Head of the Department: Dr.Chandran K Nair, Professor MD, DNB(General Medicine),DM(Clinical Hematology), Fellowship in Leukemia and Bone Marrow Transplantation(BC Cancer Agency, University of British Columbia, Canada)

Phone: 0490 23 99 245	E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
	Clinical Hematology Division
DIVISIONS	Medical Oncology Division
	Pediatric Oncology Division

The Department of Clinical Haematology and Medical Oncology in MCC has 3 divisions.

1. Clinical Haematology
2. Medical Oncology
3. Paediatric Oncology

Faculty

        1.Dr Chandran K Nair – Professor and Head of the department

      MD DNB (General Medicine) DM (Clinical Hematology), Fellowship in Leukemia and Bone Marrow Transplantation(BC Cancer Agency, University of British Columbia, Canada)

        2. Dr Vineetha Raghavan

      MD (Paediatrics)

        3. Dr Praveen Kumar Shenoy

    MD (General Medicine) DM (Medical Oncology)

        4. Dr Jithin T K

    MD (Paediatrics) DM (Paediatric Oncology)

        5. Dr Gopakumar KG

    MD (Paediatrics) DM (Paediatric Oncology)

        6.  Dr Nandini Devi

    MD (General Medicine) DM (Medical Oncology)

Brief description about the divisions

CLINICAL HEMATOLOGY DIVISION :

This division focuses on evaluation and treatment of benign hematological disorders in all age groups and malignant hematological disorders in patients aged 15 and above. Inpatient care is given  in a dedicated intensive chemotherapy unit and  general wards. High intensity chemotherapies like acute leukemia induction, consolidation etc are administered  in Intensive Chemotherapy unit, which are single occupancy  air-conditioned  rooms . Outpatient department caters to around 10000 patients in a year with around 2500 new case registrations. Day care chemotherapy is administered in a day chemo ward equipped with biosafety cabinets.

This division also provides Hematopoietic stem cell transplantation for benign and malignant disorders in both adults and in children. Bone marrow transplantation unit of MCC established in 2013 is one among the two in Kerala under government sector and the first  in government sector to perform paediatric stem cell transplant and stem cell transplantation for benign hematologic disorders. It is a 4 bedded HEPA filtered state of the art BMT unit with attached operation theatre, dialysis unit, stem cell collection unit and stem cell lab. The unit has dedicated staff nurses trained in managing patients planned for and undergoing stem cell transplant. Till date(August 2022) MCC has performed 42 allogeneic and 130 autologous stem cell transplants. This includes matched sibling transplants, matched unrelated donor transplants and haploidentical transplants. Being a government centre, a large proportion of these treatments have been given with government funds ( Kerala social security mission ).

Academic sessions are conducted every Wednesday and Thursday. Residents are assigned specific topics for presentation . They are trained to interpret the evidences and clinical trial datas through regular journal discussions. Faculty also has a regular academic schedule. CPC (clinico-pathologic correlation ) meetings happen on every 1st and 3rd wednesday for discussing cases with diagnostic dilemmas. Residents are actively engaged in these discussions.Mortality and morbidity meetings are conducted on regular basis in the department as well as in the institution.

Transplant board meetings are conducted at least once a month, and if the situation demands more frequently. Planned transplant cases are discussed and decisions on transplant, risk assessment, conditioning regimen, type of transplant etc are deliberated in this meeting.

Division of Clinical Haematology, Malabar Cancer Centre is member of Haematology cancer consortium, India and actively contributes to Haematology cancer registry and is an active participant in Virtual

Tumor Board of National Cancer Grid (NCG), India. The division also participates in active research in the field of hematology including Clinical trials.

MEDICAL ONCOLOGY DIVISION :

Medical oncology division deals with comprehensive evaluation and medical treatment of various types of solid in adults with chemotherapy, immunotherapy and targeted agents. Spectrum of cases seen in Medical Oncology division include Breast cancer, Gastrointestinal cancers, Lung cancer, Head and Neck cancers, Gynaecological cancers, Endocrine cancers, Thoracic cancers, Genitourinary cancers, Brain cancers and cancers of bone and soft tissues. The division is well versed in administration of intraperitoneal and intravesical chemotherapy.  The division participates in site specific multidisciplinary tumor boards (MDT) held thrice a week with General surgical MDT on Monday, Wednesday & Friday. Breast and gyneacology MDT on Monday, Tuesday and Thursday. Head and Neck MDT on Tuesday, Wednesday and Friday. The division closely associates with surgical oncology department in planning complex procedures like cytoreductive surgery with hyperthermic intraperitoneal chemotherapy in peritoneal surface malignancies.

Medical oncology functions from Monday to Friday from 9 am to 5 pm and on Saturday from 9 am to 1 pm. OPD census of the division in a year is around 20000. The division is involved in interdepartmental academics for training surgical, radiation and pathology residents in medical oncology.

The division has experience with running early phase clinical trials, Phase 3 randomised control trials, both industry sponsored and investigator initiated multicenter clinical trials. The division has collaborated with numerous prestigious institutions across India for various clinical trials and collaborative studies.

PEDIATRIC ONCOLOGY DIVISION :

Paediatric oncology division at MCC caters to management of childhood cancer in children below 15 years of age. The division is equipped with two paediatric oncologists, ten staff nurses, a ward assistant, a dietician, social worker and clinical psychologist along with state of the art facilities for administering chemotherapy including biosafety cabinet, and 16 bedded wards with temperature regulation facility. Chemotherapy is administered via a central line (PICC line, Broviac line or chemo-port) which is inserted at the CVAD clinic or by the surgeon. Having a bed occupancy rate of nearly 70-80%, children are admitted for evaluation, providing intensive chemotherapy as well as for managing complications like febrile neutropenia on a regular basis. Children who take chemotherapy on OPD basis do so from the day chemo ward. Sick children are managed at present in medical ICU, whenever required.

            Regular OPD functions between 9AM to 5PM on weekdays and from 9 AM to 1PM on Saturdays.  Around 200 new patients are seen each year, including some registrations taken for second opinion. The spectrum of childhood cancers that we manage include leukemias - ALL & AML, Lymphomas - Hodgkin and Non-Hodgkin lymphomas, Solid tumors - Wilm’s tumor, Neuroblastomas, Hepatobalstomas, Bone tumors (Ewing sarcoma and Osteosarcoma), Brain tumors (Medullobastomas, optic pathway gliomas and other astrocytomas), Retinoblastomas, soft tissues sarcomas (RMS and NRSTS), Germ cell tumors, LCH. Geographically, we get patients mainly from North Kerala (Kasaragod to Malappuram) and from Wayanad district.  

            Treatments for all children who are residents of Kerala State are completely free and is provided under one of the Government Schemes (Cancer Suraksha Scheme, KASP, Thalolam, Karunya Benevolent

Fund etc.). Our social worker help families in finding NGO support to provide financial assistance to those children who are residents of nearby states and hence not eligible for Kerala Govt. Schemes.     

            With interdepartmental support, patients undergo surgery for solid tumors including bone sarcomas and soft tissue sarcomas, Wilm’s tumor, Neuroblastomas and other tumors whenever required. Children with brain tumors are referred to Govt. Medical Colleges/ SCTIMST, Trivandrum for surgery after which they come back for adjuvant treatment. Children who require radiation therapy are referred to our radiation oncology department where they plan appropriate therapy which may require anaesthesia support and is provided by our anaesthetists. Cancer suvivor meets and parent support programmes are conducted on a regular basis where children (and parents) with on-going treatment interact with with medical professionals and survivors.  

            MCC has MoU with Cuddles Foundation and HOPE child cancer care groups who provide staff (including dietician, clinical psychologists and social workers), other facilities including stay (home away from home), transport and financial assistance. A first of a kind initiative in the State, for setting up an Ocular oncology unit with in house facility for ocular management of retinoblastomas, apart from existing facility to provide systemic chemotherapy is underway

Academic Courses

1. DrNB  Clinical Haematology ( 2 seats per year)
2. Fellowship in Hemato-oncology and Bone marrow transplantation ( 2 seats per year)
3. FNB  Paediatric Hematology and Oncology (1 seat per year)

Research Highlights

     Prospective and retrospective studies approved by Institutional Review Board/Institutional Ethics Committee

    Clinical Trial Unit – A clinical trial unit functions in MCC and it facilitates multiple investigator initiated and industry sponsored Phase 1-IV clinical trials. This helps in improving access to new and     certain otherwise costly treatment options for cancer patients attending MCC.

 

Publications

1. V P Praveen Kumar Shenoy, Manuprasad Avaronnan, Babu Sajith, Aravind Sithara, Narayanan Vinin N, Nayanar Sangeetha, Balasubramanian Satheesan (2022) Oral metronomic chemotherapy as a feasible preoperative therapy in advanced resectable oral cavity squamous cell carcinomas – a preliminary experience ecancer 16 1425
2. Nair CK. Pretransplant Determinants of Outcome in Patients with Myeloma Undergoing Autologous Transplantation in Lower Resource Settings. Eur Med J [Internet]. 2021 Jun 17 [cited 2022 Jan 2];101–10. Available from: https://emj.emg- health.com/hematology/article/pretransplant-determinants-of-outcome-in-patients-with-myeloma-undergoing-autologous-transplantation-in-lower-resource-settings-j190221/
3. Praveen Kumar Shenoy, Isharath Ebrahim, Anitha Mary Skaria, Manuprasad A : Toxicity profile of weekly regimen of paclitaxel in patients with non-metastatic breast cancer-a real world experience, Oncology and Radiotherapy Vol 15 Iss.2:009-012
4. Praveen Kumar Shenoy, Joneetha Jones, Vinin N V, Manuprasad A,Geetha M, Priya Rathi, Neoadjuvant platinum based chemotherapy in locally advanced triple negative breast cancer-Preliminary experience from a tertiary cancer centre.(2021).Int J Pharm Sci.12(2), 71-77
5. Avaronnan Manuprasad, Praveen Kumar Shenoy, Joneetha Jones, NV Vinin, Adarsh Dharmarajan, Geetha Muttath : Short-course adjuvant trastuzumab in breast cancer: Experience from a tertiary cancer center in rural India, Cancer Res Stat Treat 2020;3:69-73
6. Manuprasad A, Shenoy PK, Raghavan V, Shiljina K M, Nair CK. Gemcitabine, dexamethasone, and cisplatin salvage in relapsed lymphomas: A single institutional experience. Cancer Res Stat Treat 2020;3:13-8
7. Pandian J, Raghavan V, Manuprasad A, Shenoy PK, Nair CK. Infection at diagnosis—a unique challenge in acute myeloid leukemia treatment in developing world. Support Care Cancer [Internet]. 2020 Mar 12 [cited 2020 Mar 14]; Available from: http://link.springer.com/10.1007/s00520-020-05379-z
8. Nair CK, Raghavan V, Bhattacharjee A, Kurup AR. Impact of early reduction in paraprotein on survival in transplant ineligible myeloma: Lesson from a tertiary cancer center in rural India. J Cancer Res Ther [Internet]. 2020 Jan 1 [cited 2020 Aug 19];16(1):88–93. Available from: https://pubmed.ncbi.nlm.nih.gov/32362614/
9. Nair CK, Avaronnan M, Shenoy PK, Raghavan V, Jayarajan P, Rudrapathy P, et al. Impact of active tuberculosis on treatment decisions in cancer. Curr Probl Cancer [Internet]. 2020 Aug [cited 2020 Sep 30];100643. Available from: https://pubmed.ncbi.nlm.nih.gov/32972770/
10. Raghavan V, Jithin T K, Narayanan VV, Nayanar SK, Balasubrahmanian S. Predictors of survival in children with osteogenic sarcoma undergoing limb salvage surgery: Experience from a tertiary cancer center in Rural India. Indian J Med Paediatr Oncol 2020;41:335-9
11. Predictors of Survival in Children with Osteogenic Sarcoma Undergoing Limb Salvage Surgery: Experience from a Tertiary Cancer Center in Rural India. Indian Journal of Medical and Pediatric Oncology 41(3):335
12. Murugesan M, Shringarpure K, Karthickeyan DSA, Nair CK, Nayanar SK, Venugopal V, et al. Clinical and equipment-related factors associated with the adequate peripheral blood stem cell collection in autologous transplant at a tertiary cancer center in Kerala - A retrospective cohort study. Transfus Apher Sci. 2019 Aug 1;58(4):457–63.
13. Murugesan M, Nair CK, Nayanar SK PK. OJHAS: 2019-1-7. Murugesan M, Nair CK, Nayanar SK, Pentapati KC. Analysis of Flow Cytometric Enumeration of CD34+ cells in Leukapheresis Product from South Indian Cancer Centre. Online J Heal Allied Sci [Internet]. 2019 [cited 2020 Oct 14]; Available from: https://www.ojhas.org/issue69/2019-1-7.html
14. Murugesan M, Nair C, Nayanar S, Pentapati K. Flow cytometric enumeration of CD34+ hematopoietic stem cells: A comparison between single- versus dual-platform methodology using the International Society of Hematotherapy and Graft Engineering protocol. Asian J Transfus Sci [Internet]. 2019 Jan 1 [cited 2020 Feb 18];13(1):43–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/31360010
15. Nair CK, Selvaraj K, Raghavan V, A M, Shenoy PK, Kurup AR, et al. Limiting factors for autologous transplantation among transplant-eligible multiple myeloma patients: Lesson from a Tertiary Cancer Centre in rural India. Leuk Res [Internet]. 2019 Aug 1 [cited 2020 Feb 18];83:106167. Available from: http://www.ncbi.nlm.nih.gov/pubmed/31200146
16. M. S. Biji, V. Vinayagamoorthy, T. K. Jithin, Vineetha Raghavan, Kalaiselvi Selvaraj, Karthickeyan Duraisamy, Kalpita Shringarpure, S. S. Abhinaa, Vanitha Priya Deenathayalan, Kedar Mehta, Priya Rathi & Lulu Mathews (2019) Pain Management in Children With Cancer Using World Health Organization Guidelines at a Tertiary Cancer Center in Rural India, Journal of Pain & Palliative Care Pharmacotherapy, DOI: 10.1080/15360288.2019.1651438
17. Raghavan V, Manuprasad A, Sajeev Kumar P B, Raj Z, Shenoy PK, Nair CK. Health-related quality of life in patients with multiple myeloma on novel agents: Report from a tertiary cancer center in rural India. Cancer Res Stat Treat 2018;1:92-5
18. Patil VM, Chakraborty S, Jithin TK, Dessai S, Sajith Babu TP, Raghavan V, et al. Development and validation of a questionnaire to measure preferences and expectations of patients undergoing palliative chemotherapy: EXPECT questionnaire. Indian J Cancer [Internet]. 2016 Apr 1 [cited 2020 Oct 14];53(2):339–44. Available from: https://pubmed.ncbi.nlm.nih.gov/28071643/
19. Nair CK, Bhattacharjee A, Raghavan V, Babu S, Balasubramanian S. Impact of thrombosis on standard treatment in solid tumors. Thromb Res [Internet]. 2015 Nov 1 [cited 2020 Feb 18];136(5):943–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26412558
20. Patil V, Chakraborty S, Dessai S, Kumar SS, Ratheesan K, Bindu T, et al. Patterns of care in geriatric cancer patients - An audit from a rural based hospital cancer registry in Kerala. Indian J Cancer. 2015 Jan 1;52(1):157–61.
21. Nair C, Patil V, Raghavan V, Babu S, Nayanar S. Retrospective audit of clinico-pathologic features and treatment outcomes in a cohort of elderly non-Hodgkin’s lymphoma patients in a tertiary cancer center. In: Indian Journal of Cancer. Medknow Publications; 2015. p. 541–4.
22. Patil VM, Chakraborty S, Shenoy PK, Manuprasad A, Sajith Babu TP, Shivkumar T, et al. Tolerance and toxicity of neoadjuvant docetaxel, cisplatin and 5 fluorouracil regimen in technically unresectable oral cancer in resource limited rural based tertiary cancer center. Indian J Cancer 2014;51:69-72
23. Patil VM, Chakarborty S, Kumar M, Geetha MS, Dev S, Samuel S, et al. An audit of febrile neutropenia cases from a rural cancer center in India. Indian J Cancer. 2014 Oct 1;51(4):487–90.
24. Nair CK, Kumar M, Odayoth SM. Pleural effusion during acute myeloid leukemia induction chemotherapy: A perplexing case [Internet]. Vol. 9, Journal of Cancer Research and Therapeutics. 2013 [cited 2020 Feb 18]. p. 290–1. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23771378
25. Kumar M, Nair CK, Satheesan B. Off-label use of chemotherapy drugs: Look before you leap [Internet]. Vol. 7, Journal of Cancer Research and Therapeutics. 2011 [cited 2020 Feb 18]. p.382. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22044834