Targeted Drug Therapy (TDT) or gene therapy has unveiled a new era in the treatment of cancer, according to leading oncologists from the Ruby Hall Clinic, Pune.

TDT along with radiotherapy to target the cancerous tumours has now proven to be more patient friendly because it causes fewer complications unlike conventional chemotherapy. TDT specially acts on the group of cancerous cells and saves the organ, thus allowing oncologists not to opt for surgical procedures to remove the tumours, stated Dr Kumaraswamy, head of the department, Ruby Hall Clinic, and former radiation oncologist, Kidwai Memorial Institute of Oncology.

In the last two years, cancer treatment has witnessed a paradigm shift with gene therapy. Earlier treatment addressed efforts to killed cancer cells which had the propensity to multiply at a faster pace than the normal cells. During the process of chemotherapy, normal cells were attacked along with the diseased cells and this posed a serious challenge to oncologists to reduce their burden of suffering and save patients.

Now the state-of-the-art treatment modality of TDT in conjunction with radiotherapy ensures that the normal cells are untouched. In the case of head and neck cancer, BIOMAB a H-R3 anti EGFR (Epidermal Growth Factor Receptor) monoclonal antibody is proving to be a best in class of drugs showing highly favourable response with no potential side effects, informed Dr Kumaraswamy, who is conducting an institutional trial with BIOMAB at the Ruby Hall Clinic.

According to Dr Kamlesh Bokil, surgical oncologist, Ruby Hall Clinic and associate professor, dental department, Bharti Vidya Mandir, head and neck cancers are rampant in India primarily because of increased use tobacco (smoking) and chewing of pan masalas and ghutka which has led to high rates of pre-cancerous conditions among youngsters and women. There is a serious need to increase awareness and educate the masses on the detrimental affects of tobacco and pan masalas which along with alcohol was harmful and fatal. "Patients are coming to us in the advanced stages of cancer and with multiple manifestations, referred to as 'multi modality cancer", he added.

In the past, the surgeons took the brunt of the treatment but now we work as a team where radiotherapists also play a crucial role to downsize the tumour during the drug administering process. This method has shown excellent results where patients are rehabilitated faster. Therefore the onus is shifting to TDT and radiation therapy from surgeries, stated Dr Bokil.

With newer computer and imaging technologies like intensity-modulated radiation therapy (IMRT), MRI, CT and PET scans, tumours can be viewed better and also see what we treat, stated Dr. Sumit Basu of radiation department, Ruby Hall Clinic. Only time will tell how fast we can translate image guided therapies for better outcomes.

There are several new TDT molecules and oncologists have an option for treatment. The adverse reactions have been brought down to 0.5 per cent in 200 cases for the Grade III serious side affects and to 6 per cent in Grade II of moderate reactions. Though TDT is expensive, it is beneficial because it reduces hospitalization expenses and makes return to work faster.