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Dr. Mohan Ram

MBBS, DMRD

Radiologist, Chennai

31 Years Experience  ·  300 at clinic
Dr. Mohan Ram MBBS, DMRD Radiologist, Chennai
31 Years Experience  ·  300 at clinic
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I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family....more
I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family.
More about Dr. Mohan Ram
Dr. Mohan Ram is a trusted Radiologist in Peravallur, Chennai. He has helped numerous patients in his 31 years of experience as a Radiologist. He is a MBBS, DMRD . You can consult Dr. Mohan Ram at Dr. Mohan Ram@Abhijay Hospital Pvt Ltd in Peravallur, Chennai. You can book an instant appointment online with Dr. Mohan Ram 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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Education
MBBS - University of Madras - 1986
DMRD - Dr. M.G.R. Medical University - 1993

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Abhijay Hospital Pvt Ltd

#22/2, ESI Hospital Road, Peravallur Landmark : Near Peravallur Bus Stop.Chennai Get Directions
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5 Ways to Decrease The Chance of Breast Cancer

Royal College of Obstetricians and Gynaecologists (MRCOG)
Gynaecologist, Alwar
5 Ways to Decrease The Chance of Breast Cancer

While you cannot cure breast diseases, family history and maturing, but there are some hazards or risks that you can control. Keeping in mind the fact that there is no certain approach to forestall breast cancer, there are things you can do that may bring down the hazard. Here are five approaches to ensure your breast's well-being:

  1. Watch your weight: Being overweight or hefty expands breast cancer chances. This is particularly true after menopause and for women who have put on weight as grown-ups. After menopause, the vast majority of your estrogen originates from fat tissue. Having more fat tissue can heighten your chances of getting breast cancer by raising the estrogen levels. Additionally, women who are overweight have a tendency to have more elevated amounts of insulin, than other hormones. Higher insulin levels have been associated with a few tumors, including breast cancer.
  2. Exercise routinely: Many reviews have found that exercise is the sign of having a healthy breast. Studies show that one to two hours of energetic walking each week, lessened a woman’s cancer risk by eighteen percent. Walking ten hours seven days decreased the hazard all the more.
  3. Constrain liquor: Women who have two to five mixed beverages every day have a higher danger of breast cancer than women who have just one drink a day or none . As much as three to six glasses of wine seven days have been found to somewhat increase breast cancer chances. It is not clear how or why liquor raises the hazard. In any case, constraining liquor is particularly essential for women who have other hazard variables for breast cancer, like, breast cancer running in their families.
  4. Restrain time spent sitting: Research has shown that sitting time, regardless of how much exercise you get when you are not sitting, increases the probability of growing cancer, particularly for women. Women who sit six hours or more a day outside of work have a ten percent more serious risk for breast cancer compared to the ladies who sit under three hours a day, and an increased hazard for other cancer types as well.
  5. Stay away from or confine hormone substitution treatment: Hormone Replacement Treatment (HRT) was utilized frequently in the past to control night sweats, hot flashes, and other troublesome manifestations of menopause. In any case, specialists now realize that postmenopausal ladies who take a blend of estrogen and progestin might probably create breast tumors or cancer. Breast cancer disease seems to come back within five years in the wake of ceasing the blend of hormones. Therefore, get a breast cancer test even if you feel a small lump. If you wish to discuss about any specific problem, you can consult a gynaecologist.
4273 people found this helpful

Top 4 Symptoms Of Liver Cancer

MD - Oncology
Oncologist, Hubli-Dharwad
Top 4 Symptoms Of Liver Cancer

If you are concerned about liver cancer, you should know that most people do not experience signs and symptoms of the cancer in the early stages. Liver cancer is a form of cancer which occurs in the cells of the liver. There are various types of cancer which can develop in the liver. Hepatocellular carcinoma (HCC) is the most common liver cancer which begins in the hepatocyte, which is the main liver cell.

Symptoms-

Usually there are no specific primary stage symptoms of liver cancer. Some symptoms which may develop include the following:

  1. Unusual weight loss is observed

  2. Loss of appetite and developing food aversion

  3. Pain in the upper abdomen

  4. Nausea followed by vomiting

  5. General weakness with intense fatigue

  6. Swelling in the abdomen

  7. The skin may become yellow

  8. White and chalky stools are likely

Causes-

In most cases, the causes of liver cancer cannot be clearly determined. In some cases, the cause is known, such as chronic infection with the hepatitis virus, which may lead to liver cancer. Liver cancer occurs when the liver cells undergo changes or mutations in their DNA structure. DNA mutations lead to changes in instructions of chemical processes taking place in the body. The cells may grow out of control and develop into a cancerous tumour.

Risk Factors-

There are several factors which enhance the risk of liver cancer. They are as follows:

  1. Chronic infection with hepatitis B or hepatitis C increases the risk of liver cancer.

  2. A progressive and irreversible condition known as cirrhosis leads to scar tissue formation in the liver, increasing the risk of liver cancer.

  3. Certain inherited liver diseases such as Wilson’s disease and hemochromatosis also increase the chances of liver cancer.

  4. People with diabetes are also at a greater risk of having liver cancer.

  5. Non-alcoholic fatty liver disease (NAFLD), which is the accumulation of fat in the liver, also increases the chances of getting this condition.

  6. Excessive alcohol consumption is another factor which causes irreversible damage to the liver and the chances of getting liver cancer get boosted.

  7. Exposure to aflatoxins, which are poisons produced by molds growing on poorly stored crops, make you more likely to get liver cancer.

Several tests and procedures are carried out for the diagnosis of liver cancer. These include blood tests for diagnosing liver function problems, and imaging tests such as ultrasound, CT scan and MRI scan.

8 people found this helpful

I am 24yr old male and have backache for 7 month. My mri report is mild annular disc bulge is seen at l4-5 level with subtle anterior thecal sac impression. What should I do?

Diploma in Radio-Diagnosis
Radiologist, Shimla
At this age only excersises-lumber and sacral, har, bed rest, avoid jjerky movements, and sitting posture normal advised.
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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 am 36 year old having problem of of disc slip in lumbar spine Dr. Asked for the surgery is only surgery is the option please suggest me other treatment.

DNB (Radiodiagnosis), DMRD, MBBS
Radiologist, Bangalore
Hi, thanks for writing in to us. It is possible that the disc bulge might have increased in severity recently. Please get a repeat mri scan done and discuss the findings please. It is possible that you might get relief through physical therapy or mild pain relief medications. If there is no relief with medicines then there is the option of steroid injection and radio frequency nerve block procedure. Surgery is the last resort and done only in extreme cases. Please do not worry. Regards,
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Bone Cancer: Breaking The Myths

Fellowship Orthopaedic Oncology, MS - Orthopaedics
Oncologist, Mohali

What is Bone cancer?

Bone cancer is malignant tumour of the bones which can spread to lungs or other parts of the body. It may have arisen primarily from the bone itself (primary bone cancer) or more commonly, may have spread to the bones (secondary bone cancer) from cancer of some other body organ like Breast cancer, Prostate cancer etc.

Symptoms:

Primary bone cancer usually occurs in growing children and young adolescents, whereas, secondary bone cancer usually occurs in older age group. Usually, the patient experiences pain in the affected area, which over the time, gets worse and continuous. There may also be swelling in the involved region. It can cause weakening of bones resulting in fracture. Some patients may attribute these symptoms to any prior antecedent trauma. Unintentional weight loss may also be seen. Sometimes, these patients are wrongly being treated for infection, thus delaying the correct treatment which may have a bearing on the final outcome.

How common is bone cancer?

Secondary bone cancer is the most common type of bone cancer with bone being the third most common site of cancer spread (metastasis) from other organs. However, primary bone cancers are rare accounting for less than 1% of all cancers.

Causes of bone cancer?

There are no known environmental or other hereditary factors which cause bone cancer, however, certain patients are at a greater risk for bone cancer which include:

  • Patients who have received prior radiation therapy
  • Patients with a history of Paget’s Disease
  • Patients with hereditary retinoblastoma - a type of eye cancer that most commonly affects very young children
  • Patients with Li-Fraumeni syndrome - a rare genetic condition

How is it diagnosed?

A patient suspected with bone cancer needs to be investigated thoroughly with blood tests, Xrays, MRI to look for local extent of disease. Since bone cancer can spread to lungs and other bones, staging of the disease is done either with whole body PET CT or a bone scan with CT Chest. Alongwith that, a biopsy (usually with a needle) is required to establish the diagnosis. It’s important to do biopsy from the correct site since wrong biopsy site can be detrimental in limb salvage and can result in amputation (cutting the limb). Therefore, it’s recommended that the biopsy should always be done by the surgeon (Orthopaedic Oncologist) who will be doing the final surgery for bone cancer.

Treatment

Treatment of bone cancer is a multidisciplinary approach requiring an Orthopaedic Oncologist (Bone & Soft tissue tumour specialist), Medical Oncologist (Chemotherapy Specialist), Radiation Oncologist (Radiotherapy specialist) and Pathologist (Specialist in tissue diagnosis).

Usually in primary bone cancers, chemotherapy is given to the patient followed by surgery to remove the diseased bone which is further followed by adjuvant chemotherapy. Limb salvage surgery is possible nowadays for bone cancers in which the part of the bone involved with tumour is removed surgically (rather than cutting the whole limb) and the defect is reconstructed with artificial joint, thereby saving the limb. In some cases, the cancerous bone so removed is given very high dose of radiation so as to kill all the cancer cells and the sterilised bone so formed is fixed back to the parent bone with the help of plates and screws, a technique commonly called as Extra Corporeal Radiation Therapy (ECRT). In children, since the artificial joint will not grow as the child grows leading to unequal limb lengths over a period of time, the defect can be reconstructed with expandable joint which can be lengthened as the child grows which allows to maintain limb length equality at the time of skeletal maturity.

Is cure possible in bone cancer?

With the current chemotherapy regimes and advanced surgical technology, cure is possible in upto 70-75% patients with primary bone cancer. In patients with secondary bone cancer, cure can still be achieved depending upon the primary cancer and the extent of disease. In advanced cases also, a lot can be done to control the disease and give a quality of life to the patient.

Is it possible to prevent bone cancer?

Since the exact cause of bone cancer is not known, as of now it’s not possible to prevent bone cancer.

Whom to consult?

First chance is the best chance when it comes to curing bone cancers. So, it’s advisable to seek treatment from a trained Orthopaedic Oncologist when confronted with a bone cancer to achieve maximum beneficial outcome.

4 people found this helpful

Breast Cancer - The Most Common Cancer In India

FICMCH, Diploma In Laproscopic Surgery, Certified in Laparoscopy & Hysteroscopy, DNB (Obstetrics and Gynecology), MBBS
Gynaecologist, Gurgaon
Breast Cancer - The Most Common Cancer In India

Breast cancer(स्तन कैंसर) is on the rise in india. Surveys show that every 4 out of 5 Indian women who have breast cancer, suffer from an advanced stage of the disease by the time they reach the doctor. Urban women are at two times more risk of being diagnosed with breast cancer than rural women. Being overweight, eating unhealthy food, and consuming excessive alcohol or tobacco are some of causes that can make you susceptible to this disease.

How you can avoid breast cancer?

  1. Every woman should do a self-breast examination every month after the periods. You should check for any abnormal lump, change in skin texture or any abnormal discharge from the nipples. Any abnormality above aspects should be promptly investigated by a doctor's appointment, and an ultrasound or Mammography, as required.
  2. Apart from self-examining your breasts every month for a lump, going for a mammography (an X-Ray of the breast) is vital for early detection of the problem.
  3. Consult a gynaecologist before going for the test as its frequency depends on your age and risk factor. About 80-90% of tumours can be traced through this screening.

Breast cancer may run in family. If there is no family history of breast cancer, you start doing mammogram at 40 yrs of age but if there is a family history you start even earlier as advised by your gynaecologist.

3692 people found this helpful

Doctor my 13 year old daughter has developed slip disc in her L4 and L5 vertebrae. What should be her treatment?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Disc prolapse at age of 13 years is not common, though it still may occur. Treatment is analgesics, back care, rest and physiotherapy. However, the child needs to be examined before I can suggest precise treatment
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I'm 42 years old. I'm suffering from l-s 4 slip disc. please tell what can be done?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
(A) Sleep on a hard bed with soft bedding on it. (B) Use no pillow under the head. (C) Kindly take BioD3 Max 1 tab dailyx10 Paracetamol 250mg OD & SOS x5days (D) Do back(spine)/shoulder/knee exercises (E)Make sure you are not allergic to any of the medicines you are going to take (F) Do not ignore it. It could be beginning of a serious problem. (G) If no relief in 4_5 days,then contact me again. (H) Contact your family doctor or nearest hospital for emergency help.
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Symptoms of Liver Cancer in Hindi - लीवर कैंसर के लक्षण

MBBS, M.Sc - Dietitics / Nutrition
Dietitian/Nutritionist, Delhi
Symptoms of Liver Cancer in Hindi - लीवर कैंसर के लक्षण

जिगर शरीर में सबसे बड़ा ग्रंथियों वाला अंग है और शरीर को विषाक्त पदार्थों और हानिकारक पदार्थों से मुक्त रखने के लिए विभिन्न महत्वपूर्ण कार्य करता है। पेट के दाहिने ऊपरी चतुर्भुज मंर स्थित है, पसलियों के ठीक नीचे। लिवर पित्त के उत्पादन के लिए जिम्मेदार है, जो एक पदार्थ है जो आपको वसा, विटामिन, और अन्य पोषक तत्वों को पचाने में मदद करता है। यह ग्लूकोज जैसे पोषक तत्वों को भी स्टोर करता है और दवाओं और विषाक्त पदार्थों को तोड़ता है। 

लिवर कैंसर, जिसे हेपेटिक कैंसर भी कहा जाता है, एक कैंसर होता है जो लिवर में शुरू होता है। जब कैंसर लिवर में विकसित होता है, तो यह लिवर कोशिकाओं को नष्ट कर देता है और सामान्य रूप से कार्य करने के लिए लिवर की क्षमता में दखल देता है। लिवर कैंसर के दो प्रकार होते हैं। प्राथमिक लिवर कैंसर, जो लिवर की कोशिकाओं में शुरू होता है। जबकि, कैंसर जो कि कहीं और से शुरू होता है और अंततः जिगर तक पहुंच जाता है, उन्हें जिगर मेटास्टेसिस या द्वितीयक लिवर कैंसर कहा जाता है।

प्राथमिक लिवर कैंसर के विभिन्न प्रकार
विभिन्न प्रकार के प्राथमिक लिवर कैंसर लिवर के विभिन्न कोशिकाओं से उत्पन्न होते हैं। प्राथमिक लिवर कैंसर लिवर में एक गांठ के रूप में, या एक ही समय में लिवर के भीतर कई स्थानों में शुरू हो सकता है।

1. हेपैटोसेलुलर हेपैटोसेलुलर:
हेपेटोसेल्यूलर कार्सिनोमा (एच.सी.सी), जिसे हेपेटामा भी कहा जाता है, सबसे सामान्य प्रकार का लिवर कैंसर है। एचसीसी मुख्य प्रकार के लिवर कोशिकाओं में शुरू होता है, जिसे हेपोटोसेल्यूलर कोशिका कहा जाता है। एचसीसी के अधिकांश मामले हेपेटाइटिस बी या सी, या शराब के कारण जिगर के सिरोसिस के संक्रमण का नतीजा है। 

2. फाइब्रोलैमेलर एचसीसी:
फाइब्रोलामेरेलर एचसीसी एक रेअर प्रकार का एचसीसी है, जो आम तौर पर अन्य प्रकार के लिवर कैंसर की तुलना में उपचार के लिए अधिक संवेदनशील होता है।        

3. कोलेंजियोकार्सिनोमा:
कोलेंजियोकार्सिनोमा, जिसे आमतौर पर पित्त नली के कैंसर के रूप में जाना जाता है, लिवर में छोटे, ट्यूब जैसे पित्त नलिकाओं में विकसित होता है। पाचन में मदद करने के लिए, ये नलिकाएं पित्ताशय में पित्त को ले जाने के लिए जिम्मेदार हैं। जब कैंसर लिवर के अंदर नलिकाएं के खंड में शुरू होता है, तो इसे इंट्राहेपेटिक पित्त नलिका कैंसर कहा जाता है। यद्यपि, जब लिवर के बाहर नलिकाओं के अनुभाग में कैंसर शुरू होता है, तो एक्स्ट्राहेपाटिक पित्त वाहिका कैंसर कहलाता है। 

4. एंजियोसारकोमा:
एंजियोनेसकोमा लिवर कैंसर का एक रेअर प्रकार है जो लिवर के रक्त वाहिकाओं से शुरू होता है। इस प्रकार का कैंसर बहुत तेज़ी से प्रगति करता है, इसलिए यह आमतौर पर एक और अधिक उन्नत चरण में डिटेक्ट किया जाता है।

5. हेपेटोब्लास्टोमा:
हेपोटोब्लास्टोमा एक अत्यंत असामान्य प्रकार का लिवर कैंसर है। 

लिवर कैंसर के लक्षण
ज्यादातर लोगों के प्राथमिक जिगर कैंसर के शुरुआती चरणों में लक्षण नहीं होते। जिसके परिणामस्वरूप, लिवर कैंसर बहुत देर से डिटेक्ट किया जाता है। लिवर कैंसर के लक्षणों में शामिल हैं:

  1. पीलिया
  2. भूख में कमी
  3. वजन घटना
  4. एबडोमीनल पेन
  5. बुखार
  6. मतली और उल्टी
  7. सामान्य खुजली
  8. हेपटेमेगाली (बढ़े हुए जिगर)
  9. बढ़े हुए स्प्लीन

चूंकि लिवर कैंसर के लिए कोई व्यापक रूप से अनुशंसित नियमित स्क्रीनिंग टेस्ट नहीं हैं, इसलिये बीमारी के परिवार के या अन्य जोखिम कारकों के इतिहास वाले लोगों को उनके डॉक्टर से बात करनी चाहिए ताकि वे अपने जोखिम को मॉनिटर करने या कम करने के लिए सही कदम उठा सकें।

लिवर कैंसर के जोखिम कारक
प्राथमिक लिवर कैंसर के खतरे को बढ़ाने वाले कारकों में शामिल हैं:

  1. मधुमेह
  2. अफ्लाटॉक्सिन
  3. उपचय स्टेरॉयड्स
  4. आर्सेनिक
  5. धूम्रपान
  6. सिरोसिस
  7. कम प्रतिरक्षा और मोटापा
2 people found this helpful

My husband is diabetic & his height is 5ft n 11 inch & weight 94 kg. From two months he is having edema in both foot. His blood reports of kidney I s. Cretenine 1.09. He is suffering from disc slip problem also so cant walk. I am worried about foot edema.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
My husband is diabetic & his height is 5ft n 11 inch & weight 94 kg. From two months he is having edema in both foot....
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. 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. KINDLY CONSULT A PHYSICIAN FOR OEDEMA & RELTED PROBLEMS.
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I am 42 year old female .After slip disc L1toL4 problem, pain in left heel and becomes severe at times. Is it spur in the foot ,slip disc or something else.

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
I am 42 year old female .After slip disc L1toL4 problem, pain in left heel and becomes severe at times. Is it spur in...
Do Take IFT and laser Therapy for pain relief for 12 days followed by strengthening exercise from physiotherapist and need to be with Clinical examination.
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Breast Cancer Prevention:

Homeopath,

Breast Cancer Prevention:

  1. Anything that increases your chance of developing cancer is called a cancer risk factor; anything that decreases your chance of developing cancer is called a cancer protective factor.

  2. Some risk factors for cancer can be avoided, but many cannot. For example, both smoking and inheriting certain genes are risk factors for some types of cancer, but only smoking can be avoided. Regular exercise and a healthy diet may be protective factors for some types of cancer. Avoiding risk factors and increasing protective factors may lower your risk but it does not mean that you will not get cancer. Different ways to prevent cancer are being studied, including:

  3. Changing lifestyle or eating habits. Avoiding things known to cause cancer. Taking medicine to treat a precancerous condition or to keep cancer from starting.


 

General information about breast cancer:

Key points:

  1. Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. Breast cancer is the second most common type of cancer in india

  2. Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast.

  3. The breast is made up of lobes and ducts. Each breast has 15 to 20 sections called lobes, which have many smaller sections called lobules. Lobules end in dozens of tiny bulbs that can make milk. The lobes, lobules, and bulbs are linked by thin tubes called ducts.

  4. Enlarge Drawing of female breast anatomy showing the lymph nodes, nipple, areola, chest wall, ribs, muscle, fatty tissue, lobe, ducts, and lobules.

  5. Anatomy of the female breast. The nipple and areola are shown on the outside of the breast. The lymph nodes, lobes, lobules, ducts, and other parts of the inside of the breast are also shown.

  6. Each breast also has blood vessels and lymph vessels. The lymph vessels carry an almost colorless fluid called lymph. Lymph vessels lead to organs called lymph nodes. Lymph nodes are small bean-shaped structures that are found throughout the body. They filter lymph and store white blood cells that help fight infection and disease. Clusters of lymph nodes are found near the breast in the axilla (under the arm), above the collarbone, and in the chest.

     

Avoiding risk factors and increasing protective factors may help prevent cancer. The following are risk factors for breast cancer:

  1. Older agea personal history of breast cancer or benign (noncancer) breast diseasea family history of breast cancerinherited gene changesdense breasts

  2. Exposure of breast tissue to estrogen made in the bodytaking hormone therapy for symptoms of menopause radiation therapy


 

The following are protective factors for breast cancer:

  1. Less exposure of breast tissue to estrogen made by the bodytaking estrogen-only hormone therapy after hysterectomy,

  2. Estrogen-only hormone therapy after hysterectomyselective estrogen receptor modulatorsaromatase inhibitors and inactivators

  3. Risk-reducing mastectomy ovarian ablationgetting enough exercise


 

It is not clear whether the following affect the risk of breast cancer:

  1. Oral contraceptives

  2. Factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk


 

Older age:

  1. Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.

  2. A personal history of breast cancer or benign (noncancer) breast disease

     

Women with any of the following have an increased risk of breast cancer:

  1. A personal history of invasive breast cancer, ductal carcinoma in situ (dcis), or lobular carcinoma in situ (lcis). A personal history of benign (noncancer) breast disease.

  2. A family history of breast cancer

  3. Women with a family history of breast cancer in a first-degree relative (mother, sister, or daughter) have an increased risk of breast cancer.


 

Inherited gene changes:

  1. Women who have inherited changes in the brca1 and brca2 genes or in certain other genes have a higher risk of breast cancer, ovarian cancer, and maybe colon cancer. The risk of breast cancer caused by inherited gene changes depends on the type of gene mutation, family history of cancer, and other factors.

  2. Men who have inherited certain changes in the brca2 gene have a higher risk of breast, prostate, and pancreatic cancers, and lymphoma.


 

Dense breasts:

  1. Having breast tissue that is dense on a mammogram is a factor in breast cancer risk. The level of risk depends on how dense the breast tissue is. Women with very dense breasts have a higher risk of breast cancer than women with low breast density.

  2. Increased breast density is often an inherited trait, but it may also occur in women who have not had children, have a first pregnancy late in life, take postmenopausal hormones, or drink alcohol.

  3. Exposure of breast tissue to estrogen made in the body

  4. Estrogen is a hormone made by the body. It helps the body develop and maintain female sex characteristics. Being exposed to estrogen over a long time may increase the risk of breast cancer. Estrogen levels are highest during the years a woman is menstruating.


 

A woman's exposure to estrogen is increased in the following ways:

Early menstruation: beginning to have menstrual periods at age 11 or younger increases the number of years the breast tissue is exposed to estrogen. Starting menopause at a later age: the more years a woman menstruates, the longer her breast tissue is exposed to estrogen. Older age at first birth or never having given birth: because estrogen levels are lower during pregnancy, breast tissue is exposed to more estrogen in women who become pregnant for the first time after age 35 or who never become pregnant.

 

Taking hormone therapy for symptoms of menopause:

Hormones, such as estrogen and progesterone, can be made into a pill form in a laboratory. Estrogen, progestin, or both may be given to replace the estrogen no longer made by the ovaries in postmenopausal women or women who have had their ovaries removed. This is called hormone replacement therapy (hrt) or hormone therapy (ht). Combination hrt/ht is estrogen combined with progestin. This type of hrt/ht increases the risk of breast cancer. Studies show that when women stop taking estrogen combined with progestin, the risk of breast cancer decreases.


 

Radiation therapy to the breast or chest:

  1. Radiation therapy to the chest for the treatment of cancer increases the risk of breast cancer, starting 10 years after treatment. The risk of breast cancer depends on the dose of radiation and the age at which it is given. The risk is highest if radiation treatment was used during puberty, when breasts are forming.

  2. Radiation therapy to treat cancer in one breast does not appear to increase the risk of cancer in the other breast.

  3. For women who have inherited changes in the brca1 and brca2 genes, exposure to radiation, such as that from chest x-rays, may further increase the risk of breast cancer, especially in women who were x-rayed before 20 years of age.


 

Obesity:

Obesity increases the risk of breast cancer, especially in postmenopausal women who have not used hormone replacement therapy.


 

Drinking alcohol:

Drinking alcohol increases the risk of breast cancer. The level of risk rises as the amount of alcohol consumed rises.


 

The following are protective factors for breast cancer:

  1. Less exposure of breast tissue to estrogen made by the body

  2. Decreasing the length of time a woman's breast tissue is exposed to estrogen may help prevent breast cancer. Exposure to estrogen is reduced in the following ways:


 

Early pregnancy: estrogen levels are lower during pregnancy. Women who have a full-term pregnancy before age 20 have a lower risk of breast cancer than women who have not had children or who give birth to their first child after age 35. Breast-feeding: estrogen levels may remain lower while a woman is breast-feeding. Women who breastfed have a lower risk of breast cancer than women who have had children but did not breastfeed.

Taking estrogen-only hormone therapy after hysterectomy, selective estrogen receptor modulators, or aromatase inhibitors and inactivators


 

Estrogen-only hormone therapy after hysterectomy

Hormone therapy with estrogen only may be given to women who have had a hysterectomy. In these women, estrogen-only therapy after menopause may decrease the risk of breast cancer. There is an increased risk of stroke and heart and blood vessel disease in postmenopausal women who take estrogen after a hysterectomy.


 

Selective estrogen receptor modulators:

Tamoxifen and raloxifene belong to the family of drugs called selective estrogen receptor modulators (serms). Serms act like estrogen on some tissues in the body, but block the effect of estrogen on other tissues.


 

Treatment with tamoxifen lowers the risk of estrogen receptor-positive (er-positive) breast cancer and ductal carcinoma in situ in premenopausal and postmenopausal women at high risk. Treatment with raloxifene also lowers the risk of breast cancer in postmenopausal women. With either drug, the reduced risk lasts for several years or longer after treatment is stopped. Lower rates of broken bones have been noted in patients taking raloxifene.


 

Taking tamoxifen increases the risk of hot flashes, endometrial cancer, stroke, cataracts, and blood clots (especially in the lungs and legs). The risk of having these problems increases with age. Women younger than 50 years who have a high risk of breast cancer may benefit the most from taking tamoxifen. The risk of having these problems decreases after tamoxifen is stopped.


 

Taking raloxifene increases the risk of blood clots in the lungs and legs, but does not appear to increase the risk of endometrial cancer. In postmenopausal women with osteoporosis (decreased bone density), raloxifene lowers the risk of breast cancer for women who have a high or low risk of breast cancer. It is not known if raloxifene would have the same effect in women who do not have osteoporosis. Talk with your doctor about the risks and benefits of taking this drug.


 

Aromatase inhibitors and inactivators:

Aromatase inhibitors (anastrozole, letrozole) and inactivators (exemestane) lower the risk of a new breast cancer in women who have a history of breast cancer. Aromatase inhibitors also decrease the risk of breast cancer in women with the following conditions:

Postmenopausal women with a personal history of breast cancer. Women with no personal history of breast cancer who are 60 years and older, have a history of ductal carcinoma in situ with mastectomy, or have a high risk of breast cancer based on the gail model tool (a tool used to estimate the risk of breast cancer).

In women with an increased risk of breast cancer, taking aromatase inhibitors decreases the amount of estrogen made by the body. Before menopause, estrogen is made by the ovaries and other tissues in a woman's body, including the brain, fat tissue, and skin. After menopause, the ovaries stop making estrogen, but the other tissues do not. Aromatase inhibitors block the action of an enzyme called aromatase, which is used to make all of the body's estrogen. Aromatase inactivators stop the enzyme from working.


 

Possible harms from taking aromatase inhibitors include muscle and joint pain, osteoporosis, hot flashes, and feeling very tired.


 

Risk-reducing mastectomy:

Some women who have a high risk of breast cancer may choose to have a risk-reducing mastectomy (the removal of both breasts when there are no signs of cancer). The risk of breast cancer is much lower in these women and most feel less anxious about their risk of breast cancer. However, it is very important to have a cancer risk assessment and counseling about the different ways to prevent breast cancer before making this decision.


 

Ovarian ablation:

The ovaries make most of the estrogen that is made by the body. Treatments that stop or lower the amount of estrogen made by the ovaries include surgery to remove the ovaries, radiation therapy, or taking certain drugs. This is called ovarian ablation.


 

Premenopausal women who have a high risk of breast cancer due to certain changes in the brca1 and brca2 genes may choose to have a risk-reducing oophorectomy (the removal of both ovaries when there are no signs of cancer). This decreases the amount of estrogen made by the body and lowers the risk of breast cancer. Risk-reducing oophorectomy also lowers the risk of breast cancer in normal premenopausal women and in women with an increased risk of breast cancer due to radiation to the chest. However, it is very important to have a cancer risk assessment and counseling before making this decision. The sudden drop in estrogen levels may cause the symptoms of menopause to begin. These include hot flashes, trouble sleeping, anxiety, and depression. Long-term effects include decreased sex drive, vaginal dryness, and decreased bone density.


 

Getting enough exercise:

Women who exercise four or more hours a week have a lower risk of breast cancer. The effect of exercise on breast cancer risk may be greatest in premenopausal women who have normal or low body weight.


 

It is not clear whether the following affect the risk of breast cancer:

  1. Oral contraceptives

  2. Certain oral contraceptives contain estrogen. Some studies have shown that taking oral contraceptives (" the pill") may slightly increase the risk of breast cancer in current users. This risk decreases over time. Other studies have not shown an increased risk of breast cancer in women who take oral contraceptives.

  3. Progestin -only contraceptives that are injected or implanted do not appear to increase the risk of breast cancer. More studies are needed to know whether progestin-only oral contraceptives increase the risk of breast cancer.


 

Environment

  1. Studies have not proven that being exposed to certain substances in the environment, such as chemicals, increases the risk of breast cancer.

  2. Studies have shown that some factors do not affect the risk of breast cancer.


 

The following do not affect the risk of breast cancer:

  1. Having an abortion. Making diet changes such as eating less fat or more fruits and vegetables. Taking vitamins, including fenretinide (a type of vitamin a). Cigarette smoking, both active and passive (inhaling secondhand smoke). Using underarm deodorant or antiperspirant. Taking statins (cholesterol -lowering drugs). Taking bisphosphonates (drugs used to treat osteoporosis and hypercalcemia) by mouth or by intravenous infusion.

  2. Cancer prevention clinical trials are used to study ways to prevent cancer.

Age 51 years male. Slip disc happened jan'2010 and get to normal after 4 years doing only exercise till now and used lumbo scrarol belt when out of home. Due to filling uneasy during walking, a tmt brace protocol suggested. Is it ok to do the test.

dnb orthopaedic surgery
Orthopedist, Jaipur
Lumbar brace support is not recommended for you. Stop immediately to used it otherwise it will weaken your back muscles. And consult with spine surgeon.
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My mother is suffering from DVT since one week. And is in the hospital by taking medicine. Doctor suggested to do surgery tomorrow. Please suggest what is correct to do?

General Surgeon, Mumbai
To guide you better, pls upload your investigation reports. Dvt surgery is done to avoid complications like embolism, mi, stroke. Or ischemia, increasing limb edema. Etc pls discuss with your doctor in detail. If you do not get required answers. Consult me online.
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How Is Breast Cancer Diagnosed?

MBBS, MD - Obstetrtics & Gynaecology
Gynaecologist, Delhi
How Is Breast Cancer Diagnosed?

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:

  1. 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.
  2. 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.
  3. 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. If you wish to discuss about any specific problem, you can consult a general-surgeon.

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I have been suffering from disk problem since 7 months. I have consulted a doctor. I took x-Ray as per his advice. He said disk has been narrowed. He prescribed some painkillers and vitamin tablets. Could anyone please prescribe some medicine for me. I am really unable to sit without any support.

Diploma in Orthopaedics
Orthopedist, Morena
Dear, do the following things. 1. Hot fomentation for 1/2 hrs with lukewarm water. 2. Back extension excercises. 3. Pavan muktasan yoga 4. Bujangasan 5. Muscle relaxant tablets for 5-7 days. 6. Local application of analgesic ointment. 7 vitamin d in form of capsules/sachets under guidance of doctor. Check your vit. B12 level.
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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.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
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. 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. I would like to examine her personally as soon as possible.
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