Steering Dual Tracks

The destiny of a young Zoology graduate, with dreams of pursuing a Ph.D., took a meaningful turn when she secured an MBBS admission at Lady Hardinge Medical College, Delhi, graduating a second time in 1986. Dr. Vani Parmar, Chief of Breast Surgical Oncology, Punyashlok Ahilyadevi Holkar Head & Neck Cancer Institute of India (PAH-HNCII), thus stepped into the medical field. She completed her MS in General Surgery, in an era when few women chose the almost male bastion of Surgical medicine. She has since dedicated 35+ years of service; blossoming into a seasoned Breast Surgical Oncologist, specialising in breast conservation surgery. She also stumbled into motorsports in her mid-30s. She shares her zeal for cancer management and passion for motorsports across rugged terrains

In the operating room or on the racetrack, it is the sense of camaraderie and collaboration that I cherish as a truly rewarding passion in my life

-Dr. Vani Parmar

“I chose surgery, which was a bit of a challenge, because more than me, the men felt restricted. During my time, few women chose Orthopaedics or even Surgery as a specialisation,” said Dr. Vani Parmar, Chief of Breast Surgical Oncology, Department of Surgical Oncology, Punyashlok Ahilyadevi Holkar Head & Neck Cancer Institute of India (PAH-HNCII), Mumbai.

She is a key opinion leader and has played a pivotal role in evolving resource-based treatment guidelines for breast cancer in India, ensuring cost- effective and compassionate care. An active member of the Indian Council of Medical Research (ICMR) committee, she has participated in numerous breast cancer forums nationwide. She is involved across international platforms, in Southeast Asia, sharing insights, research findings and best practices in breast cancer treatment. She is a mentor to young surgeons specialising in Surgical Oncology under the ICMR and those pursuing Fellowship under Homi Bhabha National Institute. She is an active member of esteemed societies including the Association of Breast Cancer Surgeons, India (ABSI), Indian Association of Surgical Oncology (IASO), International Breast Cancer Study Group (IBCSG), Asian Breast Cancer Cooperative Group (ABCCG) and International Onco-Plastic Breast Society (IOPBS).

Starting Out

Dr. Vani completed her mandatory year of residency in surgery and medicine at the Dr. Ram Manohar Lohia Hospital in 1987. She eventually pursued a post-graduation (MS-Surgery) at Delhi’s Safdarjung Hospital in 1990, completing the Diplomate National Board (DNB) in 1991. “This was the moment I had always dreamt of—a culmination of years of hard work, dedication and unwavering passion,” she said.

Greater inroads

Vani was a Registrar in Cardiothoracic and Vascular Surgery during 1990-1992 and in mid-1992, following a family relocation to Bengaluru, took a brief hiatus, to tend to her infant daughter. She resumed her clinical work in 1993, as a senior Registrar in General Surgery with Manipal Hospital, gaining mileage as a Consultant and Specialist Surgeon at St. Martha’s Hospital, Bengaluru (1996- 1998). A significant trajectory that fulfilled her career scope was with the Tata Memorial Centre (TMC), Mumbai, where she undertook a fellowship training in Breast Surgical Oncology from 1999-2002 and became an Assistant Consultant and Assistant Professor at the TMC in Breast Surgical Oncology department in 2002.

Her association with the TMC translated into gaining expertise in Breast Conservation Surgery and as the Convenor of the Breast Cancer Disease Management Group at TMC. She led the Advanced Centre for Treatment Research and Education in Cancer (ACTREC), a state-of-the-art R&D wing under the Tata Memorial Centre (Breast Unit). “The paradigm shift was driven by a desire to ensure that women facing breast cancer could preserve not just their lives but also their physical and emotional well-being,” she said. As a former Professor of Surgical Oncology at TMC, she imparted knowledge and instilled values, a gratifying experience that taught her the enduring importance of patient-centred care and the role of education for advancing in the field. “My mission is to continue playing an active role in shaping the treatment landscape and fostering improvements benefitting patients and their families,” she said.

Counselling patients about the proposed cancer surgery and providing a sense of security and trust is integral to my teaching approach

Holistic healing

In the early stages of her career at TMC, mastectomy was the prevailing standard for surgical treatment for breast cancer. However, the team understood the need for patient's needs, taking the critical decision to extend the Breast Conservation Surgery (BCS) option to all eligible women. It was supported by global evidence of the safety of breast conservation surgery as compared to mastectomy, as long as women with conservation completed their radiation treatment. Her expertise in BCS was developed from her deep commitment and awareness of the procedure that addresses the oncological aspects of treatment, catering to the fundamental elements of a patient's body image and quality of life. “The idea is to improve the lives of the women I serve and continue the Tata Memorial Centre’s legacy in my daily practice,” she said.

Body positivity

The aspect of reinstating a patient’s self-image has been made possible with whole breast reconstruction, incorporating silicone breast implants. Although established as a standard surgery for over 15 years, not all medical centres currently offer implants in India. The procedure is less labour-intensive compared to other reconstruction methods, translating into reduced recovery time and post-operative patient discomfort. "Complications, such as implant rupture, while rare, are a possibility, and therefore patients should be informed about the potential risks as part of their treatment decision-making process. Ultimately, the goal is to empower women on their path to physical and emotional recovery,” said Vani.

Syncing greater good

Dr. Vani has been a key influencer across national and international forums in Southeast Asia. Her international collaborations with IBCSG and the ABCCG have significantly impacted global breast cancer research. “Our median age at the time of breast cancer diagnosis in India is 49 years as against 62 years in the West,” she said. She further added, “Counselling patients about the proposed cancer surgery and providing a sense of security and trust is integral to my teaching approach,” she adds.

Both the fields (Breast Surgical Oncology and motorsports) demand unwavering dedication to precision, a pursuit for perfection, quick reaction times, the ability to make rapid decisions, and an inherent capacity to handle challenging situations. What ties them together, I find, is the essential role of teamwork

3D game change

Keeping in sync with modern treatment scope and advanced research, led Dr. Vani to steer groundbreaking initiatives in 3D printing at the ACTREC, at Kharghar, Navi Mumbai. It has pioneered a 3D printing facility for cancer cure. The 3D printed personalised silicone breast implants, aim to enhance patient comfort and confidence, adding precision to surgical procedures. The tailored implants reduce post-operative complications, ensuring a more natural appearance. “Pioneering efforts in 3D printing at ACTREC have extended similar benefits to other areas of modern medicine, making healthcare more personalised, precise, and cost-effective,” she said. ACTREC’s in-house radiation delivery devices and various medical gadgets have significantly reduced the financial burden on patients and healthcare institutions.

AI advantage

Vani has faith in the potential of AI (artificial intelligence), in revolutionising breast cancer treatment and diagnosis. Her collaborations with institutions in Cleveland, Ohio and Emory University in Atlanta in the USA have propelled the field of breast pathology diagnostics using AI to new heights. AI can analyse vast datasets of medical images swiftly and accurately, improve the efficiency and accuracy of early detection, and reduce the burden on healthcare professionals. “Our focus is on the widespread impact of AI in critical breast cancer treatment, striving to uncover its multiple advantages and potential drawbacks,” she said. She, however, warns of the potential pitfalls, including data privacy and ethical considerations, for safeguarding patient interests and trust in the rapidly evolving AI-led diagnostics.

Recognising the reach of social media, her Instagram handle, "lumpsdontlie" (https://www. instagram.com/lumpsdontlie/), engages a broader and younger audience. “I hope that with time, it will attract more followers and foster a community committed to raising awareness about breast cancer,” said Vani.

Navigating terrains

A chance motivational talk by a close friend who conquered Mount Everest, propelled Dr. Vani to conquer mountains a bit differently through motorsports. At 36 years, she ventured into the sport, for her maiden entry in the ionic 'Raid De Himalaya', a rally known for its extreme challenges and breathtaking mountain routes. However, with no prior experience driving on mountainous roads or rally participation, her experienced mentor rallied around her in her debut drive. In 2014, she ventured into the coveted 'Desert Storm' cross-country rally, testing her newfound skills and determination. Despite the challenges of driving on sandy terrains, she competed in the Xplore category, an extreme route but followed a Time-Speed-Distance (TSD) format.

She teamed up with a colleague from Tata Hospital, an avid trekker, who was well-versed in mountain terrains. "During the six days of the rally, they encountered some minor incidents, but our spirit remained unbroken,” she said. Despite being designated as Did Not Finish (DNF) on a penultimate day, she views the experience as a catalyst for her ongoing motorsports ventures. There has been no looking back since as Vani dedicated herself to improving her motorsports skills. She mastered techniques in conquering extreme terrains, including snow, sand, slush, and rocky landscapes. “I acquired a 'Mahindra Thar' and actively participated in off-roading events. I embarked on various cross-border and interstate expeditions, covering thousands of kilometres as a solo driver. This journey has been a remarkable one, filled with challenges, personal growth, and an unwavering passion for motorsports,” she said.

Cross-country laurels

Vani's list of extreme terrain expeditions includes the Leh-Ladakh, Spiti Valley, North-East, Kashmir to Kanyakumari, Thailand-Myanmar-India, Everest Base Camp (North Face), Snow Escape, Extreme Himalayan drive (snow), Desert drives (Jaisalmer, Pushkar, Jodhpur, Bikaner, Mandawa) and in cross- country rallies including the Maruti-Suzuki Desert Storm Rally 2014. She won the Ladies Trophy in the 4-W category in the Extreme SJOBA Rally 2020. She has competed in 7 Indian National Rally Championship (INRC) rounds, achieving three podium finishes in extreme rallies.

Juxtaposing passions

Devoted to Breast Surgical Oncology and motorsports, Vani draws parallels between her dual passions. “Both fields demand unwavering dedication to precision, a pursuit for perfection, quick reaction times, the ability to make rapid decisions, and an inherent capacity to handle challenging situations. What ties them together, I find, is the essential role of teamwork,” she said.

Akin to multidisciplinary team efforts, in rendering any successful oncological surgery, a similar dedicated effort is envisaged in achieving the best possible outcomes, via a well-coordinated pit crew in motorsport. "In the operating room or on the racetrack, it is the sense of camaraderie and collaboration that I cherish as truly rewarding passions in my life,” she said.

Vani finds enrichment in exploring unknown places, experiencing different cultures, and creating lasting memories with her loved ones. She has also re-kindled her love for dance in her 50s and dedicated a year to honing her salsa dancing skills, rediscovering the joy of movement and expression through dance. “My work-life balance mantra is to stay active, continuously challenge myself, and consistently strive for excellence in both my professional and personal pursuits,” she said.