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!

Causes and symptoms of enlarged prostate

The problem of an enlarged prostate or benign prostate hyperplasia is a very common occurrence as you grow older. It's known to strike men above the age of 50, with more than 50% of men after the age of 60, having this complaint.

Causes of enlarged prostate

A non-cancerous condition, enlarged prostate makes the passing of urine from the bladder through the urethra difficult. The multiplication of the prostate cells causes an enlargement of the gland, leading to a buildup of pressure on the urethra, affecting the discharge of urine from the body. The narrowing of the urethra, due to this benign condition, forces the bladder to contract more vigorously so as to push urine out of the body.

As time passes, the muscles of the bladder get significantly affected, causing them to become extremely sensitive, thicker and stronger. As a consequence, the bladder begins to contract, even if the amount of urine in the organ is negligible, causing episodes of frequent urination. Gradually, the bladder fails to completely empty itself of urine due to the constriction of the urethra. This can give rise to a number of health problems including the formation of bladder stones, urinary tract infections, blood in the urine and so on.

How can you identify the signs of the condition?

Signs of enlarged prostate are very easy to identify and include:

- A slow or weak urine flow
- Difficulty in initiating urination
- Instances of frequent urination
- A feeling of not completely emptying one's bladder
- Frequent urination during the night
- Exerting a lot to urinate
- Instances of dribbling
- Urgency to pass urine
- A feeling of urinating again minutes after doing so
- Urination that starts and stops



What Leads to an Enlarged Prostate?

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!

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!

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?

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?

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