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Dr. V Arun Ramanan

MBBS, MD - Radiotherapy, DM - Oncology

Oncologist, Chennai

12 Years Experience  ·  500 at clinic
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Dr. V Arun Ramanan MBBS, MD - Radiotherapy, DM - Oncology Oncologist, Chennai
12 Years Experience  ·  500 at clinic
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I'm a caring, skilled professional, dedicated to simplifying what is often a very complicated and confusing area of health care....more
I'm a caring, skilled professional, dedicated to simplifying what is often a very complicated and confusing area of health care.
More about Dr. V Arun Ramanan
Dr. V Arun Ramanan is one of the best Oncologists in T.Nagar, Chennai. Doctor has been a practicing Oncologist for 12 years. Doctor is a MBBS, MD - Radiotherapy, DM - Oncology . Doctor is currently associated with Be Well Hospital in T.Nagar, Chennai. Book an appointment online with Dr. V Arun Ramanan and consult privately on Lybrate.com.

Find numerous Oncologists in India from the comfort of your home on Lybrate.com. You will find Oncologists with more than 29 years of experience on Lybrate.com. Find the best Oncologists online in Chennai. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Education
MBBS - Thanjavur Medical College - 2005
MD - Radiotherapy - Indian Association of Palliative Care - 2008
DM - Oncology - Madras Medical College, Chennai - 2010

Location

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Be Well Hospital

#5A, Vijaya Raghava Road, T Nagar. Landmark : Near 10 Downing Street Hotel.Chennai Get Directions
500 at clinic
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Dr. Kamakshi Memorial Hospital

1, Radial Road, Landmark : Opposite To Cognizant Technology Solutions 200 Feet Road, ChennaiChennai Get Directions
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Is this type of cancer caused by genetic factors? Are other members of my family at risk?

DNB, MBBS
Oncologist, Faridabad
Nearly 5-7 % cancers may be genetic. Genetic cancers can be due to some change in genetic make up by any means or mutations or may be transmitted from one generation to other. Only cancers which can hereditary like breast ovarian cancer, or men syndrome related cancers etc may be part hereditary cancers and other members also may suffer, not all.
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Hi i am 25 yrs old yesterday night few bleeding in my left breast and pain also. I am very afraid please tell me it could be a cancer.Please suggest

MD - Maternity & Child Health
Gynaecologist, Bangalore
25 yr old and breast cancer is unlikely but stil go n consult gynecologist for proper treatment if there is a problem or so.
1 person found this helpful
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How can I identify blood cancer? What are the controlling measures to prevent this?

DNB, MBBS
Oncologist, Faridabad
Blood cancer is caused by abnormal growth of one of the component of blood causing suppression of others. Hence leading to symptoms like prolonged fever, anaemia, bleeding, bone pains. Etc. There is no specific prevention except for to save from known carcinogens and undue exposure to radiation. Routine blood check up helps in identifying it.
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The 4 Stages Of Uterine Cancer

DNB (Obstetrics and Gynecology), MD - Obstetrtics & Gynaecology, MBBS
Gynaecologist, Delhi
The 4 Stages Of Uterine Cancer

The uterus is a very important organ within the human reproductive system as this is the chamber where an embryo grows into a baby. Due to a multitude of factors, the incidence of uterine cancer has been on the rise. Let's look at some of its symptoms.

Symptoms of uterine cancer
When cells within the uterus grow abnormally and turn malignant, it may be termed as uterine cancer. This may be in the form of a fibroid or tumor or be part of the uterine tissue itself. It may be caused due to a multitude of factors such as late menopause, radiation exposure, estrogen treatments and many others. Some of the common symptoms for uterine cancer could be:

a. Pain in the abdomen, lower back and especially the pelvic area.
b. Pain during urination,
c. Weight loss without any apparent reason
d. Vaginal bleeding with or without discharge
e. Pain during sex

Stages of uterine cancer:
Before we understand the stages of uterine cancer you need to know how doctors diagnose the various stages. This is done by the three following steps in the TNM method:

Tumor - Doctors try and search for tumors and locate them within the uterus, estimate its size and whether it is malignant or not.

Node - If the tumor is malignant, then doctors try to find out whether the tumor has reached the lymph nodes or not.

Metastasis - Doctors look for Metastasis which is whether the cancer has spread to other organs within the body and to what extent.

Stages of cancer - Cancer is primarily grouped in five stages from 0 to V according to the T, N and M stages mentioned below.

Stage 0 - This is a very early stage of cancer where the cells have malignant growth but are still small in number and haven't spread anywhere.

Stage I - If the cancer has developed a little but is restricted within the uterus, it is considered as stage one. This is also further divided into Stage 1A and 1B.

Stage II - When the cancer has started spreading but only to some parts of the cervix from the uterus, it is diagnosed as stage 2 uterine cancer.

Stage III - Categorized into Stage IIIA, Stage IIIB, Stage IIIC1 and Stage IIIC2, it is primarily where the cancer has spread to other organs but it is only limited to the pelvic area.

Stage IV A - When the cancer has gone beyond the pelvic area and also spread to the rectum and balder area.

Stage IV B - This is where the cancer has metastasized in the groin area or gone to other organs within the body as well.

Epithelial Ovarian Cancer - 4 Major Signs that Indicate it

MBBS, MD
Gynaecologist, Delhi
Epithelial Ovarian Cancer - 4 Major Signs that Indicate it

Epithelial Ovarian Cancer is a condition in which malignant tumor emerges from the tissue lining in the outer surface of the ovary. Epithelial tumors are usually benign, but this form of malignancy has been found to be the most common type of ovarian cancer. Moreover, it cannot be diagnosed until in its advanced stage. Medical research shows that factors such as multiple pregnancies, delayed childbirth and early menarche seem to raise the risk of ovarian cancer, while dietary and environmental factors also play a significant role in it.

Symptoms
1. A majority of the patients have been observed to have extensive intra-abdominal growth.
2. They may experience discomfort or swelling of the abdominal region.
3. The feeling of being bloated, lack of appetite, unnatural weight alteration, dyspepsia, malaise, and urinary problems are frequently reported symptoms.
4. Patients also experience constipation and other gastrointestinal problems.

Treatment
The first step towards treatment of ovarian cancer is to diagnose the condition. A thorough pelvic examination (consisting of an examination of the vagina, uterus, ovaries, fallopian tubes, and cervix) will help to pin point any abnormality of the ovary. If the doctor notes nodularity, firmness or lack of tenderness during the examination, these can be taken as symptoms of malignancy of epithelial ovarian tumors. Ultrasound examination of the abdominal region will also help to locate abnormality in the tissues on the outer surface of the ovary. The next logical step towards treatment is getting a biopsy. During this procedure potentially malignant cells are removed and then diagnosed by a pathologist to conclude if the cells are cancerous or not. The process of removal is known as laparotomy.

Apart from a handful of stage one patients, most women with epithelial ovarian cancer receive chemotherapy. The standard treatment for this type of ovarian cancer is the surgical elimination of tumor. This includes total abdominal hysterectomy, a surgery in which the uterus and cervix is removed through an incision in the abdomen. Post surgical treatment consists of taxane-platinum chemotherapy. Patients with minimal residual cancer undergo external radiation therapy or intraperitoneal chemotherapy (radioactive liquid is channelled into the abdomen with the help of a catheter).

A lot of research has been done in this field and a variety of clinical trials are available for a patient, if he/she wishes to be a part of it. Leading methods are immunotherapy and targeted therapy are also available. Immunotherapy uses the immune system of the patient to battle cancer. Bodily substances or substances created in the lab are used to restore and boost the body’s natural defence mechanisms against cancer. Targeted therapy, on the other hand, uses substances to identify the cancer and attack the malignant cells without jeopardizing non-cancerous cells.

3687 people found this helpful

He's suffering from skin cancer. How do I rectify it vry soonly. Nd white patches on the skin too are not gttng reduced day by day.

DNB, MBBS
Oncologist, Faridabad
He's suffering from skin cancer. How do I rectify it vry soonly. Nd white patches on the skin too are not gttng reduc...
Sir, white patches are different from skin cancers. White patches are usually leucoderma or vitiligo need treatment under care of dermatologist. If suffering from skin cancer then need to undergo surgical excision if possible and then remaing treatment as per histopathology reports.
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I am 65 years old. On medical check up, doctors diagnosed prostate enlargement (55 /58) and prescribed some medicines such as Deutas and prolif which still I continue. Should I continue the medicines or go for surgery?

MD - Oncology
Oncologist, Hubli-Dharwad
if your symptoms are controlled with medicines then you can continue and delay surgery but if not controlled then opt for surgery and do check if its a benign enlargement or cancerous. if cancerous then either surgery or radiotherapy has to be done urgently.
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I'm a 20 year old female and for the last 5-6 years (since I was about 14) I've been experiencing constant left breast pain. The pain can always be felt to some degree, although some days it's worse than others. The breast feels bigger and fuller than the right one and is painful, especially when I'

MBBS, DNB (General Surgery), MNAMS (Membership of the National Academy) (General Surgery) , Fellowship in Minimal Access Surgery, Fellow of Indian association og gastro intestinal endo surgeons
General Surgeon, Ghaziabad
This seems to cyclical mastalgia that occurs more during menstrual cycles. Nothing to worry. This is related to harmones and treatment is possible. Please consult a surgeon for confirmation of diagnosis by detailed history and examination as any proper treatment can only be advised after confirmation of disease.
1 person found this helpful
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Sir I gon under surgery of breast cancer now I having 22 days once kemo my hair full loss and nohair I want to what should I do for hair come.

(M.D.Accu), Diploma in Naturopathy & Yogic Science YS)
Acupuncturist, Delhi
Sir I gon under surgery of breast cancer now I having 22 days once kemo my hair full loss and nohair I want to what s...
Madam, please drink natural fruit juices and eat fruits and veg. Juices boiled veg. Every time. Avoid wheat. And curd and milk.
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What are the basic symptoms of blood cancer and treatment and control of the blood cancer? If any person is suffering from blood cancer at that time what type of food is suitable for him?

MS ( General Surgery)
Oncologist, Mandsaur
Symptoms of Blood cancer The list of signs and symptoms mentioned in various sources for Blood cancer includes the 22 symptoms listed below: •Fatigue •Malaise •Breathlessness •Weakness •Excessive or easy bruising •Bleeding gums or frequent nose bleeds •Recurrent infections or fever •Sweating at night •Weight loss •Anorexia •Lymph node (gland) enlargement •Lumps or abdominal distension due to enlarged abdominal organs •Abdominal pain •Bone pain •Back pain •Bone fractures from minimal trauma •Confusion •Delirium •Headaches •Visual disturbance •Fluid retention •Decreased urination Blood Cancer Prevention Even after a lot of research scientists are not able to find ways to prevent most types of blood cancer. There are no absolute risk factors identified for this cancer but the key is to reduce the known ones. Also, doing some of these simple things will boost your immunity and can reduce the risk to some extent. •Avoid exposure to radiations If possible avoid exposure to high doses of radiation as during the certain treatment procedures patients are often exposed to high intensity radiation which increases their odds of succumbing to blood cancer. •Avoid exposure to chemicals Avoid getting exposed to certain harmful chemicals such as pesticides, as this may add up to increased risk of blood cancer. If your occupation forces you to stay in touch with these chemicals you must take proper safety measures. Exposure to benzene can also increase the chances of this cancer. •Avoid smoking or tobacco in every form Cigarette or tobacco consumption is a huge risk factor for not only cancers but several other diseases and should be completely avoided. By following few healthy lifestyle habits given below one can reduce the chances of getting affected with any type of cancer. •Regular exercise Regular exercise is essential to keep the body healthy. If you exercise daily for 30 minutes there are less chances of getting affected to the blood cancer, but still there is no evidence which supports it. •Eat healthy Healthy food consumption helps you to fight against diseases. Increasing consumption of fresh fruits and vegetables that contain fibers and a lot of nutrients reduces the risk of blood cancer to some exten •Don't ignore the symptoms Be watchful of your body and the signals it gives to you, especially when you are being exposed to one or few risk factor of blood cancer. Always consult your doctor when any kind of signs related to the cancer is seen. By having regular health checkups the blood cancer detection can be done at early stages. To live healthy & happy, one must keep a check on the body’s functioning by going for regular health checkups. This helps in assessing risk factors and diagnosing diseases at an early stage, which will result in effective treatment and better management of the condition. Blood cancer treatment & therapy options Treatment for blood cancer depends on the type of cancer, your age, how fast the cancer is progressing, where the cancer has spread and other factors. Some common blood cancer treatments include: •Stem cell transplantation: A stem cell transplant infuses healthy blood-forming stem cells into the body. Stem cells can be collected from the bone marrow, circulating (peripheral) blood and umbilical cord blood. •Chemotherapy: Chemotherapy is the use of anticancer drugs designed to interfere with and halt the growth of cancer cells in the body. Chemotherapy for blood cancer sometimes consists of giving several drugs together in a set regimen. It may also be given before a stem cell transplant. •Radiation therapy: Radiation therapy may be used to destroy cancer cells or to relieve pain or discomfort. It may also be given before a stem cell transplant.
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I am 60 years old male and have prostrate gland since two years. Having no improvement I have decided to get homeopathic treatment. Any kind advice from home Dr. the type of home medicine?

BHMS
Homeopath,
I am 60 years old male and have prostrate gland since two years. Having no improvement I have decided to get homeopat...
Dear lybrate user, benign hypertrophy of prostate is a non-cancerous enlargement of the prostate gland. In this clinical condition multiple nodules are formed inside the prostate gland. These nodules often compress the urethra resulting in the narrowing of the lumen of urethra & producing a resistance to the urine flow. Resistance to urine flow requires the bladder to work harder during voiding, possibly leading to progressive enlargement, instability, or weakness of the bladder muscle. Benign hypertrophy of prostate can be easily diagnosed by an usg of whole abdomen along with blood test for prostate specific antigen (psa). Follow the given medication as directed:- 1) 5 drops of homoeopathic causticum 30 at early morning daily before brushing teeth 2) 5 drops of homoeopathic conium mac 30 before going to bath daily. 3) 5 drops of homoeopathic baryta carb 30 just one hour before dinner daily. 4) homoeopathic mother tincture sabal serrulata q, 30 drops, twice daily, after meals, in a cup of water. Along with the aforesaid medication few changes in your lifestyle are also necessary. Lifestyle alterations to address the symptoms include decreasing fluid intake before bedtime, moderating the consumption of alcohol and caffeine-containing products, and following a timed voiding schedule. Also it would be better if you could void the urine in sitting position.
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My mom she is 37 years old. She had a tumor in belly of 55mmX56mm. Can she be cured without surgery?

DNB, MBBS
Oncologist, Faridabad
Dear sir please get it checked by means of biopsy and radiological scanning. It should be excised and prognosis depends on kind of tumour whether benign or malignant and if malignant then the exact nature of disease.
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Breast Cancer - Know More to Say 'No' More!

MBBS, DGO, MD - Obstetrics & Gynaecology, MRCOG
Gynaecologist, Delhi
Breast Cancer - Know More to Say 'No' More!

Cancer is the abnormal, uncontrolled growth of cells in a particular body part. With continued growth, pieces of this tissue travel through the blood to different body parts and continue to grow in the new area. This is known as metastases. Breast cancer is one of the most common forms of cancer and affects about 1 in 8 women in the USA. Read on to know more details of breast cancer – breast anatomy, causes, symptoms, risk factors, detection, prevention, and of course treatment.

Anatomy: The main function of the breast is lactation through its milk-producing tissue that are connected to the nipple by narrow ducts. In addition, there is surrounding connective tissue, fibrous material, fat, nerves, blood vessels and lymphatic channels which complete the structure. This is essential to know as most breast cancers develop as small calcifications (hardened particles) in the ducts or as small lumps in the breast tissue which then continues to grow into cancer. The spread can happen through lymphatic or blood flow to other organs.

Warning signs/symptoms: The following are some symptoms that need to be watched out for if you have a predisposition to breast cancer.

  1. A lump in either of the breasts or armpits
  2. Change in size, shape, or contour of either breast
  3. Redness of your breast or nipple
  4. Discharge of clear or bloody fluid
  5. Thickening of breast tissue or skin that lasts through a period
  6. Altered look or feel of the skin on the breast or the nipple (dimpled, inflamed, scaly, or puckered)
  7. One area on the breast that looks very different from the other areas
  8. Hardened area under the breast skin

Either one or a combination of these should be an indication to get a detailed checkup done. Early diagnosis results in controlling the disease with minimal treatment and reduced complications.

Causes and risk factors: The exact cause for breast cancer is yet to be pinned down. However, risk factors are clearly identified, and women with risk factors need to watch out for warning signs.

  1. Family history: Of all the risk factors, the family history is the most important. Breast cancer runs in families, and if there is a first-degree relative with the breast cancer, the chances of developing it are almost double. Two genes BRCA1 and BRCA2 are the carriers of the disease, and this testing can be done in women to identify if they are at risk.
  2. Family history of other cancers: Even if there is no breast cancer, if there are other cancers that run in the family, watch out.
  3. Age: Women over 50 are at higher risk of developing breast cancer.
  4. Race: Caucasian and Jewish women are at higher risk of breast cancer than African-American women.
  5. Hormones: Greater exposure to the female hormone estrogen increases the chances of developing breast cancer. Women who use birth control pills for contraception and hormone replacement after menopause are at a higher risk of developing breast cancer.
  6. Gynecologic milestones: Women who have abnormal menstrual milestones need to watch out. These include those who attain menarche before 12 years of age, get pregnant after 30, attain menopause after 55, and have menstrual cycles shorter than 26 days or longer than 29 days.
  7. Obesity and alcohol abuse are also likely to increase a woman’s chances of developing breast cancer.

Stages: Starting from stage 0, higher stages indicate advanced disease.

  1. Stage 0: The growth which has begun in the milk-producing tissue or the ducts has remained there (in situ) and not spread to any other area, including the rest of the breast.
  2. Stage I: The tissue slowly becomes invasive and has begun to affect the surrounding healthy tissue. It could have spread to the fatty breast tissue and some breast tissue may be found in the nearby lymph nodes.
  3. Stage II: The cancer at this stage grows considerably or spreads to other parts. There are chances that cancer may grow and also spread.
  4. Stage III: It may have spread to the bones or other organs but small amounts are present in up to 9 to 10 of the lymph nodes in the armpits and collar bones which makes it is difficult to fight.
  5. Stage IV: The cancer is widespread to far-flung areas like the liver, lungs, bones, and even the brain.

Screening: This is one of the most effective ways to identify the disease in its early stages. This will help in controlling cancer from spreading with minimal treatment.

  1. Self-examination: A thorough self-examination to look for changes in terms of shape, size, colour, contour, and firmness should be learned by all women. Watch for any discharge, sores, rashes, or swelling in the breasts, surrounding skin, and nipple. Examine them while standing and when lying down.
  2. In most women, annual screening mammograms are advised after the age of 40. However, in women who have a strong family history or genetic makeup, it is advisable to have screening mammograms starting at age 20 every 3 years and then annually from the age of 40.
  3. Women in high-risk categories should have screening mammograms every year and typically start at an earlier age.
  4. Ultrasound screening can also be given in addition to mammograms.
  5. Breast MRI is another way to screen for breast cancer if the risk is greater.

Breast Cancer Prevention: Now that there is so much awareness about causes and risk factors, there are definitely ways to prevent or delay the onset of the disease.

  1. Exercise and a healthy diet with reduced amount of alcohol are definitely effective in minimising the chances of developing cancer.
  2. Tamoxifen is used in women who are at high risk for breast cancer.
  3. Evista (raloxifene) which is used to treat osteoporosis after menopause. It is also widely used in preventing breast cancer.
  4. In high-risk women, breasts are surgically removed to prevent the development of cancer (preventive mastectomy).

Treatment: As with all cancers, treatment would depend on the stage at which it is identified and include a combination of chemotherapy, radiation, and surgery. As noted earlier, if you are at risk, look out for warning signs as early diagnosis is the key to maximum recovery.

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I am 28 years old women. Before 4 years I took a surgery for lump on my right breast. At the same time a tiny lumps on my left breast too. I took needle biopsy to the both breast at that time. The result is normal. The biopsy result of right breast is also normal. After 6 months of surgery I got married and delivers a child before our first anniversary. My left breast lump is become larger during this period. Am i suspect the left breast lump cancer. I am afraid to a medical examine. Please give me a clarification.

M.CH - Surgical Oncology
Oncologist, Visakhapatnam
Hi, it is normal for benign breast lumps to enlarge rapidly during pregnancy. They usually don't turn into cancer. They enlarge secondary to the hormonal changes durimg that time and may regress back later. But if you still have a large persistent lump, please do consult a surgeon in person as a clinical examination will reveal a lot more. And if needed you can get it removed. Most importantly, your doubt regardin cancer will be clarified. Hope his helps. Take care.
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Hi, how do cancer generates in our body, what are the symptoms, can it be avoided.

MBBS, MS- Surgery , M.Ch - Surgical Oncology , FIAGES
Oncologist, Delhi
Cancer is uncontrolled proliferation of transformed cells in any part of the body. Neoplasm or tumor are used variably to describe any swelling or new growth. Benign growths don’t have potential to spread to other organs or parts of the body while malignancy or malignant growths have uncontrolled proliferation and metastatic potential. Transformation is multistep process with genetic alterations by which normal cells acquire malignant potential, uncontrolled proliferation capacity and capacity to spread to other parts of the body (metastasis) Worldwide cancer is responsile for 1 in 8 deaths
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I am 20 years old and I have concern regarding my breasts i. E whatever dress I wear my nipples are popped out to dress and easily visible. Request you to advise me on what measures to be taken to avoid it completely so that I am able to wear any type of dress.

FMAS, MS
General Surgeon, Gandhinagar
Respected lybrate-user heena first of all don't worry as it is natural thing regarding nipple size shape. So far as projection in dress is concerned you definately have to use padded braziers & with that dresses with less transparency that's all dear.
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FRAS, MD - Ayurveda, Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Alternative Medicine Specialist, Ernakulam
Cancer Symptoms Men Ignore

1. Problems When You Pee
Many men have some problems peeing as they get older, like:
A need to pee more often, especially at night
Dribbling, leaking, or an urgent need to go
Trouble starting to pee, or a weak stream
An enlarged prostate gland usually causes these symptoms, but so can prostate cancer. See your doctor to check on the cause of the problem. He?ll give you an exam to look for an enlarged prostate, and he may talk to you about a blood test (called a PSA test) for prostate cancer.

2. Changes in Your Testicles
"If you notice a lump, heaviness, or any other change in your testicle, never delay having it looked at.
"Unlike prostate cancer, which grows slowly, testicular cancer can take off overnight" Your doctor will look for any problems with a physical exam, blood tests, and an ultrasound of your scrotum.

3. Blood in Your Pee or Stool
These can be among the first signs of cancer of the bladder, kidneys, or colon. It's a good idea to see your doctor for any bleeding that?s not normal, even if you don't have other symptoms,
Although you're more likely to have a problem that's not cancer, like haemorrhoids or a urinary infection, it's important to find and treat the cause.

4) Breast Changes
"Men tend to ignore breast lumps because breast cancer isn't on their radar"
"But 1% of all breast cancers occur in men, although they're usually diagnosed much later" Don?t take any chances. If you find a lump, tell your doctor and have it checked.

11 people found this helpful

Dr. I can feel something hard in my half breast. And very little pain when I press it. What can be this.

MBBS, DNB (General Surgery)
General Surgeon,
Kindly get your self examined by a general surgeon. Considering your age we need to be on the look for many diseases. Best counselled after thorough examination and investigation.
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Does esophagus cancer or chest cancer can be detect on chest x ray pa view while in the zero stages.

Post Doctoral Research (Ph.D.) (A.M) (Oncology), Integrative Oncology for Physicians (MSKCC, N.Y, USA), Doctor of Natural Medicine (N.D/ N.M.D), Ayurveda (I) Cert., Advanced Strategic Management (APSM), B.E (Computer Sc. & Engg.), Clinically Relevant Herb-Drug Interactions (CME) - (Cine-Med Inc. USA)
Alternative Medicine Specialist, Bhubaneswar
Hi lybrate-user, I appreciate you seeking guidance. In fact, a chest x-ray is the very basic test advised by any physician should he / she suspect an abnormality. Barium swallow with x-ray is often employed to detect filling defects, if any. This often paves the way for further diagnostics as deems appropriate. Hope this clarifies.
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What are the symptoms of cancer. Sometimes little blood is coming from nose. Please let me know.

BMS
Ayurveda,
Hi lybrate-user anxiety is typical to treat. Never jump on conclusion, nose bleed can as not be common in various illness. Cancer symptoms are depends upon the age, addiction, cancer causing habitat, family history site, type, grade, involvement, it may show, fever/bleeding from site/watery discharge /pain/tenderness/swelling/normal or abnormal growth/bony pain/local pain/ local lymph node swelling etc etc. But it should conform by doctors and by required examinations only.
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