In keeping with their efforts of democratizing access to their significant expertise for patients across the country, Tata Memorial Centre (TMC) reviewed the impact of their online service in helping pediatric patients on the occasion of International Childhood Cancer day. TMC NCG Online – Navya Expert Opinion Service (available at www.navya.care) provides critical treatment opinions to parents and caregivers of children with cancer. The expert opinion helps them validate or discuss an evidence based change in treatment plan with their treating oncologists. For pediatric patients, choosing the right therapy vetted by an expert, can be the difference between cure and failed treatment.
“If a child is diagnosed early and treated appropriately, 80% of cases should lead to cure. However we are seeing many cases where parents are bringing children to us as a last resort after expensive and failed treatments” said Dr Shripad Banavali, Head of Department, Medical Oncology at Tata Memorial Hospital, Mumbai. “If they had reached out to us online through TMC NCG Navya and followed our opinion, the situation could have been better. We are also finding cases where aggressive chemotherapies are being prescribed that are not suitable for children. This is partially because of the absence of pediatric oncology expertise.”
Pediatric patients are treated differently with doses and regimens than adults, and there are only a limited number of cancer experts who specialize in pediatrics. TMC NCG Online makes it possible for patients to get the advice of specialized pediatric experts at TMC while often continuing the treatment locally. In cases where expertise or treatments that are not available locally are required, patients are advised to visit accessible expert care centers, such as those in the National Cancer Grid (NCG).
“We have been able to provide appropriate treatment recommendation to many patients in small towns where access to specialized oncology centers is sparse” continued Dr Banavali.“ A lot of these families would either have to travel significant distances or worse still proceed with suboptimal treatments leading to a reduced probability of cure.”
Pediatric oncology is a specialized expertise and often unavailable everywhere. This leads to parents approaching oncologists and physicians who lack the experience and expertise needed in treating children. In many such cases, treatment plans are followed that are not beneficial and in some cases harmful to the patient.
TMC NCG Online has also received cases where parents are reaching out to validate the need for expensive therapies. In one such case of a three month old baby boy, a reputed private hospital had recommended an expensive robotic surgery. The experts at TMC clarified that
conventional surgery would be sufficient and would avoid wait time and expense of robotic surgery.
Says Dr Tushar Vora, a nationally acclaimed pediatric solid tumor expert at TMC: “Pediatric malignancies have a very high cure rate but the best chance of cure is the first chance. Many a times, given the emotional state of diagnosis, families are financially exploited and given inappropriate treatment in the name of emergency, which significantly affects the ultimate cure rates. In such circumstances TMC NCG Online – Navya Expert Opinion Service can give the families the means to evidence based recommendations quickly and prevent the above.”
Continues Dr Vora; “Also in circumstances when heroic efforts, again with financial and emotional appeal, are counterintuitive, the expert opinions can give realistic hopes and expectations and means for the best possible course.”
On the positive side, TMC NCG Navya has been able to empower families with expert opinions that have enabled them to change treatment plans leading to improved outcomes. A child from Delhi was being treated for Tuberculosis without improvement. TMC experts suspected cancer and recommended a surgical biopsy which proved Lymphoma. The child is currently under lifesaving treatment for the same.
Urging parents of pediatric cancer patients, Gitika Srivastava, Founder of Navya, shares her personal viewpoint: “Most people who have had any experience with cancer are aware of TMC and that it is one of the largest tertiary care centers in the world. However not everyone from far flung areas in the Indian subcontinent or developing countries in Asia and Africa can come to Mumbai or is aware of the significance of a proper choice in treatment to a change in outcomes. Given the cases we have seen, we would urge everyone to get an expert opinion through TMC NCG Online. As parents, you can be assured that the opinion rests on the experience of world renowned pediatric cancer experts and follows evidence based protocols best suited to your child’s specific case.”