PSM News

June 07,2024 New Delhi: A recent study conducted by researchers at Vrije Universiteit in Amsterdam has called for thorough investigations into the potential side effects of Covid-1919 vaccines and their links to mortality rates. The study, published in BMJ Public Health, reports over three million excess deaths in Western countries during the first three years of the pandemic. According to the study, 3,098,456 excess deaths were recorded across 47 countries between January 1, 2020, and December 31, 2022. The breakdown of excess deaths is as follows: 2020: 1.03 million excess deaths. 2021: Over 1.25 million excess deaths, coinciding with the rollout of Covid-1919 vaccines. 2022: Over 808,000 excess deaths, even as Covid-19related restrictions were lifted. The researchers highlighted that “excess mortality has remained high in the Western World for three consecutive years, despite the implementation of containment measures and Covid-1919 vaccines.” They described the figures as “unprecedented” and emphasized the need for policymakers to investigate the “underlying causes of persistent excess mortality.” As per a Russia Today report, the study noted that adverse events following vaccination have been recorded in various official databases. These adverse events included ischaemic stroke, acute coronary syndrome, brain haemorrhage, cardiovascular diseases, coagulation issues, gastrointestinal events, and fatal blood clotting. Despite vaccines being intended to protect against severe illness and death due to Covid-1919, medical professionals and vaccine recipients reported “serious injuries and deaths following vaccination.” The researchers pointed out the challenges in differentiating the causes of excess mortality due to varying national statistics, different testing policies for Covid-19, and disagreements on what qualifies as a Covid-19 death. They stressed that, “during the pandemic, it was emphasised by politicians and the media on a daily basis that every Covid-19 death mattered and every life deserved protection through containment measures and Covid-19 vaccines. In the aftermath of the pandemic, the same moral should apply.” The World Health Organization (WHO) declared in May 2023 that Covid-19 was no longer a global health emergency. However, Covid-19 cases and related deaths continue to be reported globally, with the WHO tracking 36,014 cases in the week before May 19, showing a week-on-week rise of 2,336. Source: Healthworld

June 11,2024 Mumbai: As the new health minister in Prime Minister Narendra Modi’s union council of ministers, Jagat Prakash Narayan Lal Nadda will have a bunch of challenges to handle. His top priority will be to accelerate India’s universal health coverage, a grand vision of assured comprehensive primary and tertiary care that his party, the Bharatiya Janata Party (BJP), espoused from the time it was voted to power since 2014. The idea of Ayushman Bharat- Pradhan Mantri Rashtriya Swasthya Suraksha Mission (PMSSY) – took off well but the sheer scale of the scheme of reaching healthcare to over 50 crore Indians, faced hurdles of adoption in the private sector. The biggest issues revolved around huge delays in clearing payments to the hospitals. As the health minister in his previous stint in 2014, where he served the full five-year term, Nadda was among the key architects for the universal health coverage plan. While the scheme has now matured and benefited millions of citizens, the next promised step to use digital tools to expand and create medical health records for millions of Indians is being watched closely. Among the other key areas that will be closely watched is the progress made in tuberculosis control. The government has set its sights on the eradication of TB by 2025, and with just a year to go, Nadda will have to work on war footing to reach that goal. India is also seeing an unprecedented scale of chronic diseases like cancer, diabetes, and cardiac complications. Clearly, the current programs are falling short in controlling the surge of new cases. Nadda’s track record is seen by the industry and health experts as mostly positive. But the next five years will be crucial in many ways. India’s healthcare and nutrition parameters are not the least satisfactory and, in a few segments, even trails that of neighbouring countries like Sri Lanka and Bangladesh. Those will require big changes from the policy side. The recent controversies revolved around the poor dietary standards followed in India. Nadda’s job will be tougher as he is given the additional charge of the ministry of chemicals and fertilizers. This is probably an important tactical step by the government. For long, conflicts have surfaced on the turf wars between the two ministries. While the department of pharmaceuticals is under the ministry of chemicals and fertilisers, the regulations that govern the industry are under the Drugs Controller General of India (DGCI), which is part of the health ministry. With long delays on important policy issues, the industry had called for a single authority that handles the two sides. Under Nadda, that may become a reality. Source: Healthworld

June 12,2024 New Delhi: Extending the Ayushman Bharat coverage to everyone aged above 70 years and the pan-India roll out of the U-WIN portal to digitise routine vaccinations are among the highlights of Narendra Modi’s new government’s 100-day agenda for the Union health ministry . In a brief interaction with senior officials after taking charge of the ministry on Tuesday, J P Nadda, who is also the BJP president, asked them to focus on the agenda, sources said. Prime Minister Modi while releasing the BJP’s Lok Sabha poll manifesto in April had announced that senior citizens above 70 years of age and the transgender community will be brought under the ambit of the Centre’s health scheme Ayushman Bharat Yojana. Launching the National Health Claims Exchange to ensure inter-operability and faster processing of health insurance claims, use of drone services to deliver medical essentials from AIIMS and other Institutes of National Importance in difficult terrains and providing cashless treatment services to ex-servicemen also feature among the 14 agenda items for the ministry, the official sources told PTI. The other key areas of focus in the 100-day plan include ease of doing business — ‘tatkal’ issuance of licence or registration in select food businesses under the FSSAI, deployment of Arogya Maitri Cubes in central government hospitals to meet health emergencies, providing financial support to the Banaras Hindu University’s Institute of Medical Sciences on the lines of AIIMS, and making operational the National Medical Register Extending the Ayushman Bharat scheme to everyone aged 70 years and above is one of the top priorities of the government, the sources said. The modalities of the proposal are being worked out. Once finalised, the proposal will be sent to the Expenditure Finance Committee for approval of allocation of funds before being sent to the Cabinet, they said. The U-WIN portal — based on the Co-WIN COVID vaccination application’s design — for maintaining electronic registry of routine immunisations under the Universal Immunisation Programme (UIP) is at present being run on a pilot mode in two districts of each state or a Union Territory. The platform captures each and every vaccination event of children and pregnant women under the UIP. It is linked with Co-WIN and beneficiary records from Co-WIN can be accessed through U-WIN using the registered mobile-phone number for facilitation of registration of children. The National Medical Commission is in the process of creating the National Medical Register, a centralised repository of doctors practising in India as a part of which all doctors in the country will have a unique identification number by the 2024-end. A pilot project of the register is also underway. The BJP with 240 seats fell short of a majority but the NDA secured the mandate with 293 seats in the Lok Sabha polls. The Congress bagged 99 seats while the INDIA bloc got 234 seats. Following the polls, two Independents who won have also pledged support to the Congress, taking the INDIA bloc tally to 236. Source: Healthworld

May 31,2024 Hubballi: Despite efforts, authorities have been struggling to curb the sale of tobacco and gutkha, leading to a rise in oral cavity cancer cases. KIMS is currently treating 40–50 patients with this cancer, often caused by tobacco use. The 2024 theme, ‘Protecting children from tobacco industry interference’ highlights the need for increased awareness, especially as college students continue to use tobacco and illegal sales persist. According to the source, the government banned the manufacture of tobacco products in 2008. India is also the second-largest consumer and producer of tobacco. A variety of tobacco products are available at very low prices in Karnataka. Tobacco and cigarettes are being sold in public places and also near schools and colleges. Tobacco use is one of the biggest public health threats. Not only does it affect smokers directly, but it also impacts the people around them. Many patients suffering from oral cavity cancer are being treated at KIMS hospital. The head of radiation oncology at KIMS Cancer Hospital, MR Giriyappagoudar, told TOI that many awareness programmes regarding no tobacco are organized in the hospital. “We will also personally teach patients and tell them to quit using tobacco and smoking. Smoking or chewing tobacco is very harmful to humans. The most prevalent form of tobacco use in India is smokeless tobacco, and commonly used products are khaini, gutkha, betel quid with tobacco, and zarda. Smoked forms of tobacco used are beedi, cigarette, and hookah,” he informed. He said that due to a lack of awareness among people regarding the effects of chewing tobacco, so many patients come to KIMS for treatment and operations. “We treated 500 patients with tobacco-related cancer last year. It is a major risk factor for many chronic diseases, including cancer, lung disease, cardiovascular disease, stroke, etc. Youth should quit chewing tobacco products,” he added. Dr Parashuram, district surveillance officer at the office of the DHO, said that an awareness programme is ongoing in the district. On the occasion of World No Tobacco Day, we are organising an awareness programme at KCD College, Dharwad. At the GP level, various awareness programmes will be organised in govt hospitals. When asked about the continuous awareness programmes and the need for attention, Dr Parashuram said that tobacco vendors’ meetings are being held and they are continuously told to stop selling tobacco products. “A team of health officials will raid shops where selling is going on. Youngsters are chewing more tobacco. Health education is more important,” he added. Source: TOI

May 23,2024 Bengaluru: Patients visiting government hospitals in Karnataka recently were shocked when they noticed that some drugs had labels of Animal Husbandry Veterinary Sciences (AHVS) but the department concerned has said it was only a logo related issue and that the medicines were indeed meant for human use. The Karnataka State Medical Supplies Corporation Limited (KSMSCL) said there was an error in the ‘logogram’ design, but the product was of standard quality and ‘human use only’. As the typo led to panic among patients, KSMSCL Managing Director Chidananda Sadashiva Vatare said in a statement that the product permission copies were submitted and confirmed they were permitted to manufacture as per required medical standards and for human use only. According to sources in KSMSCL, there were seven drugs which had the AHVS label. This included eye and nasal drops. These drugs were supplied by a private firm with a total value of Rs 62.9 lakh and it reached the government warehouse on January 5, this year. The drugs were Methyl Prednisolone injection, Carboxymethylcellulose Eye Drops, Oxymetazoline Pediatric (Nasal) Drops, Flurbiprofen Eye Drops IP, Sodium Chloride (Nasal) Drops, Timolol Maleate Drops and Oxymetazoline Hydrochloride (Nasal) Solution IP. “The analytical test reports from NABL/government approved laboratories and in-house test reports of the products opined as the products referred above are of standard quality. The test reports from the private empanelled laboratories of KSMSCL have reported these products are of standard quality,” Vatare said. The products were supplied to all the warehouses in the state by the supplier by January 5, he said, adding the supplier requested KSMSCL on January 18 to accept the supplied products by masking the typo. “It is to be noted that no changes were done in the label of the product information provided. Also, the logogram design was correct in one part of the product and only in another part was there a printing error in the logogram design which was masked, where instead of Health department it was typed as AHVS department.” “The supplier was also imposed a fine of one per cent on the purchase order value and all warehouses were instructed to distribute the products only after masking the error. The supplier was also warned not to repeat the mistake,” he said. Source: Healthworld

May 24,2024 The Central Drugs Standard Control Organisation (CDSCO) has declared that 50 drug samples tested in both Central and State drug laboratories have failed the quality standard test during the month of April, 2024. The Central drug regulator said that almost 21 states have not submitted any data in respect of the Not of Standard Quality (NSQ) alert for the month, while another two States have not submitted the data in prescribed format. Out of the 50 NSQ samples published for the month of April, 33 were tested in CDSCO laboratory while the rest of the samples were tested in state/Union Territory laboratories including Jammu & Kashmir, Goa, Kerala, and Madhya Pradesh. Drug Licensing Authorities of Andhra Pradesh, Arunachal Pradesh, Assam, Bihar, Chhattisgarh, Gujarat, Haryana, Himachal Pradesh, Maharashtra, Manipur, Meghalaya, Mizoram, Nagaland, Odisha, Punjab, Rajasthan, Sikkim, Tamil Nadu, Telangana, Uttarakhand, and West Bengal, and Union Territories of Andaman Nicobar, Dadar and Nagar Haveli, Daman and Diu, and Lakshadweep have not submitted any data in respect of the NSQ alert for the month, despite a circular from the Drugs Controller General (India) (DCGI) directing submission of the data issued on February 9, 2024, said CDSCO. NSQ data was not received as per the format and in a prescribed file from the State Drugs Licensing Authorities of Karnataka and Uttar Pradesh for the month, said the Central regulator. State Drugs Licensing Authorities of Mizoram, Tripura and Puducherry have reported the NSQ data as nil for the month, it added. Unlike its practice in the past years, the NSQ alert for the month does not reveal the total number of samples collected and tested during the month. According to the alert, the samples failed the quality test include a sample of Norditropin Nordiflex 15mg/1.5 ml (human growth hormone injection) labelled as manufactured by Novo Nordisk, ofloxacin and ornidazole tablets from public sector undertaking Karnataka Antibiotics and Pharmaceuticals Ltd, Rez-Q 300 (quinine sulphate tablets 300 mg), and Thyrox-75 (thyroxine sodium tablets) labelled as manufactured by Shreya Life Sciences. The samples failed in the test conducted by State Drug Testing Laboratories include multiple samples supplied by Kerala Medical Services Corporation, Warfarin sodium tablet 5 mg labelled as manufactured by Centurion Remedies, Sallaki tablets labelled as manufactured by Gufic Biosciences, paracetamol paediatric oral suspension 125 mg/ml from Quest Laboratories, and paracetamol paediatric oral suspension 250 mg/ml from Zenith Drugs. It may be noted that the 63rd Drugs Consultative Committee (DCC) meeting held at the end of January sought the state drug regulators to submit data related to NSQs and spurious drugs on a monthly basis. The committee also mooted preparing a list of manufacturers who repeatedly produce Not of Standard Quality (NSQ) drugs and black list them. The Committee also noted that only a few states are sharing the NSQ data with the Central authority on a monthly basis and called for all the States to share the data periodically and in a timed manner for publication on the website. Dr Rajeev Singh Raghuvanshi, Drugs Controller General (India) (DCGI) during the meeting highlighted the concerns with respect to multiple NSQ drugs manufactured by the same manufacturer, and the need to watch such repeated offenders in future. “It was discussed about black listing of such manufacturers and preparing a list of such offenders so that the Government procurement agencies become careful before procurement of drugs from such manufacturers,” said the drug regulator. The Committee also looked at the status of the recommendation made with regard to the sharing of information on NSQs in the previous meeting. It observed that only a few states are sending the NSQ data on a monthly basis. The Central drug regulator sensitised all the States to look into the matter regarding any difficulties and to send the NSQ data periodically and in a timely manner, so that the information can be compiled and published on the website for the attention of all the stakeholders. The DCGI also requested all SLAs to strengthen or upgrade their State Drugs Testing Laboratories with the funds released by the Central Government as the Central Drugs Laboratories are overburdened with the cough syrup samples and others sent by the Central Drugs Standard Control Organisation (CDSCO) drugs inspectors. He also informed the SLAs that after a certain period of time, the CDLs will not accept samples from the states. The State Drugs Controllers urgently need to onboard the SLAs on the Online National Drugs Licensing System (ONDLS) for receiving applications and issuance of blood centre licenses online, added the Committee. Source: Pharmabiz

May 28,2024 New Delhi: Estimates show that 56.4 per cent of total disease burden in India is due to unhealthy diets, the ICMR said on Wednesday as it released 17 dietary guidelines to meet the requirements of essential nutrients and prevent non-communicable diseases (NCDs) such as obesity and diabetes. The National Institute of Nutrition (NIN) under the apex health research body said that healthy diets and physical activity can reduce a substantial proportion of coronary heart disease (CHD) and hypertension (HTN) and prevent up to 80 per cent of type 2 diabetes. “A significant proportion of premature deaths can be averted by following a,” it said, adding that the upsurge in the consumption of highly processed foods laden with sugars and fats, coupled with reduced physical activity and limited access to diverse foods, exacerbate micronutrient deficiencies and overweight issues. The NIN recommended restricting salt intake, using oils and fat in moderation, doing proper exercise, minimising sugar and ultra-processed foods. It also suggested adopting a healthy lifestyle to prevent obesity and reading information on food labels to make informed and healthy food choices. The Dietary Guidelines for Indians (DGIs) has been drafted by a multi-disciplinary committee of experts led by Dr Hemalatha R, Director, ICMR-NIN and has undergone several scientific review. Seventeen guidelines have been listed in the DGI. “Through the DGIs, we emphasise that the most logical, sustainable, and long-term solution to all forms of malnutrition is ensuring the availability, accessibility and affordability of nutrient-rich foods while promoting consumption of diverse foods. The guidelines contain in them scientific evidence-based information that would facilitate the attainment of goals stated in the National Nutrition Policy,” Hemlatha said. The dietary habits of Indians have undergone significant changes over the past few decades, leading to an increase in the prevalence of non-communicable diseases while some of the problems of undernutrition continue to persist, said Dr Rajiv Bahl, Director General, ICMR. “I am pleased that these guidelines have been made very relevant to the changing food scenario in India with addition of practicable messages and suggestions on handling food safety choosing minimally processed foods, importance of food labels and physical activity. I am sure these will complement the government’s efforts to promote holistic nutrition and health of our people,” Bahl said. Referring to the non-communicable diseases, the NIN said that 34 per cent of children between 5-9 years of age suffer from high triglycerides. A balanced diet should provide not more than 45 per cent calories from cereals, and millets and up to 15 per cent of calories from pulses, beans and meat. Rest of the calories should come from nuts, vegetables, fruits and milk, the guidelines said. Due to the limited availability and high cost of pulses and meat, a significant proportion of the Indian population relies heavily on cereals, resulting in poor intake of essential macronutrients (essential amino acids and essential fatty acids) and micronutrients, the NIN said. Low intake of essential nutrients can disrupt metabolism and increase the risk of insulin resistance and associated disorders from a young age, it said. Source: Healthworld

New Delhi: The Delhi High Court has dismissed a Public Interest Litigation (PIL) seeking direction from the Centre to mandate all medical professionals practising in the country to specify to a patient (in the form of an additional slip in the regional language) along with the prescription all kinds of possible risks and side effects associated with a drug or a pharmaceutical product being prescribed. The petitioner stated that upon being made aware of the side effects of the drug being prescribed by the doctor, the patient will be able to make an informed choice about whether to consume it or not. The petitioner, Jacob Vadakkanchery, through Advocates Prashant Bhushan and Anurag Tiwary, stated that prescription medications come with side effects that have the potential to do much harm. The patient has a right to make an informed choice and therefore, it should be mandatory for the doctor prescribing the drug to explain the side effects attached to consuming such a drug to the patient. The plea stated that in the existing regime, the obligation to communicate the potential risks and side effects exists on the manufacturer under Clause 6.2 of Schedule D(II) of the Drugs and Cosmetics Act, 1945 (‘Act of 1945’) and on the pharmacists under Regulation 9.11 of Chapter 4 of the Pharmacy Practice Regulations, 2015 (‘Regulations of 2015’). It also stated that, however, these stipulations in the law are not sufficient. It is the medical practitioner prescribing the drug who should be made responsible for handing out information about the potential risk to the patient in the regional language. Advocate Prashant Bhushan for the petitioner stated that prescribing a drug without specifying the possible side effects does not amount to obtaining valid consent of the patient. He stated that the emphasis in law on informing the patient must shift from the manufacturer and pharmacist to the medical practitioner. The medical practitioner should be the individual handing out the insert provided by manufacturers to the patient while prescribing the drug, as it would highlight the significance of the declarations made in the insert to the patient. He stated that patients do not tend to take serious note of the insert when it is provided by the manufacturer and/or the pharmacist. The bench of Justice Manmohan and Justice Manmeet Pritam Singh Arora passed an order on May 15, and since the legislature, in its wisdom, has elected to impose this duty on the manufacturer and the pharmacist, we do not find any ground for issuing a direction as prayed for in this PIL as it would amount to judicial legislation. Court further said that the Petitioner does not dispute with respect to the sufficiency of the information supplied by the manufacturer through the insert provided with the drug at the time of sale by the registered pharmacist. The Petitioner however, contends that if the same insert is provided by the doctor along with the prescription, it can be presumed that the patient/carer would be able to make an informed choice with valid consent. Appearing for Centre, counsel stated that the petition acknowledges that there exists sufficient legislation to ensure that the patient is aware of the potential risks and possible side effects of the drugs. He stated that the existing provisions in the Act of 1945 and the Regulations of 2015 ensure that the risk is duly communicated to the patient. He stated that the direction sought by the writ Petitioner is unworkable considering how overworked medical practitioners are and would hinder rather than facilitate medical advice to the patients. Source: Healthworld

May 25,2024 New Delhi: Children and adults diagnosed with high blood pressure have double the risk of major cardiovascular problems. It slowly damages almost all the vital organs including the heart, kidneys, eyes, and the brain. Its manifestations are usually seen in adults when they present with end-organ damage. At a growing age, children are getting hypertension which is between 15-20 per cent. “It’s alarming, warned an expert from All India Institute of Medical Sciences (AIIMS) Delhi on Friday. Speaking to ANI, Dr Sumit Malhotra, Professor, Centre for Community Medicine at AIIMS said, “Surveys, which are being done in different parts of the country, who have looked into the hypertension levels, we have actually found out that 15 to 20 per cent of the children and adolescents has high blood pressure and the rising figures are being consistently seen.” In children, hypertension is not as common as in adults; however, a globally increasing number of children are being diagnosed with hypertension. “Adolescents are not having a very good lifestyle in terms of physical activity, consumption of fruits and vegetables, also tobacco consumption. So all of this actually is indicative of a rise in hypertension,” he said further. Nowadays, with the increasing prevalence of obesity, sedentary lifestyle, and drug abuse in teenagers, the prevalence of primary hypertension in children is also increasing. Approximately 22 crore adults are estimated to have high blood pressure (BP) in India. There are gaps in its diagnosis, treatment, and control status, owing to a lack of awareness. Every Year, 17 May is observed as World Hypertension Day, and the whole month is dedicated to raising awareness about hypertension. The Union Health Ministry launched an ambitious 75/25 initiative of screening and putting 75 million people with hypertension and diabetes on Standard Care by 2025. To raise awareness among the general public, about hypertension, the public lecture and panel discussion, involving experts from diverse domains, was organised today on May 24. The event covered topics – measurement of BP, home monitoring, prevention, treatment and control, stress management, tobacco cessation, and complications. Several events were organised to raise awareness about screening for high BP including involvement and engagement of educational institutions like schools to tackle the rising burden of BP among young people. Source: Healthworld

May 26,2024 New Delhi: Twenty per cent of cancer patients who called an NGO-run helpline to seek a second opinion were below 40 years of age, indicating a rise of cancer incidences amongst younger people, data from the organisation stated. There were 1,368 callers between March 1 and May 15, according to the Cancer Mukt Bharat Foundation, launched by a group of oncologists. The study showed that 60 per cent of the cancer patients below the age of 40 years were men. It also found that the most prevalent cases were head and neck cancer (26 per cent), closely followed by Gastrointestinal cancers (16 per cent), breast cancer (15 per cent) and then blood cancers (9 per cent). The most number of calls were from Hyderabad, followed by Meerut, Mumbai and New Delhi, a statement by the NGO said. The helpline number (93-555-20202) was launched for the patients to seek second opinion free of cost. It is operational from 10 am to 5 pm from Monday to Saturday. Cancer patients can call the helpline number to speak to leading oncologists directly or even do a video call to discuss their cancer treatment. Dr Ashish Gupta, Principal Investigator and senior oncologist who is heading the Cancer Mukt Bharat Campaign said that since the launch of the helpline number, it has proven to be a support system for cancer patients across India and almost hundreds of calls are received every day. “This study helps us make a more targeted cancer approach towards treatment and make India ‘Cancer Mukt’. We found head and neck cancer was most prevalent which is nearly entirely preventable by lifestyle modification, vaccinations and screening strategies. Breast and colon cancers have very effective screening strategies for finding cancer in the early stages. Unfortunately as is representative of the population at large in India we found nearly 2/3rds of cancers were detected late likely due to low adoption of proper screening,” Dr Gupta said. The study also found that 27 per cent of cases diagnosed in India are in stages 1 and 2 of cancer whereas 63 per cent are in stage 3 or 4 cancer. The most common question of the cancer patients was for a second opinion and to confirm whether their cancer treatment was correct and up to date. Some also check the availability of the latest treatment or medicine to treat their respective cancer as in cancer treatment as new medicines are approved almost every week, he said. The second most common question we found was patients asking what stage their cancer is in indicating the importance of education to cancer patients and thirdly patients commonly asked regarding their family members, what they can do to prevent cancer highlighting the importance of cancer screening and awareness, he said. Cancer Mukt Bharat campaign aims to reduce the incidence and impact of cancer on individuals and communities through education and early detection, Dr Gupta said. Further, the study showed that 67 per cent of the cancer patients who reached out to the organization were the ones who were taking cancer treatment from private hospitals. While 33 per cent were those were taking treatments from government hospitals, he said. Dr Ashish Gupta further said, “In our country escalating rates of obesity, change in dietary habits, specifically the increase in consumption of ultra-processed food, and sedentary lifestyles also are associated with higher cancer rates. We must adopt a healthy lifestyle and avoid the use of tobacco and alcohol to prevent the risk of cancer in the younger generation”. The helpline number offers a free opinion from leading oncologists, providing crucial guidance to patients navigating the complexities of cancer diagnosis and treatment, he said. Source: Healthworld