Dr. Triveni K. L

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.

Breast cancer is a type of a cancerous infection that develops in the skin cells of the breast. This condition is more commonly diagnosed after you have skin cancer and is more common in women than men. There are certain signs to identify this disease, which are as follows.

1. Breast lumps - Lumps are patches of skin that occur due to the thickening and swelling of the skin. Breast lumps is a very common phenomenon for women but that does not always lead to a breast cancer; however, frequent and reoccurring instances of the same increases the risk of breast cancer. A breast lump is easily identifiable through the naked eye as it looks different from the surrounding tissues.

2. Blood discharge - The nipple is one of the most sensitive areas in the human body. In case of women, it is meant to emit milk during pregnancy, in order to feed the infant externally. A probable symptom of breast cancer can also be a frequent discharge of blood from the nipple without any visible damage or injury.

3. Breast changes - If you are experiencing any visible changes in the size, appearance or shape of the breast, then it is an indicative sign that you may have breast cancer. Thus, it is of paramount importance that you observe, touch and physically examine your breast regularly for changes. If there is any major change detected then it is advisable to consult a doctor.

4. Inverted nipple - The tip of the nipple is generally bulging and pointing outwards both in cases of men and women. But sometimes the tip of the nipple is pushed inside due to excessive suction caused by the skin tissues present inside the breast around the nipple area. This suction forces the nipple to grow inwards which is abnormal and might harm the breast and skin in various ways.

However, apart from these main symptoms, some other signs are also there that increase your chances of being diagnosed with breast cancer. They are redness or pitting of the skin over your breast like an orange, peeling or scaling of the pigmented area around the nipple, dimpling of the skin on the breasts, and such others. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

If you are suffering from breast cancer, it is recommended that you undertake Ayurvedic measures for an effective and natural treatment. Breast cancer is a form of cancer that occurs in the cells of your breasts. The breast cells undergo abnormal growth and go out of control. This form of cancer is likely to occur in both women and men, although it is most common in women. A lot of breast cancer cases start from the ducts or lobes, while others start from the cellular lining of your milk ducts.

Ayurvedic view
According to the principles of Ayurveda, your body is based on the tridoshas, which include vata, pitta, and kapha.

1. An imbalance in these doshas can lead to diseases and disruption in your health. Cancer occurs when an imbalance of all the three doshas is experienced.
2. An improper diet and lifestyle account for being the primary reason for this imbalance in doshas, leading to breast cancer.
3. Your digestive fire is also affected, which leads to the accumulation of toxins, thereby blocking all the channels of your body.
4. All these factors are collectively responsible for the development of breast cancer.

Ayurvedic treatment

1. Ayurvedic treatment for breast cancer is very effective because of its natural approach.
2. Without the use of any chemicals and radiation, you get efficient management by using Ayurvedic remedies for breast cancer.
3. Your body functioning is enhanced without the concern of any negative effect on your health.
4. Several Ayurvedic herbs are used for breast cancer treatment. These herbs help in controlling the abnormal growth of breast cells, and in the later stages of breast cancer, these also help in reducing pain.

The herbs play an important role in preventing the condition from spreading to other organs.

Ashwagandha

• This powerful Ayurvedic herb contains natural rejuvenating properties for your body.
• It also helps in eliminating stress, weakness and fatigue, which are associated with breast cancer.

Curcuma

• This effective Ayurvedic herb contains several medicinal properties.
• It is an antioxidant and helps in reducing free radicals from your body. This is beneficial for an improved health and immunity.
• The herb is capable of dealing with toxins and infections, and is super effective in treating malignant cancers.

Kanhnaar Guggul

• This is an Ayurvedic product, which is obtained by mixing several herbs such as amalaki, haritaki, ginger, kachnar bark and a lot more.
• This is effective in maintaining healthy tissues and cells. It also stops the abnormal growth of cancerous cells.

It is important for you to visit a licensed and experienced Ayurvedic practitioner for getting the best Ayurvedic remedies for breast cancer treatment. This will ensure that you get the most effective remedies, based on your condition.

Are you experiencing excessive uterine bleeding? Excessive uterine bleeding may occur between a woman’s periods or before the periods, after having sex, or due to the development of spotting or bleeding after attaining menopause. Any menstrual cycle, which lasts longer than 21–35 days is called excessive, and this is an abnormal form of uterine bleeding.

Causes of Excessive Uterine Bleeding:

The various causes of excessive uterine bleeding are as follows:

1. One of the main causes is hormonal imbalance, as the balance between estrogen and progesterone gets disrupted. This balance is required for the regulation and development of the lining of endometrium or uterus lining. Because of the hormonal imbalance, the endometrium develops excessively causing heavy bleeding.

2. Uterine fibroids, which are non cancerous tumours, may lead to prolonged and excessive uterine bleeding.

3. Polyps are small benign developments on the uterus lining which cause heavy bleeding. They occur because of high levels of hormones.

4. Adenomyosis is a condition which develops when the endometrium glands get embedded in the uterine muscle, leading to excessive uterine bleeding.

5. Using intrauterine devices or IUDs may cause side effects as well.

6. Several pregnancy complications may also lead to excess bleeding. Ectopic pregnancy is a common cause.

7. Several uterine cancers, ovarian cancers and cervical conditions may be responsible as well. Inherited bleeding disorders such as von Willebrand’s disease is another likely cause.

8. Several medicines and drugs, including NSAIDs and anticoagulants are a common cause.

9. Medical conditions such as pelvic inflammatory disease, endometriosis, liver and kidney disease or thyroid problems can also cause excessive uterine bleeding.

Treatment:

There are different ways of treating excessive uterine bleeding, depending upon the cause of bleeding and the patient’s age.

1. Medications: Several medicines are used for the treatment of abnormal uterine bleeding. Hormonal medicines and birth control pills are used to improve the regularity of periods. Non steroidal anti-inflammatory drugs are also used to manage excessive uterine bleeding. Several antibiotics are also used.

2. Surgery: In many cases, a woman has to undergo a surgery for the removal of polyps and fibroids, which cause excessive bleeding. Certain fibroids are removed via hysteroscopy and other techniques for treatment are used as well. Endometrial ablation can be carried out to manage the bleeding. This treatment aims at permanent reduction of the excess bleeding. Hysterectomy has to be carried out when other treatments are unsuccessful. This is a serious surgery and after it, a woman will no longer have periods, and she will not be able to conceive a child.

In case of excessive uterine bleeding, you must consult a doctor as soon as possible. This will enable early treatment and prevent the development of further complications.

It is perfectly normal for women to experience the periodic monthly bleeding cycle. However, if a woman experiences uterine bleeding which is abnormal and dysfunctional, it could be a symptom of infection. Other causes of abnormal uterine bleeding include hormonal imbalance, infection in cervix and cancer of the uterus. Many women can also experience abnormal uterine bleeding during first trimester of pregnancy.

The following are considered to be abnormal or dysfunctional uterine bleeding:

1. A menstrual cycles occurs between 21 to 35 days, anything shorter or longer than this is abnormal
2. No period for 3–6 months (amenorrhea) is abnormal
3. Spotting or bleeding between periods
4. Spotting or bleeding after intercourse
5. Bleeding that is heavier or lasts longer than usual
6. Spotting or bleeding after menopause

What can cause such a situation?

Some of the common causes leading to abnormal bleeding are as follows:

1. Miscarriage
2. Ectopic pregnancy
3. Pregnancy
4. Cervical or uterine infections
5. Fibroids
6. Hormonal imbalances
7. Problems with blood clotting
8. Polyps
9. Polycystic ovaries
10. Endometrial hyperplasia
11. Cancer of the reproductive tract

How to Diagnose it?

Most women tend to ignore abnormal bleeding, taking it as something to do with age or hormones. A detailed physical examination and history is done to understand menstrual cycle patterns and family history. In addition, the following would be used.

1. Ultrasound: The pelvic organs are examined through sound waves to locate the problem area
2. Hysteroscopy: Through a thin device that is inserted into the vagina, the doctor takes a look at the inside of the organs and identify the cause for the bleeding
3. Endometrial biopsy: The uterine lining tissue is removed and examined under microscope to look for tissue changes that could be causing the bleeding

How Best to Treat It?

This would depend on the reason for the abnormal bleeding. However, in most cases, combinations of the following are useful in treatment.

1. Hormone replacement can be done depending on the age and gynecological history, the type and the dose of the hormone would be decided upon. These could be in the form of tablets, vaginal creams, injections, or through an intrauterine device
2. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are useful in reducing bleeding and controlling cramps during excessive menstrual bleeding.
3. Antibiotics may be useful if there is infection of the pelvic organs.
4. Polyps, cysts, cancers, and other growths can be removed via hysteroscopy and sent for biopsy to confirm they are not cancerous.
5. Endometrial ablation where the endometrial tissue is treated with heat can be used to control bleeding permanently.
6. Hysterectomy would be done if other forms of treatment have failed. This could depend on their gynecologic history and other considerations as she cannot get pregnant after this.

Do not ignore if you see a change in the pattern of your uterine bleeding. It definitely calls for medical attention and if identified early, can be managed in much simpler ways.

Test to screen for breast cancer:

Mammogram:

1. Mammography is the most common screening test for breast cancer. A mammogram is an x-ray of the breast. This test may find tumors that are too small to feel. A mammogram may also find ductal carcinoma in situ (dcis). In dcis, there are abnormal cells in the lining of a breast duct, which may become invasive cancer in some women.

2. Mammograms are less likely to find breast tumors in women younger than 50 years than in older women. This may be because younger women have denser breast tissue that appears white on a mammogram. Because tumors also appear white on a mammogram, they can be harder to find when there is dense breast tissue.

Enlarge Mammography:

1. The left breast is pressed between two plates. An x-ray machine is used to take pictures of the breast. An inset shows the x-ray film image with an arrow pointed at abnormal tissue.

2. The breast is pressed between two plates. X-rays are used to take pictures of breast tissue.

The following may affect whether a mammogram is able to detect (find) breast cancer:

1. The size of the tumor. How dense the breast tissue is. The skill of the radiologist.

2. Women aged 40 to 74 years who have screening mammograms have a lower chance of dying from breast cancer than women who do not have screening mammograms.

Clinical Breast Exam (CBE):

1. A clinical breast exam is an exam of the breast by a doctor or other health professional. The doctor will carefully feel the breasts and under the arms for lumps or anything else that seems unusual. It is not known if having clinical breast exams decreases the chance of dying from breast cancer.

2. Breast self-exams may be done by women or men to check their breasts for lumps or other changes. It is important to know how your breasts usually look and feel. If you feel any lumps or notice any other changes, talk to your doctor. Doing breast self-exams has not been shown to decrease the chance of dying from breast cancer.

3. Mri (magnetic resonance imaging) in women with a high risk of breast cancer

4. Mri is a procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (nmri). Mri does not use any x-rays.

MRI is used as a screening test for women who have one or more of the following:

1. Certain gene changes, such as in the brca1 or brca2 genes. A family history (first degree relative, such as a mother, daughter or sister) with breast cancer. Certain genetic syndromes, such as li-fraumeni or cowden syndrome.

2. Mris find breast cancer more often than mammograms do, but it is common for mri results to appear abnormal even when there isn't any cancer.

3. Other screening tests are being studied in clinical trials.

Thermography:

1. Thermography is a procedure in which a special camera that senses heat is used to record the temperature of the skin that covers the breasts. A computer makes a map of the breast showing the changes in temperature. Tumors can cause temperature changes that may show up on the thermogram.

2. There have been no clinical trials of thermography to find out how well it detects breast cancer or if having the procedure decreases the risk of dying from breast cancer.

Tissue sampling:

Breast tissue sampling is taking cells from breast tissue to check under a microscope. Abnormal cells in breast fluid have been linked to an increased risk of breast cancer in some studies. Scientists are studying whether breast tissue sampling can be used to find breast cancer at an early stage or predict the risk of developing breast cancer. Three ways of taking tissue samples are being studied:

Fine-needle aspiration: a thin needle is inserted into the breast tissue around the areola (darkened area around the nipple) to take out a sample of cells and fluid.

Nipple aspiration: the use of gentle suction to collect fluid through the nipple. This is done with a device similar to the breast pumps used by women who are breast-feeding.

Ductal lavage: a hair-size catheter (tube) is inserted into the nipple and a small amount of salt water is released into the duct. The water picks up breast cells and is removed.

Our spinal disk resembles a jelly donut, wherein the softer insides are protected by the hard exterior. Sometimes, as a result of some injury or an accident the jelly slips out, leading to an extremely painful condition which in medical parlance is known as herniated disc. The pain that you are subjected to, during herniated disc, occurs as the nerves nearby are damaged due to the concussion.

Apart from pain, herniated disc is preceded by other symptoms, some of them are:

1. Pain in the arm or the leg: Depending on which part of the body you have suffered the herniated disc, in the neck or in your lower back, this condition is succeeded by intense pain either near the buttocks or near the shoulders. It goes without saying that this pain increases sharply with movement.
2. Numbness: That part of the body where the nerves are damaged due to herniated disc often becomes numb and has no sensation whatsoever.
3. Weakness: Due to herniated disc, the muscles become weak that considerably impairs and curbs mobility.

However, there are various ways by which you can prevent a herniated disc. Some of them are:

1. Exercise: Exercise in any form and even for a short while yields several benefits. Your body invariably gains momentum and agility. If you exercise daily, your spine becomes more stable and strong, thereby preventing a possible herniated disc.
2. Maintaining the right and good posture: A lot depends on the way you sit and walk, in fact more than you can imagine. If you sit badly, it exerts a pressure on the spine and the discs. Subsequently, a good posture does the very reverse and curbs chances of a herniated disc in the future.
3. Keep a tab on the weight: It is always healthy to maintain the right weight, the one that keeps you away from the onset of various diseases. If you are overweight, it puts more pressure on the spine disk, thereby increasing the risk of developing a herniated disc.

A brain stroke can affect anyone at any point of time when the supply of blood to the brain is interrupted. It can threaten major physical functions and can prove to be fatally dangerous at times. The brain stem which is placed right above the spinal cord controls the breathing, heartbeat and levels of blood pressure. It is also in charge of controlling some elementary functions such as swallowing, hearing, speech and eye movements

What are the different types of strokes?
There are three main kinds of stroke: ischemic strokes, hemorrhagic strokes and transient ischemic attacks. The The most common type of brain stroke is the ischemic stroke is caused by narrowing or blocking of arteries to the brain, which prevents the proper supplyof of blood to the brain. Sometimes it so happens that the blood clot that has formed elsewhere in the body have travelled via the blood vessels and has been trapped in the blood vessel which provides blood to the brain. When the supply of blood to a part of the brain is hindered, the tissue in that area dies off owing to lack of oxygen. The other variant of brain stroke is termed as hemorrhagic stroke is caused when the blood vessels in and around the brain burstor or leak. Strokes need to be diagnosed and treated as quickly as possible in order to minimize brain damage.

What are the common symptoms of a brain stroke?
The symptoms of the brain stroke are largely dependent on the area of the brain that has been affected. It can interfere with normal functioning, such as breathing and talking and other functions which human beings can perform without thinking such as eye movements or swallowing. Since all the signals from the brain as well as other parts of the body traverse through the brain stem, the interruption of blood flow often leads to numbness or paralysis in different parts of the body.

Who is likely to have a stroke?
Anyone is at a risk of developing brain stroke although ageing is directly proportional to the risk of having a stroke. Not only that an individual with a family history of brain stroke or transient ischemic attack is at a higher risk of developing stroke. People who have aged over 65 accounts for about 33 percent of all brain strokes. It is important to point here that individuals with high blood pressure, high blood sugar, cholesterol, cancer, autoimmune diseases and some blood disorders are at a higher risk of developing brain stroke.

There are a few factors which can increase the risk of developing stroke beyond any control. But there are certain lifestyle choices as well which aids in controlling the chances of being affected by stroke. It is crucial to refrain from long-term hormone replacement therapies as well as birth control pills, smoking, lack of physical activity, excessive use of alcohol and drug addiction. A brain stroke is a life-threatening medical condition, and when an individual has symptoms that resemble that of stroke, it is crucial to seek immediate medical help.

Treatment for stroke:

• Treatment depends on the type of stroke.
• Ischemic strokes can be treated with 'clot-busting' drugs.
• Hemorrhagic strokes can be treated with surgery to repair or block blood vessel weaknesses.
• The most effective way to prevent strokes is through maintaining a healthy lifestyle.

What is TPA?
TPA is a thrombolytic or a “Clot Buster” drug. This clot buster is used to break-up the clot that is causing a blockage or disruption in the flow of blood to the brain and helps restore the blood flow to the area of the brain. It is given by intravenous (IV). This can be given only within 45.5 hrs of the onset of symptoms

Time is brain

Remember Every second Loss means brain cells die.

Rush to the nearest Stroke Centre whenever you experience such symptoms.

You can save the brain cells dying if you reach within 45.5 hrs by the CLOT BUSTER. 

Endovascular procedures:
Another treatment option is an endovascular procedure called mechanical thrombectomy, strongly recommended, in whichtrained  trained doctors try  removing a large blood clot bysending sending a wired-caged device called a stent retriever, to the site of the blocked blood vessel in the brain

Stroke prevention:
The good news is that 80 percent of all strokes are preventable. It startswith with managing keyrisk risk factors, including 

• High blood pressure,
• Cigarette smoking,
• Diabetes Atrial fibrillation and
• Physical inactivity.

More than half of all strokes are caused by uncontrolled hypertension or high blood pressure, making it the most important risk factor to control. 

Rehabilitation:
The best way to get better after a stroke is to start stroke rehabilitation ("rehab"). In stroke rehab, a team of health professionals works with you to regain skills you lost as the result of a stroke. If you wish to discuss about any specific problem, you can consult a neurologist.

Breast cancer is one of the most common cancers in women about 1 in 8 women in the USA develop invasive breast cancer. The incidence of breast cancer has increased with changes in lifestyle including smoking, drinking and loss of physical activity. The risk factors are age, ethnicity and family history cannot be changed. However, there are some risk factors that can definitely be acted upon to reduce the chances of developing breast cancer.

1. Weight management: Obesity is one of the major risk factors for breast cancer and managing weight and a good body mass index will help reduce the risk of developing breast cancer. This is especially important in women undergoing menopause.
2. Reducing smoking: The benefits of quitting it are manifold and reducing the risk for breast cancer is one of them. This will, as a byproduct, also result in a host of other benefits including improved quality of life, reduced chances of heart disease, stroke, and other cancers.
3. Physical activity: In addition to helping in weight management, this also helps reduce the risk of breast cancer. Ideal recommendation is 30 minutes of physical activity per day, plus strength training.
4. Breastfeeding: This helps in reducing the risk of breast cancer. Prolonged feeding is shown to have a greater protective benefit.
5. Hormone replacement therapy: When possible, limit the use of hormone replacement therapy for prolonged periods of time. Explore options of non-hormonal substitutes or use the least permissible or required dose. Be sure to get periodic check-ups when on hormone therapy.
6. Reduce exposure to environmental pollution: Higher levels of pollutants are linked to a higher incidence of breast cancer. When possible, avoid getting exposure to environmental pollutants.
7. Screening: If there is a strong family history or other risk factors, then screening can help detect breast cancer very early in the process. Recommended ages for mammography are as follows:
   • If you are age 40 – 44: Go for annual mammograms after discussing risks and benefits with the doctor.
   • If you are age 45 – 54: Go for annual mammogram.
   • If you are age 55 or over: Mammograms are recommended every other year. You can choose to continue to have them every year. Self-breast exams are not sufficient. However, if being done, they can also be an input to an abnormality.
8. Cautious use of birth control pills: Birth control pill usage to be discussed with your gynaecologist if you are above 35 years of age and smoke. The good news is that the risk associated with it disappears slowly after the pill is stopped.

These will help reduce the risk of developing breast cancer, early detection, and improved prognosis.