‘Early cancer can be removed endoscopically’

Cancers of the food pipe, stomach, small intestine and colon can be detected at a very early stage using modern endoscopic equipment, according to Dr. Madhura Prasad Suman of VGM Hospital, Coimbatore.
According to her, one of the advancements in the field of endoscopy is narrow-band imaging or advanced optical processing which magnifies even the minutest detail and allows very early cancers to be detected. 
Even without a biopsy, such imaging can predict cancers with 90% accuracy. Early cancers most often do not present with any symptoms. 
Occasionally, they may present as stomach pain, blood in motion, black-coloured motion, loss of appetite or weight loss. Most often, by the time the cancer becomes symptomatic, it would have reached an advanced stage. 
Who are the ones who have to be tested for cancer?  
Those who smoke, consume alcohol, tobacco chewers and those who have a family history of cancer are the ones to be screened for early cancer. 
Statistics at a tertiary gastroenterology referral hospital like VGM Hospital, Coimbatore, which has an advanced gastro centre, shows that out of 35,315 endoscopies and colonoscopies performed, early cancers were found in around 225 patients (0.63%).
Advanced cancer requires invasive surgery, chemotherapy and radiotherapy but early cancer is accessible by endoscopy and can be removed entirely by endoscopic surgery. 
This surgery needs no keyhole or surgical incision and can be done by the endoscope itself. Prior to the resection, using EUS, which is endoscopic ultrasound, the layer of involvement of cancer is first checked. Following this, if the cancer is superficial, EMR is done. 
If it is deeper, ESD is performed. This technique is not available at all centres and needs advanced equipment and special skills. 
VGM Hospital has performed nearly 200 EMRs and ESDs successfully. 
Annual endoscopies have shown no recurrence of the cancer in these patients. 
Thus endoscopic surgery offers an elegant and effective solution to treat early cancers. 
Recently, Dr. Madhura Prasad Suman, a consultant gastroenterologist who specialises in endoscopic early cancer endoscopic surgeries, presented her research at the American College of Gastroenterology conference in Vancouver, Canada, and was awarded the prestigious Presidential Award and Outstanding Award for her work. 
The research was a novel technique for the removal of early neuroendocrine tumors found in the small intestine endoscopically after placing a clip safely. 
It was appreciated widely. 
Neuroendocrine tumors are slow-growing cancers. A few of these tumors turn into cancers and spread. However, they are capable of producing hormones or causing any blockage at the location where they are found and hence produce symptoms. 
The recent guidelines recommend endoscopic removal whenever possible. 
With a team of six medical gastroenterologists and one hepatologist at VGM Hospital, Dr. Madhura Prasad Suman, Dr. Vamsi Murthy and Dr. V G Mohan Prasad have been doing these advanced endoscopic 
surgeries.