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Breast Cancer - What exactly is it?
‘Breast cancer’ is a term that is used to refer to a malignant tumour, which has developed from cells present in the breast. Generally, all tumours can be divided into two categories i.e. benign and malignant and it is the malignant tumour that is responsible for causing cancer. Breast cancer generally originates in the cells the milk producing glands of the breast's or the passage, which carries milk from the glands to the lobules. Additionally, breast cancer can also originate in the stromal tissues, including the fibrous and fatty connective breast tissues.
Breast Cancer: Treatment Options
Treatment for breast cancer depends upon two things: the exact type of the cancer and how advanced the cancer is. Treatment options for breast cancer can thus be broadly divided into two categories as Local treatments and Systemic treatments.
Treatments that target the tumour without having any effect on the rest of the body are called local treatments. The following types of local treatment options are available for treating breast cancer:
- Surgery: Surgical breast cancer treatment involves removal of the malignant cancerous tumour in an operation. Smaller tumours can be removed using a surgical process referred to as ‘lumpectomy’, wherein the tumour along with a small amount of healthy tissue surrounding the tumour is removed. For larger tumours, removal of the entire breast becomes mandatory, in a surgical process known as ‘mastectomy’. Women who undergo mastectomy can choose to undergo reconstructive plastic surgery for reconstruction of the removed breast(s).
- Radiation Therapy: This basically involves using radiation to kill cancer cells present in the body. Radiation therapy is a long-drawn process that usually involves a set number of treatments administered over a long period of time. Radiation therapy is also generally the follow-up procedure after a lumpectomy, or more rarely, a mastectomy.
Treatments involving drugs that are administered via either the mouth or direct injection into the bloodstream are called systemic treatments. These include:
- Chemotherapy: This includes using drugs to destroy the cancer cells present in the body by stopping the cancer cells from growing and dividing. Chemotherapy can be administered using either an IV (intravenous) tube or via pills that can be swallowed.
- Hormone Therapy: This treatment option is used for treating tumours which have tested positive for progesterone or oestrogen receptors. Blocking hormones that fuel the tumour’s growth is the basis of this therapy.
- Targeted Therapy: This targets specific proteins and genes which contribute to growth and survival of the cancer cells. Targeted therapy is an extremely focused treatment, and is very effective in blocking the growth and division of cancer cells, as well as minimizing damage to surrounding healthy cells.
Also known as slipped disc, herniated disc or sciatica. The discs are the shock absorbers of your spine. When they are injured the inner soft part of the disc can protrude out through a tear in the outer lining of the disc. This disc material can press on the nerves in the spinal column, injuring them through direct pressure and causing inflammation.
The most common age to develop a disc prolapse is between the ages of 30-50 years., twice as many men as women are affected. Prolpased discs occur mainly in the low back (lumbar) spine. Less than I in 20 cases of back pain are due to a disc prolapse, most are due to mechanical back pain. (see section back pain).
A slipped disc is characterised by sudden, severe back pain that is often made worse by movement and which can usually be eased by lying down flat.
Nerve root pain (sciatica) can also occur because a nerve is trapped or irritated by a prolapsed disc. Although the problem is in the back, patients experience pain along the course of the nerve, for example, down a leg to the calf or foot.
With a prolapsed disc, the sciatic nerve is most commonly affected. The sciatic nerve is a large nerve that is made up from several smaller nerves that come out from the spinal cord in the lower back and travels down each leg. The irritation or pressure on the nerve may also cause pins and needles, numbness or weakness in part of a buttock, leg or foot.
In rare cases, cauda equina syndrome can occur. This is a disorder where the nerves at the very bottom of the spinal cord are trapped. It can cause low back pain as well as problems with bowel and bladder function and weakness in one or both legs. These symptoms need urgent medical treatment to prevent permanent damage to the nerves that supply the bladder and bowel.
A large number of people can have a prolapsed disc without any symptoms if it doesn’t trap or irritate the nerve.
A doctor will normally be able to diagnose a prolapsed disc from the symptoms and by examining the patient.
In most cases, no tests are needed, as the symptoms often settle within a few weeks.
Tests such as x-rays or scans may be advised if symptoms persist. In particular, an MRI scan can show the site and size of a prolapsed disc. This information is needed if surgery is being considered
Sir I have a problem of slipped disc in cervical spine. I am a dance choreographer so I should do my profession or I should stop it.
Arguably one of the most fatal diseases that threaten human life, Meningitis has been the cause of a lot of recent deaths. Essentially Meningitis is triggered off by the anomalous inflammation of the protective membranes called meninges in the brain and spinal cord. Spurred by some sort of a bacterial or viral attack, this condition emanates from an infection of the fluids in the cranial chamber. Often such conditions are also stimulated by some external injury, cancerous development or even certain kinds of reaction from a given drug or the other.
Depending on the precise cause of the disease, Meningitis may be categorized as Bacterial Meningitis, Viral Meningitis or Fungal Meningitis. Other forms of Meningitis include parasitic Meningitis, Amebic Meningitis and Non-Infectious Meningitis. Meningitis could potentially be contagious. Through lengthy and proximal contact like coughing or kissing, if saliva or spit gets exchanged, Meningitis causing germs may spread from one person to the other.
Streptococcus pneumoniae and Neisseria Meningitidis are the two of the most rampant Meningitis causing bacteria. They have the potential of causing irreversible damage to several vital organs. However, with substantive progress in medical science, effective and suitable medication has been made available to the larger populace. But, immediate attention is imperative in this case.
Viral Meningitis is relatively milder than the other forms of meningitis. Enteroviruses, arboviruses and herpes virus are some of the most common sources of this kind of Meningitis. People with strong immunity are usually able to overcome this without much ado. Vaccines are available widely in the markets to cure viral meningitis.
Fungal Meningitis are caused primarily from external influences. Inhaling fungal spores from the environment is one of the most prominent factors that lead to Meningitis. People suffering from fatal diseases like cancer, diabetes or HIV are more susceptible to fungal Meningitis. While these are a few of the primary forms of meningitis, other triggers to this disease occur due to various environmental interventions. These are consequent upon interactions with various disease causing allergens. Cure to meningitis is available in the form of intravenous injections. But timely diagnosis and treatment is essential for a good outcome. If you wish to discuss about any specific problem, you can consult a pediatrician.
It is very common for women to have heavy and painful periods or have a feeling of fullness in the lower abdomen. Although, it may not sound very alarming these could be the symptoms of uterine fibroids. These are the most common types of benign tumours found in women. The fibroids are basically some tissues and muscle cells that grow within the uterus, outside the uterus, or along the wall of the uterus. The fibroids are usually benign and asymptomatic and do not require any treatment unless they cause problems.
Know the causes
Though the exact cause of fibroid formation is not known, it is believed that the female hormones estrogen and progesterone have a role to play in their formation. Fibroids are formed only when a woman is producing these hormones and they are not seen in women in non-reproductive age i.e. before starting of menses or after stoppage of menses (menopause). If fibroids are persisting even after menopause or especially if increasing in size then it is an alarming sign. Such a fibroid needs to be taken care of immediately.
What are the symptoms?
Fibroids often remain quiet for long periods of time. They cause nonspecific symptoms in the pelvis and abdomen including:
- Fullness in the abdomen
- Low back pain
- Irregular menstruation
- Cramping with menstruation
- Painful sex
- Increased urgency to urinate
- Anemia, leading to tiredness and weakness
- Infertility Diagnosing the fibroids
When these symptoms are recurrent, it is good to confirm the diagnosis. This can happen with a pelvic exam followed by ultrasound scanning to confirm the size and location of the fibroids. A blood test also may be done to confirm anemia, which is common due to heavy periods.
Management of fibroids can range from doing nothing to periodic monitoring to surgical removal.
- If pain and heavy bleeding are the only symptoms, then pain killers like ibuprofen should suffice for symptomatic relief. Anemia, if severe, may require iron supplementation.
- Embolization is an option which shrinks the fibroid, at the same time preserving the uterus. The blood flow to the fibroid is cut off, thereby preventing its further growth. It takes about 1 to 3 hours and requires some bed rest after the procedure. There could be some pelvic pain and vaginal bleeding, which will gradually subside. The fibroids may grow back, but the benefits of keeping the uterus are definitely there. This is suitable in case of single fibroid with specific blood supply.
- The next surgical option is myomectomy, where the portion of the uterus which contains the fibroid alone is removed. This is done in women who still wish to get pregnant and in women who would like to retain the uterus. This can also be achieved laparoscopically( key hole surgery). In such cases, fibroids are cut into small pieces and then removed from the body. This procedure should be done by a doctor specialised in advanced gynecological endoscopy as all this cutting should be done in a bag to avoid any spillage of cells inside the abdominal cavity. This procedure is known as Laparoscopic Myomectomy with In-bag Moecellation.
- In women who have crossed their pregnancy phase, hysterectomy or complete removal of the uterus is advised. In these women, the bleeding and pain may not have subsided even after years of treatment with hormones. The growing fibroids could be pressing on the adjacent organs, causing pressure. This is the only definitive treatment and should be done in women have completed their family and don’t desire to be pregnant.
- Myomectomy and hysterectomy may be done laparoscopically or with an open method depending on the overall health, the size and location of the fibroids in the uterus.
MY WIFE RECENTLY HAD A CT SCAN & THE IMPRESSIONS ARE AS FOLLOWS: * Bilateral vocal cord palsy (more prominent on left side) * Few enlarged left supraclavicular lymph nodes * ~3 x 2 cm irregular mass in medial aspect of right upper lobe of lung, infiltrating the mediastinal pleura-suggestive of malignancy (metastases - known carcinoma of left breast) * I11 defined soft tissue rind measuring ~1 cm in thickness in superior mediastinum, encasing the mediastinal structures- suggestive of malignancy (spread from pleura / metastatic lymphodes) * ~2 cm right perihilar mediastinal lesion. * Multiple nodules measuring about 2 mm to 5 mm in both lungs- suggestive of metastases. * Moderate pericardial effusion. * Thin layer of left pleural effusion. I KNOW IT IS RELATED TO CANCER, BUT I WANT TO KNOW EXACTLY WHAT TYPE OF CANCER IT IS & WHAT IS THE SURVIVAL CHANCE (PERIOD) FOR PATIENT TAKING TREATMENT & PATIENT NOT TAKING ANY TREATMENT. KINDLY GIVE YOUR VALUABLE SUGGESTION. Thanks & Regards
Breast Cancer is the most common cancer of females in urban cities. It is a curable disease if detected early. The usual age of presentation is usually after 40 to 50 years of age, though it is becoming common in earlier age as well. This could be due to many factors like late marriages, older age of pregnancy, diet and lifestyle, etc. The usual presentation is a swelling or lump in the breast, not associated with pain. That is the reason why females are advised regular self-breast examination, clinical breast examination and annual mammograms for screening purpose in order to detect early breast cancers. Many times, the breast lump is associated with blood stained discharge from the nipple. There can be skin changes on the breast like thickening, crusting or sometimes itching. If the skin lymphatics get blocked, there may be pitting and or dimpling of the skin too. There may be lumps felt in the armpit felt too. Many times the lump is not noticeable or felt and felt by chance during a bath. These are some of the commonest presentations. The lady should immediately consult a doctor and get evaluated in such scenario. Many women are at increased risk of developing breast cancer like those who have a positive family history especially first degree relatives like mother& sister. Breast cancer is usually a disease of women but 1% of cases are also seen in men.
If a lady feels any such lump she should immediately bring it to the attention of a doctor or oncologist who can do the necessary evaluation and investigations. Breast cancer is curable if detected early, hence the importance!
The primary modality of treatment is surgery followed by chemotherapy and or radiotherapy and or hormonal treatment depending on the report of the specimen after the surgery. Many times if the lump cannot be operated upfront, initially chemotherapy and or targeted therapy can be given to shrink the tumor for better resectability.
People should be aware that having cancer is not the end of life. It can be treated like many other diseases and the most important thing is awareness and early detection for a durable cure.
Uterine cancer of cancer of the uterus is a fairly common type of cancer. In fact, this is the fourth most common type of cancer to affect women. This type of cancer is usually diagnosed in its early stages and hence can be easily treated. However, did you know that this type of cancer can be prevented? This is primarily because most cases of uterine cancer are caused by an increased amount of estrogen as compared to progestin. Here are a few tips to keep in mind.
- Birth control pills: The regular use of birth control pills for at least a year is believed to reduce the risk of uterine cancer by at least 50%. The longer these contraceptives are used for, the more effective they are. The protection provided by them lasts for 15 years after their use has been discontinued.
- Reduce weight: Being overweight not only increases the risk of lifestyle diseases such as diabetes and high blood pressure but can also increase a woman’s risk of suffering from uterine cancer. This is because fat cells produce estrogen that further dis-balances the estrogen to progestin ratio. Reducing weight can thus help lower the estrogen levels in the body and prevent cancer. To lose weight, one must keep a strict control over portion sizes, eat nutritious food and exercise regularly.
- Use an IUD: Some methods of contraception not only prevent unwanted pregnancy but also reduce the risk of uterine cancer. Many IUDs or Intrauterine Devices contain progestin. This helps balance the estrogen and progestin levels in the body. Additionally, it also reduces the risk of hyperplasia. This is a condition marked by the abnormal thickening of the lining of the uterus. In many cases, this condition is a precursor to uterine cancer.
- Question Your Family: Genetics can also influence the risk of developing uterine cancer. For example, people carrying the gene responsible for Lynch Syndrome or hereditary nonpolyposis colorectal cancer have a much higher risk of uterine cancer as compared to others. Thus, if you know of family members who have suffered or are suffering from uterine or colon cancer, it is a good idea to undergo genetic testing.
- Broccoli - A super food: Some foods can also help strengthen the immune system and reduce the risk of uterine cancer. Broccoli is one such vegetable. This is known as a super food that can prevent cancer. The best way to eat broccoli is by steaming it. This has the higher amounts of glucosinolate as compared to fried or boiled broccoli. If you wish to discuss about any specific problem, you can consult an Oncologist.
If you are concerned about breast cancer, you should know about the steps you can take to prevent the condition. Breast cancer is a type of cancer developing from the breast tissue. Symptoms such as a lump in the breast, fluid flowing from the nipple, changes in the shape of the breast and occurrence of red scaly patches on the breast denote breast cancer.
You need to make certain lifestyle changes in order to prevent breast cancer. The ways you should adopt include the following:
Limit your alcohol intake: The more you consume alcohol, the more you put yourself at the risk of getting breast cancer. It is recommended for you not to drink more than one drink per day. Small amounts of alcohol increase the risk of breast cancer as well.
Abstain from smoking: There is a direct link between tobacco smoking and breast cancer, and the risk is even more in premenopausal women. You should quit smoking to reduce the risk of breast cancer along with many other conditions, which can develop because of the ill-effects of smoking.
Control your weight: Obese women are more prone to breast cancer when compared with women with a healthy weight. This is especially true when obesity occurs at a later stage in life, after menopause.
Keep physically active: Regular physical activity is essential for you to maintain a healthy weight, which is important for preventing breast cancer. 150 minutes of moderate aerobic exercises or 75 minutes of vigorous exercises are recommended along with strength training.
Breastfeed: Breastfeeding plays an important role in preventing breast cancer. The more you breastfeed your baby, the more protected you are from breast cancer.
Limit the dosage and duration of hormone therapy: If you undertake combination hormone therapy for more than three to five years, you are at a higher risk of developing breast cancer. In case you are taking hormone therapy for menopausal symptoms, you should talk to your doctor about alternative options such as non-hormonal therapy and medications. If you still require hormonal therapy, you must use the lowest dose that will be effective.
Avoid exposure to radiation and pollution: Certain medical imaging procedures like computerized tomography involves radiation of high doses. There is a link between breast cancer and radiation exposure. Thus, you should abstain from getting exposed to radiation and avoid taking such tests if it is not very urgent.
Maintaining a healthy diet also helps in reducing your risk of developing breast cancer. You should include food items which are plant based in your regular diet, such as fruits, vegetables, nuts, whole grains and legumes. Also, consume healthy fats such as olive oil instead of red meat and butter. If you wish to discuss any specific problem, you can consult an oncologist.
Hi doctor, What are the chances of me getting breast cancer if my mom has got it during her menopause? I am getting married soon and this has raised a concern in my fiance's mind.
My wife is suffering from slip disc in spine after mri doctor diagnosis that she also suffering bone tb with unbearable pain in lower portion. Now as per doctor advice completely she is in bed rest. Now she cannot able to stand. Kindly advice.
Main 22 ki women hun or main memography karwana chahti hun. Memography karwane ka right time konsa hai? Period se pehle ya period ke baad ya phir period ke time?
I suffered from L2 L3 PIVD (slip disc) since last month. I took medical treatment in KEM Hospital for 15 days. I complete there Medicine Course but still I have a pain in my hips. When I try to wake up from bed or try to seat I feel pain in my hips and legs. From current medical treatment I feel only 70% recovery still I have a problem for walking I feel weakness in my both leg muscles. KEM Hospital Doctor suggested me Complete Bed Rest and I take also. But still I don't feel progress more than 70%. What should I do?
Breast cancer is a form of cancer which develops from the breast tissue. Breast cancer is indicated by signs such as a lump in the breast, changes in breast shape, fluid flowing from the nipple, dimpling of skin, or the development of red scaly patches. Breast cancer is a fatal form of cancer in women and immediate diagnosis is required on observing the symptoms.
Diagnosis of breast cancer
Other than the regular breast screening, the diagnosis of breast cancer involves the following steps and methods:
- Seeing your general practitioner (GP): It is very important to visit your GP soon after noticing the symptoms of breast cancer. Your GP will examine you properly and in case your symptoms need more assessment, he/she will refer you to a breast cancer clinic.
- Mammogram and breast ultrasound: You will be required to have a mammogram, as recommended by a specialist breast unit. This is an X-ray of the breasts. An ultrasound scan may also be required. Breast ultrasound should be undertaken only if you are less than 35 years of age. This is because, young women have denser breasts and a mammogram is not as effective as ultrasound in the diagnosis of breast cancer. In ultrasound, high frequency sound waves are used for obtaining an image of your breasts. It is observed to notice any abnormality or lumps. A breast ultrasound is also important for determining whether a lump is solid or contains liquid.
- Biopsy: In this diagnosis process, a sample of the tissue cells is taken from the breasts and tested under a microscope to find out if it is cancerous. A scan and needle test for the lymph nodes present in your armpit is also done to check whether they have also been affected. A biopsy is undertaken in several ways, depending upon the condition and severity. A needle aspiration biopsy is used for testing a sample of your breast cells without the removal of the tissues. This is the most common form of biopsy and it is also used for draining a small fluid-filled lump or benign cyst. During the process, you will be given a local anesthetic. Usually, a needle biopsy is carried out guided by an X-ray, ultrasound and an MRI scan as well. This helps in distinguishing it from non-invasive changes such as ductal carcinoma in situ.
Another form of biopsy used for the diagnosis of breast cancer is called vacuum assisted biopsy or mammotome biopsy. In this process, a needle gets attached to a suction tube, which helps in obtaining the sample and for clearing the bleeding.