Tata Memorial Centre

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Tata Memorial Hospital
Map
Geography
LocationMumbai, Maharashtra, India
Coordinates19°00′17″N 72°50′36″E / 19.004861°N 72.843235°E / 19.004861; 72.843235
Organisation
FundingGovernment hospital
TypeSpecialist
Affiliated universityHomi Bhabha National Institute
Services
Speciality
History
Opened28 February 1941
Links
Websitetmc.gov.in

The Tata Memorial Hospital (TMH) situated in Parel, Mumbai, is a cancer institute.[1] It operates as an autonomous grant-in-aid institution administered under the under the Department of Atomic Energy, Government of India.[2][3][4] Its mission is to provide comprehensive cancer care to all through a commitment to excellence in service, research, and education. It has spearheaded the Evidence-based Medicine movement in India, and prioritizes Multidisciplinary Team (MDT) management through disease-specific groups, ensuring holistic care for every patient. It has also led the way in high quality research in cost-effective and pragmatic cancer detection and management applicable to both developed and developing nations.

Now part of the larger TMC (Tata Memorial Center) umbrella, there are many firsts to this name. These include India’s first linear accelerator for radiation therapy in 1978, bone marrow transplant in 1983, tissue bank in 1988, PET/CT in 2004, and the first proton therapy unit in a government setup (and second overall) in 2023. It has spearheaded the CAR-T cell trial which has led to the approval indigenous CAR-T cell therapy in India. Importantly, with a mission centered on comprehensive compassionate cancer care for all, approximately 60% of patients receive free or highly subsidized treatments, without any difference in the quality of care or in the health care providers. Dr Sudeep Gupta is the current Director of TMC, while Dr CS Pramesh is the current Director of TMH.

History and current scope[edit]

A 1991 stamp dedicated to the 50th anniversary of the Tata Memorial Centre

The Tata Memorial Hospital was initially commissioned by the Sir Dorabji Tata Trust on 28 February 1941 for the advancement of learning and research, disaster relief and other philanthropic activities ‘without any distinction of place, nationality or creed’. The death of Dorabji's wife Meherbai due to leukemia spurred him to create a center dedicated to researching the disease.[5] In 1952, the Indian Cancer Research Centre was established as a research institute for basic research—later called the Cancer Research Institute (CRI). The Ministry of Health took over the Tata Memorial Hospital in 1957. Administrative control of both TMH and CRI was then transferred to the Department of Atomic Energy (DAE) in 1962, and these two arms merged to form the ‘Tata Memorial Center' (TMC) in 1966, with a mandate for service, education and research in cancer.

The Advanced Center for Treatment, Research and Education in Cancer (ACTREC) at Kharghar was inaugurated in 2002, and now houses the CRI and the Clinical Research Center (CRC) (inaugurated in 2005), a state-of-the-art research hospital. 

TMC has expanded its outreach across the country with nodal centers established at multiple places across the country, following the ‘hub and spoke’ model. These together register about 120,000 new cancer patients every year. Currently (as in 2024), TMC comprises of the following centres:

•          Tata Memorial Hospital, Parel, Mumbai

•          Advanced Centre for Treatment, Research, and Education in Cancer (ACTREC), Kharghar, Navi Mumbai

•          Centre for Cancer Epidemiology (CCE), Kharghar, Navi Mumbai

•          Homi Bhabha Cancer Hospital and Research Centre (HBCH&RC), Visakhapatnam, Andhra Pradesh

•          Homi Bhabha Cancer Hospital (HBCH), Sangrur, Punjab

•          Homi Bhabha Cancer Hospital and Research Centre (HBCH&RC), Mullanpur, Punjab

•          Dr. Bhubaneswar Borooah Cancer Institute (BBCI), Guwahati, Assam

•          Homi Bhabha Cancer Hospital (HBCH), Varanasi, Uttar Pradesh

•          Mahamana Pandit Madan Mohan Malviya Cancer Centre (MPMMCC), Varanasi, Uttar Pradesh

•          Homi Bhabha Cancer Hospital & Research Centre (HBCH & RC), Muzaffarpur, Bihar

Patient care[edit]

TMC is a pioneer in the delivery of evidence-based cancer management in India. It's patient-centric approach is evident through the faith of over a million patient footfalls and about 60,000 admissions annually from diverse regions, with over 275,000 patients who received specialized day-care services, and discounted medicines worth over 50 million USD being dispersed. The focus is on multidisciplinary team (MDT) management by dedicated disease management groups for various cancers, with every new patient discussed in a tumor board consisting of surgical, medical and radiation oncologists, radiologists, pathologists and other relevant members of the team together as a group, thus ensuring comprehensive cancer care by team members who are all on the same page. It is equipped with state-of-the-art facilities, including the latest diagnostic modalities (including 24-hour CT and MRI scanners), interventional and minimally-invasive treatment techniques, robotic surgery, proton therapy, 24-hour chemotherapy units, Bone Marrow Transplant, and CAR-T cell therapy.[6][7] It also provides tele-consultation and second opinion services for patients.[8] Its ethos and focus on patient care is best captured by the fact that cancer management continued even during the Covid lockdown period, during which almost 500 cancer patients were operated successfully.[9]

Apart from cancer treatment, there is an enormous focus on cancer screening and on awareness in cancer prevention and early detection as well. TMC has conducted landmark large randomized controlled trials focusing on the efficacy of simple low cost and effective technologies for early detection of breast and cervical cancers among women. These include demonstrating the effectiveness of cervical cancer screening with visual inspection with acetic acid, and of breast cancer screening with clinical breast examination.[10][11] This has led to development of pragmatic evidence-based guidelines that have strengthened national cancer control policies in India and have been adopted by other low and middle income countries (LMICs).    

Education[edit]

TMC plays a significant role in nurturing the next generation of oncologic healthcare professionals across not just India but also much of southeast Asia and Africa. The academic program at TMC includes both medical and non-medical streams related to diagnostic and therapeutic medicine, nursing, and technical courses. Some new value-added courses include masters in Patient Navigation in Oncology (KEVAT), Clinical Research, Geriatric Oncology and Public Health and Epidemiology. Trainees in TMC come from across India as also nations like Bangladesh, Nepal, Myanmar, Nigeria, Iran, Yemen, Oman, Ghana, and Iraq, amongst others.

Research[edit]

TMC has been the torchbearer for research in affordable and accessible cancer prevention and care. TMC boasts of having a state-of-the-art Clinical Research Secretariat (CRS) to support clinical research. It has successfully run many relevant and high impact investigator-initiated clinical trials as also screening and early detection trials that have impacted patient management, which have been presented in prominent international oncology meetings and published in high impact journals, as for the Proluton trial in breast cancer, the N0 trial in head and neck cancer, and POP-RT study in prostate cancer, amongst many others.[12][13][14] Initiatives like the Bhabhatron, a Tele Cobalt machine delivering conformal radiotherapy, has found its way into underprivileged regions, changing the landscape of cancer care in these areas.[15] More recently, the TMC collaborated with the Indian Institute of Technology (IIT) Powai to pioneer indigenous CAR-T cell development and conduct the trials which led to its recent approval by the Indian drug authority.

National Cancer Grid (NCG)[edit]

The National Cancer Grid is a TMC-led network of major cancer centers, research institutes, patient groups and charitable institutions across India with the mandate of establishing uniform standards of patient care for prevention, diagnosis, and treatment of cancer, providing specialized training and education in oncology and facilitating collaborative basic, translational and clinical research in cancer. [16]It showcases the power of collaborative effort by partnering with over 300 cancer centers across the nation as its members. [17] Its various achievements and initiatives include:

● The NCG cancer management guidelines are a set of pragmatic guidelines, with a resource-stratified ‘essential’, 'optimal', and ‘optional’ set of management strategies provided based on the patient’s affordability and institutional infrastructure. They have been linked to reimbursement under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) scheme.

● A successful pooled drug procurement initiative across multiple NCG centers has allowed a median of 82% savings compared to the maximum retail price, and pragmatic multi-centric research studies have been initiated, funded, and are underway.[18]

● A web based External Quality Assurance Service (EQAS) platform has been created in surgical pathology and molecular pathology. This service is provided free to member institutions, with regular feedback provided.

● NCG offers institutional peer review to all members on a voluntary basis. The purpose is to identify strengths and gaps, and opportunities for improvement which are then shared with centres as a peer review report.

● NCG Virtual Tumor Boards (VTB) work on leveraging the proven benefits of getting multidisciplinary teams to work on treatment decisions. Complex clinical situations in cancer are presented to peers with expertise and experience in cancer care using a web-based platform.

● NCG “Vishwam” Global Cancer Network endeavours towards global cancer control by working with other LMICs grappling with problems with their healthcare systems and infrastructure.

● The Koita Centre for Digital Oncology aims at centralizing NCG efforts to adopt and promote digital tools and technologies to promote cancer control. Some of its initiatives include the development of oncology-specific Electronic Medical Record systems, adoption of synoptic reporting formats, interoperability of data, seamless exchange of patient health records, digitization of standard treatment guidelines, and research on artificial intelligence, machine learning in augmenting and optimizing diagnostics and patient care pathways.

See also[edit]

References[edit]

  1. ^ "List of Centers".
  2. ^ "Nuclear India | Department of Atomic Energy". www.dae.gov.in. Archived from the original on 28 April 2021. Retrieved 18 January 2021.
  3. ^ "Tata Memorial Centre - About Us". www.actrec.gov.in. Archived from the original on 22 February 2020. Retrieved 18 January 2021.
  4. ^ "Rs 4369.17 Grant released to various Cancer Hospitals in Financial Year 2014–15". pib.nic.in.
  5. ^ History. tmc.gov.in
  6. ^ Dutta, Sumi Sukanya (16 May 2023). "Tata Memorial now 1st govt facility in India to offer breakthrough 'proton therapy' for cancer". ThePrint. Retrieved 16 May 2024.
  7. ^ PTI (4 April 2024). "Cancer Treatment Revolution Unveiled: President Hails India's First CAR T-Cell Therapy, calls it 'new hope'". The Hindu. ISSN 0971-751X. Retrieved 16 May 2024.
  8. ^ "Teleconsultation registration at Tata Memorial Hospital". tmc.gov.in. Retrieved 16 May 2024.
  9. ^ "Mumbai: Tata hospital operates on 494 cancer patients in lockdown". The Times of India. 12 June 2020. ISSN 0971-8257. Retrieved 16 May 2024.
  10. ^ Shastri, Surendra S.; Mittra, Indraneel; Mishra, Gauravi A.; Gupta, Subhadra; Dikshit, Rajesh; Singh, Shalini; Badwe, Rajendra A. (2014-03). "Effect of VIA screening by primary health workers: randomized controlled study in Mumbai, India". Journal of the National Cancer Institute. 106 (3): dju009. doi:10.1093/jnci/dju009. ISSN 1460-2105. PMC 3982783. PMID 24563518. {{cite journal}}: Check date values in: |date= (help)
  11. ^ Mittra, Indraneel; Mishra, Gauravi A.; Dikshit, Rajesh P.; Gupta, Subhadra; Kulkarni, Vasundhara Y.; Shaikh, Heena Kauser A.; Shastri, Surendra S.; Hawaldar, Rohini; Gupta, Sudeep; Pramesh, C. S.; Badwe, Rajendra A. (24 February 2021). "Effect of screening by clinical breast examination on breast cancer incidence and mortality after 20 years: prospective, cluster randomised controlled trial in Mumbai". BMJ. 372: n256. doi:10.1136/bmj.n256. ISSN 1756-1833. PMID 33627312.
  12. ^ Badwe, Rajendra; Hawaldar, Rohini; Parmar, Vani; Nadkarni, Mandar; Shet, Tanuja; Desai, Sangeeta; Gupta, Sudeep; Jalali, Rakesh; Vanmali, Vaibhav; Dikshit, Rajesh; Mittra, Indraneel (20 July 2011). "Single-injection depot progesterone before surgery and survival in women with operable breast cancer: a randomized controlled trial". Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology. 29 (21): 2845–2851. doi:10.1200/JCO.2010.33.0738. ISSN 1527-7755. PMID 21670457.
  13. ^ D'Cruz, Anil K.; Vaish, Richa; Kapre, Neeti; Dandekar, Mitali; Gupta, Sudeep; Hawaldar, Rohini; Agarwal, Jai Prakash; Pantvaidya, Gouri; Chaukar, Devendra; Deshmukh, Anuja; Kane, Shubhada; Arya, Supreeta; Ghosh-Laskar, Sarbani; Chaturvedi, Pankaj; Pai, Prathamesh (6 August 2015). "Elective versus Therapeutic Neck Dissection in Node-Negative Oral Cancer". The New England Journal of Medicine. 373 (6): 521–529. doi:10.1056/NEJMoa1506007. ISSN 1533-4406. PMID 26027881.
  14. ^ Murthy, Vedang; Maitre, Priyamvada; Kannan, Sadhana; Panigrahi, Gitanjali; Krishnatry, Rahul; Bakshi, Ganesh; Prakash, Gagan; Pal, Mahendra; Menon, Santosh; Phurailatpam, Reena; Mokal, Smruti; Chaurasiya, Dipika; Popat, Palak; Sable, Nilesh; Agarwal, Archi (10 April 2021). "Prostate-Only Versus Whole-Pelvic Radiation Therapy in High-Risk and Very High-Risk Prostate Cancer (POP-RT): Outcomes From Phase III Randomized Controlled Trial". Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology. 39 (11): 1234–1242. doi:10.1200/JCO.20.03282. ISSN 1527-7755. PMID 33497252.
  15. ^ "Narendra Modi hands over Bhabhatron to Mongolia for cancer treatment". The Economic Times. 17 May 2015. ISSN 0013-0389. Retrieved 16 May 2024.
  16. ^ "National Cancer Grid | Tata Memorial Centre". www.ncgindia.org. Retrieved 16 May 2024.
  17. ^ "NCG - List of Centers".
  18. ^ Pramesh, C. S.; Sengar, Manju; Patankar, Sumedha; Chinnaswamy, Girish; Gupta, Sudeep; Vijayakumar, M.; Sood, Sanjeev; Sathe, Anil N.; Radhakrishnan, Venkatraman; Ganesan, Prasanth; Mallavarapu, Krishna Mohan; Badwe, Rajendra A. (1 September 2023). "A National Cancer Grid pooled procurement initiative, India". Bulletin of the World Health Organization. 101 (9): 587–594. doi:10.2471/BLT.23.289714. ISSN 1564-0604. PMID 37638358.

External links[edit]

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