Brain metastases from systemic cancer are the most common type of intracranial neoplasm in adults, being almost 10 times more common than primary malignant brain tumors, which cause a significant burden on the management of patients with advanced cancer (1). The lungs represent one of the most frequent sources of metastases to the brain, with a probability of (36 64%) (3). Symptoms suffered by the patients include headaches, epilepsy, focal weakness, numbness or changes in mental status. The prognosis of patients with brain metastases is not optimistic and the median survival time is  1 2 months if left untreated. The 1-year survival rate has been recorded as 10.4% (4,5). The treatment of metastatic brain tumors is complex; not only due to being able to provide local control and improve neurological function, but also due to factors such as age, performance and systemic disease status and the size, volume, location and number of metastases at presentation

CyberKnife is a robotic radiosurgery system with a linear particle accelerator (linac), which is coupled with real-time imaging to track and compensate for the patient s or target s motion. As a relatively non-invasive treatment modality, CyberKnife demonstrates certain benefits, including a more accurate target localization and improved dose delivery for the management of metastatic brain tumors that allows higher biologically effective dose delivery without increased incidence of toxicity.

In the present case, the results for the treatment of multiple brain metastases after CyberKnife surgery with a 7 8 Gy marginal dose was promising. CyberKnife for metastatic brain tumors is an effective and safe method for reducing the marginal dose prescribed for multiple brain metastases and for minimizing the radiation-related neurotoxicities. In conclusion, CyberKnife, a focused, highly-targeted radiosurgery and fractionated radiotherapy is particularly useful for multiple brain metastases. CyberKnife provides the advantage of the management of local recurrence and a tolerable complication rate. Although the treatment of brain metastases has been performed with CyberKnife, the clinical significance and optimal dose fractionation scheme require further investigation.

In case you have a concern or query you can always consult an expert & get answers to your questions!

CyberKnife Therapy Of 24 Multiple Brain Metastases From Lung Cancer!

Irrfan Khan's saddening revelation about his health and diagnosis of Neuroendocrine tumour (NET) has undoubtedly created a rage amongst his fans, which is now being followed by good wishes for speedy recovery from his supporters all across social media.  

The actor shared in an emotional Twitter post that he s been diagnosed with NET, a rare tumour that develops from cells of the neuroendocrine system and grows predominantly in the digestive or respiratory tract - lungs, appendix, small intestine, rectum, and pancreas - it can occur in any part of the body.

Here is more on Irrfan s disease:

What is NET?

A neuroendocrine tumor is characterized by a rapid and abnormal growth that happens in the nerve cells which produce hormones. Hormones control how different organs in the body work.

It is a condition wherein, endocrine cells, the hormone-producing cells of the body, develop a tumor in any part of the body - while it can can grow in lungs or the thymus, or more rarely, in the ovaries, kidneys, or testicles - the most common is lung, intestines, and pancreas.

What causes NET?

A neuroendocrine tumour is quite a rare disease, occurs in less than one per million cases. The exact cause is not known.

The Symptoms-

It can cause a myriad of symptoms, depending on where in the body the NET is.

If it is in your digestive system, it can cause pain or discomfort in the abdomen area that comes and goes. You may feel sick, nauseated, vomited, or there may be a change in how often you pass stools.
If the NET is in the lung, it can cause shortness of breath, chest infections, or you can even have a cough up blood.
Weight loss and loss of appetite may also be some common signs of a neuroendocrine tumour.
Some NETs may overproduce a hormone-like substance called serotonin. This causes a group of symptoms called carcinoid syndrome. Symptoms include wheezing (like asthma), flushing of the skin and diarrhoea.
Who can be affected with NET?

These tumours, depending on the type, are more common in certain age or sex. And few have very strong family history too.
People who have a rare condition called multiple endocrine neoplasia 1 have an increased risk of developing a NET.
Did You Know?

Apple founder  Steve Jobs  died from the same disease in 2011. The tumour affected his pancreas.

Know The Different Types of NET:

Based on the organ that is affected, NET can vary a lot. When the chromaffin cells that produce adrenaline are affected, it is called Pheochromocytoma, and it is related to the stress levels of the body.

When a cell is formed abnormally under the skin and the hair follicles, it is called Merkel cell cancer. This is also called neuroendocrine carcinoma of the skin and the condition can occur anywhere in the body. The commonly occurring places include lungs, gastrointestinal tract, and brain.

The status of the tumour, cancerous (malignant) or noncancerous (benign), decides the survival rate. Often slow-growing and noncancerous, they can invade surrounding parts of the body and at times, turn cancerous and spread across the body. However, you can still choose to live a good quality life with strict modifications in diet and lifestyle. The changes are made after taking into consideration the symptoms of the tumor. The organ where the tumor is formed also matters.

How Is It Treated?

Treatment depends on the location of the tumour, its type, how severe it is and whether it has spread to other parts of the body. Usually, the first treatment choice is surgery to remove the tumour. And, if the NET cannot be removed, your will prescribed with a treatment that will not only relieve the symptoms but will also improve the quality of your life.

How can a NET be prevented?

The first thing you need to do for the prevention of NET is to curb stress. Stress affects the entire body severely.

Lifestyle modifications:

A healthy lifestyle is what you need to stick to if you want to manage its symptoms during the treatment cycle. Your doctor will prescribe you to do exercises at least 4 days a week for a minimum of 30 minutes. You can also try a walk instead of strenuous exercises.

People with carcinoid syndrome may be advised to avoid food or activities that may trigger flushing, such as eating spicy food or drinking alcohol.

Indulge yourself in therapies that help in gaining more positive energy. If you are already affected by NET, eliminate all the sources of stress and get a good night's sleep every day. Join the support groups that make you grow strong and happy. After all, the mind is devised to do miracles when it is full of life and positive thoughts.

Is Irrfan Khan's tumour curable?

Dr Saumitra Rawat, HOD, Surgical Gastroenterology & Liver Transplant, Sri Ganga Ram Hospital, said, "NeuroEndocrine Tumour is an abnormal growth of Neuroendo cells which are present in bodies. When there is an abnormal growth, then it forms a tumor - Normally seen in intestine, pancreas, lung, thyroid and other parts of the body".

On commenting on Khan's case, he said, "It depends on the location of tumour, its size, and what is its mitotic index".

"Depending on where the tumour is localized, you can take it out surgically and the chances of cure are very high", Dr Rawat explained.

Actor Irrfan, who has been diagnosed with the disease is one of the most versatile actors in India, has also made a name for himself in the west, where he has been an important part of critically-acclaimed films such as  The Namesake ,  Jurassic World , and  Life of Pi . At home, the actor has delivered remarkable performances in films such as  Haasil ,  Paan Singh Tomar ,  Maqbool ,  Lunch Box ,  Piku , and the most recent  Hindi Medium .

Irrfan Khan is not just a disarmingly natural actor, but also an endearing human being -- honest and humble to the core. It s time to stand together and pray for him a speedy recovery!

Irrfan Khan - Battle Against Neuroendocrine Tumour!

Skin cancer is a condition with abnormal and cancerous skin growths. This often develops due to the overexposure of skin to the rays of the sun. The three main types of skin cancer include basal cell carcinoma, squamous cell carcinoma and melanoma. Skin cancer affects those areas of skin which remains sun-exposed including ears, neck, chest, scalp, lips, face, hands, arm and legs. It can also develop on those areas of skin that are not exposed to sunlight like beneath toenails or fingernails, on palms and on the genital area.

Risk factors associated with skin cancer

Here are some of the factors which increase your risks of getting skin cancer:

1. Fair complexion: Low levels of the pigment melanin in skin causes fair complexion. Fair- skinned individuals who have a history of hazel or blue eyes, repeated sunburns and people who have red or blond hair are highly susceptible to developing this form of cancer. Less pigment in skin makes an individual more vulnerable to skin damage from harmful UV radiation.

2. Excessive sun exposure: Exposure to the sun may lead to the development of skin cancer if you don't protect your skin by sunscreen and clothing. Tanning beds and lamps may also increase the risk of developing this type of skin cancer.

3. High-altitude places: The exposure to sunlight is more intense in areas of high altitude and near the equator. Living at higher elevation also makes you more vulnerable to radiation because the sunlight is strongest there.

4. Moles: People with abnormal moles are at a higher risk of developing skin cancer. These moles are irregular in shape and are larger than normal moles.

5. Precancerous skin lesions: Your risk of developing skin cancer increases if you have skin lesion. These are scaly and rough patches that range from brown to dark pink in color. The most commonly affected areas are head, hands and face of fair-skinned people.

6. Weak immune system: Weak immune system caused by HIV or AIDS and immunosuppressant drugs that you take after an organ transplant may increase your risk of developing skin cancer.

Skin Cancer - What Can Cause It?

Breast examination is a way of detecting early changes that help in detecting lumps or other growth in the breast. This is a manual form of examination that may be carried out by the doctor or even by the patient. This kind of examination helps in detecting the onset of breast cancer and helps in successful treatment of the same. It is an essential screening strategy that all women must go through. Let us cast a glance on the various details regarding this examination, and also how frequently it must be conducted.

Age: Women who have reached the age of 18 are said to have matured physically and sexually. They should perform this examination once they have reached the said age in order to detect any anomalies in the way the physical changes occur in the breast tissue.
Procedure: One should begin by looking at one's reflection in the mirror to find any rashes or dimpling in the breasts. The shape, size and colour of the breasts and nipples must also be studied so as to check for any anomalies. Inverted nipples, redness and soreness must also be reported to the doctor. Once you are done checking the visuals, you can raise your arms and look for any changes. Then, you will need to lie down and feel your breasts by using a circular motion. The finger pads must be used in order to check for any lumps. One must start from the centre and move the breasts sideways. Any wet and slippery feeling must be reported to the doctor immediately.
Pressure: During the breast examination, you must use light pressure for the skin and tissue that lie beneath the breasts, while medium to moderate pressure should be used for the middle portion of the breasts. One must use a firm hand to check the tissue that lies at the back of the breasts, near the rib cage.
Frequency: One must get into the habit of conducting a breast examination at least once a fortnight or once a month, without fail. You can also go to the gynaecologist for an examination in case you are not confident of conducting it on your own with proper movements and accuracy. You may also journalise your breast examination findings.
Menstrual Cycles: When you are going through your menstrual cycle or period, it is important to remember that your breasts can become tender just before or after the start of the cycle. So, do not panic if you think you have found a lump or any other growth at this time. It is best to check again after a week and then visit the doctor about checking the same.

How Frequently Should a Breast Examination Be Done?

A gland that produces a liquid which mixes with sperm and is ejaculated as semen during sexual activity, is the prostate gland and is located under the bladder of a man. Cancer in the prostate is one of the most common cancers that occur among men.

The risk of developing prostate cancer increases progressively with age. Although there is no absolute prevention of prostate cancer, evidence and doctors suggest that a healthy diet can play a key role. Here are a few tips that can go a long way in prevention of prostate cancer:

Red Foods: Tomatoes, carrot, watermelon, and other red foods get their bright color from a powerful antioxidant called lycopene. Studies have proved that by having fruits that contain lycopene, you can reduce your risk of prostate cancer. Some findings suggest that cooking tomatoes make it easier for your body to absorb this antioxidant.
Fruits and Vegetables: Green vegetables contain compounds called carcinogens, which help your body in breaking down cancer-causing substances. Spreading of cancer can be slowed down through a nutrient-rich diet. Avoiding processed junk food and eating fruits and vegetables containing nutrients and vitamins may lower the risk of getting prostate cancer.
Feast on Fish: Fatty acid, also known as omega-3, is found in certain fish including sardines, tuna, mackerel, trout, and salmon. This may help in reducing the risk of developing prostate cancer.
Soy and Tea: Some studies suggest that men who drink green tea or take green tea extract supplements have a lower risk of developing prostate cancer. Many soy products and other foods contain a nutrient called isoflavones, which has been linked to a reduced risk of prostate cancer.
Coffee: Studies show that drinking three cups of coffee a day can reduce the chances of prostate cancer by 11 percent. There is a dose-response relationship between coffee and prostate cancer. The effects of prostate cancer go up or down with the amount of coffee you take. Someone who grabs an occasional cup only, may not have these effects. However, high doses of caffeine can result in major health issues.
Fat: Studies indicate that animal fats and an increased risk of prostate cancer are linked. It is advised to replace animal-based fats with any kind of plant-based fat. In addition to this, overcooking the meat produces carcinogens, therefore it is suggested to be strictly avoided.
Quit Smoking: Smokers are more likely to have an aggressive form of prostate cancer. The chances of a recurrence of the disease are more for people who smoke. It is never too late to quit smoking.
Exercise: Regular exercise and maintaining a healthy body can help you to increase your muscle mass and metabolism. Too much fat in the middle of your body is linked to an increased risk of prostate cancer. You can try walking, running, bicycling or swimming to reduce the weight to lead a healthy life.
It is important to look after yourself and start taking essential steps to prevent prostate cancer rather than trying to manage it once you get it.

8 Easy Ways By Which You Can Prevent Prostate Cancer!

Photodynamic therapy or PDT is a relatively new and non-invasive treatment for non melanomaskin cancer. It is mostly used in cases where the cancer is superficial and has not spread too deep. PDT is used mostly to treat Actinic Keratoses on the face and scalp, Basal cell carcinomas, Bowen s disease, as well as other conditions such as head and neck, mouth, lung and gullet cancer.

How does it work?
This treatment involves the use of a drug known as photosensitize or a photosensitizing agent with a specific type of light. When the photosensitizing agents get exposed to a light of a specific wavelength, a form of oxygen is produced, which eliminates nearby cancer cells. Every photosensitizer gets activated by the special light. The wavelength of the light determines how much it can penetrate into the body.

Process of Photodynamic therapy
Skin cancer is cured by PDT in several steps. The first step involves the injection of a photosensitizer into the patient s bloodstream. The blood cells absorb the agent all over the body, but in the cancer cells, it stays for a longer duration. Within 72 hours after the injection is given, the skin is exposed to light. The photosensitizer agent present in the cancer affected cells absorbs the light. An active oxygen form gets produced, which kills the cancer cells.

Other than killing the cancer cells directly, PDT uses two other ways to destroy cancerous tumors. The blood vessels in the tumor are affected, which leads to its death. The immune system also gets charged up and activated for fighting the cancer cells.

The light used for PDT is usually in the form of a laser. LEDs are also used to treat tumors present on the surface of the skin. The primary photosensitizing agent used in PDT is called porfimer sodium or Photofrin.

PDT can be undertaken in the outpatient department in a hospital. After taking the treatment, you have to keep the cancer affected area of the skin dry and covered for 36 hours. The area should be treated with care while showering. In case of thick skin lesions, repeat treatments are required within 4 weeks.

When is PDT used for skin cancer
PDT can be undertaken instead of surgery for treating basal cell cancer, Bowen s disease and actinic keratosis. PDT is used in cases where surgeries are required. It is used to treat large skin cancers, which are not very deep and in the case when several cancers develop in an area. For many skin conditions, PDT is a better remedy than undergoing a surgery.

Advantages of PDT

    There are no long term side effects.
    The process is less invasive compared to surgery.
    A very short time is taken for this therapy to be undertaken.
    The process can be repeated several times in the same area.
    Very less scarring takes place in the affected area.
    The cost of this procedure is lesser than surgery.

Treating Skin Cancer with Photodynamic Therapy

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