As per a recent study published in Financial Express organ donation rate in India is 0.34 per million of population which is way less than other countries like Spain and USA which have a rate of 35.1 and 21.9 organs per million population. These figures are disappointing with respect to the requirement of organs for transplant in India. As per Dr Ankur Garg, Director Liver Transplant and GI Surgery at LivCure Centre, Delhi/NCR, “India has 25-30 thousand patients waiting for liver transplant in India per year and against that approximately 1500 transplants are being done. Waiting time is so long!”
Number of liver transplants performed around the world are not very large in number. Ironically it is not the number of patients that are less but the availability of matching donor is the main reason. Many patients who are at the end stage liver disease need immediate liver transplant surgery to survive, however due to unavailability of a matching donor in the direct blood relation leads to their death. Even the cadaveric donors are very less in number, especially in India due to various religious beliefs organ donations are very limited.
For a liver transplant the basic requirement is that the donor’s blood group should match with the recipient’s blood group, RH typing (+/-) does not matter. With the advent of medical technology and continuous research across the globe, now liver transplant surgery can also be performed in case of unmatched donor. This is called ABO Incompatible Liver Transplant. Apprising us about the ABO Incompatible or unmatched liver transplant surgery Dr Ankur Garg says,” As of now this is still not the first choice of liver transplant in India. We go for an unmatched liver transplant surgery only in case of emergency. The biggest challenge in these transplants is to prevent rejection of the transplanted liver by the body.”
There are research going on around the world to overcome the challenge of organ rejection in ABO incompatible liver transplants. There are few methods through which liver transplant surgeon reduce the chances of organ rejection in such patients. “In some cases we remove the spleen before the organ transplant and in some cases we start Immunosuppressant a week before the transplant and continue it after the surgery as well. The only drawback with both the above procedures is that you are more prone to catch infection as your immune system is suppressed with either spleen removal or immunosuppressant”, says Dr Ankur Garg.
Whatever may be the drawbacks or the risk associated with an ABO incompatible liver transplant may be but it still gives hope to patients who are in dire need of a liver transplant surgery and are on the verge of losing their life due to unavailability of the donor or liver. Let’s follow the person who invented the airplane and not the one who invented parachute!!
Liver transplant in India is the best treatment option for people who have end-stage liver failure that can’t be controlled using other treatments. Liver failure can occur rapidly, in a matter of weeks (acute liver failure), or it can occur slowly over months and years (chronic liver failure).
Liver failure has many causes, including:
- Liver Cirrhosis
- Alcoholic Liver Disease
- Non-alcoholic Fatty Liver Disease
- Early Stage Liver Cancer
- Primary biliary cirrhosis
- Primary sclerosing cholangitis
- Wilson’s disease
- Biliary duct atresia
- Cystic fibrosis.
Liver transplant in India can be done using a living donor or a cadaver i.e. a person who has died and donated his liver. There are very few surgeons and hospitals that perform a cadaver liver transplant and the waiting time is also long in the case of a Cadaver Liver Transplant. Dr Mohammad Rela is one of the topmost Liver Transplant Surgeon in the world when it comes to Cadaveric Liver Transplant Surgery.
The donor in the case of Liver Transplant Surgery in India has to be a family member which means the donor can be from among the parents, children and siblings. In case of the donor being a non family member the association with the patient has to be for a long time and a close relative of the donor must also approve of the same.
Finding the Right Donor
A small percentage of liver transplants are completed each year using a portion of a liver from a living donor. If you have a family member or friend who is willing to donate part of his or her liver to you, talk to your transplant team about this option. However now a days cadaver liver transplant is also being done. Dr Ankur Garg at Nanavati Hospital in Mumbai, India is one of the best liver transplant surgeons in India. He has a very high success rate. The biggest challange that comes in case of cadaver liver transplant is that of the availability. However at Nanavati Hospital, Mumbai the waiting period is around 2-3 months for cadaveric liver transplant.
Living-donor transplants have good results, just like transplants using livers from deceased donors. But fewer living transplants are performed because of restrictions on the donor’s age, size and health that make finding a good match difficult. The surgery carries some risks for the donor. If you’re receiving a liver transplant from a living donor, such as a friend or family member, surgeons will transplant a portion of the donor’s liver in your body. Surgeons first operate on the donor, removing the portion of the liver for transplant. Then the surgeons remove your diseased liver and place the donated liver portion in your body. They then connect your blood vessels and bile ducts to the new liver.
The transplanted liver portion in your body and the portion left behind in the donor’s body regenerate rapidly.
Cost of Liver Transplant Surgery in India
The cost of liver transplant surgery in India is in the range of USD 45000-60000 which includes the cost for the donor and the recipient. However the costs could vary depending upon the general health of the recipient and the co-morbidities present. The Cost of Liver Transplant Surgery at Nanavati Hospital Mumbai would be in the range of USD 30000-40000.
Special medications are used more often than not to prevent the rejection of the liver and the cost of these medications are in the range of USD 10000-12000 depending on the brand of the medicine.
The hospital stay for the donor is around 7 days and the hospital stay for the recipient is around 30 days
The patient and the donor both need to be under the observation of the gastroenterologist even after discharge from the hospital to make sure that nothing goes wrong and if there is any kind of problem then it is managed properly and in time to prevent the rejection of the transplanted liver.
There are many touts in the Indian market who would promise to get you a donor for a price, you must stay clear of such people as this is an illegal act in India and both the recipient and the tout could land in trouble. Always approach the hospital directly for Liver Transplant Surgery in India.
Non-alcoholic Fatty Liver Disease is on the rise in India due to the consumption of Fat rich diet and lethargic lifestyle. Many people still associate fatty liver with the consumption of alcohol. Alcohol is still the main reason for fatty liver but not the exclusive reason. Many women and kids are coming with fatty liver disease. The number of cases of Alcoholic fatty liver are highly underreported as many people who consume alcohol are scared of getting an ultrasound done. Normal ultrasound of the abdomen is good enough to diagnose a fatty liver. Many of these patients report to the hospital when the fatty liver has turned into Liver Cirrhosis. Those who consume alcohol regularly and take more than 5-6 drinks a day are more likely to report fatty liver. Alcohol consumption coupled with absence of physical exercise is the main reason behind fatty liver. If a person is doing regular aerobic exercise for atleast one hour everyday and consuming less than 4 drinks a day, then the chances of Liver Cirrhosis is low.
Diet also plays a very important role in the health of your liver. Those who take alcohol regularly are well advised to consume 2-3 kgs of fruits and raw vegetables everyday. Liver is the only organ in the body which has the capacity to heal itself. It is therefore extremely important to get an early diagnosis of the disease. Every person who is consuming alcohol must get an ultrasound of the abdomen done once a year to check the health of the liver.
Fatty Liver Grade 1 or 2 as diagnosed on the ultrasound can be reversed by diet modifications and incorporating exercise into your daily routine. If you have been diagnosed with Fatty Liver of any grade then you must consult a physician or a Liver Specialist who can prescribe you the right treatment. Moderating your alcohol consumption and changing your diet will go a long way in healing your liver. With the right kind of treatment, fatty liver can become normal in 3-4 months time.
One must remember that once the fatty liver progresses to Liver Cirrhosis then you may not be able to reverse it with any medication or life style changes. Liver Transplant Surgery might become your only option to stay alive. India is currently doing only around 2500 Liver Transplant Surgeries due to low numbers of Cadaveric Transplant. Most of the Liver Transplant Surgeries in India are done when a relative of the patient donates the liver. This type of surgery is called Living Donor Liver Transplant. Liver transplant surgery is being done at 20-25 hospitals in India and the cost of the surgery is in the range of Rs. 18-30 Lacs. The high cost of the surgery and the difficulty in finding a matching donor are both responsible for the low number of Liver Transplant Surgeries. So take care of your liver. Moderate your consumption of alcohol and get regular testing done.
Dr Ankur Garg is the Director at LivCure – Liver Transplant and GI Cancer Surgery Centre, India.
BMT In India
A bone marrow transplant is a procedure performed to replace damaged or destroyed bone marrow stem cells with healthy bone marrow stem cells. In bone marrow transplant the healthy stem cells from your own body or from a donor are taken and transplanted in your body. Your unhealthy bone marrow cells are destroyed by the use of medicines and then it is replaced with healthy bone marrow cells.
Types of BMT
There are different types of bone marrow transplants depending on who the donor is. The different types of BMT include the following:
Autologous bone marrow transplant: In this case the healthy bone marrow cells from your own body are taken out before destroying the unhealthy cells with the use of medications. Once the unhealthy cells are destroyed, the healthy bone marrow cells which were taken out earlier from your body are transplanted back into your body.
Allogeneic bone marrow transplant: The donor is selected based on their HLA type (genetic match) and that of the patient. Stem cells are then taken from an HLA matched donor and transplanted in the body of the recipient patient.
Siblings (Matched related donor/ MRD) – Brothers/sisters are the best choice as donors, provided that their HLA type matches with that of the recipient. Siblings have the best chance of having a close match if they are born from the same set of patients.
Parent/Children (Haploidentical stem cell transplant): A haploid-identical match is when the donor is a parent and the genetic match is at least half identical to the recipient’s.
Unrelated bone marrow transplants (UBMT) or matched unrelated donor (MUD): The HLA matched marrow or stem cells are from an unrelated donor, who has been found through bone marrow registries.
Umbilical cord blood transplant: Stem cells are taken from an umbilical cord immediately after delivery of an infant. The stem cells are tested, typed, counted, and frozen until they are needed for a transplant.
Diseases That Can Be Treated By BMT
Diseases that can be treated are :
Malignant diseases :
- Multiple Myeloma
- Relapsed Hodgkins Disease
- Relapsed Non Hodgkins Lymphoma (NHL)
- Relapsed Ewings Sarcoma
- Metastatic Ewings Sarcoma
- Metastatic Germ cell tumors
- Medulloblastoma, other brain tumors
- Other solid malignancy
- High Risk ALL
- Relapsed or Refractory AML/ALL
- Refractory Lymphomas
- Myeloproliferative Neoplasms (MPN)
Non-Malignant diseases :
- Severe Autoimmune Diseases
- Multiple Sclerosis
- Aplastic Anemia
- Severe Immunodeficiency disorders
- Inherited Metabolic disorders
Best Hospitals and Doctors for BMT in India
Dr Dharma Chaudhary and Dr Rahul Bhargava are two of the most eminent doctors in India for treating all kinds of Blood Cancers and other diseases through Bone Marrow Transplant. The two hospitals which can be considered for Bone Marrow Transplant in India are Nanavati Hospital at Mumbai and Fortis Hospital at Gurgaon. Both the hospitals are easily accessible from International Airports at Mumbai and New Delhi.
Procedure And Cost
Bone Marrow Transplant Donors :
For an Allogeneic Transplant, a suitable (HLA matched) donor is a must.
What is HLA typing?
Human leukocyte antigen (HLA) typing is used to match a suitable donor for bone marrow transplant. The best transplant outcome is obtained when a patient’s HLA and the donor’s HLA closely match.
Who can be the ideal donor?
The best possible chance to get the HLA typing match is from siblings. In about 30% of the cases the patient will get a good match from their sisters / brothers. If the patient is not getting suitable HLA match with their siblings then the next possibility is the half matched HLA from their parents or children. Half of the HLA markers come from the mother and half from father. It is unlikely that other family members HLA will match the patient.
How to find donor outside the family member?
If the patient does not have suitable match in the family, then transplant team may look for an unrelated donor. In this case stem cell has to be procured from domestic/ international registry.
Is there any cost involved in preliminary Donor search from the registry?
No, there is no charge involved for a preliminary donor search. If a suitable donor is found, only then the patient has to borne the cost for Stem cell procurement which has to be paid to the donor registry.
What kind of preparation is required for the donor?
Once the potential donor is identified then he or she will undergo several tests. Tests related to his or her health will be done to determine the extent of the match.
Once a match for a patient needing a bone marrow transplant is found, then stem cells will be collected either by a bone marrow harvest or peripheral blood stem cell collection. Of the two, peripheral blood stem cell donations are now more common as the procedure is painless.
Donor has to take growth factor injection 2-5 days before his stem cell donation. Donor has to admitted and hospitalised for 1 -3 days.
What is the Cost of BMT in India?
The cost of Bone Marrow Transplant (BMT) procedure in India is in the range of USD 45000 – 60000. Since there are many variables in the procedure it is difficult to predict an accurate cost for BMT procedure. This is the reason why we give a range for the treatment.
What Is Liver Cancer
Liver is a small football size organ located just below the diaphragm on the right side above your abdomen. The main function of the liver is to clean the blood of all toxins and to segregate the nutrients in your diet and send them to the areas of your body where they are needed. Liver is one of the most important organ of your body and any damage to the liver results in poor quality of life and untimely death unless treated properly.
Just like any other cancer, liver cancer is also the result of the mutation of the liver cells. This mutation means that the liver cells start multiplying at a much faster rate than normal and form a tumour.
Several types of cancer can form in the liver. The most common type of liver cancer is hepatocellular carcinoma, which begins in the main type of liver cell (hepatocyte).
The cancer which originates in some other organ and spreads to liver is not called liver cancer but is known by the name of that particular cancer and is called metastatic liver disease
Causes of Liver Cancer
Most of the people think that Liver Cancer is caused by excessive alcohol intake only which is not correct. Many people who have never consumed alcohol also suffer from liver cirrhosis or liver cancer.
Fatty foods, Hepatitis B or Hepatitis C infection, lack of exercise, obesity and diabetes are some of the equally dangerous things for causing Liver Damage.
Symptoms Of Liver Cancer
- Sudden and unexplained weight los
- Loss of Appetite
- Upper Abdominal Pain
- Vomitting and Nausea
- Body Weakness and Fatigue
- Yellow colour of the eyes and skin
- White stool
Diagnosis and Treatment for Liver Cancer
The diagnosis for Liver Cancer starts with basic blood tests like Liver Function Test, Hepatitis B and Hepatitis C, Ultrasound of the Abdomen, Triple Phase Liver CT Scan and finally Liver Biopsy. Once the presence of Liver Cancer is established then PET CT Scan of Whole Body or Bone Scan is done to find out the spread of Liver Cancer to other parts of the body or to find out whether it is primary liver cancer or metastatic. The line of treatment will depend on this
Surgery – Liver Resection is done to remove the cancerous part of the liver and healthy liver is left inside the body. The healthy liver then grows into full liver over a period of time. If most of the liver is damaged then Liver Transplant Surgery is done in which a portion of healthy liver from a donor is taken and attached to the healthy portion of your liver. This donor liver then grows into a full liver over a period of time.
Other Treatment options include targetted drug therapy or radiation therapy.
Cost Of Liver Cancer Treatment
The first step is to correctly diagnose the stage of Liver cancer. The cost of blood tests, CT Scan, Biopsy and PET CT would be approximately USD 1000-1500. Once we know the stage of the cancer then the treatment is planned. Liver Resection Surgery costs approx 8-10 thousand USD while Liver Transplant Surgery costs USD 30-45 thousand. Other non surgical treatments could cost anywhere between USD 10-15 thousand.
The hospital stay for Liver transplant surgery would be 30-40 days for the patient and around 8-10 days for the donor. The post discharge stay in India would be about 8 weeks. So you should ideally plan a trip for about 3-4 months to India for getting the complete treatment. You can send your reports by email or whatsapp to get an estimate about the cost of the treatment before arriving in India.
Apart from the treatment the other costs like travelling, hotels and food are all cheaper in India. The boarding and lodging cost for the patient and one attendant in a decent airconditioned guest house would be around USD 40-60 per day. Those who have to stay for long periods can even rent an apartment for around 300-400 USD per month. The stay in cancer cases is longer where the patient needs multi modality treatment. For query please whatsapp at +91-8800188335 or email to email@example.com
Dr Kaushal Yadav is an extensively trained cancer surgeon in Gurgaon, India with exceptional skills. An alumini of MS (Surgery) from PGIMS, Rohtak, Haryana, India Dr Yadav did super specialization in Surgical Oncology or cancer surgery from Tata Memorial Hospital, Mumbai, India which is one of the best hospitals for cancer in Asia.
Dr Yadav is having experience in Breast Cancer surgery, Lung Cancer Surgery, Uro-oncology, Thoracic-Oncology, Retroperitoneal Tumors, GI Onco-surgeries, Gynae Onco Surgeries and Head & Neck Surgeries. After completing super specialization he went on to successfully complete Fellowship in Hepatobiliary Surgeries. Dr Kaushal Yadav is a down to earth person with immense confidence and always endeavors to provide the patient with ethical and best treatment to the patient. Dr Kaushal Yadav has given best results in some of the most complex and challenging cases that he operated in Gurgaon India.
Currently Dr Yadav is working as chief cancer surgeon at Pratiksha Hospital, Gurgaon. Before joining Pratiksha Hospital, Gurgaon he was working as cancer surgeon with some of the best hospitals in India that include Tata Memorial Hospital, Mumbai and Fortis Hospital, Noida, India, Paras Hospital and Max Hospital, Gurgaon, India.
- Member of Association of Surgeons of India (ASI)
- Life Member of Indian Medical Association
- Fellowship Hepatobiliary and Liver Transplant- Fortis Hospital, Noida, India
- MCh (Surgical Oncology)- Tata Memorial Hospital, Mumbai, India
- MS (Surgery)from PGI Rohtak, Haryana, India
- MBBS from PGI Rohtak, Haryana, India
- Cancer Surgeon at Pratiksha Hospital Gurgaon, India
- Cancer Surgeon at Max Hospital Gurgaon, India
- Cancer Surgeon at Paras Hospital, Gurgaon, India
- Cancer & HPB Surgeon at Fortis Hospital, Noida, India
- Cancer Surgeon at Tata Memorial Hospital, Mumbai, India
Dr Ankur Garg is the first surgeon in India to have super specialization in Hepatabillary, Pancreatic Surgery and Liver Transplant. Dr Garg did super specialization from ILBS, New Delhi, India the best institute for liver transplant and billary disease. Dr Garg specializes in all surgeries pertaining to GI tract like surgery for pancreas called whipple surgery, esophageal surgery, liver abscess, liver transplant and many more.
His graduation and post graduation has been from Mumbai, India. Dr Garg has trained under one of the best liver disease expert Dr S K Sarin at Institute of Liver and Biliary Sciences, New Delhi India. Dr Ankur is also a Fellow of European Board of Surgeons, which is considered as one of the most respected and top fellowships in the world. Currently Dr Ankur Garg is working as head of HPB and Liver Transplant Surgery at Nanavati Hospital, Mumbai, India.
Dr Ankur Garg is one of the best liver transplants surgeons in India with one of the highest success rates. He is competent in performing both living donor and cadaver liver transplant with equal precision and best results. Dr Ankur Garg is one of the finest and most competent surgeon when it comes to operating upon any GI cancer or general GI surgery which includes stomach cancer, intestinal cancer, cancer of food pipe (esophagus), pancreas or rectum.
A surgeon’s skills get refined by doing more and more surgeries. Dr Ankur Garg epitomizes this fact. He was considered as one of the best GI surgeons even before he specialized into HPB and Liver Surgeries. He was called by various hospitals for all the challenging surgeries and he would accomplish the goals without much ado. He was one of the busiest GI surgeons in the north India before he enlisted for Super specialization in HPB and Liver Surgery from ILBS. After passing out from ILBS he was doing Liver Transplant Surgery at BLK Hospital New Delhi before moving to Nanavati Hospital Mumbai.
- Member of European Board of Surgery
- Member of Indian Medical Association
- MBBS from Government Medical College, Aurangabad, India
- MS (Surgery)from Lok Manya Tilak Hospital, Mumbai
- FEBS, European Board of Surgery
- M.Ch (Hepatobillary Surgery and Liver Transplant) from Institute of Liver & Biliary Sciences, New Delhi, India
- GI Cancer and Liver Transplant Surgeon at Cooper Hospital, Mumbai, India
- GI Cancer and Liver Transplant Surgeon at Lok Manya Tilak Hospital, Mumbai, India
- GI, Hepatobillary, Pancreatic and Liver Transplant Surgeon at ILBS, New Delhi, India
- GI, Hepatobillary, Pancreatic and Liver Transplant Surgeon at B L Kapur Hospital, New Delhi, India
- GI, Hepatobillary, Liver Transplant and Pancreatic Surgeon at Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
- GI, Hepatobillary, Pancreatic and Liver Transplant Surgeon at Nanavati Hospital, Mumbai, India
The iconic healthcare institution of Mumbai, Dr. Balabhai Nanavati Hospital, blessed by Mahatma Gandhi and inaugurated in 1950 by India’s first Prime Minister Jawaharlal Nehru, is now reintroduced as Nanavati Super Speciality Hospital. Nanavati Super Speciality Hospital has been at the forefront of healthcare for 65 years. Today the 350 bed facility housing 55 speciality departments offers a plethora of services in practically every field of modern medicine and health care. Our well-equipped hospital rooms, state-of-the-art departments and technologically advanced systems are all backed by the expertise and reputation of over 350 consultants, 100 resident doctors, 475 nursing staff and 1500 employees.
The hospital’s state-of-the-art Imaging Centre, spanning over 10,000 sq. ft, houses 3 Tesla 32 channel wide bore Magnetic Resonance Imaging (MRI) scanner with MR guided Focused Ultrasound Surgery (MRgFUS) and High-Intensity-Focused-Ultrasound, 64 slice Positron Emission Tomography–Computed Tomography (PET CT) with cardiac capability. The centres of excellence at Nanavati Hospital includes Liver Transplant, Kidney Transplant, Bone Marrow Transplant, Heart Transplant, Cancer Surgery and Treatment, Cardiac Surgery, Cardiology and Urology.
Fortis Memorial Research Institute located in Gurugram, the medical hub of Northern India is one of the most advanced and state of the art hospitals in India. The hospital has every facility in healthcare under one roof. FMRI as generally called has more than 300 beds. Hospital caters to domestic as well as patients from across the globe. FMRI’s centre of excellence are Neurosurgery, Joint Replacement, Kidney Transplant, Urology, Cancer Care, Liver Transplant, Cardiology, Cardiac Surgery, Paediatric Surgery, Gamma Knife and Plastic / Cosmetic Surgery.
The FMRI hospital is considered as a 5 star hospital with highest end care and technology deployed. It has some of the best doctors in the country who head their respective departments like Dr Rana Patir, Dr Sandeep Vaishya, Dr Subhash Jangid, Dr Praveen Tittal, Dr Vinod Raina, Dr Niranjan Naik, Dr Pradeep Bansal to name a few.
Gall Bladder Cancer
Gall Bladder Cancer or CA Gall Bladder is a cancer that originates in Gall Bladder. Bile juice is stored in the gall bladder. The cancer of inner layer of the gall bladder is the most common type of cancer. If gall bladder is diagnosed at the early stages then the results and life expectancy are very good. However the problem with gall bladder cancer is that it is very difficult to diagnose in early stages. In late stage the prognosis or the results and survival rate is very poor. The cancer in gall bladder spreads very quickly to close organs like liver, common bile duct etc.
Symptoms and Causes of Gall Bladder Cancer
As such the symptoms of gall bladder cancer and gall bladder stones are very similar hence it becomes even more difficult diagnose. Most of the time gall bladder cancer is an incidental finding. It comes into picture once the gall bladder removal surgery is performed for stones and sent for biopsy. Following are the common symptoms:
- Pain in right side of abdomen
- Bloating of stomach
- Unwanted weight loss
- Loss of appetite
- Off and on fever, generally low grade
It is still not sure as to why gall bladder cancer happens. However as most of the cancer these is basically an uncontrolled growth of cells inside the gall bladder called adenocarcinoma. Following can be the reasons associated with gall bladder cancer:
- History of gall bladder stones
- More common in females
- Chances of having gall bladder cancer increases with the age
- Chronic gall bladder infection
Diagnosis & Treatment of Gall Bladder Cancer in India
Diagnosis of gall bladder cancer involves both blood investigations as well as radiology and nuclear medicine tests. The primary test is a liver function test that gives an idea to the doctor about the prevailing problems. Following the blood test doctor or surgeon in India may advise you to undergo an ultrasound of abdomen along with CT Scan or a MRI scan of abdomen with contrast. Surgeon may also advise a MRCP scan instead of a normal MRI Scan. In most of the cases these investigations are best diagnostic tools to understand the spread of the cancer. Ultimate choice for confirmation of staging is a PET CT Scan of whole body.
Treatment of gall bladder cancer in India depends upon the stage of the cancer. In case of stage 1 or cancer that is localized in the gall bladder only, the surgeon may advise removal of gall bladder. In case it is in stage 2 which means it has spread to near by organs including slightly into liver then the cancer surgeon in India would remove the gall bladder along with part of liver and nearby tissues for the best possible results. If the cancer has gone beyond stage 2 and has spread to distant organs which is called metastasis then the treatment available is more of symptomatic and palliative. The treatment at this stage includes chemotherapy and radiation.
Cost of Gall Bladder Cancer Treatment and Best Surgeon in India
The cost of gall bladder cancer treatment in India depends upon the spread or the stage of the disease. The cost may vary depending upon the extent of the treatment required. Cost may be USD 2000 to USD 7000. Dr Ankur Garg, Dr Kumar Vaibhaw and Dr Mayank Madaan are the best surgeons for Gall Bladder treatment in India. For more info call or WhatsApp +91-8800188335 or email to firstname.lastname@example.org.
Gastrointestinal cancer refers to malignant conditions of the gastrointestinal tract (GI tract) and accessory organs of digestion, including the esophagus, stomach, billiary system, pancreas, small intestine, large intestine, rectum and anus. The symptoms relate to the organ affected and can include obstruction (leading to difficulty in swallowing or defecating), abnormal bleeding or other associated problems even pain. GI Cancer would include cancer of esopegus i.e. food pipe, stomach cancer, pancreatic cancer and liver cancer. The most common of these are cancers of pancreas, liver and esophagus.
Following are the symptoms of GI cancer:
- Poor appetite
- Weight loss
- Abdominal pain
- Heartburn or indigestion
- Vomiting, with or without blood
- Swelling or fluid build-up in the abdomen
- Blood in the stool
- Low red blood cell count (anemia)
Cancer needs a multi modality treatment which may involve surgery, chemotherapy and radiation therapy. All types of cancers are treated with good success rate by team of very experienced team of cancer specialists and cancer surgeons.
Best Doctors and Cost
As mentioned above cancer needs a multi-modality treatment that involves surgery, chemotherapy and radiation therapy. Not all patients would need all of the above and also not in the same order. In case the patient needs surgery for GI Cancer then the best doctor for GI Cancer, pancreatic cancer, esophageal cancer and liver cancer would be Dr Kaushal Yadav and Dr Ankur Garg. In case the cancer is in advanced stage then the role of medical oncologist and radiation oncologist would be significant. Best medical oncologist for chemotherapy would be Dr Vinod Raina and for radiation would be Dr B K Mohanty. Cost of the treatment would range from USD 8000 to USD 15000 depending upon the treatment required.
The Healthcare in the ‘
B' and `C’ Category cities is transforming at a very rapid pace. New Tertiary Care Hospitals are coming up in these cities. Hospitals with capacities of 200-300 beds equipped with the latest medical technology are fast dominating the skyline in these towns. The emergence of these type of hospitals in smaller cities is a real challenge to the tertiary care hospitals in the metro cities. The hospital chains like Apollo, Max, Fortis etc are already facing the heat as the patients from these cities are slowly drying up.
Most of these tertiary care hospitals are being setup by the doctors of these cities and not by the corporate groups. The doctors who have a strong positioning and financial means to setup these hospitals are joining hands together to get a toehold in the premium healthcare delivery segment. It is one thing to acquire 1-2 acres of land and construct a hospital and it is a completely different ball game to successfully run a tertiary care hospital. The first and the biggest challenge faced by the hospital owners in the smaller cities is the availability of superspecialists who can provide tertiary care services to the patients. Finding good quality Neurosurgeons, Neurologists, Cardiologists, CTVS Surgeons, Urologists and Transplant Surgeons is a herculean task. Even if you manage to find a good superspecialist, the cost of acquisition is so high that achieving break-even becomes a headache. Typically a super-specialist doctor who is willing to go to these smaller cities would expect a minimum guarantee of Rs. 5-6 lacs. If you have to hire 4-5 such superspecialists then be ready to shell out a fixed sum of Rs. 20-25 lacs per month in terms of their salary. The amount of money paid to superspecialist doctors should not be a problem if the hospital is able to attract enough patients in the concerned specialty. However the marketing personnel at these hospitals are not trained to market a superspecialty service like Neurosurgery, Urology or Cardio-thoracic surgery. For ages they have been doing referral marketing which is a euphemism for `Relationship Management’. They neither have the requisite product knowledge, not do they possess the finesse to market such a complex product. The need of the hour is to provide high quality training to the marketing team before you even embark upon the task of hiring superspecialist doctors. This important facet is mostly ignored and the tussle between the promoters and the superspecialist doctors keeps going with both the sides blaming the other for not doing enough.
The Superspecialty hospitals in the peripheral towns need to improve their visibility and the quality of their advertising and communication. They need to hire professionals for these jobs rather than relying on the locally available stuff. The worst thing would be for the promoter doctor to start doing these things on their own at the cost of either their practice or other management functions. Marketing is too complicated a thing to be attempted by non-professionals. There is too much at stake and taking shortcuts would not take you to the destination.
Online marketing is another Achilles heel for these hospitals. The role of online marketing in healthcare cannot be underestimated. Disrupters or Aggregators, as you may call them – Practo, Lybrate etc are trying to capture this market and if the healthcare providers do not check this in time then their condition would be the same as that of the hotels who are reeling under the pressure of diminishing margins. Every such hospital needs to have a strong online marketing team to keep them within the direct reach of the patients. Having a robust website which figures prominently on relevant keywords is the minimum that any hospital owner should aspire for. Just figuring in the top search of google is not enough as the calls emanating out of this search have to be taken to a logical conclusion. The online marketing team of the hospital must have product specialists who are able to attend to the queries of the patients.
Setting up a tertiary care hospital in smaller towns makes a lot of sense as the healthcare is not closer to the patients and they would not have to travel long distances in search for good quality treatment. However the challenges mentioned above will have to be met successfully and professionally before these hospitals make a commercial success.