Is Melanoma a Serious Disorder that Cannot Be Cured?

Our Skin 

Skin is the largest organ in the body and the most visible. As a matter of fact, we take as much care of this organ as much as we look after our hair. Its texture, color, and status of its health we keep in mind all the time. We are obsessed with our skin but the case is more so with the opposite gender the lovely lasses. 

If tended to sensibly with the consumption of nutritious foods, protection from strong sunlight, and wearing the right clothes the organ stays healthy throughout life. It does get wrinkled and loose but that is the consequence of aging which is natural.   

All minor anomalies are taken care of by the lotions, creams, and essential oils some of which are gently rubbed or force-fed in a massage. We have created a mega-industry that comprises aesthetic cosmetic products and well-researched medicines. The cosmetic industry market size is around 350 billion USD and it is stated to cross over 427 billion USD by the year 2027.

Aesthetic cosmetic skin products are most advertised besides hair care products. Regional medications, cosmetic products, and therapies dominate country-wise. Most of these are not intensely researched, yet they are part of centuries of indigenous traditions with a huge consumer base. 

But aesthetics apart, the organ is subject to some troubling and life-threatening disorders as well. Melanoma is one such disease that is malignant in nature. It is one of the fast-spreading cancers that can engulf other parts of the body. If detected early the spread can be halted to extend life.     

Many types of malignancies afflict the skin namely: 

• Melanoma

• Basal Cell Carcinoma

• Squamous Cell Carcinoma

How Melanoma is Detected? 

Any unnatural eruptions in the dermal layers should be immediately brought to the doctor’s notice. An oncologist is a specialist surgeon/doctor who treats skin cancers. But the initial discovery of malignancy usually comes through the hand of your family doctor. This can be followed by a visit to an expert dermatologist on your doctor’s recommendation to detect if any malignancy exists or not.   

Physical examination is the first step usually taken by a skin specialist or dermatologist followed by a biopsy we are so familiar. In this case, a sample of tissue is obtained from the suspected lesion. This is then scrutinized under a microscope by an expert to detect if the lesion is benign or malignant.  Usually, punch biopsy or otherwise excisional biopsy is performed. In case of suspicion of malignancy spreading to lymph nodes, a sentinel node biopsy is considered. In this case, a dye is injected into the nodes, and tissue that absorbs the dye is subjected to a test. If no malignancy is detected then it is likely that the nodes have not become malignant. In case of an extensive spread, imaging tests like positron emission tomography, CT scan, or x-rays are conducted.        

The imaging tests are not required when there is no suspicion of the disease spreading to other bodies before it can be stemmed. The disease is staged using Roman numerals, and the cases with higher numbers like stage IV or V offer little chance of survival. After stage IV cancer spreads to vital organs like the lungs and the kidneys. 

Treating Melanoma 

Prognosis is favorable if the malignancy is detected early and then treated in a multispecialty hospital dealing with oncology. The dermal malignancies begin as a mole that is irregular in shape and color or frequently changes color. Melanoma is usually treated using chemotherapy, radiation, or surgery.   

If the diagnosis is positive, the extent and depth of melanoma are determined. Treating the spread is done by a team of dermatologists, oncologists, pathologists, surgeons, and plastic and reconstructive surgeons. 

The range of treatments required is immunology, targeted therapy, surgery, radiation, and chemotherapy which is using several drugs and injectables. Personalized care and regular stage diagnosis besides an observation during remission also play an important role.

People suffering from this disease can live up to ten years or more, but remember great stress is placed on early diagnosis. 

Melanoma Affliction 

Whites are most at risk followed by Hispanics and then colored people. The ratio is 1:38 for whites, 1:167 for Hispanics, and 1:1000 for colored people. The prevalence is distinctly higher among Caucasians and this could be due to a lack of melanin the black pigment in the skin that protects against nefarious rays.    

Country-wise prevalence of melanoma is as follows:

1 Australia 33.6

2 New Zealand 33.3

3 Norway 29.6

4 Denmark 27.6

5 Netherlands 25.7

6 Sweden 24.7

7 Germany 21.6

8 Switzerland 21.3

9 Belgium 19.9

10 Slovenia 18.6

11 Luxembourg 16.5

12 Ireland 16.3

13 Finland 15.8

14 UK 15.0

15= Austria 13.6

15= France (metropolitan) 13.6

17 US 12.7

18 Czech Republic 12.6

19= Canada 12.4

19= Italy 12.4

The highest prevalence of this disease among women is as follows:

1 Denmark 33.1

2 New Zealand 31.1

3 Norway 30.7

4 Australia 27.5

5 Sweden 26.2

6 Netherlands 25.4

7 Germany 24.0

8 Belgium 23.9

9 Slovenia 19.7

10 Switzerland 19.5

11 Ireland 19.0

12 Finland 15.9

13 Luxembourg 15.4

14 UK 15.3

15 France (metropolitan) 12.9

16 Austria 12.6

17 Czech Republic 12.4

18= Canada 11.7

18= Iceland 11.7

20 Estonia 11.4

21= Italy 11.0

21= US 11.0

23 Greece 10.3

24 Hungary 10.1

25 Lithuania 9.0

*Data Source:  Global Cancer Observatory

Skin cancer in India constitutes less than 1% of all diagnosed cancers yearly. The cost of treatment is around 5000 USD. The cost of screening and testing ranges from around 200$. 

According to Viadam some of the best hospitals for skin cancer treatment in India are:

• Apollo Hospitals 

• Fortis Memorial Research Institute Gurgaon

• Manipal Hospital Bangalore

• Apollo Gleneagles Kolkata 

• Kokilaben Dhirubhai Ambani Hospital Mumbai

• Artemis Gurgaon 

These are hospitals with star facilities and quality care but are comparatively costlier. The oncology departments are present in many other multispecialty hospitals where the price quoted is lower without loss of quality service. These hospitals are spread over many two-tier towns and cities in India.    

Medical Tourism Benefits: How a Facilitator Makes a Success Story in India?

Medical Tourism offers tremendous benefits but it can be fraught with risks if poorly handled. Thanks to fully reputed medical tour operators conducted safe and just tours with successful outcomes and happy endings. 

We at Fanling Wellness take utmost care while delivering. Our facilitation results in affordable treatments, safe travel, stay, and treatment in the best hospitals and clinics.   

An added advantage of being an international patient in our care is the inclusion of a holiday safari or sightseeing in the close confines of your stay. 

So precisely what can go wrong if you land up with the wrong facilitator?

Plenty!

Though India is surfeited with quality health clinics and hospitals poorly chosen ones can accord a bad experience. They can also spoil the treatment since they employ surgeons or physicians who are not experienced enough and not skillful. Choosing the right practitioner is vital for your treatment and a successful outcome is assured if the right person is in the picture. In order to enhance profit agents with a bad reputation employ the services of incompetent surgeons and physicians since their salary or visitation charges are less. Be careful!

So why will you choose health travel to another country?

Well, medical tourism has inherent benefits, and the greatest benefit is the cost difference. This is true if you choose India the cost difference could be as much as 40 % and in some instances, it could be as much stupendous 90 %. But wait what happens if the service is so cheap to do you land up with a bad outcome? Well not in India, in hospitals and niche clinics a large number follow international standards. Look for reviews and referrals and you would choose the right one. Even if the facilitator connects you with a treatment center you can still verify online. 

Medical tourism in India is growing by 30% annually and people from all countries are coming here for wellness treatments, complex surgeries, and alternative healing like Yoga and Ayurveda. These can be added to the line of treatment safely since they carry very few drawbacks and after-effects. 

In most countries in Asia including India medicines and medical devices are cheaper thus ensuring a lower cost of treatment. The country for instance is the largest manufacturer of generics and an exporter so the benefit accrues safely. What's more the diagnostics and consultation for disease diagnosis in the country are state of art and cheaper. Practically all diagnosis at hands of experienced physicians or doctors at the helm of a laboratory is possible here. 

India is the hub of wildlife tourism and sightseeing, and the tourism industry is growing year after year. Why? Apart from spectacular landscapes, exciting wildlife, and a thriving culture, the infrastructure in terms of lodging and boarding is comparatively cheaper and world-class. Though budget accommodations are very cheap the amenities are missing so choose a luxury hotel for a stay while undergoing treatment or on a holiday safari. 

The country offers several travel options, the cheapest being bus and rail transportation. You can also travel inland on metro buses, cheap tuk-tuks, and metro rails all very affordable. Luxury private taxis may cost more but comparatively, they are cheaper.   

Thus, the hospital stay is going to cost cheaper as well, and what more you have the option to stay in a private temperature-controlled room with great service in most of the hospitals in India.               

Reputed health tourism facilitators do away with the language barrier and keep cultural sensitivities in mind. The language barrier can be troubling a good agent will always have a translator speaking foreign languages in the service. He or she will make conversations with the medical fraternity possible. Most reputed hospitals and clinics have learned to comprehend cultural and religious sensitivities and provide food and follow the norms as required. 

Most international patients carry an attendant for help and company. In our facilities, the allied staff is quite considerable and a good facilitator provides 24/7 executive service wherever possible. 

Post-treatment and surgery care are excellent in the country and you can afford to stay for that as well due to the lower cost of treatment. After surgery, you can become an outpatient and keep consulting the specialist till you are beyond any complications. That is the benefit of health travel in India and under a good facilitator.   

Bone Marrow Transplant in India

When things go wrong with the bone marrow, it leads to a life-threatening situation. A mass of tissue with a dense network of nerves and highly vascularized bone marrow as the name suggests is found enclosed in bone cavities all over the body. It is part of the vital lymphatic system comprising red marrow and yellow marrow.

This lymphatic system performs a number of vital functions besides the removal of old and dead cells from the body. Most of the platelets, white and blood cells are formed in the red marrow while the white marrow produces fats, cartilage, and bone. This makes the microarchitecture a vital system for life support. The red blood cells perform the function of oxygen carriers while the white ones act like the sentinels and are indispensable for body immunity which keeps harmful pathogens at bay.   

During a lab test excess production of red blood cells or white blood cells is an indication of an abnormality and calls for medical attention. For example, excess white cell production in your bloodstream is usually a sign of disease. In a contingency especially when there is a deficiency of the RBC, WBC, or platelets body hormones trigger excess production to make up for the loss. 

Bone Marrow Transplant

When contingency strikes and the marrow becomes diseased to the point of no return then a transplant is the only recourse. In the case of cancers of various types and blood-related disorders, transplantation is lifesaving.

In this kind of procedure, stem cells play a major role. Stem cells are a special type of developing cells that turn into the RBC, WBC, and platelets depending upon their genetic coding. Thus, the diseased cells are removed and healthy stem cells are transplanted into the bone marrow. The success rate of this procedure is almost 85% and immensely helps those suffering from bone marrow disease especially those afflicted by cancer.

BMT or bone marrow transplant is required not only when the marrow is affected by cancer but the damage is also by severe infections, aplastic anemia, sickle cell anemia, and thalassemia.  

In case of a malignancy, BMT is most successful in the following instances

• ·        Hodgkin’s lymphoma
• ·        Non-Hodgkins Lymphoma
• ·        Multiple Myeloma
• ·        Acute Myeloid Leukemia
• ·        Chronic Myeloid Leukemia
• ·        Acute Lymphoblastic Leukemia (
• ·        Neuroblastoma
• ·        Myelofibrosis

Usually, the marrow is harvested from some specific bones in the body in order to find an anomaly or damage to it. The harvesting is done under general anesthesia and complications are limited. In the case of harvesting from a donor, most countries have stipulated a limit to extraction.

Allo & Auto Transplant

In the case of ALLO, the transfer takes place between two persons provided the marrows match. In order to prevent rejection a protein named HLA in WBC is matched, this protein is responsible for preventing a rejection whence the introduced cells begin attacking those already present in the body.  ALLO transplant can be impacted with a high or low dosage of chemotherapy and thus the process is differentiated accordingly by the experts.

In the case of AUTO Transplant, the healthy stem cells are removed and stored as frozen before chemotherapy or radiation. These cells are then retransferred after the cancer treatment.

The pre-transplant procedures include increasing the production of healthy stem cells, the chemotherapy is then carried out followed by reinjection of the bone marrow.

Some other types of BMT are:

• ·        Syngeneic Transplant
• ·        Haploidentical Transplant

Before the BMT takes place a number of tests have to be conducted in order to detect problems and infection if any.  Hence a variety of blood tests, CT scans, X-rays, biopsies, and heart function tests are all that the operating surgeon may deem necessary. 

Though the success rate is high almost up to 85% some complications may arise post the procedure. But the complications rarely result in death and as a result, they are becoming more and more popular.  

Nearly 100000 BMT are being carried out around the world. The rate of increase in the procedures being carried out is 7 percent which is suggestive of a growing number of ailments that afflict the marrow. 

In India, a number of bone marrow transplants are being carried out in top-rated hospitals. The cost of this procedure ranges anywhere from 20 lakhs to 45 lakhs. The cost difference arises from the type of hospital chosen and the BMT procedure itself. As compared to India the cost of BMT in The USA is as much as 200,000 USD.

Some of the best hospitals for BMT are:

• ·        Max Hospitals
• ·        Medanta
• ·        Kokilaben Dhirubhai Ambani Hospital
• ·        Global Hospital Chennai

The cost difference and the quality of service available in Indian Hospitals make them an attractive health travel destination. These factors are proving beneficial to international health travelers and they are actively seeking treatments in India.   

Fortifying Medical Tourism in India

Facilitating medical tourism for attracting international patients is just not a piece of cake. The sector is riddled with complexities, and glitches that have to be well managed in order to attract international patients and beat the competitors.

The current size of the market is a whopping 45 million USD with more than ten million people traveling overseas for healing. The sector is growing at a CAGR of 30% in India while the global average is 21.1% and this average will be stable up to the year 2027.  In spite of the pandemic MVT or medical value, tourism is expected to cross 13 billion USD in India.

Without Government support, it is a herculean task to excel in travel and treatment of overseas patients within the country.

What shapes Medical Tourism?

Our cultural ethos accords a Godly Status to overseas visitors. “Atithi Devo Bhava” along with the ancient healing traditions have laid firm roots for value-added health travel and tourism. 

An extensive framework is imperative for delivering quality healthcare, and dispensations play a major role. This calls for a joint approach wherein the public and private sectors jointly propel the initiative. The policy has to be framed at the federal level that governs entry, inland travel, ambiance, and low-cost treatment in the finest medical hospitals and clinics. The support at the state level and that of the private sector is thus crucial. A progressive policy framework that incentivizes various aspects of health care along with tourism has been the case in India, and the approach has paid a rich dividend.  

The latest policy of the Central Indian Government has to frame a draft National Policy that promotes wellness tourism in the country. The road map recognizes the tremendous benefits of attracting overseas patients leading to crucial foreign exchange earnings and providing support to the medical institutions within.  Integrating tourism is a must since both are correlated hence a larger perspective is being considered as a holistic approach.   

The FTAs or foreign tourist arrivals in the country were around 450000 in the pre-pandemic period and with a growth of 40%, the number is expected to touch nearly a million arrivals in the post-pandemic era. The figure also includes visitors arriving for sightseeing and wildlife safaris eventually ending up with scheduled treatments. Most of the arrivals are from Africa, Afghanistan, Maldives, Pakistan, Bangladesh, Sri Lanka, Oman, and Iraq. But a large number of visitors arriving for wildlife tourism and sightseeing are from the UK, USA, Australia, and EU this number will also seek medical options during their visit while some may arrive purely for treatments and procedures.

Health Infrastructure

The country has a world-class, scalable health ecosystem with considerable funding and encouragement from the Government.  This has proven to boost the activity and the cause is being furthered with a growing number of accredited multispecialty hospitals and clinics. Investment in the latest technologies, skills, and expertise pertaining to new treatment methodology and expertise makes wide spectrum disease treatments available in the country. Quality treatments and successful outcomes are the highlights of medical services in India. The country has 37 JCI-accredited hospitals, and 513 NABH-accredited ones spread all across the country. These establishments are also wide-ranged regards luxury and ambiance hence upscale international patients who seek star facilities have an option. Most of the hospitals delivering the same quality of service including the surgeries are mid-priced while government or public hospitals are much cheaper.

While discussing the health-related travel industry allied sector and diagnostics cannot be neglected. In our country, the allied sector and diagnostics are in a robust state of being. The advanced education and training reflect holistically on the allied sector as well. Patient care is much dependent upon the nursing staff, management, and people in the team that accord state of art service to inpatients as well as outpatients.   

Ease of Travel  

Medical tourists can now avail of e-tourist visa facilities the Government also included medical attendants as well to the facility. Under this sector multiple entries and extended stays are possible.

In the year 2015, NMWTB, or the National Medical and Wellness Tourism Board was constituted. The purpose was to create an institutional framework and promote tourism.   

 The Costly Battle 

At the global level, the battle depends upon the cost. In choosing a destination for impending surgery or health care, people choose on the basis of cost. But nevertheless, other factors are also taken into the consideration. Quality of service, expertise, and travel consideration also matter. Easy availability of visas and extension, economical accommodations, and cheap inland travel all matter.      

 

 

Cost Benefits and Expertise is a Factor behind Surge in Medical Tourism in India

The chosen destination for heart surgery, be it CABG or open-heart procedures is India. This is due to the cost-benefit, expertise, and availability of accredited hospitals and clinics. This is just an example; the country excels in providing excellent health care to overseas citizens in almost all disciplines. 

Well! Speaking the truth international health travel is governed by multiple factors not only the cost-benefit. But at the core of all treatments is the cost, and it outweighs all other factors.

Patients with insurance or those availing of public health care prefer local medical facilities, but sometimes these are not the binding factors. A long waiting list, lack of expertise, or medical facility in one’s country propels citizens to visit faraway destinations for healing.

Some of the preferred destinations for wellness and healing are:

• ·        Japan
• ·        Korea
• ·        India
• ·        Malaysia
• ·        Singapore
• ·        USA
• ·        UK
• ·        Thailand
• ·        Germany
• ·        Sweden

Among these top ten Nations, India ranks sixth in terms of revenue generated but the arrivals are expected to increase when the impact of the pandemic is over. The country provides surgical options and non-surgical treatments at 1/10 and 1/15 the cost of that incurred in the USA and the UK. These are comparative averages since many Asian countries also provide low-priced options, but nevertheless, India ranks as one that provides better choices and rates in most cases.

Low-cost options, expertise, and accredited hospitals are available pan India - almost in all mid-level towns. The mid-level towns due to the less economical stress and cost of living are able to provide equally good options for invasive procedures and palliative care at a much lesser price. Most of the rated hospitals and clinics are on par with those established in costlier metros and capital cities.

Another plus point that attracts international patients is the availability of cheap but expert diagnostic facilities, generic drugs, and medical devices. The country is the largest manufacturer of generic drugs and indigenous vaccines.  With increasing foreign direct investment, the pharmaceutical industry will grow by leaps and bounds.   

Wide-spectrum disease treatment availability is another virtue that the country is endowed with. This is a result of stress placed on educational intuitions to deliver the best in technology and medical sciences. The health care infrastructure is well looked after and funded by the dispensations in India. The recent allocation on health care has been Rs. 2,34,846 crores and more funding is promised in near future. The country is home to a large number of medical colleges that are imparting graduate and post-graduate degrees churning out doctors and surgeons in impressive numbers. Most of the degree holders study further in institutions of higher learning in advanced countries. Most of the fellowships obtained by Indian experts are from the USA and the UK followed by other EU countries.     

The most desired procedures and surgical options that inbound health traveler seeks pertain to cosmetic, cardiac, transplants, oncology, and dental restructuring. Patients from overseas also seek recourse to minor ailments besides major surgeries and palliative care.

With ancient indigenous healing systems prevailing since the medieval ages medical science is nothing new for Indians. Ayurveda, meditation, and Yoga offer excellent alternative recourse for people from all over the World. Ayurveda though not thoroughly researched using the modern methodology, and often criticized for unproven health benefit claims is nevertheless making inroads as modern research and studies are being applied to the ancient formulations prevailing in the system.

Thus, the country has deep-seated roots in its approach to healing. It is said that ancient practitioners developed a number of treatises pertaining to medicine, cosmetic and reconstructive surgery.  The use of Ayurveda as a holistic system of healing cannot be challenged though it does not a substitute for modern allopathic traditions. But Ayurvedic healing can be applied in conjunction without conflict with modern therapies. In order to stress the growth of medical tourism in the country, a separate ministry has been set up. Called AYUSH Ministry, its main role is to promote indigenous healing systems besides homeopathy.      

There is hence a strong basis for Indians to excel in the healing sciences and their applications. No wonder the country is attracting more and more people from developed Nations besides the neighboring countries, Africa, China, and APAC region.

The health travel country is expected to grow over 21 % CAGR between the years 2020 and 2027. The Atmanirbhar Bharat objectives along with the ministry of tourism are aim to propel inbound health travel sky-high.   The country is already gaining traction in inbound tourism related to wildlife safaris and sightseeing due to the presence of iconic wild species and places of panoramic grandeur. Thus, if tourism increases it is most likely to propel low-priced treatments available in India. Thus, the medical industry and tourism are correlated as the name suggests, and India with vast resources in both is slated to become a prominent hub.