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Dr. Manimekala E

Radiologist, Chennai

Dr. Manimekala E Radiologist, Chennai
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To provide my patients with the highest quality healthcare, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies....more
To provide my patients with the highest quality healthcare, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies.
More about Dr. Manimekala E
Dr. Manimekala E is an experienced Radiologist in Ambikapuram, Chennai. She is currently practising at Barnard Institute of Radiology in Ambikapuram, Chennai. You can book an instant appointment online with Dr. Manimekala E on Lybrate.com.

Lybrate.com has an excellent community of Radiologists in India. You will find Radiologists with more than 34 years of experience on Lybrate.com. You can find Radiologists online in Chennai and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Brain Surgery - Know The Purpose Behind It!

IFAANS, DNB (Neurosurgery), MBBS
Neurosurgeon, Ghaziabad
Brain Surgery - Know The Purpose Behind It!

The most powerful and amazing organ in our body is the brain. It differs from many other organs of our body not only by its shape, but also by its special type of cell called neurons. When these cells gets affected or dead it can never be reverted or regenerated which is the most exclusive nature found only in brain cells. The cells in other parts of our body has the capacity to regenerate (can be replaced or new one can be grown or produced), but brain cells are exception. Hence any damage to the brain, injury or trauma is really a crucial thing to be considered with utmost care.

Brain surgeries really need skill, proper training, confidence and intelligence to perform this highly complicated and risky surgery.

Purpose:
Brain surgeries are performed to:

  1. Remove the brain tissues that are grown abnormally
  2. Aneurysm is clipped to prevent flow of blood cliff off an aneurysm
  3. Biopsy purpose or to remove the tumour
  4. Make a nerve free
  5. Drain the abnormal blood or clot collection or to drain any excessive fluid collection caused by infection.
  6. To implant artificial electronic device as a treatment for conditions like Parkinson’s disease

Types:

  1. Biopsy: A part of brain tissue is removed for the brain or whole tumour is removed.
  2. Craniotomy: The skull bone is opened to remove tumour, an aneurysm and drain fluid or blood from infection.
  3. Minimally invasive endonasal endoscopic surgery: Endoscopic devices are inserted through the nose to remove the lesions or tumour.
  4. Minimally invasive neuroendoscopy: Similar to endonasal surgery but small incision is made.

Risks:

  1. Anaesthesia risks like breathing difficulty, allergic reaction to medications, excessive bleeding or clots and infection.
  2. Risk related to the brain surgeries are seizures, coma, swelling of brain, infection to brain or meanings, surgical wound infection that intrudes to the brain structures, abnormal clot formation and bleeding.
  3. General risks include muscle weakness, disturbances in memory, speech, vision, coordination, balance and other functions that are controlled by the brain. If you wish to discuss about any specific problem, you can consult a neurosurgeon.
1751 people found this helpful

My MRI INDICATE 1. Lumbosacral transitional Vertebra with complete socialization of L5 2. Disc desiccation with diffuse disc bulge and broad based posterior central disc protrusion at L4-L5 level causing ventral thecal sac indentation and significant compromise of bilateral neural forminal (right>left). Mild ligamentum flavum thickening is also seen at this level with maintained spinal canal dimensions. 3. Cervical spondylitis changes with disc osteophyte complexes at C4-C5 and C5-C6 levels. Broad based left paracentral disc protrusion at C4-C5 level causing ventral thecal sac indentation and moderate compromise of left sided neural forminal. 4. Mild disc bulge at d5-d6 (screening of rest of spine revealed) I am confused. Dr. Said physio will fix it. I read too many damages. Please guide and suggest sustainable solutions. I am willing to take prolonged treatment. What does this report mean?

Radiologist, Delhi
Hello Mr. lybrate-user. The report says that there is significant compression of nerves at L4-5, C4-5 and C5-6 vertebral levels. You need to wear lumbar hot belt on regular basis, have to take medicines, you have to undergo physiotherapy and take precautions like no forward bending, no lifting weight, using ortho matress to keep spine straight. I would advise you to meet an orthopedician and discuss your symptoms in detail. Clinical examination and some further tests are required before prescribing medicines.
3 people found this helpful
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I am 46 year old I have slip discs problem in l-4, l-5 it is curebel? and what should I do to get my self cure in this regards.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Kindly show me digital x rays of ls spine. Not all patients of backache need surgery. Most of them can be managed without operation. Rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful use no pillow under the head. Do hot fomantation. Ibuprofen 200mg od & sos x 5days bio d3 max 1tab od x10 do neck, back & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. Do reply back for detailed treatment plan. Do not ignore. It could be beginning of a serious problem.
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My mother is suffering from disc extrusion in L5, is surgery necessary? Or something other will be helpful.

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
My mother is suffering from disc extrusion in L5, is surgery necessary? Or something other will be helpful.
avoid surgery do physiotherapy treatment for few days and spine stretching and strength exercise. avoid long sitting toward bending lifting weight. posture correction must
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I am having ls S1 disk bulge problems if I am having physiotherapist it will cure or not?

DNB (Radiodiagnosis), DMRD, MBBS
Radiologist, Bangalore
Hi, thanks for your query a l 5 - s 1 disc bulge might respond to physical therapy. It cannot be cured completely like before but with precautions and medicine you will feel much better and have a normal life. Please take care not to involve yourself in any activity which might stress your lower back. This will delay recovery and might also cause complications and the pain and discomfort to increase. Avoid doing sudden movement involving lower back and lifting weight more than 5 kg. This will help you recover quickly. For mild pain you should use ointments with muscle relaxant and pain relief. In severe pain plase adk your doctor for oral ner pain reluef medicine and non steroidal anti inflammatory pills. Use of heat pack is also recommended. Regards.
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I'm suffering with l4 l5 disc bulging minimal thical. I need an acupuncture treatment.?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Kindly show me a photograph of the affected part. Rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful Do hot fomantation. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck, back & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. If it does not give relief in 4-5days, contact me again. Do not ignore. It could be beginning of a serious problem.
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Know All About Gynae Laparoscopy Surgery

Panchkula & Delhi
Mother and Child Care, Panchkula
Know All About Gynae Laparoscopy Surgery

Q1. What exactly is Laparoscopy?

Laparoscopy is an alternative to 'Open' surgery wherein the abdomen is opened by tiny 'key hole' incisions and surgery is done. 'Scopy' means the use of an endoscope or telescope to see inside the abdomen. This is attached to a camera and a light source and the inside of the abdomen is projected on to a monitor. The surgeon performs surgery looking at this screen. The surgeon makes a total of 2-4 small cuts on the abdomen ranging from half to 1 cm through which the telescope and other thin surgical instruments are passed into the abdomen. When the uterus is removed , known as hysterectomy, there is also a cut at the top of the vagina where the uterus is attached.

Q2. What kind of gynaecological surgeries can be performed by Laparoscopy?

Most surgeries done in gynaecology can now be performed by Laparoscopy and do not require the large incision as for open surgery. Laparoscopy can be done sometimes only for diagnosis and is called Diagnostic Laparoscopy, as in checking whether the tubes are open or not and to look for any causes of infertility or pain outside the uterus. In women who are unable to conceive, Diagnostic Laparoscopy is often combined with Hysteroscopy (endoscope inside the uterus, inserted from below, via the vagina). When laparoscopy is done to perform some surgical procedure inside the abdomen it is called Operative Laparoscopy. This may be for simple procedures like sterilization, minor adhesions, drilling ovaries; or for intermediate or major reasons like fibroids, endometriosis, removal of ovaries or tubes or both or removal of uterus, for staging of cancers or radical surgeries for cancer. However, about 5% of all surgeries including those for cancer or very large tumours may benefit from open surgery.

Q3. Why does an expert surgeon recommend Laparoscopy over Open Surgery?

Laparoscopic surgery has many advantages above open surgery: the incisions are much smaller (open surgery incisions are 8-10 cms long), therefore pain is much less; requirement for pain killers (which can have side-effects like sleepiness, impaired judgement) is lesser; hospital stay is shorter; complications fewer; requirement for blood transfusions infrequent; recovery in terms of physical, emotional and mental state is much better and quicker; return to work is faster with consequent lesser loss of working and earning days. Surgery with laparoscope is more precise because it is magnified view. Further vision is much better because it's like having your eye behind the structure because you can see with the telescope at places where the surgeon's eye cannot reach.

Q4. If the cuts on the abdomen are so small in Laparoscopic surgery, how do you remove the uterus or a large tumour from inside the abdomen?

Quite often if the tumour is not malignant and contains fluid, it is punctured to collapse it into a smaller size. If it is solid, it can be cut into smaller pieces inside the abdomen using a special instrument. The collapsed or cut structures can be removed gently through the 1 cm cut on the abdomen which may be increased a bit if required. After hysterectomy, the uterus can be removed easily from below, through the vagina.

Q5. Will there be much pain or discomfort after Laparoscopic Surgery?

There may be some pain and discomfort in lower abdomen for one day to few days after Laparoscopic surgery but this is much less as compared to open surgery because the incisions on the abdomen are much smaller and there is much less tissue handling inside the abdomen by fine instruments instead of rough, big, gloved hands which can cause tissue injury in open surgery. There may be some pain in the shoulder following laparoscopy. This is not serious and is due to the gas used in the surgery to make space for instruments.

Q6. When can I be discharged from hospital?

Following Diagnostic Laparoscopy or with simple Operative Laparoscopy you can expect to be discharged from hospital latest by the morning after surgery. In most other cases of intermediate or even major surgery, discharge is generally 1-2 days following the surgery unless there is some health issues prior to the surgery or any complication during the surgery. The complication rates for Laparoscopic surgery are not more than for open surgery and depend upon patient factors like anaemia, diabetes, obesity and skill of the surgeon.

Q7. When can I perform routine household activities or return to work after Laparoscopic Surgery?

Recovery after surgery depends upon many factors: presence of health problems before surgery; why the surgery is required; what surgery is being done; problems or complications of surgery, anaesthesia or blood transfusions. If all is well, one can perform routine household activities by 1 week, provided one doesn't feel tired. Although there may not be any harm, it may be unwise to be normally active within 48 hours of procedure. Following Diagnostic Laparoscopy or Operative Laparoscopy for simple procedures, one can return to work in 1 week. For other procedures, a 2-3 week off from work is reasonable. It depends on the type of work you are returning to. Avoid too rapid return to work if it is manually hard or requires standing for long durations of time. Sometimes a surgical procedure brings on a well needed rest and break from a lifetime of work. Mostly, when you return to work depends upon your own body and its signals of tiredness. You need to listen to those signals.

4326 people found this helpful

I have diagnosed with infiltrating ductal carcinoma, NOS, in right breast (in biopsy report, triple negative (ER-negative, PR-NEGATIVE, HER 2-NEGATIVE). The tumor measures 4 cm* 3 cm mammographically. After giving 3 no. Of chemo My doctor suggest me for modified radical mastectomy. Please tell me if I go for complete breast removal & subsequent chemotherapy Radiotherapy is must or optional?

MD - Radiation Oncology, MBBS, DNB (Radiotherapy)
Oncologist, Howrah
Surgery is the definitive treatment for carcinoma breast. After surgery, remaining cycles of chemotherapy needs to be completed. Whether radiotherapy will be given or not depends on postoperative histopathology report.
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Types and Diagnosis of Uterine Fibroids

Fellowship In Minimal Access Surgery, MS - Obstetrics and Gynaecology, MBBS
Gynaecologist, Hyderabad
Types and Diagnosis of Uterine Fibroids

Noncancerous growths of the muscle tissue surrounding the uterus are known as uterine fibroids. This is a common disease which about 70 to 80% of women contract by the time they are 50 years of age. The uterine fibroids can sometimes be very big and cause heavy periods as well as severe abdominal pain while at other times, uterine fibroids give no signs or symptoms whatsoever and go away on their own. This is why it is crucial to know what type of uterine fibroids you have and how to diagnose them. Here are the types of uterine fibroids and how to diagnose them;

Types
There are three main types of uterine fibroids. They are;

1. Intramural fibroids
The most common type of uterine fibroids are intramural fibroids. They typically appear in the endometrium and may grow larger which results in your womb getting stretched.

2. Subserosal fibroids
Subserosal fibroids are called so because they form on the serosa. The serosa is the outside of your uterus. Sometimes, Subserosal fibroids may grow so large that your uterus appears bigger on one side.

3. Pedunculated fibroids
Pedunculated fibroids tumors are basically Subserosal fibroids with a stem. A base which supports the tumor is called the stem.

Diagnosis
There are a number of tests done to diagnose uterine fibroids. They are;

1. Pelvic exam
A pelvic exam is a thorough inspection of a woman’s pelvic area. The organs which are in the pelvic area include the cervix, ovaries, uterus and vagina. Normally, this and the next test in this article are enough to diagnose uterine fibroids.

2. Medical history
The history of your periods as well as the other symptoms you have will often be enough to diagnose the uterine fibroids. If your medical history is not enough, then you might need to undergo a pelvic exam.

3. Pelvic ultrasound
An ultrasound is when high-intensity sound waves are used to produce images of the pelvic area. This is only done when a pelvic exam and your medical history are not enough to diagnose uterine fibroids.

2 people found this helpful

I am having problem in l4 and I5. This problem is from around 3 years. But the condition is improved now. Can you please suggest some exercises?

PG Diploma in Emergency Medicine Services (PGDEMS), Bachelor of Ayurveda, Medicine and Surgery (BAMS), MD - Alternate Medicine
Ayurveda, Ghaziabad
Hi Apply pranacharya restopain oil or prasarini oil on your affected part then give hot fomentation. Take maha rasnadi kwath 2-2 tsf twice a day. And agni tundi vati and maha yograj guggul 1-1 tab twice a day..
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MPT
Physiotherapist, Mumbai
Though not very common, but herniated disks or bone spurts in the vertebrae of the neck might take too much space and compress the nerves branching out from the spinal cord which may lead to severe pain in the neck.
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Should You Get a Mammogram?

MHA, PGDPMC, DGO, MBBS
Gynaecologist, Delhi
Should You Get a Mammogram?

A mammogram is an imaging test where an X-ray is taken to recreate the internal imagery of your breasts. This is a screening test that is widely used to find the earliest signs of cancer. There have been instances where the early signs of cancer have been found up to three years before the actual development of the same. There are a number of benefits and risks in this screening method. So let us find out more about getting a mammogram, and whether or not you should get one.

  • Procedure: A special X-ray machine is used for conducting a mammogram. There is a clear plastic plate on which the specialist will place the breast while another plate will press on the breast from above. While both the plates serve to flatten the breast and hold it still, the X-ray will be taken. Some pressure will be felt and the same steps will be repeated so as to get the side view of the breasts. The same procedure will be repeated for the other breast. Meanwhile, once it is done, you will need to wait so that the technician can check for clarity, and whether or not the procedure needs to be done again. The results of this procedure cannot be relayed by the technician, and all the images will be different because all breasts are slightly different from each other.
  • Preparation: You will need to remember that the process can be a slightly painful one, especially once the pressure gets applied. Many women complain of discomfort and pain. Yet, this discomfort gets over before you know it. The pressure and pain will depend on the size of your breasts and how much they will have to be pressed in order to get a picture. The skill of the technician will also come into play here. One must remember not to get this procedure done a week or so before or after the menstrual cycle, as the breasts tend to be tender around this time, and the pain will be much more.
  • Radiologist: Within a few weeks after the procedure, the radiologist will usually deliver the result. This is the professional who does an accurate reading of the X-ray.
  • Normal and Abnormal Readings: If your mammogram result has a normal reading, then you can resort to getting one done every once in a while. But an abnormal reading will require further X-ray and tests so as to be able to tell for sure.
  • Why should I get one: If you are over 40 and have a family history of such ailments, then you will have to get a mammogram done regularly. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
2765 people found this helpful

Fibroid Tumours - 8 Signs You are Suffering From it

MBBS, MD, Registrar, DNB, MNAMS
Gynaecologist, Delhi
Fibroid Tumours - 8 Signs You are Suffering From it

Fibroid tumour is the abnormal cell growth in the uterus and they are mostly benign. Fibroids usually affect women in the age bracket of 30 - 40. Fibroid tumours are of three types, depending on their location:

  1. Submucosal fibroids: The tumour develops under the lining of the uterus
  2. Intramural fibroids: The growth is found amongst the muscles in the wall of the uterus
  3. Subserosal fibroids: The growth develops on the wall of the uterus right in the pelvic cavity

Causes behind it
The exact cause of fibroids in not known clearly. But certain factors have been discovered that might influence their formation. These factors include:

  1. Hormones: Progesterone and estrogen are the hormones responsible for recreating the uterine lining during every menstrual cycle. These hormones might trigger the formation of tumour.
  2. Family history: If any member in your family; your mother, grandmother or sister has/had fibroids in their uterus, you may also develop it.
  3. Pregnancy: Your body produces excessive progesterone and estrogen when you are pregnant, which may cause an increase in the size of a pre-existing small fibroid. Myomectomy can be done by giving incision on the abdomen or by laparoscopy depending on the size and location of the fibroids.

Signs You are suffering from it

  1. Heavy bleeding along with blood clots during or between your periods
  2. Lower back or pelvic pain
  3. Elevated menstrual cramping
  4. Frequent urination
  5. Pain during sex
  6. Longer than normal periods
  7. Bloating or pressure in lower abdomen
  8. Enlargement or swelling of the abdomen

How it can be treated?
Your doctor will formulate the right treatment depending on your age, the mass of the fibroids and your overall health. Your doctor may choose a combination of treatment to cure your fibroids, and they include:

  1. Medication: Gonadotropin releasing hormones (GnRH) agonists, birth control pills and ibuprofen (anti-inflammatory medicine) are prescribed. GnRH agonists reduce the level of progesterone and estrogen in your uterus.
  2. Surgery: Myomectomy and hysterectomy are two common surgical procedures to treat fibroids. Myomectomy is performed by removing the fibroids only by making an incision on the abdomen. But hysterectomy completely removes the uterus. The latter is reserved for serious cases.
  3. Non-invasive surgery: Forced ultrasound surgery, myolysis (shrinking fibroids with laser or electric current), cryomyolysis (fibroids are frozen) and endometrial ablation (an instrument uses heat, hot water, microwaves or electric current to destroy fibroids) are some non-invasive surgical procedures. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
2514 people found this helpful

I have a back disc doctor has advised to take complete bed rest for 3 months but I am preparing for competitive exam which is not possible. is there any way so that I will be ok?

DNB (Orthopaedics), Diploma In Orthopaedics (D. Ortho), MBBS
Orthopedist, Gurgaon
The current philosophy of treating disc problems is to enforce strict bed rest for a week to 10 days,
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I am bodybuilder I had a disc replacement due to bulge in my disc. Is it possible to continue bodybuilding. Lifting weights etc. Plzz help me.

Fellowship of the Royal College of Surgeons (FRCS), Membership of the Royal College of Surgeons (MRCS)
Orthopedist, Trichy
lifting weights is not advisable once you have had problems in your spine. there are other discs in the spine that can always create the same problem you had initially.
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I have a Acl tear in my left knee doctor advised for an operation should I go for it I am a athlete and 21 year old male.

BPT
Physiotherapist, Hyderabad
I have a Acl tear in my left knee doctor advised for an operation should I go for it I am a athlete and 21 year old m...
Hi, we physiotherapist and rehabilitation can restore the knee to a condition close to its pre-injury state and educate the patient on how to prevent instability. This may be supplemented with the use of a hinged knee brace.
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I have L4, L5 disc bulging problem , some time it pains me that I am unable to move also , How to recover from this. Please help me out.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
I have L4, L5 disc bulging problem , some time it pains me that I am unable to move also , How to recover from this. ...
Spine physiotherapy, posture care and pain killer as and when needed. If persistent problem, please visit.
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Sir my sister aged 32 years is going under total hip replacement. I much confused about prosthetic which one to go for Ceramic with poly or Ceramic on Ceramic Please advice which one is better.

Fellowship of the Royal College of Surgeons (FRCS), MRCS, DNB (Orthopedics), MBBS
Orthopedist, Visakhapatnam
Hi Lots of studies are there. As per my experience in UK 12 yrs, ceramic on ceramic is good in long term. But risk of fracture is there always when ever patient jumps. Ceramic on poly is more safe and it's better combination too. I preserve ceramic on ceramic. Hope it solves you r question.
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All About Bone Cancer

M.Ch - Orthopaedics, Fellowship in Arthroscopy & Sports Medicine, MS - Orthopaedics, MBBS
Orthopedist, Delhi
All About Bone Cancer

Cancer that originates in the bones of a human body is referred to as bone cancer. Any bone could come under the threat of this disease, but generally the longer bones of your body, so to say the bones of your limbs, are at a greater risk. 

A few factors that might push you an inch closer to bone cancer are:

  1. Genes could jinx your health: A few typical genetic syndromes could increase a person's chances of contracting bone cancer. These syndromes could have been active in any person belonging to your lineage. One such syndrome is Li-Fraumeni.
  2. Treatment for one kind of cancer can make you prone to some other kind: Radiation affects your bones adversely. A patient of breast cancer might be undergoing radiation therapy that further increases his or her risk of contracting bone cancer in future.  
  3. Paget's disease can have unfavorable implications: Paget's disease is a disease that affects elderly people. This condition, if left untreated, can turn into bone cancer at a later stage. 

Several symptoms of bone cancer can be found below:

  1. Sudden loss of weight: If you lose a considerable amount of weight in a few weeks time without having made any effort at all, you should probably be worried about the health of your bones. Bone cancer can result in sudden and unintentional weight loss. 
  2. Unexpected bone fracture or breakage: Cancer of the bones is known to gnaw at the strength of your bones. Weakened and diseased bones can break or get fractured very easily. An unexpected fracture should not be overlooked so as to prevent chances of anything more harmful.
  3. Long spans of unyielding exhaustion: Constant fatigue and sleepiness might be hinting at a more serious underlying problem. The bones in your body hold you together; cancerous bone cells can make you feel exhausted without much exertion as your bones lose their inherent potency.
  4. Persistent pain in the bones: Excruciating cramps or pangs of stinging pain in a person's bones either continuously or at odd hours, could be indicative of bone cancer. Such instances require the advice and guidance of an experienced oncologist.
  5. Bone swelling: The area affected by bone cancer can grow big and tender or the bone itself can swell up.
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