One of the most common issues with old age in men is the enlarged prostate. Any difficulty with urination (no constant stream, difficulty initiating, or incomplete emptying of the bladder for instance), and the first suspect is an enlarged prostate. These symptoms are followed by a digital rectal exam to check for an enlarged prostate. Once confirmed, the next step is to check for levels of prostate-specific antigen (PSA). If both the exam and the PSA are positive, it could mean prostate cancer. As with any cancer, it is believed that sooner it is diagnosed and the treatment is started, the better.

Historically, the best way to rule out the prostate cancer had been to do a prostate biopsy. This is a minor invasive procedure, wherein biopsies are taken from various regions of the prostate which are known to develop cancer (about 12). A disadvantage of this procedure includes missing out on the front part of the prostate which can also develop cancer. Secondly, it is not a very pleasant experience and given a chance, most men would not want to have it done.

There is good news for these men who would like to avoid prostate biopsies. The first is the multiparametric MRI which uses no x-rays and is considered very safe with extremely accurate results. This MRI exam requires about an hour, and once the images are obtained, the doctor will analyse these images and check for several parameters to assess for prostate cancer. The absence of cancer can be confirmed with up to 90% accuracy, which is far greater than with usual biopsies. If there is a possibility of cancer, then a biopsy can be done to confirm it. 

Also, these images indicate the exact region where cancer likely is, and this guides the doctor to biopsy only where absolutely essential. The chances of false positive and false negative results are reduced drastically. The one disadvantage here is that MRI detected biopsies usually tend to be of a higher grade which requires immediate treatment.

Another way to reduce chances of the biopsy by 30% to 50% is by the 4K test. It helps detect a variety of prostate issues including cancer. It can be used once higher levels of PSA is identified and before going for a biopsy. It combined 4 prostate-specific biomarkers with clinical information to accurately provide men with a risk of developing prostate cancer. It can be used even after negative biopsies to confirm the diagnosis of prostate cancer.

These two measures can drastically reduce the incidence of prostate biopsies, which is neither pleasant for the patient nor very effective for the doctor.

Prostate Biopsies - Ways You Can Avoid It!

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.

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

    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.
    Family history of other cancers: Even if there is no breast cancer, if there are other cancers that run in the family, watch out.
    Age: Women over 50 are at higher risk of developing breast cancer.
    Race: Caucasian and Jewish women are at higher risk of breast cancer than African-American women.
    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.
    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.
    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.

    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.
    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.
    Stage II: The cancer at this stage grows considerably or spreads to other parts. There are chances that cancer may grow and also spread.
    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.
    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.

    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.
    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.
    Women in high-risk categories should have screening mammograms every year and typically start at an earlier age.
    Ultrasound screening can also be given in addition to mammograms.
    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.

    Exercise and a healthy diet with reduced amount of alcohol are definitely effective in minimising the chances of developing cancer.
    Tamoxifen is used in women who are at high risk for breast cancer.
    Evista (raloxifene) which is used to treat osteoporosis after menopause. It is also widely used in preventing breast cancer.
    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.

Breast Cancer - Know More to Say 'No' More!

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.

Surgical Procedure for Treating Breast Cancer

A breast lump is an enlargement, swell, protuberance or a bump that is different than the breast tissue surrounding it. Breast lumps can appear in men as well as women and they can be benign or malignant. Causes of benign breast lumps are as follows:

Fibroadenosis: Also known as Fibro-cystic breast disease, it is a benign condition that affects the breast. It may affect either of the breasts or both. One of the major symptoms of Fibroadenosis is a breast lump. Usually, the lumpiness disappears after the menstrual cycle is over. Fibroadenosis occurs because the breast tissue doesn t respond well to the hormonal changes during the menstrual cycle.
Fibroadenomas: Fibroadenomas occur because of abnormal response to the hormone oestrogen. The lumps are usually well formed and round, around the milk ducts of the breast. Breast lumps due to Fibroadenomas are called breast mice, because they move around the breast. In some cases, they disappear and in some, they tend enlarge during pregnancy.
Other benign causes of breast lumps are breast abscesses, breast cysts, lipoma (lump of fat), mastitis (infection in the breast tissues), fat necrosis (another name for breast lumps) and intraductal papilloma (benign tumour of the milk ducts in the breast). A breast lump that is firm, well defined and doesn t move around, i.e. it doesn t disappear after your period or pregnancy, may be a result of breast cancer.

Treatment of breast lumps
The treatment of a breast lump depends on its cause. Benign breast lumps usually disappear over time. Otherwise following treatments can be considered as per the doctor s discretion-

Medication: If the breast lumps are painful or increase over time, it is advisable to take medication.
Non-steroidal anti-inflammatory drugs (NSAIDs) and other painkillers like paracetamol
Danazol, Tamoxifen or Bromocriptine are administered to treat breast pain as well
Antibiotics which are administered to cure breast abscesses that are caused due bacterial infections
Limiting the amount of fat in the diet or wearing well fitting bras also reduces the amount of pain due to breast lumps.
Certain types of breast lumps are filled with fluid or pus. This fluid can be drained through a procedure called aspiration or drainage.
A radical way to treat a breast lump is surgery. Many a times, these lumps get bigger and painful and the most effective way to deal with it is to remove it.

Breast Lumps - How Can They Be Treated?

The most dreadful part of getting to work and getting back home in the evening is the being stuck in a traffic jam. Whether you re driving yourself or being driven home, a traffic jam can sap your spirits and make you feel tired even though you re not really exerting yourself. According to a recent study, these traffic jams not only increase your stress levels, but also make your body susceptible to cancer.

Yes! They can be a major reason behind your ill health-

Bumper to bumper traffic that moves at snail pace can be very stressful, especially if you have to get somewhere at a particular time. The irritation of not being able to move at your desired pace adds on to the million other things going on in your mind. The body reacts to stress by increasing blood sugar and blood pressure levels. Long term stress can lead to digestive problems, fertility issues and a weakened immune system that makes the body vulnerable to other diseases and infections. Stress can also lead to the development of behavior like smoking, drinking and over eating which can increase a person s risk of cancer.
Pollution levels are highest at traffic signals and at traffic jams. This is because at a busy intersection, cars go through various stages such as accelerating, braking and idling in a restricted space. Each of these actions is accompanied with emission of toxic gases and fine particles of matter which concentrate in an area and take longer to disperse. Contrary to popular belief, people in cars can be more affected by these pollutants than pedestrians. This is especially true in cases where people have their windows up and fans on as the fans suck in polluted air leading to a buildup of toxic gases inside the car. When these gases and particulate matter are inhaled, they get stuck in the nose and throat and are absorbed into the blood stream. Long term exposure to this can have serious negative effects on the body including a higher risk to cancer. To avoid this, ensure that the setting of the ac of your car or fan is set to only circulate air inside the car without drawing in polluted air from outside.
Also, try and find ways to avoid traffic jams. If your office allows, maybe you could try changing your timing a little. Experiment with routes. Often the inner roads have more twists and turns but much less traffic.


Traffic Jams - Can they Make Your Body Susceptible to Cancer

Lasers have come as a boon to treat many medical conditions very safely and effectively. They are absolutely indispensable for permanent hair removal, tattoo removal, freckle removal, skin rejuvenation, treatment of birthmarks and many other internal medical conditions. There is a common misconception that lasers are harmful for your skin and can cause skin cancers. This is far from the truth, since lasers are actually used to treat skin cancers and also help in keeping the skin youthful and rejuvenated. 

Lasers use non-ionising light (like red or green light) and not ionising radiation like x-rays or gamma rays. These spectrums of light do not induce cancer formation. 
Fair skinned races are at much greater risk than skin of color. Melanin in darker skin does not allow harmful UV light in sunlight to penetrate through and the risk of skin cancers in darker skin is therefore small with normal sun exposure. Also, common lasers do not use UV light. 
Laser treatments are administered not in prolonged durations but in pulses much less than a second and parameters in the range of milliseconds and microseconds are most commonly used. Prolonged sun exposure is the most common precipitating factor for skin cancers. 
Laser light does not reach any internal organ. In fact, it requires some expertise even to make laser light reach its target just 1-2 millimeters below the skin. This is because melanin pigment in skin blocks laser light from getting through. An expert dermatologist with sound knowledge of skin optics and laser physics is able to achieve this safely and effectively. 
Laser treatments work on the principle of ''selective photothermolysis'. This means that laser light very specifically destroys only the intended target. Thus, a hair removal laser will destroy only the hair roots while leaving surrounding skin structures unharmed. Similarly, blood vessels in birth marks, collagen in wrinkles or scars, abnormal growths and cancers and individual inks in tattoos can be targeted very specifically with lasers without affecting any other structure.

Lasers - Do Not Cause Cancers!

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