Dr. Tulasi

1. You felt a lump in your breast and it always means you have breast cancer.

The Truth

It's a small percentage of breast lumps only that will turn out to be cancer.  If you discover a persistent lump in your breast or notice any changes in breast tissue,  never ignore it.  You  must see a physician for a clinical breast examination. He or she may possibly order breast imaging studies to determine if this lump is of concern or not.

Take charge of your health by performing routine breast self-exams, establishing ongoing communication and counseling with your doctor, getting an annual clinical breast exam, and scheduling your routine screening mammograms.

2. Only women get breast cancer, men do not.

The Truth

Quite the contrary, each year it is estimated that approximately 2,190 men will be diagnosed with breast cancer and 410 will die. While this percentage is still small, men should also check themselves periodically by doing a breast self-exam while in the shower and reporting any changes to their physicians. 

Breast cancer in men is usually detected as a hard lump underneath the nipple and areola.  Men carry a higher mortality than women do, primarily because awareness among men is less and they are less likely to assume a lump is breast cancer, which can cause a delay in seeking treatment.

Breast cancer is a type of cancer which occurs due to the development of cancerous cells in a person's breasts. Women are usually affected by breast cancer and breast cancer is one of the most common forms of cancer after skin cancer. Usually fatal if not diagnosed in its early stage, breast cancer is a very serious medical ailment. Read on more to find all about the different symptoms, causes, preventive measures and treatment of breast cancer.

Symptoms-

Breast cancer has a few distinct characteristics and if you have a few or all the following symptoms you could be more likely to suffer from breast cancer. 

1. The formation of a lump in your breast which is different from the surrounding tissue and usually more thickened.
2. The discharge of bloody fluid  material from the nipples.
3. Sudden change of the size, shape and appearance of the breast.
4. Certain distinct changes to the skin over the breast for example an indentation in the skin similar to that of a dimple.
5. Appearance of an extra nipple which is inverted.
6. If the darkened area around the nipples known as the areola is flaking or peeling off.

Causes-

Studies and researches remain inconclusive on what causes breast cancer. Breast cancer occurs due to abnormal division of the cells located in the breast which over time accumulate and form lumps. They
might spread to other parts of the body. Breast cancer is caused mainly due to a complex interaction of personal genetics, environment and lifestyle choices. Breast cancer can also be caused due to genetics as about 5% to 10% of cases are due to gene mutations which pass onto generations.

Risk factors-

There are certain factors which increase the probability of contracting breast cancer. Increasing age, personal and family history of breast cancer, obesity, radiation exposure, pregnancy at an older age, post-menopausal hormone therapy are some of the factors that increase the chances of breast cancer.

Treatment-

Several forms of surgical methods exist to treat breast cancer. Depending on the condition and spread of the disease a suitable surgery is performed. These include mastectomy, lumpectomy, axillary lymph node dissection and removal of both breasts. Other forms of treatment include chemotherapy or the use of high doses of drugs to destroy cancerous cells. Radiation therapy where X-rays are used to destroy the cancer cells is also effective. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

STROKE- Popularly known as "Brain Attack". It occurs due to sudden  impairment of blood supply to a part of brain leading to acute neurological insult. 

Stroke is an emergency. Know the signs of a stroke and  Remember  FAST.

F- Face Drooping - Ask the person to smile. See for any deviation/asymmetry of mouth. If YES..

A - Arm Weakness  Ask the person to raise both arms. Does one arm drift downward? If   YES..

S- Speech Difficulty  Ask the person to speak, look for any slurring of speech. If YES..

T- Time is money , Call Ambulance/Rush to the hospital. 

Other signs/ symptoms - 

• Sudden onset of  numbness or weakness of the leg / arm. 

• Sudden confusion/ trouble seeing in one or both eyes, trouble walking, Chakker, loss of balance, severe headache / Loss of speech.

Be Aware, This can be STROKE.

Act FAST, Save LIFE and disability. Up to 80% of strokes are preventable

Test to screen for breast cancer:

Mammogram:

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

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

Enlarge Mammography:

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

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

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

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

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

Clinical Breast Exam (CBE):

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

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

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

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

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

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

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

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

Thermography:

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

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

Tissue sampling:

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

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

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

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

The womb or the uterus is a muscular structure that is fixed in its place by the ligaments and the pelvic muscles. If these ligaments or muscles become weak or stretch, they no longer will be capable of holding the uterus, resulting in a prolapse. Uterine prolapse happens when the uterine slips or sags from its usual position into the birth canal or vagina. The main indications of uterine prolapse are recurrent bladder infections, constipation, a tug at the pelvic area, the cervix or uterus protruding out of the vagina, problems during sexual intercourse, increased discharge and vaginal bleeding.

What causes it?
1. Age is the most important reason for this condition to manifest itself.
2. A dip in the estrogen level as this hormone keeps the pelvic muscles strong.
3. Damage to the pelvic tissues and muscles due to pregnancy or during childbirth can also contribute to this condition.
4. A woman who has undergone multiple vaginal births is at an increased risk of this condition.
5. Any physical activity that exerts pressure on the pelvic muscles can also result in this disorder.
6. Chronic constipation and obesity, over time, can lead to this disorder.

How it can be treated?
1. Nonsurgical methods:

• Shedding the extra kilos helps reduce stress from the pelvic structures. This helps to avert this disorder.
• Avoid lifting heavy objects throughout the course of the treatment.
• Pelvic floor exercises or Kegel exercises help build up the vaginal muscles.
• Estrogen replacement therapy or Hormone Replacement Therapy can help relieve the symptoms of this disease.
• Wearing a pessary (an instrument that is placed into the vagina and fits under the cervix) helps to push up and stabilize the cervix and the uterus.

2. Surgical treatments:

• Uterine suspension- In this case, the surgeon inserts the uterus back into its former position by reattaching the pelvic ligaments by the use of surgical techniques.
• Hysterectomy- Here, the surgeon removes either the whole or just a part of the womb.

However, such procedures should not be opted by women who plan on getting pregnant. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

Hi I am Dr. Kirti Yadav, senior physiotherapist from Mat-Harbor family clinic, Gurgaon.

Today I want to talk about a very common problem which every one, if we count about the population 100% then 70% of people they talk about Disk pain. So I want to enlighten this topic today. If there is a normal pain and ache in your neck or back you go to a doctor and the doctor assess you and tells you to get an MRI done. Whenever you get an MRI done there is some level of disk involvement and the doctor ask you to take rest, not to do exercise and all those things and then just being fear of disk pain you don’t exercise for the rest of your life.

So just to come onto that area, just to enlighten this topic, as a physiotherapist I want to tell you about the fact. Disk pain, YES it happens but it happens in 20% of the cases. The rest 50% of the cases have been misdiagnose, they take disk pain and they don’t do exercise all of their life. Now we don’t exercise, we don’t strengthen up our muscle that is the problem that we get these pains and aches and the muscle is being stretched which is counted to be as the disk pain. Now when we talk about this, when you get an MRI done even today if I get my MRI done I will have some level of disk involvement whether the disk is causing you pain or not that is more important. The nature of pain tells you about the disk involvement.

So if you have tingling sharp shooting burning kind of pain which travels through a nerve, which travels through area, it dignifies, it signifies the disk pain. But if you have a localized dull, aching kind of pain please don’t take it as a disk pain and don’t take it as a nerve pain. So just coming to the treatment part. About 50% of the people who don’t have disk pain, who says we have cervical spondylitis but they don’t have cervical spondylitis they have trapezius muscle involvement. In that case what we do please strengthen up your trapezius muscle, please strengthen up your shoulder muscle so that you don’t have these pains and aches again and again. Why this happens? This happens because of repetitive strain injuries that happens because of more of computer use more of mobile use, texting and other sedentary live cells which we are going in. So the ultimate solution for pains and aches muscular is strengthening the particular part.

If you want to know more about this, if you want to talk more about it you can contact me through Lybrate.

Breast cancer is a type of cancer, which occurs due to the development of cancerous cells in breasts. Women are usually affected by breast cancer and breast cancer is one of the most common forms of cancer after skin cancer. Usually fatal if not diagnosed in its early stage, breast cancer is a very serious medical ailment. Read on more to find all about the different symptoms, causes, preventive measures and treatment of breast cancer.

Symptoms: Breast cancer has few distinct characteristics and if you have a few or all the following symptoms you could be more likely to suffer from breast cancer. 

• The formation of a lump in your breast, which is different from the surrounding tissue and usually more thickened.
• The discharge of bloody fluid  material from the nipples.
• Sudden change of the size, shape and appearance of the breast.
• Certain distinct changes to the skin over the breast for example an indentation in the skin similar to that of a dimple.
• Appearance of an extra nipple which is inverted.
• If the darkened area around the nipples known as the areola is flaking or peeling off. 

Causes: Studies and researches remain inconclusive on what causes breast cancer. Breast cancer occurs due to abnormal division of the cells located in the breast, which over time accumulate and form lumps. They
might spread to other parts of the body. Breast cancer is caused mainly due to a complex interaction of personal genetics, environment and lifestyle choices. Breast cancer can also be caused due to genetics as about 5% to 10% of cases are due to gene mutations which pass onto generations.

Risk factors: There are certain factors, which increase the probability of contracting breast cancer. Increasing age, personal and family history of breast cancer, obesity, radiation exposure, pregnancy at an older age, postmenopausal hormone therapy are some of the factors that increase the chances of breast cancer.

Treatment: Several forms of surgical methods exist to treat breast cancer. Depending on the condition and spread of the disease a suitable surgery is performed. These include mastectomy, lumpectomy, axillary lymph node dissection and removal of both breasts. Other forms of treatment include chemotherapy or the use of high doses of drugs to destroy cancerous cells. Radiation therapy where X-rays are used to destroy the cancer cells is also effective.

The very term 'breast cancer' can send shivers down a woman's spine. The associated pain, agony, sufferings are enough to deter a person. The effectiveness of the treatment depends on the stage in which the condition is detected. Unfortunately, many women neglect and overlook the early signs, thereby delaying the treatment.

Self-awareness is vital for prevention, early detection and treatment of breast cancer. Treatment and prevention can only work when a person is alert and agile. If you notice any unusual symptoms, waste no time and consult an experienced physician at the earliest. However, prevention is always better than a cure. A few healthy habits, if practiced diligently, can go a long way to prevent and reduce the incidences of breast cancer.

1. A healthy body weight: Overweight and obese women are at a greater risk of suffering from breast cancer. The key to this problem is as simple as shedding off the extra kilos. Research suggests that incidences of breast cancer are slightly lower in women who maintain body weight within healthy limits. Enrich your diet with fruits and vegetables. Drink water and other healthy fluids (coconut water, fresh fruit juice,) at regular intervals.
2. Breastfeed for a healthy breast: Breastfeeding is important for the health of both the baby and the mother. While babies get the necessary nourishment, women who are into breastfeeding are less likely to suffer from breast cancer. Thus, all healthy lactating mothers should breastfeed their babies.
3. Keep the vices at bay: Severe smoking and alcohol consumption can harm your body beyond imagination, with breast cancer being one the many harmful side effects. Drinking within limits (1 drink or even less per day) is still acceptable, but anything in excess is sure to spell doom.
4. Some of the imaging and diagnostic tests can be harmful to your body: Repeated exposure to the radiations from CT-scan can put a woman at an increased risk of developing breast cancer. Limiting the exposure to such radiations may help to check the incidences of breast cancer.
5. Physically active and agile: Lack of physical exercise and an unhealthy lifestyle can wreak havoc with health complications as serious as breast cancer. It is important to keep your body physically active. Light to moderate exercise (for 30 minutes), jogging, cycling, swimming and other physical activities can work wonders for your body. Avoid stress and anxiety. Proper rest and a sound sleep are equally important.

Various research and studies suggest that women who are into hormone therapy are more susceptible to breast cancer. Such patients are often advised to avoid and replace hormone therapy with alternative treatments. However under extreme conditions (where the alternative treatments fail to produce the desired result), limiting the duration as well as the dosage of the hormone therapy may be helpful. If you wish to discuss about any specific problem, you can consult an Oncologist.

Extracorporeal Shock Wave Therapy (ESWT) is a highly effective and innovative treatment option in a variety of fields, from urology to cosmetology including orthopedics. This is a non-invasive method that employs high-energy shockwaves to bring about the healing of the affected tissues. It has been found to provide good results for recalcitrant orthopaedic problems like frozen shoulder to certain chronic degenerative or tendon conditions such as Achilles tendinitis (injury of the Achilles' tendon due to overuse) and plantar fasciitis in heel pain.

How does it work?

The procedure is basically an outpatient/ daycare job. It involves the application of a non-invasive probe to the affected tissue. This is followed by the external generation of shockwaves focused on the target area. The shockwaves cause a force to be created that brings about healing. Although it's still not clear as to why this kind of therapy works, the dominant understanding is that shockwaves render an improvement in the flow of blood so as to promote the body to fix and heal itself.

Depending on individual cases, high or low energy waves may be employed. While pain may occur during the transmission of high energy waves and would require short general anaesthesia, low-energy ESWT is carried out without anesthesia.

What problems can this form of therapy effectively tackle?

ESWT can be used to treat a number of musculoskeletal disorders. From plantar fasciitis (heel pain), tennis elbow, shoulder rotator cuff, degenerated tendons (Achilles' tendon) to hip and knee pain, the therapy has been found to reduce pain as well as accelerate healing in individuals.

Complications are very few and far between with this therapy. Individuals who suffer from hypersensitivity or poor sensation in the affected area are usually not recommended this procedure. Even individuals with heart conditions, seizures and open sores need to consult a doctor before going forward with the therapy.

The therapy has also been found to be very effective in bone healing as well as treatment of bone necrosis (a disease that occurs due to permanent or temporary loss of blood flow to the bones). Additionally in place of surgery, ESWT may also be a valuable option for non-healing fractures.

Medical science constantly challenges the boundaries by finding not only the cures to the most dangerous diseases, but finds a way to prevent them even before they occur. With years of research, practice and data available for analysis, scientists are using advanced technology in combination with years of research to create a predicting mechanism for often fatal diseases like cancer.

Breast cancer screening has always been done with mammography. The fact is that this method is only 75% accurate, laden with false positives and misses a whole set of women totally- and that too when cancer has already developed. Part of the problem comes from the dense breast tissue which one in three women have. This tissue masks the lumps, which makes it difficult for mammograms to accurately screen cancer.

Some breakthrough scientific methods are changing this by drawing on years of research to predict this deadly disease, years before it can manifest itself.

A genetic test to predict cancer 10-11 years ahead of time. This test was performed to see how environmental factors could influence cancer, along with habits like smoking, abusing alcohol or hormones, genetic changes that occur and are put a large percentage of the women at a high risk of developing this disease.

A simple blood test is used for the genetic analysis of hereditary cancer. Researchers found a biological marker, methylation of the ATM gene, which has a very high ability to predict the risk of developing cancer, several years before diagnosis. 'Methylation' concluded that when one biological indicator is exposed to carcinogenic substances, or other abusive substances like tobacco and alcohol, it may trigger the development of cancer.  On the flip side, this test will take time to reach the commercial market and even then cannot give an exact timeline as to when someone may develop the disease.

A simple blood test to predict breast cancer 5 years before it develops. This is the kind of medical miracle the world is looking for. Last year in April, researches in Denmark identified a simple blood test that can predict breast cancer five years before it actually develops with an accuracy of a whopping 80%.

It works by "measuring all of the compounds in the blood to build a 'metabolic profile' of an individual, in order to detect changes in the way chemicals are processed, during a pre-cancerous stage," says Laura Donnelly, health editor at The Telegraph, which covered this development. Danish researchers observed 57,000 participants over 20 years, gathering blood samples along the way, specifically comparing a set of 800 women who remained healthy or developed breast cancer within 7 years of their first blood sample. The researchers found they were able to predict, with 80 percent accuracy, which patients would be affected by the disease, just by looking at the metabolic profiles they built from the participants' blood samples. The results have been published in Metabolomics. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

If you are concerned about breast cancer, you should know about the steps you can take to prevent the condition. Breast cancer is a type of cancer developing from the breast tissue. Symptoms such as a lump in the breast, fluid flowing from the nipple, changes in the shape of the breast and occurrence of red scaly patches on the breast denote breast cancer.

You need to make certain lifestyle changes in order to prevent breast cancer. The ways you should adopt include the following:

1. Limit your alcohol intake: The more you consume alcohol, the more you put yourself at the risk of getting breast cancer. It is recommended for you not to drink more than one drink per day. Small amounts of alcohol increase the risk of breast cancer as well.

2. Abstain from smoking: There is a direct link between tobacco smoking and breast cancer, and the risk is even more in premenopausal women. You should quit smoking to reduce the risk of breast cancer along with many other conditions, which can develop because of the ill-effects of smoking.

3. Control your weight: Obese women are more prone to breast cancer when compared with women with a healthy weight. This is especially true when obesity occurs at a later stage in life, after menopause.

4. Keep physically active: Regular physical activity is essential for you to maintain a healthy weight, which is important for preventing breast cancer. 150 minutes of moderate aerobic exercises or 75 minutes of vigorous exercises are recommended along with strength training.

5. Breastfeed: Breastfeeding plays an important role in preventing breast cancer. The more you breastfeed your baby, the more protected you are from breast cancer.

6. Limit the dosage and duration of hormone therapy: If you undertake combination hormone therapy for more than three to five years, you are at a higher risk of developing breast cancer. In case you are taking hormone therapy for menopausal symptoms, you should talk to your doctor about alternative options such as non-hormonal therapy and medications. If you still require hormonal therapy, you must use the lowest dose that will be effective.

7. Avoid exposure to radiation and pollution: Certain medical imaging procedures like computerized tomography involves radiation of high doses. There is a link between breast cancer and radiation exposure. Thus, you should abstain from getting exposed to radiation and avoid taking such tests if it is not very urgent.

Maintaining a healthy diet also helps in reducing your risk of developing breast cancer. You should include food items which are plant based in your regular diet, such as fruits, vegetables, nuts, whole grains and legumes. Also, consume healthy fats such as olive oil instead of red meat and butter. If you wish to discuss any specific problem, you can consult an oncologist.