CONSULTATIVE WORKSHOP ON INTEGRATIVE APPROACH TO CANCER

CONSULTATIVE WORKSHOP ON INTEGRATIVE APPROACH TO CANCER

On the occasion of silver jubilee celebration of the Raja Ramdeo Anandilal Podar Ayurveda Cancer Research Institute, Mumbai (RRAPACRI), a unit of Central Council for Research in Ayurvedic Sciences (CCRAS), a one day consultative workshop on ‘Integrative Approach to Cancer’ was organized on April 28, 2012 at Mumbai. The objective was to initiate a dialogue between the experts from modern and Ayurveda, Yoga-Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) systems of medicine and to identify probable integrative models for cancer research and health care. The patronage was from CCRAS and Dept. of AYUSH, New Delhi. Nearly 350 delegates attended the workshop.

The workshop was inaugurated by Dr. Rajiv Sarin, Director, Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Navi Mumbai. Dr. M.R.V. Nampoothiri, ex-Director, Ayurveda Medical Education, Kerala and Prof. Manoranjan Sahu, Head, Dept. of Shalya, Banaras Hindu University, Varanasi, were guests of honor. Dr. Anil Nandode, Assistant Director, AYUSH-Cell, National Rural Health Mission (NRHM), Mumbai, was a special invitee and Dr. M.M. Rao, Director, Ayurveda Central Research Institute (CCRAS), New Delhi, was the presiding officer.

Dr. R. Govind Reddy, in-charge RRAPACRI, briefed about the activities of the institute. A souvenir in print and DVD form was released on this occasion. Dr. Sarin in his talk explained the reductionist approach of modern system of medicine along with its advantages and drawbacks. He informed about evolving systems biology approach and its existence in Ayurveda centuries ago. He discussed the prevalence of cancer and its burden in India, as well as the existing treatment for cancer. In purview of side effects of existing treatment and need of multimodal treatment for maximum benefit, he highlighted the scope of Ayurveda in prevention and cure of cancer. He envisaged having an AYUSH OPD in every hospital in India and an Ayurvedic department in every cancer hospital in the near future.

Dr. Rao in his presidential speech reviewed the activities and contribution of CCRAS in the field of cancer research. He informed the gathering about the in vitro studies of screening of Ayurvedic herbal extracts and multicentric clinical trial to evaluate efficacy of Ayurvedic drugs as add-on therapy to improve ‘quality of life’ in cancer patients. Dr. Arun Jamkar, Vice-Chancellor, Maharashtra University of Health Sciences, Nasik; in his video message stressed on research on basic concepts of Ayurveda.

Keynote address was delivered by Dr. Ashok Vaidya, Research Director, Medical Research Centre- Kasturba Health Society (MRC-KHS), Mumbai, on ‘Preventive and Integrative Oncology: Models, Modalities and Modus Vivendi’. Dr. Vaidya covered cancer from its history to current developments in the research and treatment. He urged for a paradigm shift, an out-of-the box approach to implement successful prevention of cancer saying that the fundamental principles of Ayurveda can inspire us to evolve new models, modalities and modus Vivendi to prevent, delay or diminish the scourge of major cancers in India. For a preventive model of Ayurvedic oncology, he proposed the Shat-Kriya-Kala of cancer, however he also expressed the need to conduct a Tadvidya-Sambhasha to discuss and identify their cancer-biology correlates and to generate a consensus. He highlighted the personalized approach of Ayurveda and suggested that the model proposed for intervention must prioritize the most challenging carcinogenetic factor first. He also suggested a tobacco de-addiction and cancer prevention unit at RRAPACRI. Dr. Vaidya further added the need of a pre-model workshop to gather, identify, evaluate, and consider diverse modalities of proposed interventions. Observational Therapeutics, Ayurvedic Pharmaco-epidemiology, Reverse Pharmacology, Systems Ayurveda, and Ayurvedic Biology may be the domains which will be resources for the modalities. He proclaimed that the challenges of preventive and integrative oncology demand an endeavor that would require quality of leadership, openness and creativity. Translational research, across the systems of medicine may be fruitful to prevent certain types of cancer, delay complications, and alleviate the side effects of chemotherapy.

In the first technical session Prof. M. S. Baghel, Director, Institute of Post Graduate Training and Research in Ayurveda, Jamnagar, described the Ayurvedic perspective of the side effects of the chemotherapy and radiotherapy in cancer. He elaborated the concept of Rasayana with more emphasis on Ghrita.

Dr. Jayashree Joshi, Joint Research Director and Consultant, MRC-KHS, Mumbai, stressed on chemo-prevention of cervical cancer. She informed that sexually transmitted diseases (STDs) and infections including human immunodeficiency virus/human papilloma virus (HIV/HPV) may cause cancers which are preventable and can be managed well with Ayurveda. She discussed the results of clinical safety and tolerability study on turmeric oil and its possible mechanism of action.

Prof. Sahu dealt with the concept of neoplasia vis-à-vis Arbuda in detail. He described the management of these conditions along with asadhya vrana, and other malignant lesions of annavaha srotas like tridoshaja gulma, asadhya udara, sahaja arsha, etc. He also described the medicinal plants and herbo-mineral preparations commonly used for the management of cancer.

Prof. R.R. Shinde, Head, Dept. of Preventive and Social Medicine, King Edward Memorial Hospital, Mumbai, expressed his views from public health perspective. He emphasized the importance of screening for prevention and detection of cervical cancer and suggested to take this task as a part of Reproductive and Child Health Program or as a separate National Cancer Control Program. Dr. Nampoothiri in his speech on ‘Cancer in Ayurveda - Hopes and Highlights’ said that there are numerous reports of isolated success stories of cancer management but there is a lack of enough scientific documentation. He described the Ayurvedic samprapti of cancer along with insights into treatments of few cancer cases. He discussed about the drugs of choice for cancer treatment like Pippali rasayana, Indukanta ghrita, Guggulutiktaka ghrita, Trayantyadi kwatha, and Bhallataka (Semecarpus anacardium). He also highlighted the effect of psyche on immunity in cancer patients and stressed to change the attitude of the patients by increasing the awareness of patient and counseling.

Prof. Shripad Banavali, Head, Medicine and Pediatric Oncology, Tata Memorial Centre, Mumbai, in his talk explained the importance of randomized controlled trials and data publication in peer reviewed journals. He pointed out the pitfalls in AYUSH systems as lack of standardized protocols, multicentric trials, publications in peer reviewed journals and openness about treatment given. Despite these drawbacks, Prof. Banavali highlighted the need of integration and scope of Ayurveda in patients who have a relapse of their disease.

Vaidya Balendu Prakash of VCP Cancer Research Foundation, Dehradun, in his talk on ‘Integrative Treatment of Cancer’ applauded the CCRAS and RRAPACRI for taking an initiative to have a workshop on such an important theme and disease. He stressed on an approach developed by integrating classical Ayurvedic concept with tools of modern science. He illustrated few cases, which were successfully managed through Ayurveda without any allopathic medicine. He also mentioned about the project ‘Effect of Metal based Ayurvedic formulations in the patients of acute pro-myelocytic leukemia (APML)’ which was carried out under the aegis of CCRAS from October 1997 and later a joint US and European patent was also obtained.

Totally 12 research papers and 15 posters were presented in different technical sessions. Dr. A. Shridhar, Lecturer, A.L.Government Ayurvedic College, Warangal, was awarded the best paper prize for his presentation ‘Immunomodulatory effects of different types of standardized Ashwagandha extracts/powders’. The best poster prize was awarded to Dr. Arti Joshi et al., PG scholar from Stree-Prasuti Department, R.A.Podar Medical (Ayu) College, Mumbai, for ‘Cervical Cancer: A Global Problem’.

The panel discussion was chaired by Dr. A. B. Vaidya and the discussion was coordinated by Dr. G. Venkateshwarlu and Dr. Manohar Gundeti. Dr. Vaidya urged the initiation of a collaborative study at RRAPACRI with TMC and VCP Cancer Research Foundation. Balendu Prakash emphasized the need to prepare standard protocol for cancer treatment, drug development and publication of data in medical journals. Prof. Banavali suggested cooperation between Ayurvedic and modern physicians with mutual trust. Dr. Shailesh Nadkarni said that atomic absorption spectrophotometry (AAS) technique could be used for standardization of bhasmas. Dr. Nampoothiri felt the need to invite practitioners from various parts of the country to develop a centralized knowledge database. Dr. Mohammed Raza highlighted the need to address ethical issues whereas Prof. Sahu suggested to explore the possibilities of collaboration of BHU and RRAPACRI/CCRAS on integrative approach for rectal cancer.