Monday, 30th October 2017

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Cancer advice network expands

Second opinion can be sought from a wider pool of consultants

By G.S. Mudur
  • Published 7.01.17

New Delhi, Jan. 6: A network of cancer specialists available to patients for a "second opinion" about treatment options is set to expand.

The number of consultants volunteering for the two-year-old National Cancer Grid - a digital network that facilitates information transfer across 89 hospitals - has doubled.

The network had so far relied primarily on doctors from the Mumbai-based Tata Memorial Hospital to offer second opinions. It has now expanded to add consultants from other networked hospitals, the grid's managers said.

A patient can seek a second opinion on paying a service fee of Rs 5,000 and submitting his medical history and related documents online into the grid, which then standardises the information and relays it to experts who respond within 24 hours.

Around 8,000 patients from India and other countries have so far sought such guidance provided by experts drawn from a pool of about 30 Tata Memorial doctors, network members said.

About 30 more doctors from hospitals in Calcutta, Delhi and other cities have now joined the pool.

"There are two ways this expansion will help: the grid can manage many more patient queries and we want to keep the turnaround time to 24 hours," C.S. Pramesh, a surgical oncologist at Tata Memorial and the coordinator of the grid, told The Telegraph from Mumbai. "We don't want delays in the second opinions."

Since the grid was established in 2014 through support from charitable foundations, including Tata Trusts, oncologists have used it to share evidence-based treatment guidelines and conduct training and research programmes in addition to providing guidance to patients.

The online service allows patients or their families, wherever they are, to receive evidence-based and experience-based treatment recommendations.

"Many patients do not have access to experts in their geographical area, and it may not be feasible for them to travel," said Gitika Srivastava, the founder of Navya Networks, the technology partner in the grid that provides digital backbone to the initiative.

Grid-linked doctors have provided second opinions to patients from Bihar, Jharkhand, Jammu and Kashmir and other states, as well as many from Bangladesh and Mozambique.

The queries, grid executives say, reflect the scarcity of oncologists in India and in other developing countries.

Cancer specialists estimate India has around 1,500 oncologists, or one oncologist for about 1,600 cancer patients.

The grid is expected to provide standardised treatment-based guidelines developed by a consortium of oncologists across the country to treat a set of 24 types of cancers, including those of the breast, gastrointestinal tract and lungs.

Doctors say that treatment options may appear confusing to patients and their families given that the prescribed treatments depend on factors such as differences in tumours, other underlying illnesses, and patients' financial constraints.

"The standard guidelines are expected to resolve differences of opinion. The consultants in the grid will typically rely on the guidelines to provide second opinions to patients," Pramesh said. "The guidelines themselves are updated as new evidence emerges."

Among the consultants in the grid is Raghunadharao Digumarti, an oncologist at the Homi Bhabha Cancer Hospital and Research Centre in Visakhapatnam.

A typical query from a patient, processed by trained staff in the grid, arrives on the doctor's mobile phone, displaying relevant information and treatment options he can suggest.

Oncologists say they always work in teams to determine the best course of treatment for individual patients and the team effort required makes the grid an ideal technology-driven platform to fight cancer.

Srivastava says the idea of establishing Navya Networks emerged when a close family member was diagnosed with cancer.

"The first thing that struck me is the willingness of cancer experts to collaborate with each other," she said. "They routinely consult their colleagues or refer patients to other specialists to make informed decisions."

The new pool of consultants in the grid will be drawn from Calcutta's Tata Memorial Centre; the All India Institute of Medical Sciences, New Delhi; the Regional Cancer Centre, Thiruvananthapuram; the Adyar Cancer Institute, Chennai; and the Kidwai Memorial Institute of Oncology, Bangalore, among other hospitals.