Colorectal cancer is otherwise known as cancer of the colon or the rectum. This can affect both men and women with age being a major risk factor. Majority of such cancers are seen to occur after age of 50 years.

Type: colorectal cancers can present as one of the following types: 

Adenocarcinomas are the most common type of colorectal cancers. These cancers begin in the cells making mucous and other fluids. Certain colorectal cancers begin as adenomatous polyps (adenomas) that turn cancerous over a period of time. This is precisely why the adenomas are regarded as pre-cancerous or pre-malignant.

Gastrointestinal (GI) carcinoid tumors, GI stromal tumors, primary colorectal lymphoma, leiomyosarcoma, melanoma & squamous cell carcinoma are certain other colorectal cancers

Carcinoid tumors: start in specialized cells that produce hormones, in the intestine.

GI Stromal tumors: start in the interstitial cells of Cajal (ICC), in the wall of the colon.

Lymphomas: start typically in the lymph nodes but they may also start in colon or rectum.

Sarcomas: can start in the muscle and the connective tissue in the walls of the colon and rectum.

Gender: it affects both male and female populace.

Etiology: mostly, the factors that are associated with increased risk of colorectal cancer include the following  

Age exceeding 50 years.

Racial & ethnic background such as African Americans, in the USA, are known to have the highest incidence of colorectal cancer, and mortality rates.

Low fibre and high fat diet. Excessive consumption of red meat (e.g. goat meat, beef, pork, lamb, or liver), processed meats, butter, refined grains, sweets, sugary drinks etc all can increase the risk of colorectal cancer.

Personal history of inflammatory bowel disease (IBD) (e.g. ulcerative colitis), Crohn s disease, adenomatous colorectal polyps, colorectal cancer etc all.

Family history of colorectal cancer or adenomatous polyps etc all.

Inherited syndromes such as familial adenomatous polyposis (FAP) and Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC).

Sedentary lifestyle/ associated Obesity.

Type 2 diabetes.

Tobacco and alcohol abuse.

Features or symptoms can vary from person to person depending on the size and location of the tumour. Following are the signs & symptoms mainly -

Changes in bowel habits, diarrhea or constipation or an alternating diarrhea and constipation.

Occult/ blood in the stool, and 

Problems related to blood loss (e.g. anemia, weakness, fatigue, intolerance to exercise, shortness of breath, increased heart rate, chest pain etc all),

Abdominal discomfort (frequent gas/ flatulence, bloating, fullness, cramps, and pain), vomiting etc.

Unexplained weight loss,

Pain with bowel movement,

Feeling that bowel does not empty completely,

Stools are narrower than usual.

Diagnosis: Following are the diagnostics employed. Abnormal blood test results may be indicative of malignancy, but a follow-up imaging/ biopsy is always the gold standard for accurate diagnosis.
Blood: fecal occult blood test, Carcinoembryonic Antigen (CEA) assay values are raised, Hb/ RBC counts may be low.
Imaging: Colonoscopy, Endorectal Scan/ CT Scan followed by Biopsy clinches the diagnosis and the nature of the disease.
Apart from the above-mentioned barium enema X-Ray, USG, Chest X-ray, PET CT scan etc all help detect metastasis, if any. An increase in level of the serum tumor marker  CEA  is indicative of metastatic spread/ proliferation that can be ascertained through a PET CT scan.
Treatment: Conventional treatment includes surgery, radiation and chemotherapy as contextually appropriate. Simultaneously, an adjunctive/ integrative naturopathic treatment with suitable complementary & alternative medicines (CAM)/ therapies too can help improve clinical outcomes and facilitate recovery as feasible contextually.
Prognosis: preventive measures, earlier diagnosis and right early treatment is key for better prognosis and efficient/ effective therapeutic management. Usually, the chances of cure for an early stage cancer are more. Above-mentioned apart, recovery chances are influenced by the grade, stage of cancer, recurrence and the patient s general health & vitality etc all too.

Prevention: rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an adherence to a Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising (for at least 30 minutes daily), de-stressing and relaxation is highly recommended for prevention or reducing the risks of colorectal cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. It is advisable to limit milk/ dairy, preferably of low fat content, to 1 to 2 servings max daily. Although alcohol is optional and is not for everyone, the consumption of the same, if any, has to be strictly in moderation, and is best avoided. Smoking is to be avoided as well. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly or are best avoided too. Apart from the generic preventive measures as mentioned above, certain pre-malignant conditions, of which adenomas are the most common, can be successfully treated with complementary and alternative medicines too.

Colorectal Cancer - In a Nutshell!

Cancer, in any form, is a deadly disease that requires immediate attention and treatment. Colon cancer is a common form of the disease, with over 10 lakh people reportedly affected in India each year.

In some cases, surgery is the only remedy for colon cancer. Depending on the progression of your cancer, if surgery becomes necessary, you should consider undergoing laparoscopic surgeries.

What is a laparoscopic surgery?

While most surgeries are open, where a large incision is made on the body to operate on the internal organs and tissues, it s not the same with laparoscopic surgery. Here very small incisions are made on a particular body part to carry out the surgery. The procedure gets its name from the equipment used in the operation. A laparoscope is a tube-like instrument that has a camera on one end. During the surgery, this laparoscope is inserted in the patient s body and the image relayed back by the camera is used to perform the surgery.

In case of laparoscopic colon cancer surgeries, the surgeon uses the same method to reach your the cancerous mass in your colon and remove it.

Why choose laparoscopic colon cancer surgeries?

As a person affected by cancer, you have already endured substantial pain and discomfort. You do not need additional discomfort from your surgery. This is why laparoscopic surgeries are so popular when it comes to colon cancer. Here are some benefits of the procedure over the standard surgery.

  Less pain after the surgery
  Limited stay at the hospital post surgery
  Allows you to return to a solid food diet sooner after the surgery
  Allows normal bowel function to resume quicker
  Less scaring from the procedure
  Faster return to a normal lifestyle

Not everyone is eligible for open surgery to treat colon cancer. For instance, open surgery on elderly people can be extremely dangerous. For them, laparoscopic surgeries are a better alternative.

Are you eligible for laparoscopic surgery?

Before you opt for laparoscopic surgery to treat your colon cancer, consult an expert. The surgeon will help you understand whether you meet the requirements for laparoscopic surgeries. Your doctor will evaluate your case and let you know which procedure will have the maximum impact on your long-term recovery from cancer.

Is laparoscopic surgery as effective in treating colon cancer as open surgery?

According to a study performed by a Canadian team of researchers, the laparoscopic procedure is just as useful in treating colon cancer as the standard surgery. However, each case of colon cancer is different and the outcome of surgery may vary from person to person.

Laparoscopic Colon Cancer Surgeries!

GERD is a digestive disorder that affects the lower esophageal sphincter, which is the ring of muscle between the esophagus and stomach. Gastroesophageal reflux is the backward flow of acids from the stomach into the esophagus. Doctors believe that some people usually suffer due to a condition called hiatal hernia. Pregnant women usually suffer from heartburn or acid indigestion caused by Gastroesophageal Reflux Disease.

The primary goals in the treatment of this disease are relief from symptoms, healing of erosive esophagitis and prevention of complications of esophagitis. The symptoms include heartburn and regurgitation. The setting includes a proton pump inhibitor (PPI). Patients suspected due to GERD with non-cardiac chest pain are recommended to have diagnostic evaluation before institution of therapy. For diagnosing GERD, barium radiographs should not be used.

The other points that must be remembered to diagnose GERD are
1. Endoscopy is recommended only in case of alarming symptoms. Even in typical symptoms, the upper endoscopy is not recommended.
2. For preoperative evaluation, esophageal manometry is recommended, but it has no role in diagnosing GERD.
3. Ambulatory reflux monitoring is a test that can assess association of reflux symptoms.

Management:
The suggested lifestyle modifications for the patients with GERD are

    Weight loss is recommended for patients who are overweight. So, avoid large meals and decrease dietary fat intake.
    Avoid alcohol, chocolate, onions, garlic, acidic foods and peppermint.
    Do not lie down within 3 to 4 hours after meal (recommended for nocturnal GERD patients).
    For symptom relief and to heal erosive esophagitis, a 8-week course of PPIs is the therapy of choice.
    Medications that help in potentiating GERD symptoms, including alpha-adrenergic agonists, nitrates, calcium channel blockers and theophylline should be avoided.
    For patients without diagnostic evaluation, therapy for GERD other than acid suppression, including prokinetic therapy should not be used.
    For patients with partial response to PPI therapy, additional symptom relief can be achieved by increasing the dose twice daily or switching to a different PPI.
    It is recommended to elevate the head of the bed 10 to 20 cm.
    Avoid wearing clothes which are tight around the waist.
    If patients experience heartburn relief, Histamine-receptor antagonists (H2RA) therapy can be used as a maintenance option in patients without erosive disease.

Some surgical options
1. For long-term therapy for patients suffering with GERD, surgical therapy is the best treatment option.
2. In patients who have no evidence of erosive esophagitis, preoperative ambulatory pH monitoring in mandatory.
3. Gastric bypass is the preferred operation for patients who are suffering with obesity and are contemplating surgical therapy for GERD.

Apart from these, there are potential risks that are associated with PPIs such as switching them can be considered in setting of side effects and the therapy can be a risk factor for Clostridium difficile infection.

Management of Gastroesphageal Reflux Disease (GERD)

Orange Peel Scrub For Flawless Glowing Skin

An orange is much more than just a refreshing tangy fruit. Orange, rich in Vitamin C, is the best all rounder when it comes to your skin. It’s rich in antioxidants and helps your skin to get younger looking, glowing and healthy. It’s almost a miracle for your skin.

Ground orange peels (and nothing else) just on their own make for the perfect scrub. 

It has these 4 effects on your skin.

1. Scrubbing off Dead Skin: The leathery granular texture & calcium present in it, serves as a gentle but extremely effective scrub, removing layers of dead and decaying skin. 

2. Moisturizing: The natural oil & potassium present in orange peel moisturizes & hydrates your skin simultaneously. 

3. Anti-ageing: The antioxidants neutralize the free radicals keeping wrinkles and sagging cheeks at bay.  Vitamin C & Magnesium present in it make skin glowing, youthful & healthy.

4. Skin Lightening: The orange peel also serves as a natural bleaching agent which helps with skin whitening. 

How to Get the Glow: To get an instant glow, all you need to do is rub frozen orange peel cubes onto your skin.  Continue rubbing till the cubes dissolve onto your skin into a scrub/mask. Splash your face with water to reveal the magic!

If you would like to consult with me privately, please click on 'Consult'.

4 Magical  Effects Orange Peel Has On Your Skin

Obesity is a condition characterized by the accumulation of large quantities of fat in the body. This condition drastically increases the risks of health problems. The most important cause for obesity is the intake of larger number of calories than what are usually burned through exercises or other routine activities. One with a BMI (Body Mass Index) more than 25 is considered obese. The primary ways of treating obesity are through exercising regularly and following a healthy diet.

How can Ayurveda help?
Ayurveda is a holistic system of medicine which is free from side effects, unlike conventional methods of treatment. Ayurvedic treatments focus on getting to the root cause of the disorder instead of just focusing on the symptoms. There are multiple remedies in Ayurveda that are effective in controlling obesity. They are:

Restrict your calorie intake: While this may sound easy, it is actually difficult to implement. One of the major reasons for obesity is eating too much. The idea is to avoid overeating, so you need to be aware of your portion size. Eat frequent meals but in smaller quantities; this helps in keeping your metabolic rate elevated, that in turn is a prerequisite for greater fat burning.
Start exercising: Exercise is a great way to burn those extra calories around your middle. The best and simple way to go about it is to start jogging. Low intensity jogging done over a period of time is a great way to burn fat. If you want to gain muscle, then do weight based exercises instead of just doing cardio.
Meditate: The beneficial effects of meditation are well known. Apart from reducing your stress level, it also helps in boosting your focus and concentration. Being stressed can make you eat more and thus gain weight, so meditating on a regular basis can help manage stress effectively.
Get sufficient rest: Sleeping less than 6 hours a day? You are only setting your body for obesity. Not sleeping enough brings about hormonal changes in the body which increase your appetite.
Avoid junk food: Junk food should strictly be avoided as it can make you put on some serious pounds. Instead, opt for healthier food options, but keep in mind the portion sizes.

Obesity - How Ayurvedic Remedies Are Best For It?

Since the development of modern medicine, doctors and health care professionals have always tried to come up with minimally invasive procedures for both diagnostic purposes as well as surgery. Endoscopy was developed to see inside a human body without the need for large incisions or surgery.

What is Endoscopy?
Endoscopy is a type of procedure wherein the doctor inserts a long thin tube into the body through an opening such as the mouth, anus or the urethra. Sometimes small incisions may be made on your body to insert the tube as well. The tube which is inserted within the body is fitted with a camera which allows the doctor to see what is wrong within your body, a specific section or organ. Doctors can even take images or videos of your organs which help them to determine a due course of action in your treatment. Endoscopy may also be used as a part of a laparoscopic operation to correct problems within the body, especially in cases wherein tissues have to be removed.

Types of endoscopy and its uses-
Although endoscopy could be used in any part of the body, there are certain areas where they are used more commonly than the others. Some of the types or endoscopies are mentioned below:

Colonoscopy   Used to examine your colon wherein the scope is inserted through your anus
Laparoscopy   This is one of the most common forms of diagnosis as well as surgery wherein the tube may be inserted through a small area in your abdomen or the pelvic area. This is not only used for imaging or diagnosis but is used in surgery as well.
Arthroscopy   Here, an incision is made on the joints of your body to check for problems
Cystoscopy   In this type, the tube is inserted through the urethral opening to check for problems in the urinary tract or the bladder. Another variation of this would be ureteroscopy.
Enteroscopy   This is an endoscopic examination of the intestines wherein the tube is inserted via the anus or the mouth.
Hysteroscopy   Here, examination of the uterus and the female reproductive organ is carried out wherein the endoscope is inserted into the vagina.
Bronchoscopy   It entails an examination of the lungs wherein the scope may be inserted through the nose or mouth to check the lungs
Upper gastrointestinal endoscopy - This is used for the examination of the esophagus and the upper intestinal tract.
Risks and safety-
Endoscopy is a widely performed and very reliable procedure. In the hands of a skilled doctor, endoscopy will be able to determine the cause of the problem and also correct the issues if surgery is also performed along with it. However, like any procedure, it does carry certain risks although the chances are fairly low. Some of the risks are mentioned as follows  

Perforation or other injuries to your organs such as scraping or bruising
Fever due to the introduction of foreign materials
Persisting pain in the specific area wherein endoscopy was performed
Swelling of the area wherein the tube was inserted
Infections after the procedure
Bleeding at the site of the incision or entry of the tube
However, these cases are rare and only occur in a very small section of the cases. Although there is minimal pain associated with the procedure, the benefits far outweigh the risks and inconveniences.

8 Types Of Endoscopies & For What They Are Used For!

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