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  2. Service
  3. OPD Meetings
  4. Teaching & Training
  5. Research
  6. Publications
  7. News & Events
  8. Contact Us
  9. Pulmonary Medicine Unit
Convener : Dr. Sabita Jiwnani ( Surgical Oncology )
Secretary : Dr. Naveen Mummudi ( Radiation Oncology )
Pathology
  • Dr. Rajiv Kumar
  • Dr Anuradha Chougule
  • Dr Trupti Pai
  • Dr Omshree Shetty
Surgical Oncology
  • Dr. C S Pramesh
  • Dr. George Karimundackal
  • Dr. Sabita Jiwnani
  • Dr Virendra Kumar Tiwari
  • Dr Devyani Niyogi
Radiation Oncology
  • Dr. Jai Prakash Agarwal
  • Dr. Naveen Mummudi
  • Dr. Anil Tibdewal
Medical Oncology
  • Dr. Kumar Prabhash
  • Dr. Vanita Noronha
  • Dr. Amit Joshi
  • Dr. Vijay Patil
  • Dr Nandini Menon
  • Dr Ajaykumar Singh
Nuclear Medicine and Molecular Imaging
  • Dr.Venkatesh Rangarajan
  • Dr.Nilendu Purandare
Dept Of DIG DIS & CLI Nutrition
  • Dr. Shaesta Mehta
  • Dr. Prachi Patil
  • Dr. Shridhar
Radiology
  • Dr. Amit Janu
  • Dr Nivedita Chakraborty
  • Dr Satish Sorte
Palliative Care
  • Dr. Joyita Deodhar
  • Dr Shamali Poojary
Speech & Swallowing Therapy
  • Dr. Arun Balaji
Intervention Radiology
  • Dr. Suyash Kulkarni
  • Dr. Kunala Gala
  • Dr. Nitin Shetty
  • Dr. Daksh Chandra
Pulmonary Medicine
  • Dr. Sandeep Tandon
  • Dr. Maheema Bhaskar
  • Dr Pavankumar Biraris
Physiotherapy
  • Dr. Anuradha Daptardar
  • Dr Manali Kamat
Anesthesia & Critical Care
  • Dr Madhavi Shetmahajan
  • Dr. Priya Ranganathan
  • Dr. Swapnil Parab
Thoracic DMG Co-ordinator
  • Dr Srushti Jain
  • Mr. Sujat Kamble

DMG activity (Service) – yearly aims and objectives, special arrangements to achieve these, any audit report, OPD timings, surgery days etc. other information relevant to patients and referring doctors.

The thoracic oncology DMG is amongst the few specialized multidisciplinary thoracic oncology groups in the country treating a wide variety of lung, esophageal, chest wall and mediastinal tumors.

A team of experts from different specialties customize the management of patients by designing the most effective combination of Surgery, Radiation therapy, Chemotherapy and Radiology & Pulmonary Medicine to suit the individual’s needs in a multi disciplinary Joint Clinic (JC) which is held on every Monday and Wednesday . All newly diagnosed patients as well as patients who have undergone a complete staging evaluation are usually evaluated during this clinic. These management decisions are based on evidence but tailored to the individual patient.  

OPD Timings (General & Private)

Surgical Oncology: Monday and Wednesday 9.30 to 5.30 PM
Radiation Oncology: Monday to Friday 9.30 to 5.30 PM
Medical Oncology: Monday to Friday 9.30 to 5.30 PM
OT Days- Tuesday, Thursday & Friday

Pulmonary Medicine: Monday to Friday ( Except Wednesday ) 8 am to 1 pm

Thoracic JC: Monday & Wednesday 12:30 to 3:00 pm.

High Risk JC  The initiation of the “high-risk” multidisciplinary meeting with thoracic surgeons, anesthesiologists, critical care specialists and pulmonary physicians, a unique feature of the DMG has led to increasing numbers of high-risk patients being considered for surgery with the aim of improving outcomes, optimizing the care of patients with multiple comorbidities prior to surgery. Active participation from the physiotherapy department on postoperative rounds ensures individualized attention to specific patient needs over and above the routine.

Achievements

  • Lung & Esophagus Cancer Support group meeting: Esophageal and lung cancer support group meeting is held on 4th Tuesday of every month. It has invited talks, discussions focusing on patient-centric problems. The involvement from patients has been encouraging and this provides them a forum for exchange of experiences, discussing their fears, concerns and closer interaction with other patients and their treating physicians. In addition, the availability of dedicated counselors for patients with thoracic cancers and the institution of early palliative care into the treatment continuum are some more initiatives to improve the overall experience for patients.

  • Management of complex airway problems including tracheobronchial stenting and laser therapy

  • Evidence based management of advanced lung and esophageal cancers with molecular-based personalized targeted therapy and chemotherapy

  • State of the art radiotherapy services include tomotherapy, image-guid ed and stereotactic body radiotherapy

  • Immediate postoperative, post chemotherapy and radiation therapy outcomes comparable with similar high volume centers in the world.

  • In addition to the above the DMG also has a very effective program for palliation of both advanced esophageal and lung cancers, with early involvement of the palliative care team

  • The Pulmonary Medicine Unit has proposed a 2 year academic programme towards Fellowship in Onco-Pulmonology for Chest Physicians through Homi Bhabha National Institute (HBNI) that is currently awaiting approval by the Board of Studies for academic year 2018-2019.

 

The DMG conducts dedicated teaching sessions and on-the job training for the MCh (Surgical Oncology), DM (Medical Oncology) and MD (Radiation Oncology) courses. In addition, a two-year fellowship in thoracic surgical oncology is offered under the Homi Bhabha National Institute and is the only one of its kind in the country. The teaching programme is highly structured and includes didactic lectures, seminars and case-presentations. Regular orientation lectures are taken for all new registrars and fellows working in thoracic surgery nine times a year. Two comprehensive CMEs were conducted covering the entire spectrum of lung cancer which was attended by postgraduates, residents and fellows from across the country. A lung practicum was conducted in the department of radiation oncology, a limited hands-on course focusing especially on stereotactic radiotherapy in lung cancers.

The DMG has several trainees - ten thoracic surgical fellows (two 2-year fellowships, two one-year fellowships and six 6-month fellowships); twelve senior MCh (Surg Onco) registrars, fifteen junior MCh (Surg Onco) registrars, six medical and twelve radiation oncology registrars rotate through the DMG every year. In addition, training is provided in diagnostic bronchoscopy to 24 physicians from across the country annually.

We also conduct:
Case capsules: Every Monday and Wednesday in surgical oncology department.
Difficult Case Discussion : Tuesday & Thursday in Medical oncology department.

Newer initiatives in the DMG

  • Enodbronchial Ultrasound (EBUS) and EBUS guided trans-bronchial needle aspiration (TBNA)
  • Robotic surgery for thoracic cancers
  • Stereotactic radiotherapy for lung cancers
  • Lung and esophagus cancer patient support group.
  • Pharmacovigilance program for chemotherapy drugs.
  • Introduced early palliative care for lung cancer patients.
  • Dedicated counsellor for lung cancer patients.
  • Availability of 68Galium DOTA Peptide for neuro-endocrine tumors
  • Alk-1 IHC test for lung was introduced as routine diagnostic test in TMH since Jan 2015 In June 2015, ALK testing by Ventana D5F3 IHC clone (used in TMH) got US FDA approval as companion diagnostics.
  • Started a preceptorship program with hands-on training for EGFR and alk mutation testing.

Key indicators of DMG activity: Information that emphases activity.

  • The DMG is amongst the highest volume thoracic cancer referral centers in the world. A total of 3802 new patients, comprising over 10% of the hospital registrations were registered in the DMG in 2014, of which 2,263 (59.6%) were general and 1537 (40.4%) were private patients. Lung cancers were the majority, 2374 (62.4%) followed by esophageal cancer 1070 (28.1%).

  • The thoracic surgical unit is the highest volume thoracic oncology centre in India and operated 197 patients with esophageal cancer, 104 patients with lung cancer, 145 patients with pulmonary metastases, 35 patients with mediastinal tumors and 32 patients with chest wall tumors. In addition, several minor procedures including diagnostic and therapeutic bronchoscopy, port insertions, intercostal drainage, pleurodesis etc were performed. Early post-operative outcomes are comparable with most high volume centres in the world. A large number of patients are operated by minimally invasive surgery including thoracoscopy, laparoscopy and robotic surgery.

  • The thoracic medical oncology unit has amongst the highest volumes in the country and treated 1414 patients with lung cancer and 503 patients with esophageal cancer. These include neoadjuvant, adjuvant and palliative chemotherapy including targeted therapy. Overall response rates, toxicity and survival figures were similar to high quality thoracic oncology centres worldwide.

  • Thoracic radiation oncology treated 503 patients with lung cancer with compliance of 98% and 77 patients with esophageal cancer with a compliance rate of 91 percent. Short and medium term outcomes have been meticulously documented and periodic audits conducted to monitor performance critically. All modern techniques of radiation including IGRT, IMRT, 3DCRT and SBRT are available and used regularly to provide superior treatment outcomes.

  • Development of guidelines, scientific report, educational modules, etc: The guidelines for the treatment were last updated in the Evidence Based Management Guideline Meeting on Thoracic cancers held in February-March 2013. In addition any updates in literature that warrant a change in the management guidelines are also taken into account. An annual report including the annual activities of the DMG and DMG members is compiled every year.

The DMG maintains ongoing quality improvement measures with continuous audits of peri-operative, post chemotherapy and post radiotherapy morbidity and mortality estimation with emphasis on post operative infections and treatment compliance

Research

The thoracic DMG conducts several investigator-initiated and sponsored research studies. Practice changing studies in the Thoracic DMG

  • Three field radical esophagectomy versus two field esophagectomy – a prospective randomized controlled trial
  • Effect of screening with visual examination and double-contrast barium swallow on oral and upper aerodigestive tract cancer mortality – a cluster-randomized trial
  • A prospective study of telephonic contact and subsequent physical follow up of radically treated lung cancer patients
  • Prospective study of variations in breath holding times in various phases of respiration & effect of respiratory training in Lung cancer patients. A step towards image guided radiotherapy
  • Phase II randomized trial comparing NACT and NACTRT for locoregionally advanced esophageal cancer
  • Molecular Profiling of lung cancer for actionable mutations
  • Comparative study for efficacy and safety of Paclitaxel with Cisplatin/Carboplatin versus 5-Fluorouracil with Cisplatin/Carboplatin in resectable carcinoma esophagus or gastroesophageal junction carcinoma
  • A randomized trial comparing metronomic chemotherapy vs observation in patients receiving chemoradiation in esophageal cancer.
  • A randomized study comparing IV chemotherapy vs TKI in third line and beyond in advanced non-small cell lung cancer
  • Phase III Study Evaluating Efficacy and Safety of low dose Gemcitabine compared to standard dose Gemcitabine with platinum in advanced non-small cell lung cancer -
  • Comparative study of QOL of patients on Pemetrexed versus Erlotinib in Maintenance therapy for Advanced NSCLC (Other than Squamous Cell Carcinoma)
  • A randomized study comparing Erlotinib vs Gefitinib in second line in advanced non-small cell lung cancer
  • A Study to evaluate the variability in delineation of the target volumes in lung cancer by comparing two techniques using Four- dimensional computed tomography
  • Distress screening and Quality of Life in treatment naive Lung cancer patients attending radiotherapy outpatient department
  • Randomized clinical trial of best supportive care compared with best supportive care with chemotherapy in advanced unresectable or metastatic esophageal cancer
  • Prospective observational study of thromboembolic events in patients of advanced stage non-small cell lung cancer (NSCLC) treated with platinum based chemotherapy

The thoracic DMG is involved in the conduct of several investigator-initiated and sponsored research studies. Some of the studies initiated earlier were published and presented in high impact journals and international conferences respectively. The randomized trial evaluating the role of perioperative erythromycin to prevent delayed gastric emptying in patients undergoing esophagectomy was presented in the biennial conference of the International Society for Diseases of the Esophagus in Vancouver. Ongoing randomized trials include the trials comparing radical three-field vs two field esophagectomy for operable esophageal cancer, and neoadjuvant chemotherapy with neoadjuvant chemoradiation for locoregionally advanced esophageal cancer. In addition, several new studies were initiated this year and planned for the next year.

The CHEST (Cancers of the Hypopharynx and Esophagus Trial) screening trial is underway in Ratnagiri district with over 33000 individuals having been screened and given health awareness for upper aerodigestive tract cancers. Extensive health education and awareness of health hazards of tobacco use is an integral part of the programme. Several other randomized trials are underway in advanced lung and esophageal cancers. Several articles have been published by DMG members in various peer reviewed journals.

Staff Publications 2015-2017
Thoracic Department
Sr.no.
Title
Description
Details
Identifiers
1
Chemotherapy for resected colorectal cancer pulmonary metastases: Utilization and outcomes in routine clinical practice. Karim S, Nanji S, Brennan K, Pramesh CS, Booth CM. Eur J Surg Oncol. 2017 Aug;43(8):1481-1487. doi: 10.1016/j.ejso.2017.05.003. Epub 2017 Jun 1. PMID:28634014
2
Extent of Lymphadenectomy in Operable Esophageal Cancer. Shetty PS, Sawant A, Mankar H, Pramesh CS. Ann Thorac Surg. 2017 Jul;104(1):375. doi: 10.1016/j.athoracsur.2016.06.101. No abstract available.  PMID:28633241
3
Delivery of meaningful cancer care: a retrospective cohort study assessing cost and benefit with the ASCO and ESMO frameworks. Del Paggio JC, Sullivan R, Schrag D, Hopman WM, Azariah B, Pramesh CS, Tannock IF, Booth CM. Lancet Oncol. 2017 Jul;18(7):887-894. doi: 10.1016/S1470-2045(17)30415-1. Epub 2017 Jun 2. PMID:28583794
4
Common pitfalls in statistical analysis: Logistic regression. Ranganathan P, Pramesh CS, Aggarwal R. Perspect Clin Res. 2017 Jul-Sep;8(3):148-151. doi: 10.4103/picr.PICR_87_17. PMID:28828311 | PMCID:PMC5543767
5
Management of locally advanced primary mediastinal synovial sarcoma. Chatterjee AS, Kumar R, Purandare N, Jiwnani S, Karimundackal G, Pramesh CS. Lung India. 2017 Mar-Apr;34(2):185-188. doi: 10.4103/0970-2113.201295. PMID:28360472 | PMCID:PMC5351366
6
Protective Lung Strategy During Bronchoscopic Laser Resection of Tracheobronchial Tumors: A Case Series. Agarwal V, Parab SY, Pramesh CS. J Cardiothorac Vasc Anesth. 2017 Feb 24. pii: S1053-0770(17)30245-8. doi: 10.1053/j.jvca.2017.02.183. [Epub ahead of print] No abstract available.  PMID:28587760
7
VATS Versus Open Lobectomy: Need for a Prospective Trial. Sawant A, Mankar H, Chatterjee A, Pramesh CS. Ann Thorac Surg. 2017 Feb;103(2):690-691. doi: 10.1016/j.athoracsur.2016.06.047. No abstract available.  PMID:28109362
8
Differential diagnosis of lung cancer, its metastasis and chronic obstructive pulmonary disease based on serum Vegf, Il-8 and MMP-9. Balla MM, Desai S, Purwar P, Kumar A, Bhandarkar P, Shejul YK, Pramesh CS, Laskar S, Pandey BN. Sci Rep. 2016 Nov 4;6:36065. doi: 10.1038/srep36065. PMID:27811960 | PMCID:PMC5095766
9
ADD-ASPIRIN: A phase III, double-blind, placebo controlled, randomised trial assessing the effects of aspirin on disease recurrence and survival after primary therapy in common non-metastatic solid tumours. Coyle C, Cafferty FH, Rowley S, MacKenzie M, Berkman L, Gupta S, Pramesh CS, Gilbert D, Kynaston H, Cameron D, Wilson RH, Ring A, Langley RE; Add-Aspirin investigators.. Contemp Clin Trials. 2016 Nov;51:56-64. doi: 10.1016/j.cct.2016.10.004. Epub 2016 Oct 21. PMID:27777129 | PMCID:PMC5127874
10
Management of N2 non-small cell lung cancer. Shetty PS, Mankar H, Pramesh CS. J Thorac Cardiovasc Surg. 2016 Nov;152(5):1463-1464. doi: 10.1016/j.jtcvs.2016.06.018. No abstract available.  PMID:27751250
11
Involvement of general public in biomedical research. Pramesh CS, Venkataramanan R, Suvarna V, Goel NS, Lakshman S, Venkatesh V, Gupta V, Badwe R. Perspect Clin Res. 2016 Oct-Dec;7(4):152-155. PMID:27843788 | PMCID:PMC5079086
12
Pulmonary hemangioendothelioma with osteoclast-like giant cells: A rare observation. Adamane SA, Deodhar KK, Gupta AM, Karimundackal G, Desai SB. Indian J Pathol Microbiol. 2016 Jul-Sep;59(3):398-400. doi: 10.4103/0377-4929.188125. PMID:27510689
13
Common pitfalls in statistical analysis: Intention-to-treat versus per-protocol analysis. Ranganathan P, Pramesh CS, Aggarwal R. Perspect Clin Res. 2016 Jul-Sep;7(3):144-6. doi: 10.4103/2229-3485.184823. PMID:27453832 | PMCID:PMC4936074
14
A randomized trial to assess the utility of preintubation adult fiberoptic bronchoscope assessment in patients for thoracic surgery requiring one-lung ventilation. Amin N, Tarwade P, Shetmahajan M, Pramesh CS, Jiwnani S, Mahajan A, Purandare N. Ann Card Anaesth. 2016 Apr-Jun;19(2):251-5. doi: 10.4103/0971-9784.179614. PMID:27052065 | PMCID:PMC4900363
15
Thymic epithelial tumors: Can fluorodeoxyglucose positron emission tomography help in predicting histologic type and stage? Purandare NC, Pramesh CS, Karimundackal G, Jiwnani S, Agrawal A, Shah S, Agarwal JP, Prabhash K, Noronha V, Joshi A, Kumar R, Rangarajan V. Indian J Cancer. 2016 Apr-Jun;53(2):270-273. doi: 10.4103/0019-509X.197717. PMID:28071625
16
Common pitfalls in statistical analysis: The perils of multiple testing. Ranganathan P, Pramesh CS, Buyse M. Perspect Clin Res. 2016 Apr-Jun;7(2):106-7. doi: 10.4103/2229-3485.179436. PMID:27141478 | PMCID:PMC4840791
17
Common pitfalls in statistical analysis: Absolute risk reduction, relative risk reduction, and number needed to treat. Ranganathan P, Pramesh CS, Aggarwal R. Perspect Clin Res. 2016 Jan-Mar;7(1):51-3. doi: 10.4103/2229-3485.173773. PMID:26952180 | PMCID:PMC4763519
18
Common pitfalls in statistical analysis: Odds versus risk. Ranganathan P, Aggarwal R, Pramesh CS. Perspect Clin Res. 2015 Oct-Dec;6(4):222-4. doi: 10.4103/2229-3485.167092. PMID:26623395 | PMCID:PMC4640017
19
Surgical site infection rates in six cities of India: findings of the International Nosocomial Infection Control Consortium (INICC). Singh S, Chakravarthy M, Rosenthal VD, Myatra SN, Dwivedy A, Bagasrawala I, Munshi N, Shah S, Panigrahi B, Sood S, Kumar-Nair P, Radhakrishnan K, Gokul BN, Sukanya R, Pushparaj L, Pramesh CS, Shrikhande SV, Gulia A, Puri A, Moiyadi A, Divatia JV, Kelkar R, et al. Int Health. 2015 Sep;7(5):354-9. doi: 10.1093/inthealth/ihu089. Epub 2014 Dec 8. PMID:25487724
20
Global cancer surgery: delivering safe, affordable, and timely cancer surgery. Sullivan R, Alatise OI, Anderson BO, Audisio R, Autier P, Aggarwal A, Balch C, Brennan MF, Dare A, D'Cruz A, Eggermont AM, Fleming K, Gueye SM, Hagander L, Herrera CA, Holmer H, Ilbawi AM, Jarnheimer A, Ji JF, Kingham TP, Liberman J, Leather AJ, et al. Lancet Oncol. 2015 Sep;16(11):1193-224. doi: 10.1016/S1470-2045(15)00223-5. Review. PMID:26427363
21
International Consensus on Standardization of Data Collection for Complications Associated With Esophagectomy: Esophagectomy Complications Consensus Group (ECCG). Low DE, Alderson D, Cecconello I, Chang AC, Darling GE, DʼJourno XB, Griffin SM, Hölscher AH, Hofstetter WL, Jobe BA, Kitagawa Y, Kucharczuk JC, Law SY, Lerut TE, Maynard N, Pera M, Peters JH, Pramesh CS, Reynolds JV, Smithers BM, van Lanschot JJ. Ann Surg. 2015 Aug;262(2):286-94. doi: 10.1097/SLA.0000000000001098. PMID:25607756
22
Giant mediastinal carcinoid. Jiwnani S, Karimundackal G, Pramesh CS. Indian J Med Paediatr Oncol. 2015 Jul-Sep;36(3):194. doi: 10.4103/0971-5851.166764. No abstract available.  PMID:26855531 | PMCID:PMC4743190
23
Institutional external peer review: A unique National Cancer Grid initiative. Raghunadharao D, Kannan R, Hingnekar C, Vijaykumar DK, Mani CS, Ghosh-Laskar S, Gujral S, Chaudhari S, Nayak S, Dikshit R, Badwe RA, Pramesh CS; National Cancer Grid.. Indian J Med Paediatr Oncol. 2015 Jul-Sep;36(3):186-8. doi: 10.4103/0971-5851.166753. No abstract available.  PMID:26855528 | PMCID:PMC4743180
24
Common pitfalls in statistical analysis: Clinical versus statistical significance. Ranganathan P, Pramesh CS, Buyse M. Perspect Clin Res. 2015 Jul-Sep;6(3):169-70. doi: 10.4103/2229-3485.159943. PMID:26229754 | PMCID:PMC4504060
25
Writing case reports for ecancer. Ranganathan P, Bavdekar SB, Pramesh CS. Ecancermedicalscience. 2015 Jun 30;9:ed49. doi: 10.3332/ecancer.2015.ed49. eCollection 2015. No abstract available.  PMID:26180549 | PMCID:PMC4494821
26
A simplified interventional mapping system (SIMS) for the selection of combinations of targeted treatments in non-small cell lung cancer. Lazar V, Rubin E, Depil S, Pawitan Y, Martini JF, Gomez-Navarro J, Yver A, Kan Z, Dry JR, Kehren J, Validire P, Rodon J, Vielh P, Ducreux M, Galbraith S, Lehnert M, Onn A, Berger R, Pierotti MA, Porgador A, Pramesh CS, Ye DW, et al. Oncotarget. 2015 Jun 10;6(16):14139-52. PMID:25944621 | PMCID:PMC4546456
27
An approach of selecting appropriate markers from the primary tumor to enable detection of circulating tumor cells in patients with non-small cell lung cancer. Warawdekar UM, Sirajuddin MM, Pramesh CS, Mistry RC. J BUON. 2015 May-Jun;20(3):782-90. PMID:26214631
28
Regional variation in identified cancer care needs of early-career oncologists in China, India, and Pakistan. Lyerly HK, Fawzy MR, Aziz Z, Nair R, Pramesh CS, Parmar V, Parikh PM, Jamal R, Irumnaz A, Ren J, Stockler MR, Abernethy AP. Oncologist. 2015 May;20(5):532-8. doi: 10.1634/theoncologist.2014-0213. Epub 2015 Apr 17. PMID:25888267 | PMCID:PMC4425376
29
Management of esophageal small cell carcinoma. Purwar P, Jiwnani S, Karimundackal G, Pramesh CS. Ann Thorac Surg. 2015 Apr;99(4):1488. doi: 10.1016/j.athoracsur.2014.11.029. No abstract available.  PMID:25841845
30
Primary undifferentiated spindle cell sarcoma of the lung with metastasis to bone--A rare clinical entity with even rarer clinical course. Gulia A, Puri A, Rekha B, Pramesh CS. Indian J Cancer. 2015 Apr-Jun;52(2):254-5. doi: 10.4103/0019-509X.175839. No abstract available.  PMID:26853426
31
Common pitfalls in statistical analysis: "P" values, statistical significance and confidence intervals. Ranganathan P, Pramesh CS, Buyse M. Perspect Clin Res. 2015 Apr-Jun;6(2):116-7. doi: 10.4103/2229-3485.154016. PMID:25878958 | PMCID:PMC4394578
32
Issues in management of N2 disease in NSCLC. Kumar T, Jiwnani S, Karimundackal G, Pramesh CS. Ann Thorac Surg. 2015 Feb;99(2):744-5. doi: 10.1016/j.athoracsur.2014.09.032. No abstract available.  PMID:25639431
33
Common pitfalls in statistical analysis: "No evidence of effect" versus "evidence of no effect". Ranganathan P, Pramesh CS, Buyse M. Perspect Clin Res. 2015 Jan-Mar;6(1):62-3. doi: 10.4103/2229-3485.148821. PMID:25657905 | PMCID:PMC4314850

Lung & Esophagus Cancer Support group meeting: Esophageal and lung cancer support group meeting is held on 4th Tuesday of every month. It has invited talks, discussions focusing on patient-centric problems. The involvement from patients has been encouraging and this provides them a forum for exchange of experiences, discussing their fears, concerns and closer interaction with other patients and their treating physicians. In addition, the availability of dedicated counselors for patients with thoracic cancers and the institution of early palliative care into the treatment continuum are some more initiatives to improve the overall experience for patients.

Phone: Department Office Number: (+9122) 24177000 / Ext.No. 7070, 7277, 6667, PA- 6310 /
MOBILE No. SR II/III: 22161, 22404, 22160

Address: Department of Thoracic,  

TATA MEMORIAL HOSPITAL, Dr.E.Borges Road, Parel, Mumbai-400-012

Maharashtra, India

Fax: Hospital Fax Number: (+9122) 24101656

Email-id: Email-id: dmgth@tmc.gov.in

About Us

Realizing the increasing need to address the respiratory co-morbidities in cancer, the seed for the Pulmonary Medicine Services was sown in 2006 by Dr. Sandeep Tandon, Pulmonologist and Staff Physician at Tata Memorial Hospital.

What began with a few referrals has exponentially increased to over 6000 consultations annually.

The Department now is constituted by Dr. Tandon, two-part time Pulmonology Consultants and a Post MD (Respiratory Medicine) Senior Registrar.

The Pulmonary Medicine Unit aims at creating a teaching programme that will train future young minds to develop the skills to cater to this ever increasing need for Pulmonologists specializing in management of respiratory diseases that are prevalent and often unique to Cancer patients.

We also aspire to developing research aimed at creating new information that will bolster management of respiratory disorders and strive towards achieving a better quality of life in this group.

The 2 year HBNI fellowship in Onco-Pulmonology has been proposed with this goal in mind.

The Unit has been set up with an aim to increase the scope of diagnostic services offered including EBUS with rapid on-site cytology, medical thoracoscopy and bronchoscopy for pulmonary infections in paediatric age group apart from adults and in intensive care unit, in conjunction with the Department of Thoracic Surgery, Anesthesiology, Interventional Radiology, Microbiology and Pathology thus promoting a multidisciplinary approach.

In the pipe-line is also the plan for setting up a state of the art Airway Management Lab in conjunction with the Department of Thoracic surgical services that will ensure catering to the ever increasing need for palliative relief of airway obstruction in cancer patients.

Departmental Activities.

Outpatient Department

The Pulmonary Medicine Unit runs an Outpatient Department Monday through Friday between 8 AM and 1 PM

The Services essentially include respiratory evaluation of cancer patients referred from Oncology Units at Tata Memorial Hospital

The spectrum includes

  • Assessment of cancer patients with respiratory symptoms such as cough, breathlessness, chest pain or hemoptysis.
  • Diagnosis, treatment and ensuring pulmonary rehabilitation of cancer patients with co-morbid respiratory conditions such as COPD, asthma, interstitial lung disease, obstructive sleep apnea, pulmonary and pleural infections and metastatic lesions in lung and pleura aimed at improving quality of life.
  • Pre-operative evaluation of cancer patients for respiratory co-morbidities and optimization of therapy with an aim at improving performance status and reduction in adverse respiratory events in the perioperative period.
  • Undiagnosed pulmonary pathologies that are referred to Tata Memorial Hospital for presumed malignancy. This group includes infectious, autoimmune and other disorders that may mimic cancer and in the Indian scenario tuberculosis often forms a bulk of these mimics.
  • Evaluation of incidentally detected radiological pulmonary lesions in cancer patients
  • Assessment, diagnostic workup and treatment of pulmonary infections in the immune-compromised cancer patients with hematological malignancies, patients on chemotherapy and post bone marrow transplant cases
  • Diagnosis and management of pulmonary toxicities during the course of cancer treatment that includes chemotherapy, radiotherapy, immunotherapy and targeted therapy
  • Assessment and management of post –operative pulmonary and pleural infections, pneumonias and exacerbation of underlying respiratory pathologies like COPD and asthma

Inpatient services

The Pulmonary Medicine Unit attends to the need for respiratory opinion and assistance in management of admitted patients referred from across all oncology departments at Tata Memorial Hospital including the intensive care units.

  • Respiratory distress and respiratory failure in critically ill cancer patients
  • Respiratory infections including pneumonias, lung abscess, empyema
  • Post –op respiratory distress and infections

Procedures

  • Endo-bronchial ultrasound FNAC for staging of lung cancer, diagnosis of mediastinal lymphadenopathy in cancer and suspected cancer patients in conjunction with thoracic surgical and interventional radiology departments.
  • Fiber optic bronchoscopy including broncho-alveolar lavage, biopsy: endo-bronchial and trans-bronchial lung biopsy in conjunction with thoracic surgery.

Education and Courses.

The Pulmonary Medicine Unit has proposed a 2 year academic programme towards Fellowship in Onco-Pulmonology for Chest Physicians through Homi Bhabha National Institute (HBNI) that is currently awaiting approval by the Board of Studies for academic year 2018-2019. The aim of this fellowship is to provide a structured curriculum and training to pulmonologists to enable them to manage pulmonary diseases, complications, co-morbidities and toxicities prevalent in the cancer patient cohort. The planned curriculum will also include training in bronchoscopy, pleural procedures, EBUS and intensive care. The programme also will include a mandatory research topic that hopes to encourage young doctors to conduct respiratory research relevant to the oncology field.

The unit also proposes to have regular academic teaching Chest-Radiology meetings with experts in the field of radiology and relevant clinicians, intensivists and students for multi- disciplinary discussion and approach towards complex respiratory radiology and clinical presentations.

Research interests

COPD and lung cancer.

Pre-operative respiratory optimization for cancer surgery and its impact on peri-operative respiratory events

Role and yield of EBUS in mediastinal lymphadenopathy

Pulmonary rehabilitation and its impact on QALY in cancer patients with respiratory co-morbidities

Pulmonary infections in patients with cancer and on cancer therapy

Role of newer modalities and therapies for drug induced pulmonary toxicity

Broncho-alveolar lavage and its yield in diagnosis of infections in immune suppressed hosts

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Patient Information

Pulmonary Medicine OPD

This is located in the Golden Jubilee Building Basement Room No 13.

OPD timings: Monday to Friday 8 am to 1 pm

Consultations are available for both private as well as general category patients in the same OPD

A prior appointment is necessary for consulting us, both for first time and follow up visits.

Consultations include referrals from within our institution from the various oncology departments. If you wish to consult us, please request your treating doctor at Tata Memorial Hospital to make a formal referral.

If you are diagnosed as having cancer, you will need to see the appropriate oncology department who would refer you to us for a respiratory consult, if required.

Appointments may be taken personally by contacting our secretary at the OPD Counter between 8am to 5pm

Telephonic appointments are possible, please contact the appointment desk at least a week prior to the desired date.

Tata Memorial Hospital Chest Physician OPD: Tel NO: 022-24177000 Extension 4540 between 9 am and 5 pm. Please quote your Hospital File number at the time of taking an appointment

In case you are unable to keep your appointment, kindly call up the above number to cancel the appointment so that another needy patient is not deprived of a consultation.

Typical waiting time for an appointment for a first consult may be 3 to 5 working days and for follow-up consults may be 1 to 3 working days. Consultations without a prior appointment are subject to unforeseen cancellations of prior appointments and availability of time slots.

Patients are requested to please get any prior consultation details, X-rays, CT scans and investigations for review at the time of the OPD visit. This enables us to get a comprehensive view on sequence of medical events that is often a pre-requisite for better understanding and prompt diagnosis of your condition.

Faculty

  1. Dr Sandeep Tandon:  Professor (Pulmonary Medicine)

  2. Dr Sandeep Tandon completed his MD in Respiratory Medicine from Seth GS Medical College and KEM Hospital in 1994 following which he was Lecturer in Chest Medicine Department at KEM Hospital until 2002. He joined the General Medicine Department of Tata Memorial Hospital in 2002 and from mid- 2006 he has initiated the Pulmonary Medicine OPD and the Pulmonary Medicine Unit as well as taken up additionally the clinical and administrative responsibilities of the Staff Clinic ( Occupational Health Clinic ) as the Staff Physician of Tata Memorial Hospital. He has developed and given shape to the Pulmonary Medicine Unit in its current form.

  3. Dr.Maheema Bhaskar: Pulmonary Physician (Adhoc)

  4. Dr. Maheema Bhaskar completed her training in Tuberculosis and Respiratory Diseases from Seth G.S. Medical College and KEM Hospital, Mumbai. She has over 12 years of medical teaching experience initially as Assistant Professor at Seth. G.S.M.C and then Associate Professor at L.T.M.M.C and Sion hospital and is keenly interested in developing an academic teaching programme, upscaling paediatric bronchoscopy services and respiratory research.

    She is trained in flexible bronchoscopy, EBUS and medical thoracoscopy.

  5. Dr.Aparna Iyer : Pulmonary Physician (Adhoc)

  6. Dr Aparna Iyer completed her training in Tuberculosis and Respiratory Diseases from Seth G.S. Medical College and KEM Hospital, Mumbai. She has over 8 years of medical teaching experience as Assistant Professor at Seth G.S.M.C and Dr. D. Y. Patil Medical College, Navi Mumbai and is keenly interested in developing an academic teaching programme and respiratory research especially in the field of lung cancer.

    She has completed her Fellowship in Interventional Pulmonology from Vrije University Medical Center, Amsterdam and is trained in performing EBUS, rigid and flexible bronchoscopy and diagnostic medical thoracoscopy.

Contact Us - Our team, address and contact numbers.

Pulmonary Medicine Unit,
Tata Memorial Hospital,
Dr. Ernest Borges Marg, Parel, Mumbai 400 012.
INDIA.

Telephone: 091- 022-24177000 Ext. 4540
Fax: 091-022-
Email Address: tandonsp@tmc.gov.in

 

Contact Us

TATA MEMORIAL HOSPITAL
Dr. E Borges Road, Parel, Mumbai - 400 012 India
Phone: +91-22- 24177000, 24177300, 24161413
Fax: +91-22-24146937
E-mail : msoffice@tmc.gov.in(for patient care and queries)/cash@tmc.gov.in(for accounts related)/fundraising@tmc.gov.in (for donors and donation related)/registrar@tmc.gov.in(for education and training)/hrd@tmc.gov.in(for administrative - HRD matters) This email address is being protected from spambots. You need JavaScript enabled to view it.

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