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Dr Harsh Shah - Surgical Gastroenterologist and GI Robotic Surgeon, Ahmedabad
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Dr Harsh Shah - Surgical Gastroenterologist and GI Robotic Surgeon, Ahmedabad

Dr Harsh Shah

Does Metformin Improve Liver Cancer Treatment? What Patients Should Know

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Does Metformin Improve Liver Cancer Treatment? What Patients Should Know

You are here >> Home > Latest Updates > Liver Cancer > Does Metformin…

The Effect of Metformin on AtezolizumabBevacizumab Treatment in Patients with Hepatocellular Carcinoma and Diabetes.DOI 10.32604or.2026.073063

Liver cancer is a serious condition. One common type is hepatocellular carcinoma. Many patients also have diabetes and take a medicine called metformin.

Doctors use a combination treatment called atezolizumab and bevacizumab for advanced liver cancer. Some believed metformin might improve cancer treatment because it has effects beyond blood sugar control.

A recent study looked into this question.

It included more than 500 patients with liver cancer. Around one-third also had diabetes. Researchers compared patients who were taking metformin with those who were not.

The results were clear.

Metformin did not improve survival. It did not slow down cancer growth. It also did not increase the response to treatment.

Even in patients with diabetes, metformin did not show extra benefit when combined with cancer therapy.

What does this mean for you?

If you are taking metformin for diabetes, you should continue it as prescribed. It helps control blood sugar and supports overall health.

But it should not be expected to improve liver cancer treatment outcomes.

Cancer treatment decisions should be based on proven therapies like the combination your doctor recommends.

Key points to remember:

⦿ Metformin is useful for diabetes

⦿ It does not boost liver cancer treatment outcomes

⦿ Follow your cancer treatment plan carefully

⦿ Keep diabetes under good control

Managing both cancer and diabetes together is important. Regular follow-ups and clear communication with your doctor help you stay on track.

DOI: 10.32604/or.2026.073063

Are IBD Medicines Safe During Pregnancy? What New Research Shows

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Are IBD Medicines Safe During Pregnancy? What New Research Shows

You are here >> Home > Latest Updates > Ulcerative Colitis > Are IBD…

Safety of advanced therapies in pregnant women with inflammatory bowel disease a systematic review and Meta-Analysis.DOI 10.1093ecco-jccjjag035

Inflammatory bowel disease (IBD) often affects women during their childbearing years. Many worry about taking medicines during pregnancy. They fear harm to the baby.

A large study looked at over 17,000 pregnancies in women with IBD. It studied newer treatments like vedolizumab, ustekinumab, and JAK inhibitors.

The results bring some reassurance.

Most women had healthy pregnancies. Early pregnancy loss happened in about 8 out of 100 cases. Preterm birth was seen in about 9 out of 100. Birth defects were rare, seen in about 3 out of 100 pregnancies.

These numbers are close to what is seen in the general population.

Some medicines showed slightly higher risks. JAK inhibitors and ustekinumab were linked with a higher chance of early pregnancy loss. Vedolizumab was linked with more preterm births. Still, the overall safety remained acceptable.

Women with active disease had a higher risk of complications. Older age and longer disease duration also increased risk.

What should you do?

 

⦿ Do not stop your medicines without medical advice

 

⦿ Plan pregnancy with your doctor

 

⦿ Keep your disease under control

 

⦿ Attend regular check-ups

 

Each case is different. Your doctor will guide you based on your condition and treatment.Healthy pregnancy is possible with IBD. The right balance between treatment and monitoring makes a big difference.

DOI: 10.1093/ecco-jcc/jjag035

Can Appendicitis Be Treated Without Surgery? What 10 Years of Data Shows

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Can Appendicitis Be Treated Without Surgery? What 10 Years of Data Shows

You are here >> Home > Latest Updates > Appendix > Can Appendicitis…

Antibiotic Therapy for Uncomplicated Acute Appendicitis Ten-Year Follow-Up of the APPAC Randomized Clinical Trial.DOI 10.1001jama.2025.25921

Appendicitis is a common emergency. Many people are told they need surgery to remove the appendix. This operation is called an appendectomy.A long-term study followed patients for 10 years to see if antibiotics alone can be a safe option.The results give a clear picture.About 6 out of 10 patients who took antibiotics did not need surgery even after 10 years. Around 4 out of 10 had appendicitis again and eventually needed surgery.
This means antibiotics can work well for many people, but not for everyone.There is more.
Patients who had surgery had more complications over time. Around 1 in 4 people in the surgery group faced issues. In the antibiotic group, less than 1 in 10 hadcomplications.Quality of life was similar in both groups. Patients felt just as healthy whether they had surgery or took antibiotics.This is usually decided after a scan confirms the condition is not severe.
Doctors may suggest:
⦿ Antibiotics first, with close follow-up
⦿ Surgery if symptoms return
⦿ Immediate surgery if the condition is complicated
It is important to understand the trade-off. Antibiotics can help avoid surgery at first, but there is a chance of recurrence.Speak with your doctor about what suits your situation. Your age, health, and symptoms all matter.Early treatment and regular follow-up help preventcomplications and keep you safe.

Dr Harsh Shah, MS, MCh (GI), DrNB (GI), performs laparoscopic appendicectomy for appendicitis that does not settle with antibiotics or that returns, at Apollo Hospital, Bhat, Gandhinagar. Consultations: Shah’s Gastro, Cancer & Robotic Surgery Centre, Gota, Ahmedabad.

DOI: 10.1001/jama.2025.25921

Major Cancer Surgery Can Benefit Selected Patients Over 75

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Major Cancer Surgery Can Benefit Selected Patients Over 75

You are here >> Home > Latest Updates > HIPEC Updates  > Major Cancer…

Survival and morbidity in elderly patients treated with cytoreductive surgery and HIPEC for colorectal peritoneal metastases a population-based study.DOI 10.108002656736.2026.2620731

When colorectal cancer spreads to the lining of the abdomen, doctors may treat it with an intensive procedure called cytoreductive surgery with HIPEC. This surgery removes visible tumors and then delivers heated chemotherapy directly into the abdomen to kill remaining cancer cells.
Because the operation is complex, doctors sometimes hesitate to offer it to older patients. A new study from Sweden looked at whether patients aged 75 or older had worse outcomes than younger patients.
Researchers analyzed 592 patients treated with this procedure. Most were younger than 75, but 39 patients were 75 or older.
The results were encouraging. Survival rates were similar in both age groups, meaning older patients benefited just as much from the treatment as younger patients. Serious complications after surgery were also comparable, and no patients aged 75 or older died during their hospital stay.
Instead of age, other factors had a bigger effect on survival. Patients did worse when cancer had spread widely in the abdomen or when surgeons could not remove all visible tumors.
These findings suggest that age alone should not prevent someone from receiving CRS-HIPEC surgery. With careful patient selection and experienced surgical teams, older adults can safely undergo this treatment and achieve meaningful outcomes.

DOI: 10.1080/02656736.2026.2620731

Robotic Surgery May Improve Recovery for Obese Patients With Colon Cancer

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Robotic Surgery May Improve Recovery for Obese Patients With Colon Cancer

You are here >> Home > Latest Updates > Robotic Surgery > Robotic Surgery…

Surgical approach and textbook outcomes in patients with obesity undergoing cancer surgery

Surgery is a key treatment for colon cancer. Doctors aim for what is called a “textbook outcome”, meaning the patient recovers smoothly without complications, does not need another operation, and can leave the hospital quickly.
For patients with obesity, surgery can be more technically difficult and may carry a higher risk of complications. A new study looked at whether the type of surgical approach could influence recovery outcomes in these patients.
Researchers studied more than 10,000 people who had surgery for right-sided colon cancer, including about 1,700 patients with severe obesity (BMI ≥35). They compared two common minimally invasive approaches: laparoscopic surgery and robotic-assisted surgery.
The results showed that patients with severe obesity were more likely to achieve a textbook recovery with robotic surgery. About 66% of patients who had robotic surgery recovered without complications, compared with about 56% who had laparoscopic surgery.
Robotic tools may help surgeons operate more precisely in patients with higher body weight, making the procedure easier to perform in complex situations.
These findings suggest that robotic-assisted surgery may improve recovery outcomes for obese patients undergoing colon cancer surgery, although more research is needed to confirm the long-term benefits.

Dr Harsh Shah, MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology), performs robotic and laparoscopic colectomy for colon cancer at Apollo Hospital, Bhat, Gandhinagar. Consultations: Shah’s Gastro, Cancer & Robotic Surgery Centre, Gota, Ahmedabad.

DOI: 10.1097/DCR.0000000000004055

Why Some Rectal Cancer Patients Avoid Surgery

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Why Some Rectal Cancer Patients Avoid Surgery

You are here >> Home > Latest Updates > Rectal Cancer > Why Some…

Where to get help

Dr Harsh Shah, MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology), performs rectal cancer surgery at Apollo Hospital, Bhat, Gandhinagar.

The OPD is in Gota, Ahmedabad. Surgery is at Apollo Hospital, Bhat, Gandhinagar. Are you trying to avoid an operation? Ask us. Send your reports. You can read about talking to a rectal cancer surgeon in Ahmedabad on that page. Bring your reports. Second opinions are welcome.

Call +91 63555 64601
Ask on WhatsApp

Last updated: 26 September 2026

The Impact of Patient, Disease, and Social Determinants of Health on Receipt of Nonoperative Management for Patients With Rectal Adenocarcinoma.DOI 10.1097COC.0000000000001243

Surgery has long been the main treatment for rectal cancer. But in some cases, doctors now use a “watch-and-wait” or nonoperative management (NOM) approach. This means patients receive treatments like chemotherapy and radiation first, and if the tumor disappears completely, surgery may be avoided.
A large study looked at more than 128,000 patients with rectal cancer to understand who receives this non-surgical approach. Researchers found that about 10% of patients were treated without surgery.
Several factors influenced whether patients received NOM. Older patients, those with certain tumor characteristics, and people treated at community hospitals were more likely to receive this approach. Social factors also played a role, including race, insurance coverage, and geographic location.
The study also found differences in survival among patients treated without surgery. Outcomes were better when patients received both radiation therapy and chemotherapy, and when care was delivered at experienced centers.

These findings highlight that treatment decisions are influenced not only by the cancer itself but also by social and healthcare access factors. As nonoperative treatment becomes more common, doctors hope to ensure that all patients have equal access to the best treatment options.

DOI: 10.1097/COC.0000000000001243

Dr Harsh Shah - Surgical Gastroenterologist and GI Robotic Surgeon, Ahmedabad

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