Dr. Mohammed Imaduddin is a surgical oncologist specialising in complex abdominal and gastrointestinal cancers — including peritoneal surface oncology (HIPEC, PIPAC, CRS), upper GI cancers (gastric, oesophageal, pancreatic), colorectal and rectal cancer, ovarian cancer surgery, hepatobiliary cancers, and retroperitoneal sarcomas. He is one of very few surgeons in India with formal fellowship training in HIPEC and PIPAC, having trained at Medizinische Hochschule Hannover, Germany — where PIPAC was developed.

The main clinic is at Office No. 302, 3rd Floor, ANR Centre, Road No. 1, Naveen Nagar, Banjara Hills, Hyderabad — 500034. Additional CION Cancer Clinic locations are available across Hyderabad including Kukatpally, Kompally, Ameerpet, Tolichowki, Masab Tank, and LB Nagar. Please visit our Contact page for details and directions.

The easiest way is via WhatsApp at +91 9063490160 — message directly with your name, the cancer type, and any reports you have. You can also call the same number. For outstation patients, a preliminary video consultation can often be arranged before the in-person visit. Please bring all imaging (CT/MRI CDs), biopsy/pathology reports, and any previous operative notes.

Yes — second opinion consultations are actively welcomed. Patients from any hospital, any city, and any stage of treatment are welcome to consult. A second opinion is one of the most important things you can do after a cancer diagnosis — it changes the management plan in approximately 20–30% of cases. Please bring all original reports, imaging CDs, and operative notes.

Dr. Mohammed Imaduddin is an MS (General Surgery) and MCh (Surgical Oncology) trained specialist with fellowship training at AIIMS New Delhi, Medizinische Hochschule Hannover (Germany), and Charité Berlin. He is a Fellow of the American College of Surgeons (FACS) and a European Board of Surgery (FEBS) qualified surgical oncologist with over 15 years of experience.

HIPEC (Hyperthermic Intraperitoneal Chemotherapy) is a surgical procedure in which heated chemotherapy (usually cisplatin or oxaliplatin) is circulated directly inside the abdominal cavity for 90 minutes immediately after cytoreductive surgery (CRS) to remove all visible tumour. It is intended for patients with peritoneal involvement from colorectal, ovarian, gastric, appendiceal (PMP), or primary peritoneal cancers, with a Peritoneal Cancer Index (PCI) typically ≤20, no unresectable distant metastases, and adequate performance status.

Yes — HIPEC is performed at CION Cancer Clinics by Dr. Imaduddin, who trained in this technique at Medizinische Hochschule Hannover, Germany. Indian patients no longer need to travel abroad for HIPEC.

HIPEC is an open surgical procedure performed after cytoreductive surgery — it requires a large abdominal incision and is intended for curative or near-curative treatment. PIPAC is a minimally invasive laparoscopic procedure (2 small incisions) that delivers chemotherapy as a pressurised aerosol into the abdominal cavity, repeated every 6 weeks. PIPAC is used for patients who cannot have open surgery, who need disease stabilisation, or who have already progressed after systemic treatment. HIPEC treats more aggressively; PIPAC treats more gently and repeatedly.

PMP is a condition where a ruptured appendiceal mucinous tumour fills the abdominal cavity with mucin-producing cells and gelatinous material. It is one of the most curable peritoneal malignancies — with 10-year survival exceeding 80% for low-grade PMP treated with complete CRS + HIPEC at specialist centres. Critical rule: do not operate on a mucocele of the appendix without consulting a peritoneal oncology specialist first.

The Peritoneal Cancer Index (PCI, scored 0–39) is assessed by two methods: CT/MRI imaging gives an estimate, but the most accurate assessment is diagnostic laparoscopy — a key-hole procedure where the surgeon directly visualises all 13 abdominal regions and scores each one. Dr. Imaduddin performs staging laparoscopy for all patients being considered for CRS+HIPEC before committing to open surgery.

No. Approximately 15–20% of patients have resectable disease at diagnosis, and a further 20% have borderline resectable disease that may become operable after neoadjuvant chemotherapy (FOLFIRINOX or gemcitabine+nab-paclitaxel). Never accept “inoperable” without a specialist surgical evaluation. I regularly see patients who were told elsewhere that surgery was not possible — and in some cases, it is.

The Whipple’s procedure (pancreaticoduodenectomy) removes the head of the pancreas, the entire duodenum, the distal stomach, the gallbladder, and part of the common bile duct — followed by complex reconstruction. It is the standard curative operation for cancer of the head of pancreas. In experienced hands, surgical mortality is under 3%, and most patients are discharged within 7–10 days.

After Whipple’s, the pancreatic remnant is reconnected to the small bowel (pancreaticojejunostomy). Pancreatic exocrine insufficiency is common — patients need pancreatic enzyme supplements (Creon) with every meal for life. Blood sugar levels may become unstable or diabetic if significant pancreatic tissue is removed. Most patients adapt well and achieve a good quality of life within 3–6 months.

“Resectable” means the tumour does not contact major blood vessels (SMA, SMV, portal vein, celiac axis) and R0 surgery is expected. “Borderline resectable” means the tumour abuts these vessels — surgery is possible but technically demanding. “Locally advanced” means the tumour encases major vessels — surgery typically requires vascular reconstruction or may not be feasible. These distinctions require dedicated pancreatic protocol CT to determine.

A D2 lymphadenectomy removes lymph nodes from two nodal stations around the stomach — the immediate perigastric nodes (N1) and the nodes along the major feeding vessels (N2). Multiple studies from Japan and South Korea have confirmed that D2 dissection significantly improves long-term survival in gastric cancer compared to D1, with acceptable complication rates in experienced centres. It is now the international standard for curative gastrectomy.

Yes, with modifications. After total gastrectomy, the stomach is replaced by a Roux-en-Y reconstruction. Key adjustments: eat 6–8 small meals per day rather than 3 large ones, avoid concentrated sweets to prevent dumping syndrome, take lifelong vitamin B12 injections (3-monthly), and take iron supplements if needed. Most patients achieve satisfactory eating within 2–3 months and a good quality of life within 6 months.

Yes — minimally invasive oesophagectomy (MIO), using thoracoscopy and laparoscopy, is available and preferred for eligible patients. The TIME trial demonstrated that MIO reduces pulmonary complications, blood loss, and ICU stay compared to open surgery, with equivalent oncological outcomes. Dr. Imaduddin offers MIO as the preferred approach where technically feasible.

The CROSS protocol is the standard pre-operative (neoadjuvant) chemoradiotherapy regimen for locally advanced oesophageal and gastro-oesophageal junction cancers: weekly carboplatin/paclitaxel chemotherapy concurrent with 41.4 Gy radiotherapy, given for 5 weeks before surgery. Approximately 30% of patients achieve a pathological complete response (the tumour is destroyed by treatment alone), with excellent long-term outcomes.

In the majority of cases, no. Modern total mesorectal excision (TME) with sphincter-preserving low anterior resection or colo-anal anastomosis avoids a permanent colostomy for most patients — even those with low rectal cancers. A temporary defunctioning ileostomy (closed 2–3 months later) is often created to protect the anastomosis. Permanent stoma is needed only when the tumour is very close to the sphincter muscle, or when sphincter function is already poor.

Yes — for 15–20% of patients with colorectal liver metastases, surgical resection offers 5-year survival rates of 35–50%. The criteria are: R0 resection is achievable, future liver remnant (FLR) is adequate (≥30%), and there is no unresectable extrahepatic disease. For patients with initially unresectable metastases, conversion chemotherapy (FOLFOX, FOLFIRI with targeted agents) downstages disease in 20–30% of cases. Never accept “the liver spread is untreatable” without specialist evaluation.

TME is a surgical technique developed by Professor Richard Heald in which the rectum is removed by sharp dissection along the mesorectal fascia, preserving the intact mesorectal envelope containing lymph nodes and blood vessels. This technique reduced local recurrence rates in rectal cancer from 25–30% (with blunt dissection) to under 5% in experienced hands. It is now the global standard for rectal cancer surgery and requires specialist training to perform safely.

After curative resection: colonoscopy at 1 year post-surgery, then every 3–5 years if normal. Blood CEA every 3 months for 2 years, then 6-monthly. CT abdomen/pelvis every 6 months for 2 years, then annually for 3 years. This surveillance protocol detects liver, lung, and local recurrence early — when treatment with curative intent is still possible.

Yes — the OVHIPEC-1 randomised controlled trial (van Driel et al., NEJM 2018) demonstrated that adding HIPEC (cisplatin) to interval cytoreductive surgery improved median overall survival by 3.5 months (45.7 vs 33.9 months) with no increase in serious adverse events. HIPEC is now incorporated into ovarian cancer treatment guidelines in the Netherlands and recommended by ESGO/ESMO in selected cases. Dr. Imaduddin offers HIPEC for eligible ovarian cancer patients in Hyderabad.

“CC0” means complete cytoreduction — zero visible residual tumour after surgery. This is the goal for every ovarian cancer operation. CC1 means residual nodules ≤ 2.5 mm; CC2 means residual up to 2.5 cm. Every mm of residual disease reduces survival. Achieving CC0 often requires extensive surgery — bowel resection, splenectomy, diaphragm stripping — and requires a surgeon willing and able to perform these procedures.

Yes — all patients with ovarian cancer (particularly high-grade serous histology) should have germline BRCA1/2 testing, regardless of family history. BRCA mutations are found in 15–20% of HGSC. A positive result predicts better response to platinum chemotherapy, eligibility for PARP inhibitor maintenance therapy (olaparib, niraparib), and identifies at-risk family members for counselling and prophylactic surgery.

PIPAC (Pressurised Intraperitoneal Aerosol Chemotherapy) is a laparoscopic procedure delivering cisplatin/doxorubicin as a heated aerosol into the peritoneal cavity, repeated every 6 weeks. For platinum-resistant recurrent ovarian cancer with peritoneal involvement, PIPAC offers a low-toxicity treatment that can stabilise or reduce disease. It does not require a large incision and patients typically recover within 2–3 days.

For any cancer surgery, you need a surgical oncologist — a surgeon with specific training in oncological principles: wide excision margins, lymph node dissection, avoiding tumour spillage, and understanding multimodal treatment sequencing. A general surgeon can perform routine procedures, but complex cancer resections — Whipple’s, oesophagectomy, total gastrectomy with D2, CRS+HIPEC, retroperitoneal sarcoma resection — require specialist training. The surgeon’s experience with your specific operation is the single biggest determinant of your outcome.

“R0” means the tumour was removed with clear (negative) microscopic margins — no cancer cells at the cut edges. “R1” means microscopic positive margins (cancer cells found at the edge). “R2” means macroscopic residual disease. R0 resection is the goal of all curative cancer surgery — R1/R2 significantly worsen prognosis and often require re-operation or radiotherapy. Not all surgeons achieve the same R0 rates; this is why volume and experience matter.

ERAS is an evidence-based perioperative pathway that improves recovery after major surgery. Key elements include: preoperative carbohydrate loading, avoidance of prolonged fasting, minimally invasive surgical approaches where possible, avoidance of drains and nasogastric tubes unless necessary, early oral feeding (day 1–2 post-operatively), early ambulation (day 1), and multimodal analgesia avoiding excess opioids. ERAS protocols reduce hospital stay, complications, and improve patient experience — they are standard practice at Dr. Imaduddin’s clinic.

For eligible patients and suitable tumours, laparoscopic (keyhole) surgery offers equivalent oncological outcomes with faster recovery, less pain, shorter hospital stay, and lower wound complication rates. The decision depends on tumour stage, location, prior surgeries, and the surgeon’s laparoscopic expertise. Some operations — major retroperitoneal sarcoma resection, CRS+HIPEC — require open surgery. Others — colectomy, gastrectomy, distal pancreatectomy, liver resection — can often be done laparoscopically. Dr. Imaduddin offers both approaches.

For most solid abdominal cancers, you should see a surgical oncologist early — ideally before starting chemotherapy. Starting chemotherapy before surgical evaluation can reduce surgical options in some cases. The surgical oncologist and medical oncologist should ideally discuss your case together at a multidisciplinary tumour board. There are exceptions — for borderline resectable pancreatic cancer or locally advanced rectal cancer, neoadjuvant therapy is planned upfront — but this decision should be made jointly.

An MDT (tumour board) is a meeting where specialists from different disciplines — surgical oncologist, medical oncologist, radiation oncologist, pathologist, radiologist, and sometimes a gastroenterologist or gynaecologist — discuss a patient’s case together and agree on the optimal management plan. Reviewing all complex cancer cases at MDT is the international standard of care. At CION Cancer Clinics, every complex case is discussed at MDT before a final plan is made.

Please bring: all CT, MRI, and PET scan imaging on CD (DICOM format, not just printed reports), all pathology/biopsy reports, any operative notes from previous surgeries, previous chemotherapy or radiotherapy summaries, a list of current medications, and a list of questions you want answered. If possible, bring a family member who can listen alongside you. The consultation is unhurried — you will have time to ask everything.

Yes — absolutely. In my experience, 20–30% of patients told they are not surgical candidates are found to be operable on specialist evaluation. “Inoperable” in the context of cancer surgery is not a permanent label — it depends on who is making the assessment and whether the right staging investigations have been done. I actively encourage second opinions, and I am happy to review any case.

It is almost never too late. Some patients come to me after 6, 8, or even 12 cycles of chemotherapy — and surgery is still possible and beneficial. Chemotherapy can also work in your favour: in some cancers (colorectal liver metastases, peritoneal carcinomatosis), pre-operative chemotherapy may have reduced disease burden enough to make previously unresectable disease operable. Please do not assume that because you have had chemotherapy, surgery is no longer an option.