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Every year, September is observed as Gynecologic cancer awareness month. It is important for women to understand what are most common Gynecologic Malignancies and how to prevent them and detect them early, to save lives.

Three Commonly encountered Gynecologic cancers are:

Cervical cancer

Endometrial cancer

Ovarian cancer

Cervical cancer: It is the most common gynecologic malignancy. It arises from lower part of uterus.  lt is mainly linked to HPV infection. It can be prevented by vaccine against HPV (Nanovalent Gardasil). Cervical cancer can be detected early by regular pap smears and HPV testing. Treatment options for very early cervical cancer include surgery. For early stage bulky disease and locally advanced stages, Radiation therapy along with chemotherapy followed by brachytherapy is the mainstay of treatment.

Endometrial cancer: Endometrial cancer incidence is on rise due to several factors like life style , habits, obesity, use of hormonal pills, family history. It malignancy that arises from the uterus and its lining. It is usually encountered in post menopausal women , but now we see rise in incidence in younger age group as well, probably due to above mentioned factors. A simple ultrasound is adequate to understand uterine cavity lining. There are no specific guidelines for screening for Endometrial cancer , but a simple USG and pap smear would aid in early detection.We prefer to do a Endometrial curettage or biopsy to diagnose Endometrial cancer. Surgery is the mainstay of treatment, followed by radiation therapy and chemotherapy if required based on risk factors. In advanced and metastatic cases, apart from chemotherapy, targeted agents and immunotherapy can be considered based on molecular markers.

Ovarian cancer: It is a cancer that begins in ovaries( female organs that produce eggs). Exact cause is unknown , but linked to risk factors like age above 50yrs, family history of breast or ovarian cancer. Majority of them do not experience any symptoms in early stages, hence goes undetected till advanced stages. Early stages treatment is mainly surgery followed by chemotherapy if needed. Advanced stages need both chemotherapy and surgery. Nowadays there is role of targeted agents also as maintenance if BRCA mutations are positive.

Common symptoms and signs:

Intermenstrual bleeding per vaginum, pelvic pain, discharge (cervical cancer)

Post menopausal spotting and bleeding per vagimun with abdomino pelvic pain (endometrial cancer)

Early satiety, bloating, weight loss (ovarian cancer)

Early Detecting Aids:

Periodic pap smear with HPV contesting after age of 30 yrs. A simple Ultrasound when in doubt Serum CA 125 tumor marker specifically for Ovarian cancer Knowing your family history (Breast Ovarian, Endometrial cancer) Most importantly consulting an oncologist to guide you about screening and understanding family history.

Early detection and knowledge is the key to conquer cancer.

HE Dr (Smt) Tamilisai Soundararajan, Hon’ble Governor of Telangana, has formally launched the fourth edition of the Guinness World Record holding ‘NMDC Grace Cancer Run‘ being organised across the globe, by the city based Grace Cancer Foundation (GCF), at Hotel Daspalla, today. Also present on the occasion were Guest of Honour Shri Sumit Deb, CMD, NMDC Ltd.; Dr Chinnababu Sunkavalli, Robotic Surgical Oncologist & CEO, Grace Cancer Foundation; Shri. Ajay Misra, IAS (Retd.), Former Special Chief Secretary, Govt. of Telangana & Advisory Board Member, GCF; Shri Sujatha Rao, IPS (Retd.), Former IG & Chairman, Grace Cancer Foundation; and Dr Prameela Sunkavalli, Founder Trustee, Grace Cancer Foundation. The Race ambassadors from across the globe including Dr Joseph Paturi, Founder Chairman, Global Grace Health, USA; Dr Satish Chandra, Race Ambassador Australia; Dr Sathya Kalangi, USA; Dr Joshua Banda, Africa; Mrs Sonia Chadha Nihal, UK and Europe; Ms Paulina, South America and Dr Dilip Pawar, Mumbai; were present virtually.

In 2020, the Grace Cancer Run won the Coveted Guinness World Records on two counts of, most live viewers for a female health awareness lesson on YouTube and most videos of people running/ jogging uploaded to Facebook in one hour and is proactively aspiring for more recognitions this year.

The ‘NMDC Grace Cancer Run’ being organized on October 10^th, 2021; has a hybrid format, enabling participants to choose as per their convenience between the virtual and physical running. The virtual run amplifies the reach of the message on early Cancer detection and prevention by manifold, across the globe. The Run sponsored by NMDC and powered by Ryan and Apollo Hospitals, is imbibing the spirit of ‘Azadi ka Amrit Mahotsav’ celebrating 75 years of India’s freedom and pursuing the goal of freedom from Cancer for humanity.

HE Dr (Smt) Tamilisai Soundararajan speaking on the occasion said, cancer prevention is the need of the hour globally and Chinnababu of GCF is the pedda babu in controlling cancer through this initiative. It’s an honor to be part of this program to inaugurate initiatives of the NMDC Grace Cancer Run. As we celebrate Azadi ka Amrit Mahotsav, it’s high time we inculcate the spirit of patriotism among all sections of the society and all the generations. We must salute the spirit of services and sacrifices made by the great freedom fighters. Azadi ka Amrit Mahotsav is an occasion to pay tributes to them in whatever way possible. I am delighted to launch this program creating awareness of cancer, it’s a unique program. Our Prime Minister and Home Minster have guided us to conduct some programs to celebrate the 75^th Independence year. This program is unique as its corelating freedom fight with the fight against cancer. It’s a poignant occasion also to remember several youth, who became victims of cancer for lack of cancer screening and good care. I dedicate this Azadi ka Amrit Mahotsav NMDC Grace Cancer Run, to all the cancer patients who lost their life, so that no one loses their life because of cancer. Cancer is a word that reflects more than a disease, it stands for fear, helplessness, pain, distress, and loss. The reason is low awareness levels in our society about cancer. Many of us are not aware that cancer has become the second most prevailing cause of death across the world. It is estimated that there are more than hundred types of cancer affecting the people of all ages and genders. The global burden of cancer is expected to increase by 47% in the next twenty years, just imagine it can afflict children, young mothers, old people, anyone anytime, causing immense distress to the individuals, families and societies. It is difficult to determine the exact cause of its onset because we are exposed to so many risk factors, lifestyle changes. But precautions, timely screening, early detection and appropriate treatment can become the single line of hope for many. Cancer mortality rate in low- and middle-income groups continues to be high. It is increasing at a very alarming rate and requires effort of global collaboration to reduce the high mortality rate. The reason for such mortality is multifactorial. In 2020 most cancer deaths occurred in low-income countries, that constituted 70%, which is close to 7.2 mn compared to 30% of High-Income countries. Lack of awareness and screening facilities are the main causes, as cancer can be cured if detected early. Most common cancer in women like breast cancer and cervical cancer can be detected early through simple screening methods. People should undergo regular screening to detect cancer early. Increasing incidence of obesity is also leading cause of cancer, we are counting our currencies, but not counting our calories, so focus on calories too. Physical activity is a simple tool accessible to everyone to combat obesity and thereby prevent cancer. Shri Narendra Modi ji has initiated Fit India to raise awareness in this direction. As the saying goes You Can, yes, we can remain alert, we can alert others, we can spread awareness, we can remain vigilant about the symptoms, we can encourage others to get screened, we can seek early care and that is what this program is doing. I appreciate Grace Cancer Foundation for the work it’s doing through its various initiatives in India and abroad. The 4^thEdition of NMDC Grace Cancer Run, is a call to all of you who wish to get associated with a cause, to participate in this run, which means a lot in embracing an active lifestyle. I am happy that enthusiasts from 150 countries are participating. As we celebrate Azadi ka Amrit Mahotsav, I am confident that India will very soon get freedom from cancer. Request everyone to take active participation and run, run for others, run for yourself, run for cancer free future, every step taken by you will leave its mark in someone’s life.

Shri Sumit Deb said, the run intends to spread the message on good health and fitness, while spreading awareness about cancer. Grace Cancer Foundation’s endeavor to eliminate the cancer burden of our country through awareness is commendable. Cancer is a deadly disease, as we never know who and how somebody gets affected. A study says an estimated 0.44mn have died due to cancer during the year 2011, 0.6 mn people are likely to get affected due to cancer in 2021 and estimated cancer mortality is likely to be 0.7 mn due to cancer by the year 2026. It’s a social responsibility to make the society aware of this disease as a responsible corporate citizen. With the ongoing Azadi ka Amrit Mahotsav, we are celebrating a New India – a Fit India. Through NMDC Global Grace Cancer Run 2021, we aim to promote physically more towards fitness in our country. To commemorate India@75, NMDC has curated a series of academic, cultural, and sports events in the 75-week run up to August 22, says Shri Sumit Deb.

Dr Chinnababu Sunkavalli said, the question that crops up during these times is, during COVID times what is the relevance of cancer? But let me share some alarming statistics, more than half of the cancer deaths occur in less developed countries in the world, every nine seconds a person is detected with cancer. Among causes of cancer lifestyle ranks first, by the year 2030 that global cancer deaths will touch 13 mn every year, that’s a huge number. How can we impact them and reduce the number of deaths. Grace Cancer Foundation was set up with a vision to reduce the burden of cancer across the globe. One third of cancers can be prevented by modifying lifestyle, one third can be prevented if detected early. Taking these two ideas Grace Cancer Foundation has come up with a two pronged strategy of Awareness and cancer screening programs across the country and globe. We are equipped with six state of the art cancer screening vehicles and are touching lives across the country and globe. The theme for this year is freedom from cancer, even as we celebrate Azadi ka Amrit Mahotsav, we are working to gain freedom from cancer in India and abroad. In a short span of eight years, Grace Cancer Foundation has conducted more than 1250 mobile cancer screening programs and could touch more than 2 lakh people. Most common cancers detected were cervical, breast, oral and lung cancers. In addition to screening for cancer the Foundation is aggressively pursuing Awareness drives through cancer run. Children above sixth grade from more than 550 Navodaya Schools are part of this run, more than 3.5 lakh children and 25000 teachers are part of this revolutionary movement to raise awareness to prevent cancer. The Grace Cancer Run continues to have enormous significance this year too, as the all-embracing Covid 19 fear is restricting patients suffering other ailments from seeking medical attention. Patients with symptoms of non-Covid diseases are postponing their treatment for the pandemic conditions to subside. However, the delay can be unimaginably fatal for serious ailments like Cancer. This scenario presents serious and irretrievable consequences for the community by raising the disease burden manifold, says Dr Chinnababu Sunkavalli. This run will help sensitise patients to seek immediate medical help and nip a dreaded disease like cancer in the bud stage. It’s also heartening that this edition like in the previous year will expand its footprint across the globe to 150 plus countries and positively impact even those in the remotest part of the World, by spreading the word on prevention and early detection of Cancer. Physical activity is key to disease prevention, especially cancer and this Run helps to achieve the objective, he adds.

Grace Cancer Foundation, a charity organisation, working towards providing succour to cancer patients, has initiated Grace Cancer Run, to raise public awareness against cancer, its prevention and early detection, with the moto ‘No patients should be deprived of treatment for lack of financial support.’ Cancer survivors participating in the Run instil confidence and hope of cancer being conquerable, among cancer patients. The funds mobilised from the run will be utilised to provide Cancer Screening across rural India and care for needy patients diagnosed with cancer, besides conducting virtual Cancer awareness program and spreading knowledge across the globe.

The Foundation has framed stipulations for the virtual run, to ensure safety and wellness of the participants in these unprecedented times of Covid 19, while affording them the privilege of being a part of a noble cause with ability to spread the message on cancer. The virtual run enables the participants to be part of it from the comfortable and secure confines of their homes on a treadmill or at a nearby track. The race rules are designed to permit the participant to reach the desired distance in a prescribed timeframe. Besides creating awareness, the virtual run serves as an add-on to stay fit and healthy, thus lifting the spirits of the participants especially during these somber times.

The Run will be in three categories of: 5K, 10K and 21.1K (Half Marathon)

Each participant registering for the Run will be provided with an ‘e-bib’ (a personalized, printable picture). The participants need to log on to activity Apps of their choice, though Strava is the preferred app for recording the run. After the completion of the run, the runners have to post the distance of the run along with a selfie or photograph with the bib on the chest for the organizers to record their participation.

The interested participants should register for the Run through the following links

www.gracecancerrun.com

www.gracecancerfoundation.org

Last year 50000 people from 119 nations participated in the Global Grace Cancer Run and GCF is striving to enhance the participation to 150 countries. Since early detection and lifestyle modification is the key to conquer cancer, a physical activity like running is strongly advocated for all age groups, says Dr Prameela Sunkavalli.

MADURAI: Health Minister Ma Subramanian said there was little chance of students being allowed in the current academic year at the All India Institute of Medical Sciences (AIIMS) in Maduraí (2021-22). This year, the proposal for the start of classes came before the Madurai Bench at the High Court in June, but the Minister stated that the Union government’s proposed class-leading alternatives were not practical. On September 12, this is coming ahead of the NEET this year. Since last year, NEET results have been based on admission to MBBS training at AIIMS and JIPMER.

Subramanian said, “During the meeting with Union Health Minister Mansukh Mandaviya in New Delhi on September 3, it was conveyed that none of the suggestions put forward regarding temporary arrangements were feasible for the State. TN is for beginning admissions only after construction of the planned buildings at Thoppur. Thus, we insisted on expediting the project. The Ministry acknowledged the practical difficulties in meeting the criteria of the National Medical Commission to admit students at AIIMS this year.”

The Union government had suggested three temporary options to begin classes this year for 150 students of Madurai AIIMS: to host them at JIPMER in Puducherry, at a government medical or arts college in Madurai, or at any private medical college in Madurai. The State did not find these options viable and instead suggested 50 students each be accommodated at the Madurai, Theni, and Sivaganga government medical colleges. However, all these options have now been ruled out.

‘Temporary campus will not reflect well on TN’

Subramanian explained JIPMER was ruled out as it would not be appropriate when the project concerned Tamil Nadu. Starting classes at a private medical college in Madurai, too, is out of question as AIIMS is an autonomous institution of national importance. Similarly, accommodating the students at the Madurai Medical College is not feasible since the college already admits 250 MBBS students every year.

An additional 150 students would burden the college which does not have the required infrastructure. The final option of admitting 50 students each at Madurai, Theni, and Sivaganga government medical colleges was also deemed logistically unfeasible. “It will only lead to inconvenience for the faculty and students,” he added.

“Most students securing admission to AIIMS are from northern States and would have greater expectations of the amenities as provided at other AIIMS. It would not reflect well on TN to accommodate them in a hastily-arranged temporary campus,” Subramanian said. On June 30, commencement of classes from this year was mooted during the hearing of a plea at the Madurai Bench.

The petitioner, a law student, sought a direction to the Union and State governments to take steps to commence the functioning of the institute at a temporary campus, until the construction of the main building was completed. It was then that the Union government told the court it was willing to start outpatient services and MBBS classes at a temporary alternative space identified by the TN government.

Meanwhile, Health Secretary Dr J Radhakrishnan said except for vague correspondences and submissions of affidavits at the court, neither a MoU nor a concrete plan of action was chalked out by the Union Health Ministry to immediately start MBBS admissions at a temporary campus. Hence, after explaining the technical aspects, the State has insisted that the Union government fast-track the construction of AIIMS, he added.

THE ROAD SO FAR

JUNE 30Centre tells HC it is keen to start outpatient services & classes, subject to availability of alternative space & manpower till the building is set up

JULY 7 State says Union govt suggested three places in Puducherry and Madurai to temporarily conduct MBBS classes for 150 students

JULY 26 TN says it sought an AIIMS report on the proposal to take 50 students in 2021- 22. Also says students can be taught at nearby govt colleges

AUG 17 AIIMS executive director says Centre is ready to start classes at any of the colleges chosen by TN, subject to infrastructure requirements. State seeks time.