New Delhi: Lalit Modi’s claim yesterday that his wife who has been fighting metastatic cancer for 17 years could walk away after treatment in a Portugal clinic doesn’t surprise oncologists.
Senior doctors who are not associated with the treatment of Minalini Modi say there could be circumstances in which patients could quickly return to their daily activities after treatment for relapse of their cancers.
“Every cancer, every patient is different – without details, we would only be speculating but recovery periods can vary from person to person, it can be long for some, quick for others,” said Ashok Vaid, a medical oncologist based in New Delhi.
Documents released by the Lalit camp suggest that Minalini has been under treatment for metastatic cancer since 1997, mainly under the care of Dennis Slamon, an oncologist who specializes in breast cancer at the University of California, Los Angeles.
Metastasis is a condition in which tumour cells spread from the primary site to other organs in the body.
A witness statement from Minalini sent to the UK government in support of Lalit’s application for travel documents says she had been in remission for most of the time but the cancer had turned active.
“After being under Professor Slamon for 15 years without defeating the cancer, I decided to turn to an alternative approach offered by Professor Carlo Greco at the Champalimaud Centre in Lisbon (Portugal),” she said in her statement.
Greco, the director of clinical research at the Champali maud Centre for the Unknown, has confirmed that Minalini has been under the institution’s care and treatment for “a long-lasting and extremely serious medical condition”.
In a statement released on June 13, Greco said she had sought medical advice at Champalimaud following the failure of multiple lines of treatment performed elsewhere. “Since November 2012, the patient has received four procedures for potentially life-threatening conditions which in all cases required a thorough assessment of the cost-benefit ratio,” Greco said.
In July 2014, a relapse of the disease demanded urgent treatment. “We felt the patient’s immediate family members be physically present with her for emotional support as well as for the delicate discussion on the potential risks of the proposed treatment,” Greco said, adding that the procedure was carried out on August 4, 2014.
While the clinic has not released details about the procedure she received, Lalit has in the television interview indicated that the clinic offered procedures not available elsewhere in the world at the time.
In March 2014, only five months before Minalini’s procedure, the Champalimaud Centre became the first cancer clinic in the world to offer a new radiosurgery system that uses high-energy X-rays to destroy tumours without any incision in the body. (Charles Correa, who passed away on Tuesday night, was the architect of the Lisbon centre, Lalit tweeted today.)
Minalini’s witness statement, citing the clinical department’s webpage, said the equipment “allows for highly accurate placement of the radiation beam to fight tumours and metastasis, while vastly reducing the risk to healthy tissue”.
While it is unclear whether this equipment was indeed used on Minalini, doctors say such radiosurgery equipment could be used on sections of patients who have been in remission for long and have limited recurrence of metastatic tumours.
“Surgery is not standard therapy for metastatic breast cancer – it is chemotherapy. But surgery may be considered when metastatic disease is limited to a small number of sites,” said Rajeev Kumar, a senior surgical oncologist at the Rajiv Gandhi Cancer Institute and Research Centre, New Delhi.
Oncologists call such recurrence oligometastasis, a condition in which tumour cells from the primary site have migrated to five or less secondary sites.
“Studies suggest that surgery or radiosurgery to remove these few metastastic tumours can significantly improve the outcome,” said Tejinder Kataria, a senior radiation oncologist at the Medanta hospital, Gurgaon.
The new radiosurgery system that the Champalimaud Centre acquired in early 2014 allows doctors to destroy tumours from outside the body after using high-energy X-rays.
“There are no incisions in radiosurgery and patients do not experience pain associated with conventional surgery,” said Kataria. “At times, people can go home the same day.”
