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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
1. 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.
2. Infiltrating Ductal Carcinoma (IDC): Represents majority (about 3/4th) of the breast cancers, and is known to metastasize commonly to bones, lungs and liver.
3. Lobular Carcinoma In Situ (LCIS): Develops in multiple lobules of the breast (bilaterally). LCIS is less commonly seen, compared to DCIS.
4. 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
5. Inflammatory Breast Cancer: Is relatively uncommon and are caused probably owing to viral infections. The breast is warm, red and swollen.
6. 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.
7. Medullary Carcinoma
8. Mutinous Carcinoma
9. Tubular Carcinoma
10. 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.
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:
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.
Uterine fibroids, which are non cancerous tumours, may lead to prolonged and excessive uterine bleeding.
Polyps are small benign developments on the uterus lining which cause heavy bleeding. They occur because of high levels of hormones.
Adenomyosis is a condition which develops when the endometrium glands get embedded in the uterine muscle, leading to excessive uterine bleeding.
Using intrauterine devices or IUDs may cause side effects as well.
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.
Several medicines and drugs, including NSAIDs and anticoagulants are a common cause.
There are different ways of treating excessive uterine bleeding, depending upon the cause of bleeding and the patient’s age.
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.
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.
I am a 25 years old male, I have been suffering from bulging disk at l5-s1. I have been resting for 2 months, now my neck has started paining too and left pelvic joint is making popping sound everytime it is bend. So I got my blood acid checked. And its been 8 for last two months, I have been drinking like 6 lts water everyday. Is uric acid main reason of pain? And how can I get it down as I don't want to start the medicine so early in life and drinking water is not working. Please suggest, my career is suffering a lot.
Hi I'm from South Africa. I need to have a hysterectomy done .What are cost of hospital fees, Dr. and anesthetic ,theatre fees etc awaiting your response kind regards Mariam Patel.
The symptoms caused due to herniated disc can be very severe and can also cause a bit of disability. The disc of the spine is like a cushion and separates the set of bones on the backside. The discs are shock absorbers of the spine and are mainly composed of 2 parts, a soft jelly centre called the nucleus and a tough outer covering called the annulus.
Effects of Herniated Disk
A herniated or cracked disc is a severe condition and it seems to happen most commonly in the lower back. It happens when a fraction of the soft centre gets pushed through the destabilized area due to degeneration, trauma or by putting pressure on the spinal cord.
Nerves are located precisely at the back of every disc and are responsible for controlling everything in our body. While a disc gets herniated, the external covering of the disc tears and creates a bulge. The soft jelly gets shifted from the centre of the disk to the region where the damage has occurred on the disc. Most commonly, the bulge occurs in areas where the nerve is located and it causes strain on the affected nerve. It has been observed that individuals do not feel any painful sensations even if their disc gets damaged.
When is Surgery Recommended for Herniated Disc?
Surgery for herniated disc is recommended only after options like steroid injections, pain relievers, exercise and non-steroid anti-inflammatory drugs do not work. If the pain persists even after these options, then it becomes important to go for surgery. There are certain risks involved in this surgery like infection, bleeding or nerve damage.
There are chances that the disc may get ruptured again if it is not removed. If you are a patient suffering from degenerative disc disease, then there are chances that problem occurs in other discs. It is very important that a patient maintains healthy weight to prevent any further complications.
The main factor that increases the risk of herniated disc is excess body weight, which causes a lot of stress on the lower back. A few people become heir to a tendency of developing this condition. Even individuals with physically demanding jobs are prone to this condition.
Activities like bending sideways, pushing, twisting, repetitive lifting can increase the risk of a herniated disk. At times, emergency surgery is also required to avoid paralysis in a patient. If you wish to discuss about any specific problem, you can consult an orthopedist.
Dear sir. My mother is suffering from pain in waist and legs unable to stand for sometime and unable to walk due to L5 L6 displaced and make pressure on nerve. I don't want to operate for this . Is any other solution.
Hello, Due to C5 & C6 disc buldge in neck I have severe neck pain. Please tell me a remedy. I have gone under dr treatments, pills & psychotherapy but still have a severe pain
Hello doctor plzz say me is surgery essential for Diffuse annular disc bulge seen at l4 and l5 level causing indentation over thecal sac with bilateral recess narrowing and significant nerve decompression.
Many women develop uterine fibroids by the time they hit the age of 50 years and above. These are non-cancerous growths that may occur in the uterus. Most women go through severe bleeding and pain as well as discomfort as a result of these fibroids. Age, family history of the same condition, obesity or being overweight, eating habits and even ethnicity play a large role in deciding the risk of each individual patient. These fibroids can grow in the submucosal, intramural and subserosal areas.
Following are the common side effects of uterine fibroids:
- Frequent urination: Due to the pressure of the fibroids on the uterus, the patient may experience a constant feeling of fullness in the lower pelvic area of the body, which may lead to frequent filling of the bladder. This gives rise to frequent trips to the washroom for urination.
- Heavy Bleeding: Severe bleeding is one of the most common causes of the presence of these kinds of fibroids. The patient may experience a lot of bleeding during menstrual periods, as well as pain and cramps the rest of the time. The periods will also be very painful when there are fibroids in the uterus or the uterine lining.
- Painful Intercourse: It is a well-known fact that any kind of infection or growth as well as sores and other such ailments can lead to vaginal dryness as well as pain during sexual intercourse. This is true for uterine fibroids as well, which can lead to severe pain during sexual activity. These fibroids can also give rise to pain in the lumbar or lower back region.
- Abdomen Swelling: The abdomen may go through significant swelling in such a condition and the patient may even look like she is pregnant. The growth can push the shape of the abdomen outwards and create a full feeling.
- Pregnancy Complications: The presence of uterine fibroids can give rise to several complications during pregnancy and even after child birth. One of the most common problems in this case is bleeding, followed by more severe outcomes like miscarriage. The women suffering from uterine fibroids are at greater risk of undergoing a caesarean section for the delivery of the baby. The baby may also be born breech and a premature delivery may take place.
- Infertility: This is also a rare side effect of the uterine fibroids and is generally seen only in very severe cases.
- Cancer: Only one in every 1000 cases might transform into malignant tumours. These uterine fibroids are generally known to be non-malignant.
Any symptoms must be reported to a gynaecologist at the earliest to avoid any serious complications.
Flattening of thoracic curvature ,to some extent .diminution of disc spaces with small osteophytes formation at the adjacent vertebral margins at T4>T8. No other obvious abnormality IMPRESSION - (Early/min) spondylitis changes -Mid-thoracic spine This is my x ray report please tell me is that a major problem or it can be heal with medicine and exercise and what r the reason for this. Please tell.
Uterine cysts are a type of cysts or tumours, which grow in the uterus. This is prevalent in women when they are near their childbearing years. Uterine cysts have some typical symptoms, which would let you know when to consult a medical practitioner for further help. It would cause excessive bleeding for a long duration of time. There is bleeding from the uterus in between your menstrual cycles. At times, it becomes very difficult to empty your bladder and irritation and discomfort are caused. It also leads to constipation. These are frequent symptoms, which accompany uterine cysts. These types of cysts are almost always non-cancerous, but it is beneficial to take an expert advice on that matter. Homeopathy is a great option to treat such cysts.
Homeopathy is becoming increasingly popular throughout the entire world. Now it is time to prove to the world what homeopathy can offer in surgical diseases. Homeopathic medicines cannot take the place of surgery but can be of great help to the patients who do not want to go for surgery or cannot be operated upon due to various medical reasons. There are specific medications to treat cysts through homeopathy.
Some of them are:
Calcarea Carbonica: This medicine is suitable for those who bleed profusely during their menstrual cycle. Such excessive bleeding causes shivers and shrills in them, making them more prone to anaemia. In fact, excessive bleeding also influences their fertility cycles. This medicine is administered on overweight women who suffer from uterine cysts.
Thlaspi Bursa Pastoris: This is prescribed to women who experience frequent menstrual cycles within short intervals. In fact, one does not even recover from the shock of the previous cycle and the new one starts. It is usually accompanied by excessive pain in the uterus. This medicine not only treats the cysts, but also the frequent period cycles and pain in the uterus.
Trillium Pendulum: At times, due to excessive bleeding from the uterus, the patient suffers from fainting spells. Such cysts are also characterised by bright red blood flow during the menstrual cycle. These are the two main symptoms to administer this medicine on the individual.
Fraxinus Americana: Apart from irregular periods with pain in the uterus, it is also followed by breaking down spells. One experiences cramps in the feet during this type of cyst. In such conditions, the best natural homeopathic therapy that can be administered is Fraxinus Americana.
Calcarea Fluorica: This is a common medicine which is given to those patients who have extremely large tumours. These tumours are also characterised by their unique hardness.
Uterine cysts are a common problem in women and can be treated effectively. One needs to be alert about the symptoms and must immediately report to a specialized homeopathic practitioner for an effective administration of medicines, which may lead to a successful cure.
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:
- A menstrual cycles occurs between 21 to 35 days, anything shorter or longer than this is abnormal
- No period for 3–6 months (amenorrhea) is abnormal
- Spotting or bleeding between periods
- Spotting or bleeding after intercourse
- Bleeding that is heavier or lasts longer than usual
- Spotting or bleeding after menopause
What can cause such a situation?
Some of the common causes leading to abnormal bleeding are as follows:
- Ectopic pregnancy
- Cervical or uterine infections
- Hormonal imbalances
- Problems with blood clotting
- Polycystic ovaries
- Endometrial hyperplasia
- 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.
- Ultrasound: The pelvic organs are examined through sound waves to locate the problem area
- 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
- 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.
- 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
- Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are useful in reducing bleeding and controlling cramps during excessive menstrual bleeding.
- Antibiotics may be useful if there is infection of the pelvic organs.
- Polyps, cysts, cancers, and other growths can be removed via hysteroscopy and sent for biopsy to confirm they are not cancerous.
- Endometrial ablation where the endometrial tissue is treated with heat can be used to control bleeding permanently.
- 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.
I have had a limbo sacral spine MRI. Conclusion of result is "Mild annular disc bulge with superimposed broad based posterocentral disc protrusion and annular tear at L4-L5 level is causing indentation on thecal sac. No central canal or existing foramina stenosis or nerve root compression" can anybody tell is it worrisome.
The uterus is a muscular structure held in place inside your pelvis with the help of muscles, ligaments, and tissues. These muscles weaken in women due to pregnancy, childbirth or delivery complications and can lead to severe complications. One such complication is a uterine prolapse. Uterine prolapse occurs when the uterus sags or slips from its normal position into the vaginal canal.
The causes of uterine prolapse are varied and include:
- Delivering a large baby
- Difficulty in labor and delivery
- Reduction in estrogen levels post menopause
- Traumatic childbirth
- Loss or weakening of the pelvic muscle
- Conditions which lead to increased pressure in the abdominal area such as a chronic cough, straining, pelvic tumors or accumulation of fluid in the abdomen
- Loss of external support due to major surgery in pelvic area
Uterine prolapse can be complete or incomplete depending on how far the uterus sags into the vagina. Women who have minor uterine prolapse may not have any visible symptoms. However, if the condition worsens, it manifests itself in visible signs.
Symptoms of moderate or severe prolapse are:
1. A feeling of fullness or pressure in your pelvis when you sit
2. Seeing the uterus or cervix coming out of the vagina
3. Vaginal bleeding or increased discharge
4. Painful sexual intercourse
5. Recurrent bladder infections
6. Continuing back pain with difficulty in walking, urinating and moving your bowels
Without proper attention, the condition can cause impairments in the bowel, and can also affect bladder and sexual function. If you wish to discuss about any specific problem, you can consult a Gynaecologist.