Sometimes, attitude is more important than attribute when it comes to being a good doctor.
Monday, September 30 | 11:00 am – 12:00 pm | Grand Ballroom AB
The Eugene N. Myers, MD International Lecture on Head and Neck Cancer award was endowed by Leslie Nicholas, MD, in honor of his nephew, Eugene N. Myers, MD, who is dedicated to the management of head/neck cancer and has interest in international medicine. This year’s Guest Lecturer is Pankaj Chaturvedi, MD, MBBS, the director of the Advanced Centre for Treatment, Research and Education in Cancer, at the Tata Memorial Centre in Mumbai, India. He is also a professor and surgeon in the Department of Head and Neck Surgery.
Areas of research and clinical investigation that are of interest to Dr. Chaturvedi include public health, tobacco cessation, cancer prevention, early diagnosis, and working with government and regulatory agencies for the prevention of cancers. He also has special interest in the management of head and neck squamous cell carcinoma, especially oral cancer. Dr. Chaturvedi has conducted and published several pivotal research studies that have impacted cancer care globally.
Q: Congratulations on being named Guest Lecturer for the Eugene N. Myers, MD International Lecture on Head and Neck Cancer. What does it mean to be presented with this esteemed recognition?
Dr. Chaturvedi: First, I would like to thank the AAO-HNSF for bestowing this opportunity to be named Guest Lecturer for the Eugene N. Myers, MD International Lecture on Head and Neck Cancer. I am deeply honored and humbled for being recognized in the field of head and neck cancer, a discipline that I hold with the utmost respect and passion. This honor means that your work, dedication, and impact have been acknowledged by respected peers, institutions, as well as the broader community. I represent the spirit and culture of Tata Memorial Centre in Mumbai, and this award is a testament not only to my efforts but to the collective dedication of the entire team. I want to thank my mentors who have guided me, my colleagues who have collaborated with me, and my patients who have placed their trust in my hands. I also owe a lot to my family who supported me in this entire journey.
Q: Can you share some pivotal moments in your training and career?
Dr. Chaturvedi: Just after I graduated in 1991, I served at an orphanage that was witnessing a serious outbreak of mumps and measles, and they did not have a doctor to help deal with the crisis. I had very little practical experience in managing illnesses such as that in children, however, the critical nature of the situation motivated me to take up the challenge. This experience transformed me from an inexperienced graduate to a compassionate and bold doctor. It taught me that attitude is more important than attribute when it comes to being a good doctor.
In 1993, one of the South Indian states was stuck by a massive earthquake that led to death of 10,000 people and injuring 50,000 people. Seeing the plight of my countrymen, I volunteered in the relief effort. During those three months of relief work, I gained immense courage, confidence, and insight into public health. And recently, I had a very touching experience while visiting a senior living home in South India. This exposed me to an emerging social problem of older patients living alone or even being abandoned by their children, especially when they have serious health issues such as cancer. You can read about this and my other experiences here.
Q: How did you become interested in public health, tobacco cessation, oral cancer and cancer prevention, early diagnosis, and more?
Dr. Chaturvedi: As a head and neck cancer surgeon, nearly three quarters of the cancers that I treat are related to tobacco, areca nut, and alcohol. For example, oral cancer is the most common cancer in Indian men, and it is the most common cause of cancer related death in Indian men. These established causative agents are brazenly advertised and marketed despite the scientific evidence against them. The industry targets teenagers and youth as their new consumer base, yet tobacco use only leads to death and disabilities.
Apart from treating cancer, I decided to work on cancer prevention and early detection. I started a campaign called “Voices of Tobacco Victims” that played a pivotal role in tobacco control in India and led a nationwide campaign to raise taxes on tobacco products. I also conducted sensitization programs for the members of parliament and assemblies to accelerate tobacco control. With the Ministry of Health, I developed a powerful outdoor awareness campaign, and I worked with several NGOs to improve the implementation of anti-tobacco laws in India. I have also worked with the Ministry of Health to strengthen pack warnings and stop the introduction of electronic cigarettes in India. In 2012, I was one of the five civil society representatives in the United Nation’s Summit on Non-Communicable Diseases.
July 27 is recognized as World Head and Neck Cancer Day with an aim to promote cancer care and control. Since 2014, it has been observed in 48 countries. Learn more about World Head and Neck Cancer Day here.
Q: Your presentation indicates that India has one of the highest burdens of oral cancer and is the number one cause of cancer-related death in Indian men. Why do you think this is and what are some current models for prevention and early detection?
Dr. Chaturvedi: India has one of the highest instances of oral cancer in the world, and several factors contribute to this alarming trend. A significant portion of India’s population uses smokeless tobacco products like gutka, paan, and khaini. These products contain carcinogenic substances that directly contact the oral mucosa, leading to a high risk of oral cancer. Although not as common in the West, the prevalence of smoking, particularly bidi smoking, also contributes to the high incidence rates. The carcinogens in tobacco smoke are harmful not only to the user but also to those exposed to second-hand smoke. Areca nut, often chewed with betel leaf (paan) and lime, also has widespread use in India, often in combination with tobacco, which significantly increases the risk of developing oral cancer. The cultural acceptance of tobacco and areca nut chewing in social and religious contexts contributes to the widespread prevalence of these habits. Alcohol consumption is also quite high in India and increases the risk exponentially when combined with tobacco use.
A majority of oral cancer is preventable. Educational campaigns to inform the public about the risk factors for oral cancer should target high-risk groups and be culturally sensitive. Integrating oral cancer prevention into school curricula to educate young people about the risks of tobacco, alcohol, and poor oral hygiene is also very effective. Screening strategies, especially for individuals at high risk, have been shown to result in early detection of lesions and improve survival rates. Dentists and healthcare providers should be trained and perform opportunistic screening to identify early signs of oral cancer. Lastly, national and international collaboration is very important to share knowledge, strategies, and resources for oral cancer prevention.
Q: You have helped establish cancer centers in different parts of India with a vision to make cancer care more affordable and accessible. Are there certain trends and therapies that can be applied by attendees of the Annual Meeting from other parts of the world?
Dr. Chaturvedi: Hospitals in different parts of India are offering evidence-based treatment through multi-disciplinary tumor boards. These centers are also creating skilled medical, nursing, and technical manpower to tackle the rising burden of cancer in India. I would urge senior doctors to take up hospital administration as one of their career progression paths.
When a clinician becomes involved in the administration of a hospital, they bring a unique and valuable perspective that bridges the gap between patient care and hospital management. This dual role can enhance the quality of care, improve operational efficiency, and align clinical practices with the cancer control’s strategic goals. However, lack of formal training in business, management, or finance can be a challenge when dealing with complex administrative tasks. Participating in leadership programs or taking on smaller administrative tasks initially can help build confidence and competence.
Q: How can medical students, residents, mid-career physicians, and late-career physicians each benefit from your presentation?
Dr. Chaturvedi: My presentation reflects on my journey so far and where I am heading. By devoting part of my time to public health advocacy, I have achieved much more than I can do as a surgeon. Doctors make very powerful advocates for prevention and early detection in their respective geographic locations. By working in the control of etiology and by promoting early detection, we can save more lives than doing clinical interventions on those visiting our hospitals.
Q: Is there anything else you would like to share about your experience or research?
Dr. Chaturvedi: This recognition is a reminder of the impact we, as clinicians, can have. It is a reminder of the responsibility we bear every time we enter the hospital. The trust placed in us by our patients and their families is sacred, and it is a trust we must continue to honor with every decision and every action we take. This award is not the culmination of my journey but rather a milestone along the path of lifelong dedication to the art and science of head and neck cancer.
In Bhagwat Geeta, a revered scripture among Hindus, it is said that we do two kinds of things every day. First is called “actions (or, Kriya)” that we do for the benefit of ourselves and our family. Second is called “service (or, Karma)” that is for the betterment of the lives of others. All living beings including animals perform actions every day for their existence. A good human being is the one who indulges in more of service or Karma as part of their life. Being a compassionate doctor is not a service, but it is the duty of every doctor.
