Dr. Naeem A. Leghari
Dr. Naeem Ahmed Laghari is currently working as a DCMO/ Director of Nuclear Institute of Medicine & Radiotherapy NIMRA, Jamshoro, Sindh. Muhammad Fareed, Publisher & Managing Editor, Medical Review and his team during the visit to Hyderabad got the opportunity to interview Dr. Naeem Ahmed Laghari. Following are the excerpts.
Q – Please tell something about yourself.
Ans – I am Dr. Naeem Ahmed Laghari, DCMO/ Director of Nuclear Institute of Medicine & Radiotherapy NIMRA, Jamshoro. I gra-duated in 1980 from Liaquat Medical College, Jamshoro. I did my Internship from Liaquat Medical College Hospital aJamshoro in 1981 and joined Pakistan Atomic Energy Commission at (AEMC) Jamshoro in 1982. I worked at NIMRA, Jamshoro (previously known as AEMC) from 1982 to 1993. I got my fellowship in Radio-therapy from ENEA Italy in 1988 and then selected for UICC ICRETT fellowships in Brachytherapy of Gynaecological Tumours from Royal Marsden Hospital Fulham Road London, UK in 1993. I remained Director and Oncologist at LINAR, Larkana from December 1993 to December 1997 and then transferred as an Oncologist and Director to BINO (Cancer Hospital Bahawalpur). I established BINO from scratch and remained there for 11 years and now joined again NIMRA in October 2008 as an Oncologist and Director. I got MCPS Radiotherapy from CPSP in 1995 and then Diploma in Medical Radiotherapy DMRT in 2003 from Liaquat University of Medical & Health Sciences, Jamshoro Sindh.
Q – What are the common cancers you encounter.
Ans – Head and Neck cancers are the most common cancer in male and females in southern region of our country. Jamshoro, Hyde-rabad, Badin, Thatta, Mirpurkhas and Karachi is one of the highest incidence zone for Head & Neck cancers because of Pan, Gutka, Naswar, Beatle Nuts and Tobacco chewing.
In Head and Neck cancers there are also few other factors responsible for occurrences, but it has been seen that more than 90 per-cent of the Head and Neck cancers patients gives history of Pan, Gutka, Mainpuri, Naswar, Beatle Nuts and Tobacco chewing.
Submucosal Fibrosis, a pre-malignant condition com-monly seen in our population is due to above habits. Other common cancers are Breast, Lung, Gynaecology and GI cancers.
Q – Is there any Gender prevalence.
Ans – The lung cancer is more common in males due to a habit of tobacco smoking and occupational factors. Gall bladder cancer is more common in females due to more incidences of gall stones in females.
Q – What are the treatments available in the country.
Ans – Although with limited resources all kind of basic treatment is available like Surgery, Radiotherapy and Chemotherapy in our country. Due to lack of funds there is shortage of trained Manpower and latest high-tech equipments in the fast emerging field of Oncology.
Q – Are the treatment facilities satisfactory.
Ans – No, due to few number of cancer hospitals in the country, it does not cover the entire population of the country. There is great room for improvement. There is need of proper funding to open new hospitals up to division levels. Training of cancer experts and pro-curement of latest equipments. Public awareness is the most important factor in up gradation of all these facilities.
Q – What are the measures necessary to further augment treatment facilities.
Ans – Public awareness, about cancer in health professionals, health workers, and general public is required to augment knowledge and treatment facilities. Among all cancers few cancers are preventable like Liver Cancer, most important etiological factor for Liver Cancer is Hepatitis B and C Virus. Everybody knows that the factor responsible for spreading of this deadly virus is due to the syringes. Reuse of these syringes by the mafia on cheaper rates causes spend of Hepatitis B and Hepatitis C diseases. If public is aware of the fact and proper hospital measures are taken by health authorities and medical professional then the incidence of liver cancer can be brought down to less then 50 percent of present incidence. With these measures, not only liver cancer is prevented but also many other diseases may also be prevented.
Q – What are the level of cancer awareness among the people and how the doctors can help to increase the level of awareness.
Ans – Public awareness is on a lower side about cancer and its treatments, that’s why patients usually report late to the tertiary healthcare setups when productivity of costly treatment becomes worthless.
Family doctors should have refresher courses to update their knowledge so that they can guide the patients to get best out of available resources. To keep the public conscious about their health, electronic and print media should be properly utilized by the health professional in this regard.
Q – How will you rate prevalence of cancer in rural and urban areas.
Ans – Comparative awareness of cancers in urban area is better but the atmosphere is poor. Ultimate effect is accumulated as no much difference in the result, although prevalence and patterns of different cancers is different in two areas like Hepatitis C, Viral Infection is common in rural areas; so we have more patients in liver cancers from rural areas.
Q – What treatment options are available through use of medicine and which are the common drug used.
Ans – Conventional Chemo-therapy, Hormone Therapy, Immunotherapy and now High Targeted Therapies are effective and available throughout the world but the later is costly treatment options. Common drugs are schedules in specific order/ sequences and are different for different cancers.
Q – What is the level of treatment of breast cancers available at present.
Ans – Breast cancer is the most common cancer among females. A lot of work has been done on this cancer and lots of achievements have been made. Now clinician can expect good response even in stage IV disease which was a dream in the past.
Q – Has awareness been introduced among women for prevention of breast cancers.
Ans – Yes, a campaign could be launched in a local com-munity for prevention and early detection of Breast Cancer by arranging lectures and seminars in a district hospitals as well as through electronic and print media. In a recent future, NIMRA will start a campaign for public awareness about Breast Cancer.
Q – Is there any separate branch of Oncology which deals with breast cancers.
Ans – Yes, a mobile Mammo-graphy Unit and a team consisting trained doctors and technical staff is available which deals with the Breast diseases. (Courtesy – ICI Pakistan Ltd.)