now available to identify genetic changes and biomarkers to help with treatment plans, the infrastructure, for the most part, is still in tier 1 and tier 2 cities, making access an issue, says Dr. Prabhash. When it comes to treatment options too, most are available in India, but affordability remains a challenge. Immunotherapy, which has been showing promising results in lung cancer in other countries, is only partially available. 'Some of these drugs are approved in India, while others are not. But even the drugs that are approved are extremely expensive, putting them out of the reach of most people,' says Dr. Medhi. The way forward At present, the way air pollution is viewed is very narrow, says Abhishek Shankar, assistant professor, radiation oncology, AIIMS, Delhi. 'It is now emerging as a serious killer and should be viewed as such,' he points out. Currently, he says, India reports about 75,000 new cases of lung cancer each year, but this is projected to go up to 1 lakh cases, calling for urgent action. Data, say doctors, is what is needed: more research from India about the causes of lung cancer beyond smoking. 'While tobacco and smoking continue to be major risk factors, the pattern that has emerged now is well established, and we need to utilise this to find the links to the causes. Remember, air pollution is not only a risk factor for lung cancer – there is evidence for it across cancer sites including oral and urological, as well as childhood leukaemia,' says Dr Krithiga. In addition to extensive, India-based research into the links between air pollution and cancer, the country also needs measures to combat pollution, experts say. There is a window of opportunity in the Northeast now, to prevent the hazards of environmental pollution, says Dr. Kannan. 'We can intervene now, with a concentrated effort from the government, non-governmental organisations and civil society. The Northeast can learn, and equip itself to be able to prevent, and better handle cases in the future,' he says. When it comes to the rest of the country, household air pollution has been progressively declining in India. 'It has not been fully tackled, but we are making progress, especially with the provision of cleaner sources of fuel such as gas,' says Dr. Krithiga. Outdoor air pollution presents more of a challenge, she adds. 'The sources of outdoor pollution are multiple, and our handling of it needs to be multi-sectoral. We are at the stage of acknowledging and finding ways to address the problem. This is the way forward.'
