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What Is MSI-High Cancer, and Why Does It Change Everything About Your Treatment? For a long time, hearing “stage 4 cancer” felt like a final verdict. Once cancer had spread to organs like the liver or lungs, doctors mostly aimed to control it for as long as possible. That picture is slowly changing, and one of the biggest reasons is a biological feature called MSI-high. Dr Viraj Lavingia, who treats gastrointestinal cancers, explains why this single test can shape an entire treatment plan. The “Typo” Idea: What MSI-High Really Means Think of your cells as fast typists. Every time a cell divides, it copies a huge instruction manual of DNA, about 3 billion letters long. With that much typing, a few mistakes are natural. Healthy cells have a built-in spell-check team called mismatch repair. It scans the freshly copied DNA, spots the typos and fixes them straight away. In some tumours, this spell-check team is missing or broken. Doctors call this mismatch repair deficiency. Without it, thousands of typos pile up in repeating stretches of DNA known as microsatellites. When that happens, the tumour is labelled MSI-high, short for microsatellite instability-high. It sounds like bad news, but here is the twist. Because the tumour is full of errors, it looks strange and “foreign” to your body. That turns out to be its biggest weakness. Why Immunotherapy Works So Well Here Your immune system has soldier cells, called T-cells, whose job is to attack abnormal cells. Many tumours survive by showing a “fake ID” that puts these soldiers to sleep. Immunotherapy removes that fake ID. The T-cells wake up and go after the tumour. Since MSI-high tumours already look so unusual, the immune system reacts to them strongly. What the Research Shows Two studies, both published in a leading medical journal, get a lot of attention: KEYNOTE-177 trial (stage 4 colorectal cancer): Standard chemotherapy gave a median survival of around 36 months. Immunotherapy as the first treatment raised this to about 78 months. More than half of the patients on immunotherapy were alive at five years, and many had long-lasting responses. Dostarlimab study (localised rectal cancer): In this small study of patients with dMMR tumours, everyone who received the drug had a complete clinical response. Their tumours could no longer be seen, and they were able to avoid chemotherapy, radiation and surgery. These results are remarkable. Still, they apply to a specific group of patients, and the dostarlimab study was small. Your own doctor is the right person to say what applies to you. How Is MSI Status Checked? The test is simple and routine. It uses a small piece of tumour tissue from a biopsy or surgery, and no extra procedure is needed if the sample already exists. There are two main methods: IHC (immunohistochemistry): A special stain examined under a microscope. It checks four spell-checker proteins. If one or more are missing, the tumour is called “mismatch repair deficient”. PCR or NGS (next-generation sequencing): A molecular test that counts the typos in the microsatellite regions to confirm whether the tumour is MSI-high. Two Facts Worth Remembering Not every tumour is MSI-high. About 15% of early colorectal cancers are MSI-high, but only around 4 to 5% of stage 4 colon cancers are. It is also seen in some stomach, uterine, and pancreatic cancers. Since you can’t guess it from symptoms or scans, testing early matters. Stage 4 is not one-size-fits-all. Stage tells us where the cancer is. It doesn’t tell us how it behaves. Two people with stage 4 disease can have very different outlooks, depending on the biology of their tumours. An MSI-high tumour follows a different path from a non-MSI-high one, because doctors have more precise tools to treat it. My Analytical Take The bigger lesson here is about asking better questions. Families often focus on the stage of cancer and the choice of hospital. Both matter. But biomarker testing can matter just as much, because it decides which treatment is likely to work best. A short conversation with your oncologist about testing can open doors that older, one-size-fits-all approaches never did. Knowing your tumour’s biology is quickly becoming part of good cancer care, not an optional extra. The Bottom Line A cancer stage describes where the disease is, not what your future holds. With precise testing, doctors can now match the right treatment to the right tumour. For some people with MSI-high cancer, that means long-term control and, in select cases, cure. As Dr. Viraj Lavingia emphasizes, if you or someone in your family is facing an advanced cancer diagnosis, ask about MSI testing early. It is a small step that can make a big difference.

Can a Simple Blood Test Really Detect Cancer Early? Imagine catching cancer the way you catch high cholesterol: a routine blood draw during your annual check-up. That idea is no longer science fiction.Blood tests for cancer detection are here, and they are changing how doctors think about early cancer screening. Dr Viraj Lavingia, who treats colorectal cancer, explains what these tests can and cannot do. How Does a Blood Test Find Cancer? Tumours are messy. Their cells die and are replaced constantly, and when a cancer cell dies, it releases tiny fragments of its DNA into the bloodstream. This is called circulating tumour DNA. A liquid biopsy looks for these fragments. Cancer cells also carry chemical “bookmarks” on their DNA, called methylation patterns, that tell a cell how to behave. Cancer cells have different bookmarks from healthy ones, so specialised labs can pick up this signature from a single tube of blood. Two names you may hear: Shield: an FDA-approved blood test in the US for colorectal cancer screening in adults at average risk. Galleri: a multi-cancer detection (MCD) test that looks for signals from over 50 cancer types, including some, like pancreatic and ovarian cancer, that have no routine screening today. What the Numbers Say The numbers show both the promise and the limits: Strength: Shield catches roughly 83% of colorectal cancers that are already present. Limitation: It detects only about 13% of advanced adenomas, the precancerous polyps that could turn into cancer years later. That second number matters. A colonoscopy doesn’t just find cancer; the doctor can remove a polyp on the spot, so it works as prevention too. A blood test mostly detects cancer that has already started shedding DNA. So it is a very good smoke alarm, but it isn’t a fire prevention system. Why Would Anyone Skip the Gold Standard? Here is my analytical take. The best test is useless if people don’t take it. A study in India surveyed doctors and their parents, people who understand medicine better than most. Of 1,374 eligible individuals above 45, only about 7% had ever had a screening colonoscopy. Their reasons were practical: It feels invasive. Nobody looks forward to a camera test. The bowel prep is unpleasant. Drinking litres of laxative solution puts many people off. Results can vary. One doctor may spot a polyp; another misses. There is a small risk of complications. Add the logistics: someone has to accompany you, you may need a day or two off, and there is worry about costs. Behavioural experts call this the “ostrich effect”: we bury our heads and assume cancer happens to someone else. Even in the US, where colonoscopy is heavily promoted and insured, screening rates hover around 60%. Where a Blood Test Fits If you’re already getting your sugar and cholesterol checked, adding a cancer screening test removes most of the friction. As medical oncologist Dr. Viraj Lavingia points out, “perfect” shouldn’t become the enemy of “good”. A simple test that a person actually takes is better than a gold-standard test they never book. What a Blood Test Cannot Do? Let’s stay realistic: It is not a diagnosis. A positive result means a cancer signal. You’ll still need confirmation through scans, a colonoscopy, or a PET scan. It can miss early or precancerous changes. A negative result doesn’t mean you can skip other recommended screening, especially if you have symptoms or a family history. It isn’t for everyone. Recommendations differ by age and risk, and availability in India is still limited and evolving. Practical Steps You Can Take Know your family history of colon or other cancers. Start the conversation at 45, or earlier if cancer runs in your family. Ask your doctor which screening option, colonoscopy, stool test, or blood test, suits you. Don’t ignore symptoms such as blood in stool, a lasting change in bowel habits, or unexplained weight loss. Keep up healthy habits: more fibre, regular walks, no tobacco, less alcohol. Moving Forward with Better Health So, can a simple blood test detect cancer early? Yes, in many cases, but it isn’t perfect, and it doesn’t replace a colonoscopy. What it can do is get more people to take that first step. Whichever route you choose, the message is simple: get screened. https://www.youtube.com/watch?v=meZRabsAEiM

How Does Colorectal Cancer Start? What Every Indian Should Know We usually expect a serious illness to announce itself with pain or obvious warning signs. Colorectal cancer often doesn’t. It starts quietly inside the large intestine, sometimes years before anyone feels unwell. The encouraging part is that this slow start gives us something few cancers do. What Is a Polyp, And Should You Be Worried? This microscopic pileup of confused cells forms a small, fleshy bump on the inner wall of the colon. That bump is called a polyp.  There are two types:  Hyperplastic polyps — These are completely harmless. They stay small, cause no trouble, and never turn into cancer. Most polyps fall into this category. Adenomas — These are the ones that matter. An adenoma is a precancerous polyp. It is not cancer yet — but given enough time and the right conditions, it has the potential to become one.  The 10 to 15 Year Window Here is the most important fact. An adenoma doesn’t turn into cancer in days or weeks. On average, it takes around 10 to 15 years. My honest take is that colorectal cancer isn’t dangerous only because of the disease itself. It’s dangerous because of the delay. When a polyp is found and removed, the cancer never gets a chance to happen. Few conditions give us that kind of head start, and it’s a shame to waste it. Why Do Polyps Form? Doctors group the causes into two buckets. Sporadic (about 90% of cases) These happen by chance, mainly through ageing and lifestyle. As we get older, the body’s “spell checker” misses more mistakes. Common contributors include: A diet heavy in ultra-processed food and red or processed meat Very little fibre Smoking and tobacco Heavy alcohol use A sedentary routine Genetic (about 10% of cases) Some people are born with a fault in their DNA repair system. The best-known example is Lynch syndrome. Imagine being born without the right toolkit to fix everyday cell errors. In such families, polyps can turn cancerous much faster, sometimes in the 30s or 40s. That’s why family history matters. If a parent, brother, or sister has had colon cancer, your screening plan changes. How a Polyp Becomes Cancer Your colon lining sits on a foundation layer called the basement membrane. While abnormal cells stay above it, they are just a polyp, contained in one place. Cancer begins when a later change lets those cells break through the membrane and invade the deeper muscle layer. Beneath it lie blood vessels and lymph nodes, which can carry cancer cells to other organs like the liver or lungs. This is why catching problems early makes such a difference. You Can Stop This Before It Starts The origin story of colorectal cancer is not a story of bad luck. It is a story of missed opportunities, and we now have the tools to stop missing them.  Dr. Viraj Lavingia, one of Ahmedabad’s leading GI medical oncologists specialising in colorectal cancer, puts it simply: “This is a slow-moving train. We can see it coming from a mile away. We just need people to show up for their screenings.”  Colonoscopies, stool tests, and simple lifestyle changes- these are not scary things. They are the tools that stop cancer before it even gets a chance to start. You do not have to be a victim of this timeline.  What You Can Do Now Know your family history- ask relatives about colon cancer or polyps. It’s one of the most useful health conversations you can have. Eat more fibre. Dal, seasonal sabzi, fruits, whole grains, and salads all help. Go easy on packaged snacks, fried foods, and processed meats. Move daily. Even a brisk 30-minute walk counts. Avoid tobacco in all forms, and limit alcohol. Ask about screening. A colonoscopy lets doctors find and remove polyps before they cause harm. Ask your doctor when you should start, especially if colon cancer runs in your family. Don’t ignore persistent changes. Blood in the stool, a lasting change in bowel habits, unexplained weight loss, or constant tiredness deserve a check-up. These signs can have many causes, but they shouldn’t be brushed aside. The Takeaway Colorectal cancer is often described as a slow-moving train that we can see coming from a long way off. You have time to act, but only if you choose to use it. Fear keeps too many people from asking questions, so start the conversation with your family and your doctor. As Dr. Viraj Lavingia often reminds his patients, awareness and timely screening are your strongest tools.

Why Is Colorectal Cancer Increasing Among Young Adults? For decades, colorectal cancer was considered a disease of aging something to start worrying about after 50. That assumption is no longer safe to make. Rates among adults under 50 have been climbing steadily for years, even as rates among older adults have fallen thanks to better screening. Dr. Viraj Lavingia has watched this shift firsthand in clinic: clinically fit, health-conscious people in their 30s and 40s being diagnosed with advanced-stage colorectal cancer, often after months of symptoms being dismissed as something else entirely. Understanding why this is happening is the first step toward catching it earlier. The Numbers Tell a Clear Story Since the 1990s, colorectal cancer rates among older adults have dropped meaningfully, largely due to widespread colonoscopy screening. But over the same period, rates among adults under 50 have been rising steadily. Some projections suggest colorectal cancer could become the leading cause of cancer-related death in people under 50 within the next several years. This isn’t a statistical blip. It reflects a real shift in how and in whom this disease is developing. What’s Actually Driving the Rise Researchers point to a combination of factors that have changed significantly over the past three to four decades: Shifts in the gut microbiome. Generations raised largely on ultra-processed diets, combined with frequent childhood use of broad-spectrum antibiotics, appear to have altered gut bacteria in ways that create chronic, low-grade inflammation, a known contributor to colorectal cancer risk. Environmental exposure. Ongoing exposure to microplastics, persistent industrial chemicals, and agricultural pesticides in food and water may be affecting the DNA of the intestinal lining over a lifetime, starting from a young age. Long-term dietary patterns. Diets consistently low in fiber and high in processed foods, sustained over decades rather than years, compound risk in ways not seen in previous generations. The Bigger Problem: Diagnosis Comes Too Late Rising incidence is only part of the concern. The bigger issue is timing. When an older adult develops colorectal cancer, it’s often caught early because routine screening is already in place. Younger adults typically aren’t eligible for routine screening, so the disease often has more time to progress before anyone thinks to look for it. By the time a diagnosis is made in someone in their 30s, the cancer has frequently reached a more advanced stage,e often stage 3 or 4, simply because nobody was looking for it sooner. Why the Delay Happens Two patterns tend to contribute to late diagnosis in younger patients. On the patient side: Fatigue gets blamed on work stress or poor sleep Abdominal discomfort gets attributed to diet or a stressful lifestyle Blood in the stool gets assumed to be hemorrhoids, especially in physically active people Embarrassment or busy schedules delay a visit to the doctor altogether On the medical side: Younger patients presenting with symptoms like changing bowel habits or rectal bleeding are sometimes told it’s irritable bowel syndrome, stress, or simple hemorrhoids explanations that are often reasonable, but that can also delay the right test being ordered if symptoms persist. Dr. Viraj Lavingia emphasizes that persistent symptoms deserve proper evaluation regardless of age. A colonoscopy is the only way to truly rule colorectal cancer in or out, and age alone shouldn’t be the deciding factor in whether one is recommended. What This Means for You Age can no longer be treated as automatic protection. If you’re under 50, it’s worth paying closer attention to your body rather than assuming you’re too young to be at risk. Signs worth taking seriously, especially if they persist, include: Unexplained or ongoing rectal bleeding A noticeable, lasting change in bowel habits Persistent fatigue without a clear cause Unexplained weight loss If a symptom continues for more than a couple of weeks, or if an explanation offered doesn’t quite add up, it’s reasonable to ask directly for further evaluation rather than accepting the first explanation given. Early detection remains the single biggest factor in successful treatment outcomes. The earlier colorectal cancer is caught, at any age, the more treatment options are available and the better the long-term outlook tends to be.

Can Your Diet Increase the Risk of Colorectal Cancer? It’s a question that comes up in almost every consultation: “Doctor, did something I ate cause this?” It’s a fair question, and an important one because the honest answer is yes, diet can meaningfully influence your risk of colorectal cancer. Not as a single cause, but as one of the strongest, most modifiable factors we know of. Dr. Viraj Lavingia often tells patients that colorectal cancer isn’t caused by one bad meal or one “unhealthy” week; it’s shaped by patterns repeated over years. Understanding those patterns is where prevention actually begins. Why Diet Matters So Much for This Particular Cancer Unlike some cancers where diet plays a smaller, indirect role, colorectal cancer develops in an organ that comes into direct, constant contact with everything you eat. Your colon isn’t a passive tube; it’s lined with tissue that reacts to what passes through it, and it hosts a vast community of bacteria that respond directly to your food choices. This direct exposure is exactly why researchers have been able to establish clearer links between diet and colorectal cancer than with many other cancer types. What the Research Actually Shows A few dietary patterns consistently show up in global health data as risk factors worth taking seriously: High intake of processed meat, bacon, sausages, and deli meats has been classified by international health bodies as a definite cancer-causing factor for colorectal cancer specifically. Frequent consumption of red meat in large amounts is linked to increased risk, particularly when cooked at very high temperatures. Low fiber intake is consistently associated with higher rates of colorectal cancer, since fiber affects how quickly waste moves through the colon and what it’s exposed to along the way. Regular alcohol consumption is another well-documented contributor, with risk rising as intake increases; there isn’t a level considered entirely risk-free. Diets low in fruits, vegetables, and whole grains are repeatedly associated with higher colorectal cancer rates across large population studies. It’s Not Just What You Eat & It’s How Much and How Often Two people can eat similar foods and end up with very different risk levels, depending on: Frequency: occasional red meat is very different from daily consumption. Portion size: larger, more frequent portions compound exposure over time. Cooking method: grilling or charring at high heat can create additional harmful compounds. Overall dietary balance: a diet heavy in processed foods with little fiber carries more risk than one with more variety and plant-based foods, even if occasional red meat is included. Going Deeper: The Specific Foods Worth Watching The patterns above are backed by research, but knowing the why behind them makes it easier to actually act on. Processed meat, excess red meat, and ultra-processed foods don’t just add empty calories; they interact directly with your gut lining and the bacteria living there, creating conditions that make colorectal cancer more likely to take hold over time. Dr. Viraj Lavingia breaks down exactly how these specific foods affect your colon at a biological level and which foods actively work in your favor instead in What Foods Are Feeding Colon Cancer And What’s Protecting You? It’s worth a closer look if you want to understand not just what to avoid, but why it matters. What Actually Lowers Risk The encouraging side of this research is that protective dietary habits are just as well established as the risk factors: Fiber-rich foods whole grains, legumes, vegetables, and fruits support a healthier gut environment and speed up transit time through the colon. A varied plant-based intake feeds beneficial gut bacteria, which produce compounds that help protect the colon lining. Reducing processed and red meat frequency, even without eliminating it, measurably lowers long-term risk. Limiting alcohol reduces one of the more direct, well-documented risk contributors. Diet Is One Piece of a Larger Picture It’s worth being clear-eyed here: diet is a major, modifiable risk factor for colorectal cancer, but it isn’t the only one. Family history, age, certain inherited conditions, and lifestyle factors like physical activity and smoking all play a role too. This is why dietary changes work best alongside, not instead of, routine screening, especially for anyone with a family history of colorectal cancer or other known risk factors. A conversation with an experienced oncologist can help clarify what your personal risk profile actually looks like, rather than relying on general assumptions. Colorectal cancer risk isn’t fixed. What you eat, how often, and in what combination genuinely shapes that risk over time, which means there’s real, meaningful room to act, starting with the next meal on your plate.

Is Blood in Stool Always a Sign of Rectal Cancer? Seeing blood when you use the washroom is one of those moments that can genuinely stop you in your tracks. Your mind jumps straight to the worst-case scenario. But here’s something worth knowing upfront: blood in stool, while it should never be ignored, is not automatically a sign of rectal cancer. As a medical oncologist, Dr. Viraj Lavingia sees this fear play out often, with patients delaying a visit out of dread, or rushing in convinced the worst has already happened. The truth sits somewhere calmer and more useful than either extreme. What Blood in Stool Can Actually Mean Blood in the stool has several possible causes, and most of them are far more common and far less serious than cancer. Hemorrhoids — swollen veins around the rectum or anus, often caused by straining, constipation, or prolonged sitting. This is, by far, the most frequent cause of visible blood. Anal fissures — small tears in the lining of the anus, usually from passing hard stool, which can cause sharp pain along with bright red blood. Infections or inflammatory bowel conditions — such as colitis, which can irritate the lining of the intestine. Diverticular disease — small bulging pouches in the colon wall that can occasionally bleed. Rectal or colorectal cancer — a less common, but important, cause that needs to be ruled out, especially depending on age and other symptoms. Clues That Help Tell the Difference While only a proper examination can give a definitive answer, a few patterns can offer early clues: Color of the blood matters: Bright red blood, especially seen on toilet paper or coating the stool, often points toward hemorrhoids or fissures. Darker, tarry-looking stool can indicate bleeding higher up in the digestive tract and needs prompt evaluation. Pain pattern is a clue: Sharp pain during bowel movements often suggests a fissure. Painless bleeding is actually one of the patterns doctors pay closer attention to. Timing and consistency count: A one-off episode after straining is different from blood that keeps appearing over weeks. Other changes in bowel habits matter too: such as unexplained weight loss, persistent changes in stool shape or frequency, or ongoing fatigue. None of these clues alone confirm anything. They simply help a cancer doctor decide what to check first and how urgently. Why Age and Family History Change the Picture Colorectal cancer has traditionally been associated with older adults, but this is shifting; a growing number of cases are now being diagnosed in people in their 30s and 40s. This makes it especially important not to dismiss symptoms simply because someone feels “too young” for cancer. Family history also plays a meaningful role. If a close relative has had colorectal cancer or certain inflammatory bowel conditions, that raises the case for earlier and more thorough evaluation. What Actually Happens When You See a Doctor A lot of the fear around this symptom comes from not knowing what the process looks like. In reality, it’s usually straightforward: A physical examination, including a simple visual and manual check Basic blood tests to rule out anemia or infection In many cases, a colonoscopy, a procedure that allows direct visualization of the colon and rectum lining, and is considered the most reliable way to identify or rule out cancer A colonoscopy sounds intimidating to many people, but it’s a well-established, routine procedure and often the fastest way to get a clear, reassuring answer rather than living with uncertainty. When You Should Not Wait While a single, minor episode tied to straining is usually not urgent, certain situations call for prompt medical attention: Blood that continues over more than a couple of weeks Blood accompanied by unexplained weight loss or persistent fatigue A noticeable, lasting change in bowel habits A family history of colorectal cancer, combined with any of the above In these situations, seeing a Dr. Viraj Lavingia sooner rather than later isn’t about assuming the worst; it’s about ruling it out quickly and confidently, one way or the other. Blood in the stool is a signal from your body worth listening to, not panicking over. Most of the time, the explanation is manageable and treatable. But the only way to know for sure is through proper evaluation, not guesswork, and not avoidance.

What Foods Are Feeding Colon Cancer And What’s Protecting You? If you picture chemotherapy the way it’s shown in old movies, a frail, bald patient hooked to a drip, visibly wasting away, you’re not alone. That image has stuck in the public mind for decades. And it’s exactly why so many patients sit in a clinic, newly diagnosed, and quietly wonder: is this treatment even worth it? As a practicing Medical Oncologist, Dr. Viraj Lavingia hears this fear constantly. Your Colon Is a Living Ecosystem Your colon isn’t just a passage for waste; it’s home to trillions of bacteria, fungi, and other microbes, collectively called the gut microbiome. Think of it as a densely populated city living inside you. Every meal either feeds the “good” residents of that city or the “bad” ones. When good bacteria are fed well (mainly through fiber), they produce a compound called butyrate, which coats and protects the colon lining, reduces inflammation, and can even signal abnormal cells to self-destruct. When the wrong foods dominate your diet, harmful bacteria take over instead, producing toxins that strip away the colon’s protective lining and create chronic inflammation, which is often the spark behind cancer development. The Three Food Villains, Backed by Real Data This isn’t internet speculation; these classifications come from global health data. Processed meat: Bacon, hot dogs, salami, and deli meats are classified by the WHO as Group 1 carcinogens, the same category as tobacco smoke. When these meats are cured, smoked, or preserved with nitrates, they form compounds that can directly damage DNA in the colon lining. Excess red meat: Beef, lamb, and pork fall under Group 2A carcinogens, less risky than processed meat, but still significant with daily consumption. Red meat’s heme iron can irritate the colon lining and push cells to divide more frequently, raising the odds of mutation. Charring or grilling red meat at high heat adds another risk layer, producing compounds linked to cancer. Ultra-processed foods: packaged snacks, artificial sweets, and fast food are engineered with emulsifiers and preservatives for shelf life, but inside the body, these same chemicals can strip away the colon’s protective mucus layer, leaving it more exposed to bacterial toxins. The Antidote Isn’t a Supplement It’s Fiber. No pill or powder replaces this. Dietary fiber works in two clear ways: It moves things along faster. Fiber speeds up transit time through the colon, meaning harmful substances spend less time in contact with the colon wall. It feeds your protective bacteria. Beans, lentils, vegetables, fruits, nuts, and whole grains are exactly what good gut bacteria need to keep producing that protective butyrate layer. A practical target worth aiming for: around 30 different plant types a week. It sounds like a lot, but it adds up quickly; a handful of mixed nuts can count as three or four types, and one varied salad can cover seven or eight. What About Alcohol? Alcohol deserves its own mention. When your body metabolizes it, it converts into a compound called acetaldehyde, which damages DNA and interferes with your body’s ability to repair that damage. For colorectal cancer specifically, there is no clearly “safe” amount — risk increases with intake. Diet Helps Prevent — It Doesn’t Replace Treatment This is an important distinction a Cancer Specialist will always be upfront about: diet is a powerful preventive tool, not a treatment substitute. A healthy plate cannot replace surgery, and it cannot replace chemotherapy if a tumor is already present and advanced. Where diet matters most is in prevention, stopping a tumor from forming in the first place, and in survivorship, helping lower the chances of recurrence after treatment. Building Your Own Prevention Plate The goal isn’t to eliminate everything enjoyable from your diet. It’s about shifting the balance: Cut back on processed and cured meats where possible Moderate red meat intake, and avoid regularly charring it at high heat Reduce ultra-processed, packaged foods Build meals around a wide variety of plants,  not just “more vegetables,” but more variety Limit alcohol intake Small, consistent shifts matter more than occasional extreme changes. Every added plant, every swapped meal, adds another layer of protection. The Bottom Line Your fork won’t cure cancer, but it can meaningfully influence whether one develops in the first place, and whether it returns after treatment. If you have concerns about your personal risk or want guidance personalized to your health history, speaking with an experienced Medical Oncologist can help you build a realistic, sustainable plan.   YouTube video The Food Feeding Cancer: Why Your Diet Dictates Your Colon Health

Is Chemotherapy Really “Poison”? Here’s What It Actually Does If you picture chemotherapy the way it’s shown in old movies, a frail, bald patient hooked to a drip, visibly wasting away, you’re not alone. That image has stuck in the public mind for decades. And it’s exactly why so many patients sit in a clinic, newly diagnosed, and quietly wonder: is this treatment even worth it? As a practicing Medical Oncologist, Dr. Viraj Lavingia hears this fear constantly. If Surgery Removed the Tumor, Why Do You Still Need Chemotherapy? Imagine pulling a weed out of your garden by the stem. The main weed is gone, but before you pulled it, the wind may have already scattered a few tiny seeds across the lawn. You can’t see them. The yard looks clean. But if left untreated, those seeds take root, and the weeds return. Cancer can behave the same way. A tumor may shed microscopic cells into the bloodstream, cells far too small for any CT scan or MRI to detect. Left alone, they can eventually settle elsewhere in the body. Surgery works like a precise, targeted strike; it removes what’s visible. Chemotherapy works differently: it travels through the bloodstream, searching the entire body for those invisible remaining cells. When it’s used after surgery to lower the risk of relapse, doctors call this adjuvant chemotherapy, essentially, an added layer of protection. So, How Does Chemotherapy Actually Work? For colorectal cancer, treatment usually isn’t a single drug; it’s a carefully chosen combination, often referred to by names like FOLFOX or CAPOX. The backbone of many of these combinations is a drug that works through a clever bit of biochemical trickery: It mimics a normal building block of DNA Cancer cells, dividing rapidly, mistakenly absorb it This causes their DNA to break apart, leading the cell to self-destruct Chemotherapy isn’t selective enough to tell a fast-dividing cancer cell apart from a fast-dividing healthy cell, like those in your hair follicles, stomach lining, or blood cells. That overlap is where most side effects come from. Why Does Chemotherapy Cause Hair Loss and Does It Happen to Everyone? This is one of the biggest myths worth addressing directly: complete hair loss is not the reality for most colorectal cancer patients. The specific drug combinations commonly used for GI cancers typically cause, at most, mild thinning, not the total baldness shown in films. Most patients don’t need wigs, and most people around them wouldn’t even know they’re undergoing treatment. That said, other side effects are more common, though manageable: Neuropathy: Tingling or numbness in fingers and toes Cold sensitivity: A sharp, electric-like feeling when touching something cold, even a glass of ice water Fatigue: A few days of feeling flu-like and drained after each session A Cancer Specialist will usually prepare patients for these in advance, simple adjustments like drinking room-temperature water or wearing gloves in cold weather make a real difference. What About Nausea? This is where modern oncology has changed the most. Chemotherapy today is almost always paired with advanced anti-nausea medication that blocks nausea signals in the brain before treatment even begins. For most patients, the realistic experience isn’t days of vomiting, it’s more like two or three days of feeling run-down, followed by a steady bounce-back. Chemotherapy Is a Season, Not a Life Sentence Perhaps the most reassuring shift in perspective is this: chemotherapy is temporary. It’s demanding, and it does take a toll, but it’s a phase, not a permanent state. Many patients continue working through treatment, adjusting their schedule around sessions rather than putting life on hold entirely. The goal of modern chemotherapy isn’t just to fight cancer, it’s to do so while protecting quality of life as much as possible. The Bottom Line Chemotherapy in 2026 looks very different from the image most people carry in their heads. It’s more targeted, better supported by side-effect management, and far less disruptive to daily life than decades-old portrayals suggest. If you or a loved one has questions about what to expect from chemotherapy, speaking directly with an experienced Medical Oncologist can help replace fear with a clear, realistic picture of what lies ahead. YOUTUBE VIDEO The Truth About Chemotherapy: Debunking the Myths of “Poison” & Hair Loss

What Does Your Cancer Stage Actually Mean? Hearing the word “stage” after a cancer diagnosis can feel like the ground has shifted under your feet. Stage 1. Stage 3. Stage 4. For most people, these numbers land like a verdict, as if they already know how the story ends. They don’t. As a practicing Medical Oncologist in Ahmedabad, Dr. Viraj Lavingia meets this fear in his clinic almost every week. Patients walk in holding a report, convinced their stage number has already decided their future. It hasn’t. Staging is a tool doctors use to understand and treat cancer, not a prediction carved in stone. Let’s break down what staging really means, in plain language. So, What Is Cancer Staging, Really? In simple terms, staging tells your doctor how much cancer is in the body and where it’s located. That’s it. It’s a snapshot, not a sentence. Doctors usually rely on something called the TNM system to work this out: T (Tumor): How large is the main tumor, and has it grown into nearby tissue? N (Nodes): Has it spread to nearby lymph nodes? M (Metastasis): Has it spread to distant parts of the body? These three pieces of information are combined to give an overall stage usually from Stage 1 (early, localized) to Stage 4 (spread to other organs). Note: These are approximate standard-dose costs for a single cycle. Most patients require 4 to 6 cycles spaced two to three weeks apart at the beginning, and based on the results, may extend up to one year. The hospital infrastructure—such as corporate daycare charges versus trust-based center fees—also affects the final bill. Why Do Doctors Even Need This Number? Because treatment isn’t one-size-fits-all. A Cancer Specialist uses the stage to decide the right course of action, surgery, chemotherapy, radiation, targeted therapy, or a combination. Think of it like a map. It tells the doctor where things stand right now, so they can plan the best route forward. Without staging, treatment would essentially be guesswork. The Myth That Needs Busting Here’s where most of the fear comes from: people assume stage equals prognosis, that a higher stage automatically means a shorter or harder life. This isn’t accurate, and it’s important to say that clearly. A few things staging does not tell you: It doesn’t predict your individual outcome. Two people with the same stage can have very different journeys, depending on overall health, cancer type, and how the body responds to treatment. It isn’t permanent. Stage is usually set at diagnosis (clinical stage) and may be reassessed after surgery or treatment (pathological stage); it can shift as more information becomes available. It doesn’t replace your doctor’s full assessment. Age, general health, genetics, and even the specific subtype of cancer all play a role in how things unfold — not just the stage number. This is really the heart of the idea: your stage guides treatment; it doesn’t decide your destiny. Different Cancers, Different Staging Approaches It’s worth knowing that staging isn’t identical across all cancers. For example, blood cancers like leukemia are often not staged the same way as tumor-based cancers, since they behave differently in the body. This is one of many reasons a personalized conversation with your Cancer Specialist matters more than comparing notes with someone else’s diagnosis, even if the stage number sounds the same. For a deeper, stage-by-stage breakdown, from Stage 1 all the way to Stage 4, Dr. Viraj Lavingia’s detailed guide on cancer staging walks through what each stage typically involves and how treatment approaches shift accordingly. The Bigger Picture A cancer diagnosis brings enough uncertainty on its own. Understanding what staging actually means, and, just as importantly, what it doesn’t mean, can take some of that fear out of the room. If there’s one thing to hold onto, it’s this: staging is information, not a forecast. Your care team, your response to treatment, and the choices you make along the way matter just as much, if not more, than the number on your report. Connecting with an experienced Medical Oncologist can help turn uncertainty into a clear, actionable plan.

Cost of Immunotherapy in Ahmedabad: An Oncologist’s Guide for Patients Immunotherapy has changed what’s possible in cancer treatment, but it remains one of the most expensive options available today. As a Medical Oncologist who has spent over a decade treating cancer patients in Ahmedabad, I’ve noticed that the real source of patient anxiety usually isn’t the decision to start treatment. It’s the uncertainty around what the bill will actually look like and why costs vary so much depending on where you go. If you are evaluating immunotherapy, you deserve complete transparency. Here is a breakdown of what these drugs actually cost, how Patient Assistance Programs (PAPs) work, and how we leverage clinical data to make these treatments significantly more affordable without compromising outcomes. The True Cost of Immunotherapy Drugs (Per Cycle) The single biggest factor in your bill is the drug itself. Pharmaceutical companies offer Patient Assistance Programs (PAPs) to help offset the financial burden, usually structured as “Buy X, Get Y free.” I ensure my patients have direct access to these programs so they only pay the subsidized rate. Here is a realistic look at the standard-dose costs for the most common immunotherapy drugs in India before and after PAPs (as of 15th July 2026): # Drug (Brand Name) Standard Dose Approx. MRP Per Cycle Typical Patient Assistance Program (PAP) 1 Pembrolizumab (Keytruda) 200 mg ₹4,00,000