Royal care Super speciality hospital

Uterine fibroids, also referred to as uterine myomas) are non-cancerous tumors that grow within the muscle tissue of the uterus. As many as 20% to 50% women between the age group of 18 to 40 suffer from the condition, but not all cases warrant treatment. 

It may be as tiny as a coin or it may grow to the size of a watermelon, making people think the lady is 6/7 months pregnant! There may be one big fibroid or several small ones. 

Causes

Though the exact causes are not known, family history and hormonal imbalances are said to be the main causes for the same.

Types of Uterine Fibroids

1. Subserosal Uterine Fibroids: Develops outside the uterus and continues to grow.
2. Intramural Uterine Fibroids: The most common type that lead to pregnancy like tummy. They develop within the uterus wall and continue to expand.
3. Submucosal Uterine Fibroids: Because these develop within the uterus lining, they are most likely to be the cause of heavy flow during periods.
4. Pedunculated Uterine Fibroids: These grow on the inner or outer side of a small stalk connecting to the uterus.

Common Symptoms

1. An enlarged uterus is the most common symptom. It is often mistaken for general weight gain or pregnancy.
2. Prolonged and painful menstrual cycle, that is many times irregular.
3. Urinary incontinence and constant urge to urinate.
4. Pelvic pressure.
5. Pressure on the bowels leading to constipation.
6. Pain during intercourse.

General treatment 

If you find out that you have fibroids during an examination or if you visit a doctor with any of these symptoms, they will most likely ask for an ultrasound or Magnetic Resonance Imaging (MRI) which will confirm the type of fibroid and the extent of your problem. Treatment includes non-invasive-focused ultrasound surgery. 

Treatment with Homeopathy

One of the best advantages of choosing Homeopathy is that it works without side effects. It addresses the issue rather than the symptom. A surgical procedure mentioned in general treatment does remove the fibroids but there is no guarantee that they won't grow back as the underlying issue of hormonal imbalance remains. 

During a clinical study of the effects of Homeopathy on fibroids, 85% patients showed improvement and 48% people had complete fibroid removal. There are medicines in Homeopathy that can treat uterine fibroids, cervical fibroids and help maintain normal hormonal balance in females. 

Collectively grouped under the Ewing sarcoma family of tumors, Ewing's sarcoma is the second most common primary bone cancer occurring predominantly in children and in adolescents. Very rarely is it experienced in adults above the age of 30.

Typically forming in the bones of the chest, pelvis, head, back or trunk and in the long bones of the arms and legs, Ewing's sarcoma is believed to originate in certain kinds of primitive cells. When it begins to affect similar kind of cells found outside the bone, it is usually called an extraosseous Ewing's sarcoma.

Causes

1. Similar to all types of Ewing tumors, Ewing's sarcoma is generally caused by an alteration in a certain cell compelling a gene named EWS found on chromosome no. 22 to move over to a DNA section on any one of the surrounding chromosomes resulting in the activation of the EWS gene.

2. While it is not a hereditary condition, it usually occurs after childbirth, but no substantial evidence has been found as to why it happens so.

Symptoms

Symptoms of Ewing's sarcoma may include:

1. Swelling and pain especially in the arms, legs, back, chest or pelvis
2. Swelling accompanied by joint immobility
3. A bone breaks having no apparent cause
4. Swelling which may or may not be accompanied by a warm, tingling sensation
5. Fever resulting from unknown causes
6. Lumps or bumps which do not subside over time
7. Abnormal weight loss
8. High levels of fatigue
9. Tumors which have spread over to the lungs may cause shortness of breath
10.Tumors spread over to the spine may cause weakness or even paralysis.

Because the symptoms of Ewing's sarcoma can hardly be distinguished from symptoms caused by other infections or injuries, an early diagnosis is absolutely necessary for a successive treatment.

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

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

Purpose:
Brain surgeries are performed to:

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

Types:

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

Risks:

1. Anaesthesia risks like breathing difficulty, allergic reaction to medications, excessive bleeding or clots and infection.
2. Risk related to the brain surgeries are seizures, coma, swelling of brain, infection to brain or meanings, surgical wound infection that intrudes to the brain structures, abnormal clot formation and bleeding.
3. General risks include muscle weakness, disturbances in memory, speech, vision, coordination, balance and other functions that are controlled by the brain.

A clinical or self-breast exam involves feeling the breast for lumps or other abnormalities. A number of screening tests have been employed, including clinical and self-breast exams, mammography, genetic screening, ultrasound, and magnetic resonance imaging.

In case you have a diseased uterus, which makes you infertile, you can undergo a procedure known as uterus transplant or uterine transplant to get pregnant. In the process of sexual reproduction, a diseased uterus does not allow embryonic implantation. This factor is referred to as uterine factor infertility or UFI. As a result, you will not be able to get pregnant.

Who requires a uterus transplant?

This procedure involves women who have UFI and women who had their uterus removed by hysterectomy. Women who have a damaged uterus on account of an injury or infection, which does not function anymore, can also undergo a uterus transplant procedure. Women from the age of 21 to 45 are eligible for this procedure. Many women are born without having a uterus. This condition is called Mayer-Rokitansky-Küster-Hauser syndrome.

Procedure

Uterus transplantation begins with undertaking a uterus retrieval surgery on the uterus donor. The uterus, which is recovered has to be stored and transported to the location of the patient undergoing the transplant. An ischemic tolerance may last over 24 hours. Three major surgeries have to be carried out with the recipient. Firstly, a transplantation surgery is required in which the donor’s uterus gets transplanted. In case pregnancy develops, a caesarean section surgery has to be performed. The patient is given immune suppressive therapy. After childbirth, a hysterectomy is done in order to terminate the immune suppressive therapy.

Will the women be able to get pregnant after having sex?

Women receiving a uterus transplant will not be capable of becoming pregnant without undergoing fertility treatments. The transplanted uterus is not connected with the fallopian tubes, which is the location of the normal fertilisation process. The women will require to carry out IVF or in vitro fertilisation to become pregnant after a uterus transplant. IVF is a process in which the eggs are removed from the ovaries and get fertilised in a laboratory. Then, they are implanted in the uterus. After undergoing the uterus transplant procedure, a woman has to wait for a period of one year. The uterus requires time for healing and after recovery, the embryo may be implanted for pregnancy. After giving birth successfully, a woman will be able to keep the transplanted uterus.

She has the option to get pregnant again. However, after giving birth twice, a hysterectomy must be carried out for the removal of the uterus. This is done so that the woman can stop using the immune suppressant drugs, which are associated with major risks. Uterus transplant is a relatively new technology. In October 2014, the first healthy baby was born to a woman who had undergone a uterus transplant. This surgery is kind of experimental in nature and is usually the last option for getting pregnant.

With the recent number of breast cancer cases on the rise, it is important that we should get the examination done on a regular basis as a preventive measure. Even if someone is suffering from it, it is important that we should make an effort and learn about.

If you have breast cancer then a surgery will be part of your treatment. Based on the condition, surgery will be carried out due to any of the following reasons:

1. To remove the cancerous tissues from the breast
2. To reconstruct the breast once the cancer is removed
3. To check whether the cancer has spread to the lymph nodes below the arm
4. To treat symptoms of cancer that has progressed to an advanced stage

Breast cancer surgery may be classified into two types

1. Mastectomy: Mastectomy involves removing the entire breast; tissues in the adjoining region may also be removed. A double mastectomy is a procedure where both the breasts are removed.
2. Breast-conserving surgery: In this surgery, only parts of the breast affected by cancer are removed. The area of the breast that is to be removed will depend on the severity of the cancer. Some healthy tissues may also be removed in this surgery.

Usually, if a woman is in the initial stages of cancer then she may opt for the latter as it entails removing parts of the breast. They may also undergo radiation therapy along with these surgeries.
For checking if the cancer has spread to the lymph nodes below the arm, the lymph nodes are removed from the body. Once they are removed, they are studied under a microscope to check if it has spread, if yes then the extent of their damage. This procedure is carried out along with the surgery to remove the cancer.

Once the mastectomy procedure is completed, you can opt for a breast reconstruction surgery to rebuild the area. You may opt for this procedure at the time of breast cancer removal or at a later stage. If you are considering breast reconstruction surgery then you should discuss it with your surgeon.

Surgery is sometimes not used to treat cancer, but in slowing the progression of cancer or even reducing its symptoms.It is important you talk to your surgeon before the procedure to understand the goal of the surgery.

Breast cancer is an abnormal growth of cells in the tissues of the breast. Mainly it occurs in females but less than 1% of all the breast cancer cases develop in males. The majority of breast cancers start in the milk ducts. A small number start in the milk sacs or lobules. It can spread to the lymph nodes and to the other parts of the body such as bones, liver, lungs and to the brain.

With more reliable early detection methods as well as the trend towards less invasive surgery, there is hope that even more women with breast cancer will be treated successfully and will go on to resume their normal lives.

Signs & Symptoms 

It is painless, especially, during the early stage. Watch out for the following changes in the breast:

1. A persistent lump or thickening in the breast or in the axilla. 
2. A change in the size or shape of the breast. 
3. A change in the colour or appearance of the skin of the breast such as redness, puckering or dimpling. 
4. Bloody discharge from the nipple. 
5. A change in the nipple or areola such as scaliness, persistent rash or nipple retraction (nipple pulled into the breast).

Consult a doctor immediately if you notice any of these changes.

Risk Factors 

Being a woman puts you at risk of getting breast cancer. There are certain factors that increase the risk of breast cancer. Some of them have been listed below:

1. The risk increases with age; most cases of breast cancer develop after the age of 50 
2. Genetic alterations in certain genes such as BRCA1 and BRCA2 
3. Family history of breast cancer 
4. Being overweight 
5. Early menarche (onset of menstruation before the age of 12) 
6. Late menopause (after the age of 55) 
7. Never had children 
8. Late childbearing 
9. No breast feeding 
10. Excessive consumption of alcohol 
11. Use of hormonal replacement therapy (HRT) for a long period of time

However, most women who have breast cancer have none of the above risk factors. Likewise, not having any of these risk factors does not mean that you will not get breast cancer.

Early Detection and Screening

More treatment options are available when breast cancer is diagnosed at an early stage and hence the chances of recovery is also higher. So regular breast screening is important for early detection even if there are no symptoms. Following are the ways of screening:

1. Breast Self-Examination (BSE): Perform BSE once a month about a week after your menses are over. If you no longer menstruate, choose a date each month which is easy to remember e.g. your date of birth or anniversary.
2. Clinical Breast Examination: Get a breast specialist to examine your breast once a year if you are 40 years and above.
3. Mammogram: Go for a screening mammogram once a year if you are 40 to 49 years old and once every two years if you are 50 years and above even if you do not have any symptom. It is not recommended for younger women (less than 40 years of age) as they have dense breasts, making it difficult for small changes to be detected on a mammogram. So ultrasonography of the breasts is advisable to them.

Types of Breast cancer

1. Non-Invasive Breast cancer: These are confined to the ducts within the breasts. They are known as Ductal carcinoma in-situ (DCIS).
2. Invasive Breast cancer: It occurs when cancer cells spread beyond the ducts or lobules. Cancer cells first spread to the surrounding breast tissue and subsequently to the lymph nodes in the armpit (Axillary lymph nodes). These cells can also travel to the other parts of the body such as bones, liver, lungs or brain and hence known as metastatic breast cancer.

Making A Diagnosis 

If you notice any unusual changes in your breasts, you should see a doctor immediately. He will examine you clinically and may ask you to undergo some tests so that a definitive diagnosis can be made. Further, the staging work up is done to find out the stage of the disease and management accordingly.

Treatment options 

Treatment of breast cancer may include various methods such as surgery with or without breast reconstruction, chemotherapy, radiation therapy, hormonal therapy and targeted therapy. Treatment options offered, depend upon the number of factors such as the stage of cancer and likelihood of cure, your general health and your preference.