Shahid Akhter, editor, ETHealthworld interviewed Dr Dattatreyudu Nori, International Director, Apollo Cancer Centres on the latest advancements in oncology. Expert comments as follows:

Worldwide, there are 19 million cases of cancer every year andaround 1.3 or 1.5 million new cancer cases every year in India. The types of cancers usually vary from country to country. In the US, lung cancer is the number one among men and in females is the breast cancer. In India, the top 2 or 3 cancers in females are cervix, breast and oral cavity.

According to DrDattatreyuduNori, the latest advances in oncology are immunotherapy. He explained that cancer is in the central DNA of the normal cell, there is a cell membrane and a central nucleus. It was thought that the nucleus is getting highly proliferating and producing a DNA typo, which is a programming error, resulting in cancer. The normal cell becomes cancerous was a misunderstanding they had for many decades.

It is understood now that it is not the central area, the signal to multiply come from the cell membrane. While some enters from outside the membrane, from the membrane and also from inside the membrane, there are signals which goes to the DNA to multiply and this understanding has resulted in the discovery of drugs to block signal for controlling cancer in the center or eradicating it completely. These are called designer drugs or targeting drugs precision medicine, hence each drug discovered has blocked the signal and ensuresto cure that particular cancer. For example, chronic myelogenous leukemia can be cured by Gleevec, a signal-blocking drug. One more is Tarceva, which is helpful in lung cancer.

Each designer drug controls, cures and helps one particular cancer which was the era of precision medicine. Immunotherapy can work across all the signals around cell membrane simultaneously and can have a chance for eliminating, controlling and curing cancer, even if it is a fourth stage cancer. This is the beauty and the advantage of immunotherapy because like chemotherapy or radiation, it will not kill the cancer cells but stimulatethe body‘s immune system. This is the major difference between chemotherapy, radiation and immunotherapy.

During the development of cancer cells, it produces two nasty substances one is called PDL 1 and the other is called CTLA and these two substances produce a molecular shield in the body’s immune system. Drugs were found for these two nasty substances that can eliminate them, known as break releasing drugs. These drugs are also called molecular shield penetrating drugs or immune modulation drugs and have completely changed the outcome of cancer treatment. It is the new paradigm in cancer treatment because it is the stimulation of immunity in the body to control and eliminate the cancer cells.One case example is Jimmy Carter, one of the ex-presidents of USA. He had developed melanoma that is cancerous to the brain, liver, lung, bone and there was not much the doctorscould offer him but gave him immunotherapy where the immune system was stimulated with these drugs. The brain tumour, brain lesion disappeared and he is free of cancer for around seven years. These kinds of miraculous responses were not seen before but is a good news for all patients.

Dr Dattatreyudu Nori’ scontribution, in terms of technology, is that he has developed a lot of new technological pieces that treat gynecological, GU or genitourinary cancers which are applicable and the treatments are made very safe, very fast, and highly reliable with the help of robotic remote after a roller prototype which was designed at Sloan Kettering. Currently, this technology is available in every oncology department in the world including China, Russia and South America.

Also, in terms of education, Dr. Nori have arranged the fellowships programs for Indian doctors to come to America and get trained at Sloan Kettering. They can attend six months and one-year training and help patients in India. A number of doctors have been benefited through this programmeand are now practicing in all parts of India.