Retinoblastoma can be treated upon early detection

Health Care, Heart Care Foundation of India, Social Health Community Comments Off

Several cancers are treatable, however, there still remains lack of awareness about this fact

New Delhi 3rd February 2018: A rare form of cancer, affecting only about 2,000 people in India per year, Retinoblastoma, is the most common among the cancers of the eye in children under the age of five. About 92% of such children live in the developing nations. Many children lose their eye sight or die from this cancer due to lack of awareness of the initial signs of presentation, poor access to proper treatment or lack of finances to finish the treatment.

Retinoblastoma is a cancer that starts in the retina, the very back part of the eye. It occurs when nerve cells in the retina develop genetic mutations. These mutations cause the cells to continue growing and multiplying when healthy cells would die. This accumulating mass of cells forms a tumor.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, President Heart Care Foundation of India (HCFI) and Immediate Past National President Indian Medical Association (IMA), said, “In children with retinoblastoma, the disease often affects only one eye. However, one out of three children with retinoblastoma develops cancer in both eyes. One of the first common signs of this cancer is a visible whiteness in the pupil called ‘cat’s eye reflex’ or leukocoria. This becomes more noticeable in dim light or in photographs taken with a flash. On World Cancer Day, it is important to raise awareness on the fact that Retinoblastoma is often curable when it is diagnosed early. However, if it is not treated promptly, this cancer can spread beyond the eye to other parts of the body. This advanced form of retinoblastoma can be life-threatening.”

Some other symptoms of this condition include poorly aligned or “wandering” eye, known as strabismus; reddish pupil, often with pain; larger-than-normal pupil; different-colored irises; and poor vision or decreased vision.

Adding further, Dr Aggarwal, who is also the Group Editor of IJCP, said, “When retinoblastoma is suspected, a pediatric ophthalmologist examines the retina by dilating the eye, sometimes under general anesthesia. They may also prescribe some imaging tests, like an ultrasound of the eye, a computerized tomography (CT) scan, or magnetic resonance imaging (MRI), as well as blood tests.”

People with retinoblastoma may want to consider genetic counseling before having children to learn more about the risks of passing on the gene change and perhaps to explore ways to avoid this. If a preventive option is not used, children born to a parent with a history of retinoblastoma should be screened for this cancer starting shortly after birth because early detection of this cancer greatly improves the chance for successful treatment.

One of the focus of the year ling 25th years of Perfect Health Mela Celebrations will be on retinoblastoma awareness.

Cancer is very much a preventable condition

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Being aware of the symptoms and making lifestyle changes is imperative

New Delhi, 03 January 2018: A recent study has indicated that cancer cells alter the body clock to boost tumor growth and survive conditions that would kill normal cells. Cancer cells need to make larger than normal amounts of nucleic acids and protein to replicate and for the tumor to grow and spread. Cancer cells have developed the capability to use the unfolded protein response (UPR) to slow protein synthesis when needed, to handle the backlog of misfolded proteins. This helps them survive in conditions that would kill normal cells, found the study.

There are about 2.5 million people living with cancer in India and over 7 lakh new cases get registered every year. Of all the various types of cancer, those of the oral cavity and lungs in males and cervix and breast in females account for about 50% of all related deaths in the country.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, President Heart Care Foundation of India (HCFI) and Immediate Past National President Indian Medical Association (IMA), said, “The prevalence of cancer in our country is not uniform all over. There is a difference in the types of cancer that affect people basis rural and urban settings. We have seen that in rural women, cervical cancer is the most widespread while in urban women, breast cancer is the most rampant. In case of men, rural people are majorly affected by cancers of the oral cavity while rural men are greatly inflicted by cancer of the lung. Although cancer has become an epidemic with a steep rise in its incidence, the irony is that cancer medicines are very expensive and beyond the reach of a common man. Thus, price control is very necessary to provide people with affordable cancer medicines. The government should also take adequate steps to ensure early diagnosis of cancer because it is a proven fact that early diagnosis can save many lives.”

Cancer is the name given to a collection of related diseases that are caused when a group of abnormal cells begins to grow uncontrollably, often forming a tumor. Tumors can either be benign or malignant.

Adding further, Dr Aggarwal, Vice President CMAAO, said, “Although the exact cause of cancer is not known, research indicates that certain risk factors may increase a person’s chances of developing cancer. These include things people cannot control, like age and family history. Lifestyle choices that increase your chances of contracting breast cancer are the usual suspects such as smoking, obesity, lack of exercise and poor diet.”

There are four major types of clinical preventive care: immunizations, screening, behavioral counseling (lifestyle changes), and chemoprevention. Screening is the identification of an asymptomatic disease, unhealthy condition, or risk factor. Primary prevention are interventions to keep disease from occurring (eg, immunization for communicable disease); secondary prevention as detection of early asymptomatic disease (eg, screening); and tertiary prevention as reducing complications of disease (eg, eye examinations in patients with diabetes). This nomenclature is applied differently by some other disciplines.

Here are some ways in which one can diagnose and prevent the onset of this condition at an early stage.

  • Pay attention to symptoms and get yourself checked regularly.
  • Using any type of tobacco puts a person at an increased risk of cancer. Avoiding or stopping the consumption of tobacco is one of the foremost steps in cancer prevention.
  • Filter tap water properly as this can reduce your exposure to possible carcinogens and hormone-disrupting chemicals.
  • Get vaccinated on time and as per schedule. For example, the Human Papilloma Virus (HPV) vaccine helps prevent most cervical cancers and several other kinds of cancer.
  • Drinking plenty of water and other liquids can help in reducing the risk of bladder cancer by diluting the concentration of cancer-causing agents in urine and helping to flush them through the bladder faster.
  • Most importantly, make lifestyle changes such as eating a healthy diet and getting regular exercise. Fruits and vegetables are rich in antioxidants which can help ward off diseases.

Vitamin D supplementation: Choose vitamin D3 over D2

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Vitamin D deficiency is highly prevalent in India, almost in epidemic proportions. There are several reasons for deficiency of vitamin D. Lack of food fortification policies and more commonly our sociocultural practices, ‘sun-fleeing’ behavior, are major factors contributing to deficiency of this ‘sunshine vitamin’ in India which has abundant sunshine. Many people are unaware that they are vitamin D deficient.

Vitamin D, as we know, is essential for bone health. Evidence has also demonstrated its role in chronic diseases such as cardiovascular disease, cancer, diabetes, infertility, dementia and autism, among others.

There are two forms of vitamin D: vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). D2 is plant-based and D3 is derived from animal sources.

Vitamin D levels below 20 ng/ml need to be treated and are an indication for vitamin D supplementation.

The question arises which one to choose: vitamin D2 or D3?

Several international guidelines have recommended either D2 or D3 for vitamin D deficient patients stating that the two forms of vitamin D are equivalent and are equivalent in their effectiveness in treating patients with low vitamin D levels.

However, findings of a new randomized-controlled trial from the UK have raised questions on these recommendations as the study found that vitamin D3 was twice as effective in increasing levels of serum 25-hydroxyvitamin D (25[OH]D) compared to vitamin D2 at a low dose of 15 μg daily.

In the study published online July 5, 2017 in the American Journal of Clinical Nutrition, vitamin D3 fortified foods (juice, biscuits) during winters led to higher serum 25[OH]D levels after 12 weeks of supplementation compared to D2 fortified foods (juice, biscuits) in healthy South Asian and white European women.

Vitamin D levels in women who received vitamin D3 via juice or a biscuit increased by 75% and 74%, respectively vs those who were given D2 through the same methods. Those given D2 saw an increase of 33% and 34% over the course of the 12-week intervention.

Therefore, D3 should be the preferred form when advising vitamin D supplementation as it is the most effective form of increasing vitamin D levels in the body.

Even low doses of vitamin D3 are effective in achieving the desired levels as demonstrated in this study.


1. University of Surrey, Eurekalert Press Release, July 5, 2017.
2. Tripkovic L, et al. Am J Clin Nutr. 2017 Jul 5. Epub ahead of print

Dr KK Aggarwal
National President IMA & HCFI

Recipient of Padma Shri, Dr BC Roy National Award, Vishwa Hindi Samman, National Science Communication Award & FICCI Health Care Personality of the Year Award
Vice President Confederation of Medical Associations of Asia and Oceania (CMAAO)
Past Honorary Secretary General IMA
Past Senior National Vice President IMA
President Heart Care Foundation of India
Gold Medalist Nagpur University
Limca Book of Record Holder in CPR 10
Honorary Professor of Bioethics SRM Medical College Hospital & Research Centre
Sr. Consultant Medicine & Cardiology, Dean Board of Medical Education, Moolchand
Editor in Chief IJCP Group of Publications & eMedinewS
Member Ethics Committee Medical Council of India (2013-14)
Chairman Ethics Committee Delhi Medical Council (2009-15)
Elected Member Delhi Medical Council (2004-2009)
Chairman IMSA Delhi Chapter (March 10- March 13)
Director IMA AKN Sinha Institute (08-09)
Finance Secretary IMA (07-08)
Chairman IMAAMS (06-07)
President Delhi Medical Association (05-06)

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