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Scaleable 7 elements of Preventive Radiology in Cancers & Risk Factor reduction in NCD for healthy ageing

Authors: Dr Rijo Mathew Choorakuttil, Dr Praveen Nirmalan

Dr Rijo Mathew Choorakuttil is the Founder and National Coordinator for the Preventive Radiology Initiative of IRIA. Dr Praveen Nirmalan provides the research support for the program.

Medical imaging offers the possibility of minimal contact, non-invasive and painless identification of diseases at various stages. Imaging studies allow healthcare practitioners to objectively assess the onset and progress of disease and the effectiveness of interventions in a painless manner. Rapid advancements in medical imaging modalities have resulted in the evolution of techniques for better visualization of structures, the reduction of turnaround times using better algorithms that provide better interpretations, and improved access through portable and point-of-care applications. Medical imaging is an integral part of the screening and management of several cancers including breast cancers, lung and colon cancers, gastrointestinal cancers, head and neck and oral cancers and prostate cancers. These approaches play an important role in early identification, therapeutics, and assessment of the progress of disease and the effectiveness of the interventions.

Medical imaging has an important role to play in three aspects of individualized medicine for cancers and other diseases

·        The disease-prevention model

·        The individualized diagnostic model

·        The individualized therapeutic model

The disease-prevention model aims to identify early pre-clinical stages of disease and subgroups of patients at risk of developing symptoms and signs of abnormal structure and function. It relies on a combination of genetic, environmental, social and other information integrated with predictive biomarkers (biomolecular or imaging) that help to monitor disease development and preventive interventions. 

The Individualized diagnostics model aims to identify the specific molecular substrate and structural and functional basis of alterations leading to disease. These look carefully to identify the location and extent of primary and secondary changes integrating the physiological characteristics of disease lesions like perfusion, flow, metabolism, and diffusion.

The Individualized treatment model focuses on the identification of patient subgroups that are more likely to respond favourably to different therapeutic models integrating information on side effects or consequences, therapeutic modulations, and localized therapy. 

Medical imaging in clinical medicine is not restricted to the diagnosis of an abnormality- a disease, an injury, or a malformation but considers the localization of the abnormality, the extent of the abnormality and its impact on structural and functional parameters.

Scaleable 7 elements of Preventive Radiology in Cancers & Risk Factor Reduction

  1. To promote Awareness programs on Kerala Cancer Crusade on Preventive strategies in Print, Visual and Social Media on a regular basis 
  2. To develop and train Skilled Navigators to implement and scale up program initiatives- From grassroots to the sky.
    The program will include Kudumbasree, Asha workers, NSS students, Lavender Army, and Digital Healthcare Volunteers
    Their role is Awareness creation and connecting service providers for screening and treatment.
  3. To connect and network with service providers of different entities to work towards Kerala Cancer Crusade initiatives using digital platforms and interconnected networks that suit the dynamics of each entity to contribute to the cause. The technical package of screening programs will focus on common cancers in Kerala. The service providers will include Public Sector Hospitals including PHC, Taluk hospitals, District hospitals, Medical Colleges, and Regional Cancer Centres. and Central Govt. Institutions.
    Large Corporate enterprises Medium enterprises. Small enterprises and NGOs/ Charity/ Trust hospitals will also be included in the network
  4. To promote indigenous Technology development in cancer awareness, early detection and management using the untapped Leverage of Medico Engineering Nexus for Living.
  5. Research, Data Analysis, Documentation, Publication on cancer prevention and healthy ageing.
  6. To create a Platform to interact with policymakers on Health cost Analysis on a continuous basis.
  7. Promote Social Entrepreneurship Initiatives in risk factor reduction and cancer prevention.
Dr Praveen Nirmalan

Written by Dr Praveen Nirmalan

Dr. Nirmalan did his basic medical education from Thrissur, Kerala and followed it with a PG Diploma in Ophthalmology from Aravind Eye Care System, Madurai and a Vitreo-retinal Fellowship from Mumbai. Subsequently, he completed his MPH and a Public Health Ophthalmology Fellowship from the Johns Hopkins School of Public Health in the USA. He has led community-based and clinical research in some of the top eye care institutes of India and led a clinical research program at a top tier obstetric and neonate institute as well. He has experience chairing Ethics Committees and has helped with the setting up of Institutional Review Boards. Besides mentoring clinical faculty, he has mentored DNB and PhD students through their dissertation work and research methods.

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