Doctor in Sri Venkateswara C M Hospital
Submit a review for Sri Venkateswara C M HospitalYour feedback matters!
Breast cancer begins when cells in the breast(s) start to grow out of control. It is understood as being the most common cancer, seen predominantly in females, globally. It is reasonably treatable and often curable.
1. Type: Adenocarcinomas constitute more than 95% of breast cancers with infiltrating ductal carcinoma (IDC) being the most common form of invasive breast cancer.
Frequently occurring breast cancers present as one of the following types mainly
- Ductal Carcinoma In Situ (DCIS): Is the most common type of non-invasive breast cancer and is confined to the milk ducts of the breast. There is no invasion in the basement membrane. Pure DCIS metastasizes rarely. Non comedo cribrioform carcinoma is the most common DCIS found which, when compared to the comedo type, is mostly non-aggressive.
- Infiltrating Ductal Carcinoma (IDC): Represents majority (about 3/4th) of the breast cancers, and is known to metastasize commonly to bones, lungs and liver.
- Lobular Carcinoma In Situ (LCIS): Develops in multiple lobules of the breast (bilaterally). LCIS is less commonly seen, compared to DCIS.
- Infiltrating Lobular Carcinoma (ILC): Represent about a tenth of all breast cancers and tends to metastasize to other regions of the body.
Less commonly occurring breast cancers such as
- Inflammatory Breast Cancer: Is relatively uncommon and are caused probably owing to viral infections. The breast is warm, red and swollen.
- Paget’s disease of the nipple: Is a rare form of breast cancer. It begins in the milk ducts and spreads to the nipple and areola.
- Medullary Carcinoma
- Mutinous Carcinoma
- Tubular Carcinoma
- Phylloides tumor etc all.
2. Gender: Affects the female populace predominantly. However, a small percentage of breast cancer is attributable to the male populace as well.
3. Etiology: No definite cause is known. However, diet, lifestyle, environment, hormonal/ reproductive factors, personal or family history of breast cancer especially in first degree relatives and also any benign breast disease history etc all are known to increase the risk of breast cancers. Specifically, excessive fatty diet, obesity, type 2 diabetes mellitus, benign breast disease, heredity/ inheritance of mutated breast cancer genes 1 (BRCA1) and 2 (BRCA2), smoking, alcohol intake, infertility, estrogen therapy/ hormone replacement therapy (long term) in post menopausal women, delayed age at first pregnancy, nulliparity (not having child), early menstruation, delayed onset of menopause, lactating mothers not breast feeding, exposure to ionizing radiation, sedentary lifestyle, depression, exposure to MMTV virus etc all can potentially increase the risk for breast cancer.
4. Features: Signs & symptoms, of breast cancer, manifest majorly in the following ways
- Lump/ nodule in the breast that gets attached to the skin of the breast over time. The lump / nodule could be hard and painless with irregular edges or it could also be soft, rounded, tender and painful.
- Enlarged lymph nodes in the axilla which are palpable.
- Swelling of whole or a part of a breast. This is even if there is no distinct lump felt.
- Retraction or thickening of the nipple(s).
- Pain in the breast or nipple.
- Discharge from nipple other than breast milk.
- Irritation/ scaliness of skin over the breast.
- Redness of nipples
- Rarely, red, swollen and tender breast.
5. Screening: Is generally recommended for asymptomatic populations goal of which, as usual, is to be able to detect & diagnose breast cancer at an early stage which is potentially curable. It is mostly radiologic with mammography/ USG being instrumental in raising suspicions for further diagnostics (i.e. biopsy) that help detect breast cancer, if any, early.
6. Diagnosis: A self-examination/ clinical exam of the breast(s)/ axilla that reveals a palpable mass prompts the following diagnostics. Abnormal blood test results may be indicative of malignancy, but a follow up imaging/ biopsy is always the gold standard for accurate diagnosis.
- Blood: ER/ PR/ HER2/neu, uPA, PAI-1, CA15-3, CA27.29 etc all tumor markers are helpful.
- Imaging: Mammography/ USG Scan usually, as relevant. Again, CT Scan of abdomen & pelvis and chest, PET CT scan, bone scan etc all help detect metastasis, if any, for cancers in stage III & above.
- Biopsy: either excisional, incisional, fine needle aspiration (FNA) or core biopsy technique, as contextually appropriate, is frequently employed and a histopathological examination (HPE) thereof clinches the diagnosis and the nature of the disease.
7. Treatment: Conventional treatment includes surgery, radiotherapy, hormone therapy/ chemotherapy as deems appropriate. Simultaneously, an adjunctive or integrative naturopathic treatment with suitable complementary & alternative medicines (CAM) too can help improve clinical outcomes and facilitate recovery as would be feasible contextually.
8. Prognosis: Preventive measures, earlier diagnosis and right early treatment is key for an effective therapeutic management & better prognosis. Like most other cancers, the chances of cure for an early stage breast cancer are more. The cure/ recovery chances are influenced by the type, grade, stage of cancer, recurrence and the patient’s general health & vitality etc all. Above-mentioned apart, age, menopause status, lymph node status, ER/ PR/ HER-2/ neu status, size & extent of breast cancer etc all also influence the treatment outlook in breast cancer. The five year survival rate is strongly correlated with the stage of breast cancer.
9. Prevention: Rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an increased focus on protective factors and avoidance of the risk factors can be of help. An adherence to a Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising (for at least 30 minutes daily), de-stressing and relaxation is highly recommended for reducing the risks of breast cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. It is advisable to limit milk/ dairy, preferably of low fat content, to 1 to 2 servings max daily. Although alcohol is optional and is not for everyone, the consumption of the same, if any, has to be strictly in moderation, and is best avoided. Smoking is to be avoided as well. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly or are best avoided too. Limiting dosage/ duration of hormone therapy, if any, especially to counteract post menopausal symptoms and also avoiding exposure to radiation and environmental pollution can help reduce the risks of breast cancer. Apart from the above-mentioned, for high risk cases, a prophylactic oophorectomy, prophylactic radical mastectomy, long term hormone therapy etc all can help reduce the chances/ risks of developing breast cancer significantly. Breastfeeding is known to confer protection against breast cancer risk too.
Epithelial Ovarian Cancer is a condition in which malignant tumor emerges from the tissue lining in the outer surface of the ovary. Epithelial tumors are usually benign, but this form of malignancy has been found to be the most common type of ovarian cancer. Moreover, it cannot be diagnosed until in its advanced stage. Medical research shows that factors such as multiple pregnancies, delayed childbirth and early menarche seem to raise the risk of ovarian cancer, while dietary and environmental factors also play a significant role in it.
1. A majority of the patients have been observed to have extensive intra-abdominal growth.
2. They may experience discomfort or swelling of the abdominal region.
3. The feeling of being bloated, lack of appetite, unnatural weight alteration, dyspepsia, malaise, and urinary problems are frequently reported symptoms.
4. Patients also experience constipation and other gastrointestinal problems.
The first step towards treatment of ovarian cancer is to diagnose the condition. A thorough pelvic examination (consisting of an examination of the vagina, uterus, ovaries, fallopian tubes, and cervix) will help to pin point any abnormality of the ovary. If the doctor notes nodularity, firmness or lack of tenderness during the examination, these can be taken as symptoms of malignancy of epithelial ovarian tumors. Ultrasound examination of the abdominal region will also help to locate abnormality in the tissues on the outer surface of the ovary. The next logical step towards treatment is getting a biopsy. During this procedure potentially malignant cells are removed and then diagnosed by a pathologist to conclude if the cells are cancerous or not. The process of removal is known as laparotomy.
Apart from a handful of stage one patients, most women with epithelial ovarian cancer receive chemotherapy. The standard treatment for this type of ovarian cancer is the surgical elimination of tumor. This includes total abdominal hysterectomy, a surgery in which the uterus and cervix is removed through an incision in the abdomen. Post surgical treatment consists of taxane-platinum chemotherapy. Patients with minimal residual cancer undergo external radiation therapy or intraperitoneal chemotherapy (radioactive liquid is channelled into the abdomen with the help of a catheter).
A lot of research has been done in this field and a variety of clinical trials are available for a patient, if he/she wishes to be a part of it. Leading methods are immunotherapy and targeted therapy are also available. Immunotherapy uses the immune system of the patient to battle cancer. Bodily substances or substances created in the lab are used to restore and boost the body’s natural defence mechanisms against cancer. Targeted therapy, on the other hand, uses substances to identify the cancer and attack the malignant cells without jeopardizing non-cancerous cells.
Amongst the different types of gynecological cancers prevalent today, ovarian cancer is associated with the highest rate of fatality. This type of cancer refers to tumours that grow in the ovaries. In most cases, these develop on the outer lining or epithelium of the ovary. Though this type of cancer is difficult to treat in its later stages, if diagnosed early enough it can be easily managed.
In the early stages of ovarian cancer, very few symptoms may be present. Many women do not experience any symptoms at all. The symptoms that may be experienced can be associated with other conditions and hence often go unrecognized. However, in the case of ovarian cancer, these symptoms will gradually increase and worsen with time. Some of the early symptoms of ovarian cancer could include:
- Pain in the lower stomach or pelvic area
- Back aches
- Frequent urge to urinate
- Change in bowel habits
- Weight loss
- Loss of appetite or feeling full without eating too much
Ovarian cancers affect usually after the age of 65 years, but offlate its also prevalent in younger age in third decade and fourth decade aged ladies. Women with a family history of breast cancer or ovarian cancer have a higher risk of developing these tumours. Endometriosis and hormone replacement therapy could also increase one’s risk of ovarian cancer.
As with other types of cancer, treatment for ovarian cancer depends largely on how far it has advanced. The main forms of treatment include surgery, chemotherapy and radiation. Surgery is usually the first step of treating ovarian cancer. This involves a partial or complete hysterectomy. In the former, only one ovary and the adjoining fallopian tube is removed while in the latter both ovaries, fallopian tubes and the uterus are removed. The lymph nodes around the reproductive system and the fatty tissue in the abdomen may also be removed. In cases of advanced ovarian cancer, surgery may also include removing cancerous cells from the urinary system, intestines and spleen.
Surgery is usually followed by chemotherapy, medication for targeted therapy or hormone therapy. Radiation is rarely used to treat ovarian cancer. In addition, many patients also require counselling to cope with body change issues and the loss of sexual desire. Ovarian cancer can recur and hence it is also important to get regularly screened for any signs of recurrent tumours. In cases of recurrent cancer, chemotherapy is the most preferred form of treatment.
Ayushmann Khurrana's Wife Tahira Kashyap revealed over the weekend that she has been diagnosed with breast cancer. The cancer was detected in her right breast; the other breast is unaffected by it. Specifically, she has been diagnosed with DCIS, which stands for ductal carcinoma in situ. DCIS was detected along with high-grade malignant cells.
She is being treated for it since last one week and is back to normal now.
Let’s try to know more about this disease:
What is DCIS?
DCIS is a type of breast cancer. This is a non-invasive type of the disease. It is quite prevalent; one in five new breast cancer cases are of DCIS type. More than 60,000 cases of DCIS type of breast cancer are detected per year in the US alone.
- “D” stands for Ductal. This symbolises that cancer has started from milk ducts.
- “C” stands for Carcinoma. This refers to any cancer that starts from skin or tissues. In case of breast cancer, this refers to the fact that DCIS starts from breast tissue.
- “IS” stands for In-Situ. This means “in its original place”.
DCIS is called a non-invasive type of breast cancer because it hasn’t yet spread to other tissues, apart from the original milk duct, where it originated.
How is DCIS Detected?
Like any other breast cancer, DCIS is also detected with the help of a Mammogram. A mammogram is like an X-Ray of the breasts. It reveals the presence of cancerous cells in the breasts. Mammograms have been becoming more accurate over time and have now better detection ratio.
But how to know if someone needs to get Mammogram done? The simplest test of that is regular self-analysis of breasts. If some nodules or hard parts are felt, then it is better to consult a doctor, who can further recommend a Mammogram.
Treatment Options for DCIS?
There are multiple treatment options for DCIS. The first option is a breast-conserving surgery. In this, the abnormal cells are removed. Also, tissue from some other body parts can be added to breasts to fill the void that is created. In case of Tahira Kashyap, tissues from her back were inserted into her breast.
Sometimes the surgery can also be combined with follow-on radiation treatment.
Is DCIS Fatal?
The good news is that DCIS is not life threatening. If it is detected early on, it can be easily cured. However, one negative aspect associated with DCIS is that a person who has DCIS has a higher probability of getting breast cancer. In fact, the recurrence ratio is around 30%. The recurrence can happen within 5-10 years.
If a patient got radiation therapy, along with the surgery, then chances of recurrence reduce to 15%.
Tahira Kashyap put out a long Instagram post about her condition. This was pretty brave on her part, as she not only acknowledged the presence of this disease, but also encouraged others to take this seriously, and get regularly tested.
DCIS is non-fatal but can be followed up by the more fatal forms of breast cancer. So, if there is any symptom of it, immediately contact the doctor to rule out the possibility of it.
I am 62+ years suffering from grade 3 prostatomegaly where as per USG of whole abdomen revealed that urinary bladder is distended, wall thickness appears normal. No intraluminal pathology (calculi/mass) is seen. No significant residual urine is seen in post void study. Prostate is grossly enlarged in size. Echo- texture appears within normal limits. No detectable focal lesion is seen. It measures 5.1 cm X 5.0 cm X 4.6 cm. It weights = 64 gms (approx). No detectable lymphadenopathy, localised collection or ascites is seen in the abdomen and pelvis. Lower pleural spaces appear clear. Serum PSA test scores at 0.969 ng/ml with respect to the Biological Reference Interval for 60-70 years: 1.65-4.1. Uroflometry test reports an average flow rate of 17 ml/sec with no hesitancy. Urine RE and Culture found no evidence of abnormalities. I am advised to take one duprost .5/dutas .5 mg after breakfast and one urimax D at bedtime for six months by an Urologist and will be reviewed thereafter followed by USG of KUB and Serum PSA test. Also I am advised to take one each of Glyciphage G1 before breakfast and dinner, Telsartan AM and Febutaz 40 after breakfast for one month. I want to know whether the uro medicines will cure my issues related to enlargement of prostate or I will have to take homeopathic medicines in this regard?
Hi, Post whipple Surgery in recent PET scan report of my mother who is 65 years outcome is "A hypodense Non FDG avid collection 20HU is seen in the region GB fossa subhepatic region & posterior to the stomach" measuring approx 3TRx2. 4APx7.5 CC. Can someone share it's meaning.
Hello Doctor, My father had pain while urinating. There was also blood present. The doctors found that there was a block in the urinary bladder. It was operated out and removed. Upon lab testing of the removed item doctor said that there was early stage cancer in urinary tract connecting the kidney and bladder and that kidney may have to be removed. We tried with ayurvedic doctors for about 3 months and then underwent another lab testing. I have the old reports as well as the new one. Please inform us the present status of the illness and the ways to effectively treat it. I am attaching the reports here. Thank you
The sound of the word cancer can be really traumatic and the fact the one may most of the time be unaware of this condition can be hard to handle. The same is the situation in the case of lung cancer as it does not produce any remarkable signs and symptoms in its early stages. However, there are ways in which you can be aware of this life-threatening ailment. Here are some tell-tale signs of an early stage of lung cancer:
A stubborn cough:
Beware when a cough is lingering on for long with no sign of relief. When a cough is related to cold and respiratory infection, it will subside within a week or so. But in case the cough is persistent, it can be a symptom of lung cancer. You should never dismiss a stubborn cough regardless of whether it is dry or producing mucus. You should talk to a doctor right away as he can check the lungs and may order for other tests to determine whether you have cancer.
Becoming easily winded or shortness of breath is considered the most prominent symptoms of lung cancers. This may occur when cancer blocks or inhibit the airway or when the fluid from the tumor starts building up in the chest. If you find that it is becoming difficult for you to breathe in doing tasks that you found easy before, you should not ignore it.
When the airways become inflamed, blocked or constricted, then the lungs would produce a wheezing and whistling sound while breathing. It can be associated with a host of other causes that are easily treatable but could also be due to lung cancer.
Even though headaches are considered one of the most common health problems, if there is a persistent headache, then it could be a sign that lung cancer has spread to the brain. It is important to understand that all headaches are not associated with the brain metastases. There are times when the lung cancer creates pressure on the superior vena cava which is in charge of supplying blood to the upper part of the brain. This pressure can also lead to headaches.
Pain in the bone:
If the lung cancer has spread to the other parts of the body, then it may produce mild pain in the back and other parts of the body. It tends to become worse during the night when you are resting on your back. But it can be difficult for a commoner to differentiate between muscle and bone pain. In case you are suffering from bone pain, you will see that it is becoming worse with movement. Moreover, lung cancer is also associated with pain in the shoulder, neck, and arm even though it is very rare. You should be very attentive to the pain and aches in the body and consult with an expert at the earliest.
You can easily combat lung cancer if diagnosed and treatment is started in its early stages.