Dr. Agasthian T

Dr. Agasthian T

Cancer Specialist - Surgical Oncologist

  Mount Elizabeth Hospital, Mount Elizabeth, Singapore

  25+ Years of experience

BIOGRAPHY

About Doctor

Dr. Agasthian is an acclaimed surgeon at Mount Elizabeth Hospital, Singapore. He has 20+ years of experience and he specialises in non-cardiac general thoracic surgery. He performs procedures that include surgery for benign and malignant lung, pleural and mediastinal diseases. He also performs minimally invasive thoracic surgery, pulmonary metastasectomy, oesophagal surgery for benign and malignant cancers, tracheal and airway surgery for cancers and benign strictures and lung transplantation. He has pursued Bachelor of Medicine, Bachelor of Surgery, Master of Medicine and is trained in robotic thoracic surgery for thymectomy and tumours.

Medical Expertise

He was the lead surgeon for the first lung transplant carried out in Singapore and has trained a majority of thoracic surgeons and all advanced cardiothoracic trainees in Singapore too. He was a general thoracic fellow in the Division of General Thoracic Surgery of Mayo Clinic and Thoracic Surgery and Transplantation of Cleveland Clinic. Dr. Agasthian was appointed as a senior consultant at the National Cancer Centre Singapore and he is also appointed as visiting consultant to National Heart Centre, Tan Tock Seng Hospital, KK Women’s Children’s Hospital and Changi General Hospital. He was the head of the Division of Surgical Oncology at the National Cancer Institute of Singapore. He was responsible for setting up thoracic surgery services in Tan Tock Seng Hospital, National Cancer Center and National Heart Center. Dr. Agasthian has trained in Singapore. He gave a platform of the regional centre of excellence for the advanced thoracic training of doctors and fellows from the region, including India, Pakistan, China and Malaysia. He is an advisor and founding board member of the Asian Thoracoscopic Surgery Education Program. He is also the assistant editor for the Journal of Thoracic Diseases and acts as a reviewer for the European Journal of Cardiothoracic Surgery, Annals of Medicine Singapore, Singapore Medical Journal Asian Annals of Cardiovascular and Thoracic Surgery too. He has published more than 50 papers in academic journals and has been invited as a speaker for many workshops and seminars in the region and worldwide. He is amongst the best surgeons in the world.

Past Experience

  • Senior consultant at National Cancer Centre Singapore visiting consultant to National Heart Centre Tan Tock Seng Hospital Changi General Hospital KK Women’s and Children’s Hospital Head of the Division of Surgical Oncology at the National Cancer Institute of Singapore

Qualifications

  • Bachelor of Medicine Bachelor of Surgery, (MBBS) 1984
  • Master of Medicine (MMed) (Surgery) 1990
CERTIFICATIONS (1)
  • Fellow of The Royal College of Surgeons of Edinburgh (FRCSEd) 1990 Fellow of the Royal College of Surgeons of Glasglow (FRCSG) 1989
MEMBERSHIPS (1)
  • Member of the Singapore Thoracic Society and the Asian Surgical Society Advisor and founding board member of the Asian Thoracoscopic Surgery Education Program.
RESEARCH PAPERS AND PUBLICATIONS (1)
  • He has published more than 50 papers in academic journals
Procedures
Breast Cancer Treatment

The recent advances made in breast cancer treatment have revolutionized the way how women from this rare disorder are diagnosed and suggested a personalized treatment plan. These advances have made it easier for the doctors to arrive at a treatment plan, which is most suitable for the patient as per their individual characteristics and needs.

Different breast cancer treatment options help destruct complex mixture of cancer cells, which are otherwise difficult to treat using conventional breast cancer treatment. The treatment is started by the doctors handling the case as soon as the breast cancer diagnosis is confirmed.

Before the article delves into the different breast cancer treatment options, lets first take a look at how breast cancer develops and what are its symptoms and diagnosis methods.

Breast cancer: What do the statistics say?

Breast cancer primarily affects females aged above 40. However, that does not mean that it does not affect women aged below 40. Breast cancer can also affect males, although rarely.

Breast cancer starts in the cells of either one or both the breasts. It accounts for more than 16 percent of female cancer and contributes to 18.2 percent of all deaths that take place around the world because of cancer.

In the US alone, breast cancer affects more than 232,000 females and 2,200 males each year. It leads to death of more than 39,000 breast cancer patients in a year.

Breast Cancer Symptoms

The symptoms of breast cancer can be easily identified at home through breast self-examination. You should consult your physician on how to conduct this exam at home.

The most common breast cancer symptoms include:

  • Change in the size or shape of the breast
  • Lump in the breast
  • Swelling in armpit
  • Change in colour and shape of the nipples
  • Rash, redness or pitting on the breast skink
  • Pain in the breast or armpits
  • Abnormal discharge from the nipples

In case of more aggressive breast cancer called inflammatory breast cancer, severe redness and itching may be present.

The patients are advised to contact their physician as soon as they notice any of the symptoms of breast cancer. The physician is the best person to diagnose whether it is normal or inflammatory best cancer, and accordingly, suggest treatment for breast cancer.

Breast Cancer Causes

The exact reason that causes breast cancer is unclear, despite the fact that every eighth woman suffers from it. However, there are several factors that have been associated with the development of breast cancer. Some of the breast cancer risk factors include:

  • Prolonged use of birth control pills
  • Obesity
  • Use of hormone replacement therapy
  • High breast density
  • Alcohol addiction
  • No history of pregnancy
  • Pregnancy after 35
  • Exposure to radiation

The risk of breast cancer naturally increases as women age. The risk is also higher in women who have a family history of breast or ovarian cancer, possess BRCA1 and BRCA2 genes or who have had their periods before the age of 12.

Cervical Cancer Treatment

Cervical cancer is an abnormal growth of cancer cells that starts in the cervix. The cervix is the narrow part of the lower uterus. It is the entrance of the uterus, often referred to as the neck of the womb. Cervical cancer is the fourth most common type of cancer in women around the world. It is the fourth leading cause of death caused by cancer in women. However, the important thing to note is that cervical cancer is also one of the most preventable types of cancer and early diagnosis of the disease can improve the mortality rate amongst patients.

A dramatic reduction in cervical cancer occurrence is primarily due to the widespread use of advanced screening tests such as pap tests to detect cervical abnormalities and allow for early treatment.

Where does cervical cancer take place?

Under normal circumstances, the ectocervix is covered with flat, thin cells called squamous cells and the endocervix is made up of another kind of cells called columnar cells. The area where these cells meet is called the transformation (T) zone. The T zone is the most likely location for cervical cancer cells to develop.

Cervical Cancer Causes

A majority of cervical cancer cases occur because of a virus called human papillomavirus (HPV). HPV is a sexually transmitted virus. It can transfer through a sexual contact with an infected male partner.

There are many types of the HPV virus and not all types of HPV cause cervical cancer. Some of the HPV may cause genital warts. Some other cervical cancer risk factors include smoking, weak immune system, oral contraceptives, and multiple pregnancies.

Cervical Cancer Types

More than 90 percent of the cervical cancers are squamous cell carcinoma. The second most common type of cervical cancer is adenocarcinoma. Adenosquamous carcinomas or mixed carcinomas are some of the rare types of cervical cancer.

Cervical Cancer Symptoms

Usually, there are no early signs of cervical cancer, but several cervical cancer symptoms may appear as the tumor grows in size. Some of the common cervical cancer symptoms include the following:

  • Bleeding between periods
  • Bleeding during sexual intercourse
  • Bleeding after menopause
  • Smelly or blood-filled vaginal discharge
  • Pelvic pain, back pain, and swollen legs
  • Weight loss
  • Fatigue 
Colorectal Cancer ( Colon Cancer ) Treatment
  • Overconsumption of animal protein, saturated fats, and calories
  • Low dietary fibre intake
  • Overconsumption of alcohol
  • Excessive smoking
  • Family history of colorectal cancer
  • Obesity
  • Physical inactivity

Colorectal cancer is the second most common cancer in the world. It can metastasize and spread to other body parts. Colorectal cancer is dangerous and can be life-threatening. But death rate from colorectal cancer has dropped in the recent years, thanks to advance screening techniques and better colorectal treatment options.

What is colon cancer?

Colorectal cancer is also known as bowel cancer, colon cancer, or rectal cancer. Colorectal cancer begins as an abnormal growth of cells in the inner lining of the colon or rectum. This abnormal growth is called a polyp.

Some types of polyps can change into cancer over the course of several years. But it does not mean that all polyps have the tendency to become cancerous. The chance of changing a polyp into colorectal cancer depends on the type of polyp that grows. 

Colorectal cancer can affect men and women equally. However, studies have proven that men might develop it at a younger age.

What causes colon cancer?

There is no definite cause of colorectal cancer, but old age and certain lifestyle factors can increase colorectal cancer risk. Some of these colorectal cancer risk factors include the following:

Types of Colorectal Cancer

A majority of colorectal cancers are adenocarcinoma. If you have been diagnosed with colorectal cancer, there are 95 percent chances that it is an adenocarcinoma. But there are some other types of colorectal cancer such as carcinoid, gastrointestinal stromal, lymphomas, and sarcomas.

Colorectal Cancer Symptoms

There are no early signs of colorectal cancer, but once it grows, the patients may experience the following colon cancer symptoms:

  • Fatigue, weakness, and shortness of breath
  • Change in bowel habits, including diarrhoea or constipation
  • Blood in stool
  • Abdominal discomforts such as cramps, bolting or pain
  • Dramatic weight loss
Lung Cancer Treatment

Lung cancer is an uncontrolled growth of cells that start off in the lungs. Usually, lung cancer starts in the cells that line the air passages. Instead of developing into healthy lung tissue, the cells divide rapidly and form tumours.

Lung cancer can grow and spread beyond the lung to reach other parts of the body through metastasis. Lung cancers can begin in any part of the lung, but 90 percent of lung cancers begin in the epithelial cells, which are the cells lining the larger and smaller airways also known as bronchi and bronchioles.

This is the reason why lung cancers are sometimes called bronchogenic cancers or bronchogenic carcinomas. Lung cancer is the most common cancer in the world, among both men and women. It is the leading cause of cancer deaths worldwide.

Lung Cancer: Causes and Risk Factors

Long-term smoking is the main cause of lung cancer. After smoking, genetic factors and exposure to radon gas, asbestos, second-hand smoke or other forms of air pollution can also increase the risk of lung cancer.

Types of Lung Cancer

There are two major types of lung cancers, based on the appearance of lung cancer cells under the microscope:

  • Non-small cell lung cancer (NSCLC): It is an umbrella term for several types of lung cancers that behave in a similar way, such as squamous cell carcinoma, adenocarcinoma, and large cell carcinoma.
  • Small cell lung cancer (SCLC): This type of lung cancer occurs mostly in heavy smokers and it is less common than non-small cell lung cancer. 

Lung Cancer Stages

It is necessary to determine the stage of lung cancer by finding out how far cancer has spread, before initiating treatment of lung cancer.
The following are the four lung cancer stages of NSCLC:

  • Stage 1 lung cancer: Cancer is restricted to the lung
  • Stage 2 lung cancer: Cancer has spread to the nearby lymph nodes
  • Stage 3 lung cancer: (3a) Cancer is in the lung and the lymph nodes located on the same side  (3b) Cancer is in the lung and has spread to lymph nodes on the opposite side
  • Stage 4 lung cancer: Cancer has spread to both the lungs and other organs and surrounding tissues

The following are the two lung cancer stages of SCLC:

  • Limited stage: Cancer is present in just one lung and lymph nodes on the same side of cancer.
  • Extensive stage: Cancer has spread throughout the lung or both the lungs, to the lymph nodes on the opposite side, to the bone marrow, and to the distant organs.

After the determination of stage, treatment of lung cancer starts with choosing the best suitable option for the patient. However, there is usually no single treatment for lung cancer. So the patient often receives a combination of therapies and palliative care. 

Lung Cancer Symptoms

Lung cancer symptoms may vary, depending upon where and how widespread the tumour is. A person with lung cancer may have following lung cancer symptoms:

  • A persistent or chronic coughing
  • Pain in chest, shoulder or back
  • Difficulty in breathing and shortness of breath
  • Hoarseness or change of voice
  • Chronic bronchitis, pneumonia or respiratory infections
  • Blood in the sputum and cough


Stage 3 lung cancer symptoms include the following:

  • Wheezing
  • General pain in the chest or when breathing
  • Persistent cough with or without blood
  • Altered voice
  • Loss of appetite
  • Unplanned weight loss
  • Fever, headache, weakness, and bone pain
  • Difficulty swallowing
Pancreatic Cancer Treatment

Pancreatic cancer starts from the cells and tissues of the pancreas – a crucial organ that releases enzymes for digestion. It is also responsible for the production of insulin, the crucial hormone that regulates blood sugar in humans.

The pancreas can be affected by both non-cancerous as well as cancerous tumors. The most common type of pancreatic cancer is pancreatic ductal adenocarcinoma, which starts in the cells that line the ducts responsible for the transport of enzymes from the pancreas to the outside.

Pancreatic cancer is often diagnosed at an advanced stage – when it has spread to other nearby organs and therefore, the treatment is challenging in such situations. The diagnosis mostly takes place when certain symptoms are observed.

Stomach Cancer Treatment

Stomach cancer, also known as gastric cancer, is the fifth most common cancer worldwide. This disease is a result of the growth of cancerous and malignant cells in the inner lining of the stomach.

Stomach cancer does not grow overnight as this disease usually grows slowly over many years. Some pre-cancerous changes take place before true cancer actually develops. But these early changes rarely result in any symptoms and therefore, often go undetected in the early stage when it is most easy to treat it.

Gastric cancer can grow through the wall of the stomach and invade nearby organs. It can easily spread to the lymph vessels and lymph nodes. In an advanced stage, it can travel through the bloodstream and spread or metastasize to organs such as the liver, lungs, and bones. Usually, people diagnosed with stomach cancer have either experienced metastasis already or eventually develop it.

Types of Stomach Cancer

Stomach cancer should not be confused with other cancers in the abdomen or esophageal cancer. Some other cancer can also occur in the abdomen, including cancer of the large and small intestine, liver or pancreas. These cancers may have different symptoms, outlook, and options for treatment.

Some of the common types of gastric cancer include:

  • Adenocarcinoma: It is the most common form of stomach cancer and about 90 to 95 percent of stomach cancers are This form of cancer develops from the cells that form the innermost lining (mucosa) of the stomach.
  • Lymphoma: This is a rare form of stomach cancer and only about four percent of stomach cancers are lymphomas. These are cancers of the immune system tissue, sometimes found in the wall of the stomach.
  • Gastrointestinal stromal tumor (GIST): It is a rare kind of tumor that starts in very early forms of cells in the wall of the stomach calledinterstitial cells of Cajal. GISTs can be found anywhere in the digestive tract.
  • Carcinoid tumour: It is also a rare form of stomach cancer and about three percent of stomach cancers are carcinoid tumors. Carcinoid tumors start in cells of the stomach that produced hormones.

Some other types of stomach cancers include squamous and small cell carcinoma and leiomyosarcoma. These cancers are very rare.

Stomach Cancer Causes

There is no single, definite cause behind stomach cancer. However, several stomach cancer risk factors have been identified that could potentially lead to the formation to a tumor in the stomach. Some of these stomach cancer causes or risk factors include:

  • Inflammation of the gut called gastritis
  • Infection with common bacteria called Helicobacter pylori
  • Long-lasting anaemia
  • Growth in stomach called polyps
  • Smoking
  • Obesity
  • Excessive consumption of smoked, pickled or salty foods
  • A-type blood group
  • Epstein-Barr virus infection
  • Certain genes (family history of disease)

Stomach Cancer Symptoms

There can be several early stomach cancer symptoms. However, the signs of stomach cancer could be present because of some other underlying condition as well. Unfortunately, this is the main reason why it is difficult to make stomach cancer diagnosis at an early stage.

Some of the early stomach cancer symptoms may include:

  • Heartburn
  • Regular indigestion
  • Slight nausea
  • Loss of appetite
  • Frequent burping
  • Feeling bloated

But just experiencing indigestion or heartburn after a meal does not really mean that you have cancer. Although, if you experience these symptoms a lot, talk to your doctor, who can decide whether to conduct further tests or not.

As advanced gastric cancer grow, you may experience more serious signs of stomach cancer, including the following:

  • Frequent stomach ache or pain in the sternum
  • Frequent heartburns
  • Vomiting containing blood
  • Dysphagia (swallowing difficulties)
  • Loss of appetite, accompanied by sudden weight loss
  • Blood in stools
  • Excessive fatigue
  • Yellowish eyes or skin
Frequently Asked Questions
What area of specialization does Dr. Agasthian T have?
Dr. Agasthian T is specialized in Singapore and of the most sought after doctors in Cancer Specialist.
Does Dr. Agasthian T offer Telemedicine Consultation through Medigence?
No, this doctor dose not offer telemedicine via MediGence
How many years of experience does Dr. Agasthian T have?
Dr. Agasthian T is one of the most sought after specialists in Singapore and has over 25+ Years years of experience.
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