As much as you want to avoid, there are things you have no control over. Lung cancer (Bronchogenic Carcinomas) is one such nemesis that can throw life in shambles. The malignant tumor that originates in the lungs slowly spreads onto the other distinct and vital organs as well. Thought to be mostly affecting men who are chain smokers and into severe tobacco consumption, incidences of lung cancer in women are rising at an alarming rate over the past few years. Non-smokers may also be susceptible (to a lesser extent though) to lung cancer.

Lung cancer can be either

Non-small cell lung cancers: The NSCLC, accounting for ~85% of the lung cancer is one of the most common types of lung cancer affecting people, NSCLC may further be divided into
Adenocarcinoma: This type of NSCLC originates mostly in the peripheral regions of the lungs and may affect (spread) the lymph nodes. Non-smokers and women are mostly at the receiving end (other than the chain smokers).
Squamous Cell Carcinoma: Also known as Epidermoid Carcinoma, often affects men, epidermoid carcinoma may originate in the tissues that line the bronchial tubes. The lymph nodes are often affected by Epidermoid Carcinoma.
Large-cell Undifferentiated Carcinoma: The point of origin of large-cell undifferentiated carcinoma is the surface of the lungs. They have a higher probability of spreading to the lymph nodes.
Bronchioalveolar Carcinoma: Though rare, bronchioalveolar carcinoma originates close to the air sacs.
Small Cell Lung Cancer (SCLC, accounting for ~25% of the lung cancer): As the name suggests, SCLC is marked by the rapid proliferation of small cells into large malignant tumors. SCLC can move throughout the body (affecting vital organs).
Radiotherapy to treat Lung cancer:
Radiotherapy plays a pivotal role in the treatment of lung cancer. The radiation therapy is mainly of two types

External beam radiation therapy (EBRT)
Internal radiation therapy (Brachytherapy)
In external beam radiation therapy, high-energy rays are focused on the cancer cells (thereby resulting in the apoptosis of the cancer cells) externally, from outside the body. EBRT is particularly helpful in case of Non-small cell lung cancers.

The EBRT may be of the following types

3D-CRT (Three-dimensional conformal radiation therapy): An advanced radiation therapy, 3D-CRT accurately marks the position of the cancer cells (using advanced computers). The treatment ensures minimum damage to the other healthy cells and tissues (energy rays are directed at the affected cells from different positions).
SBRT (Stereotactic body radiation therapy): This is a radiation therapy used in the treatment of NSCLC, when it is at a nascent stage.
IMRT (Intensity modulated radiation therapy): As the name suggests, in IMRT, the intensity of the radiation reaching the normal tissues and cells can be modulated. Like 3D-CRT, the radiation in IMRT is directed from different angles (for maximum results).
Internal radiation therapy (Brachytherapy): This type of radiation therapy is generally used to deal with lung cancers that tend to block the airways. In this therapy, the radiation process is carried out through a narrow tube, thereby, shrinking and collapsing the tumor.
The effect, dosage, and duration of radiation therapy depend on the stage and severity of the condition. In some cases, radiation therapy may be given together with chemotherapy.

Radiotherapy - Is It Beneficial For Lung Cancer?

The prostate gland in a man begins to grow in size on reaching 25 years of age quite naturally, and this is known as benign prostatic hyperplasia abbreviated as BPH. Now the problem arises when the enlargement of the prostate is more than normal.

In men, the urine flows through the urethra from the bladder. An abnormally enlarged prostate blocks the flow of urine through the urethra. The cells of the prostate slowly multiply to cause it to enlarge. This puts pressure on the urethra thereby giving rise to a number of problems, most of which manifest as symptoms.

Common Symptoms of an Enlarged Prostate Gland
The condition of enlarged prostate gives rise to some noticeable symptoms which provide the signs that you need to visit a doctor to get it treated. A weak or slow urinary system is one of the most common symptoms of being affected with an enlarged prostate. This includes urinating more often, an increase in the urgency to urinate, difficulty in starting urination and a feeling of incomplete bladder emptying immediately after urinating. At times, it is seen that passing urine becomes very strenuous. All these above symptoms indicate that there is an enlargement of the prostate gland and medical help should be sought immediately to prevent the condition from worsening.

Steps to Manage an Enlarged Prostrate

Effective medication is usually the first step in the management of an enlarged prostate gland. Alpha blockers are the drugs that are most commonly used in this situation. These drugs do not reduce the size of the prostate, but they are great in relieving the symptoms to allow free and painless passage of urine. Another group of drugs known as 5-alpha reductase inhibitors can help in shrinking an enlarged prostate. The drugs work by the reducing the levels of the male hormone called dihydrotestosterone.
In some advanced stages of prostate enlargement, minimally invasive treatments are used for the effective management of the condition. Transurethral Microwave Thermotherapy or TUMT is used to treat mild blockages that reduce the frequency of urination, the urgency, and straining. However, it is not able to correct the bladder emptying issues. Transurethral Radio Frequency Needle Ablation or TUNA helps in the destruction of the prostate tissues resulting in an improvement in the flow of urine.
Prostatic stents are also sometimes used for the management of the condition of an enlarged prostate. In this treatment procedure, a small metal coil is inserted into the urethra for widening it and keeping it open. In most severe case of prostate enlargement, only surgical methods remain as the opted method of treatment. Laser surgeries are performed to destroy the tissues of the prostate for easing of the condition. Ultimately, an open prostate surgery is performed when the transurethral procedure cannot be used. In this surgery, the tissues of the prostate are removed by the surgeon in case of great enlargement.
The condition of an enlarged prostate gland requires medical attention and treatment for the most effective management, and it is best that a medical professional is consulted as soon as any of the symptoms surface.
Enlargement starts usually after 50 years. Surgery 'Transurethral resection of prostate (TURP)' either by monopolar or bipolar electrocautery. Enucleation of prostate by laser is also an option.

Enlarged Prostate - How Can It Be Managed?

Prostate cancer is a cancerous tumor in a man s prostate gland, a small gland that is responsible for producing the seminal fluid which transports and nourishes the sperm. It is a very common type of cancer among men. A few cases of prostate cancer tend to develop slowly while others may progress very fast.
Symptoms-
In the initial stages, prostate cancer may not show any symptom. However, in the latter stages, there may be symptoms such as:
Pain in the bones.
Erectile dysfunction.
Urination can get troublesome.
Presence of blood in the semen.
Pain and discomfort in the pelvic region.
Causes-
The exact causes of prostate cancer are not known. It starts to develop when certain cells in the prostate gland start to mutate. These mutations cause these cells to multiply at a very fast rate and thus, soon form tumors. Although the causes are not known, certain factors tend to aggravate this condition; them being:
Color: According to certain medical reports, a darker skin may mean increased chances of suffering from prostate cancer.
Age: The risk of developing prostate cancer tends to increase with age.
Genetics and Family History: Faulty genes could be another cause of this condition. Also, having some member in the family who is diagnosed with this type of cancer only increases the risks of you suffering from them.
Obesity: If you are obese, then you are more likely to develop prostate cancer.
Treatments-
The treatments for prostate cancer include:
Radiation Therapy: In this procedure, high energy rays are used to target and destroy cancer cells. Usually X-rays or protons are used to treat the cancer cells.
Hormone Therapy: Hormone therapy is a type of treatment wherein certain medications are administered to prevent your body from producing testosterone.
Surgery: If the other treatment methods do not produce desired results, then a surgery is carried out for the removal of the prostate gland. In addition to the prostate gland, some adjoining lymph nodes and tissues are also removed.
Chemotherapy: Chemotherapy is method of destroying cancer cells by injecting chemicals into the body. The medicines are injected into the veins in the arms. 

All About Prostate Cancer

One of the most common problems faced by ageing men is benign prostatic hypertrophy. Prostate is the gland at the base of the urethra near the bladder and when it enlarges it can lead to symptoms, mostly related to urination.

1. Frequent urge to pass urine
2. Prolonged urination
3. Frequent nocturnal visits to the toilet
4. Intermittent urination
5. Difficulty to start urinating
6. Inability to completely empty the bladder
7. Urinary tract infections

There are medications available to manage this, but offer only temporary relief. Many men therefore prefer to have the surgery undergone to manage these bothersome symptoms. However, like any surgery, the risks and benefits need to be considered along with other conditions like age, overall health status, other comorbid conditions, etc.

Surgical removal of the enlarged prostate gland is a more definitive approach to manage these symptoms. In addition to providing a quick cure, it also is used in the following cases:

1. Patients who do not respond to medications
2. Presence of blood in the urine
3. Associated bladder stones
4. Frequent infections of the urinary tract
5. Associated damage to the kidneys

Procedure of Surgery
During the procedure, a tube is passed through the tip of the penis into the urethra towards the bladder neck. Once it is in the desired position, laser is passed through it to deliver energy that acts on the prostate to either completely or partially destroy it. There are two methods by which laser acts on the enlarged prostate and making way for free flow of the urine.

1. Ablation: Excess prostate tissue is melted away by the laser by using photosensitive vaporization of the prostate. This is also known as Greenlight laser therapy or KTP laser vaporization. Alternately, Holmium can be used as the source of laser energy to ablate the prostate tissue.

2. Enucleation: Excess prostate tissue is cut and teased out through the urethra. Holmium laser is used to resect the prostate into smaller pieces, which are then removed out through a resectoscope. Another technique uses a tissue morcellator which grinds the enlarged prostate into smaller pieces to enable easy retrieval.

More men now opt for laser prostate removal as it has the following advantages:

1. Reduced risk of bleeding: This becomes essentially important in patients who are on blood thinners.
2. No hospitalization: This can be done either as an outpatient or with minimal one day stay at the hospital
3. Immediate symptom relief: As compared to medications, the relief is felt almost immediately after the surgery
4. No catheter: With laser surgery, a catheter may be required for less than 24 hours unlike in open surgical cases.

As noted above, as with any surgery, once enlarged prostate symptoms set in, have a detailed discussion with your doctor to identify if you are a suitable candidate for laser surgery.

Know About Laser Prostate Surgery

Without our lungs, it would be impossible to breathe. People suffering from chronic lung diseases have compromised lung functioning. This leads to shortness of breath, fatigue and weakness. In turn, this can make the person avoid anything that exerts the lungs such as exercise. While this may seem like a good idea, it is actually detrimental. Not exercising can further weaken the lungs and muscles and make this a vicious cycle. This is where physiotherapy can help with lung rehabilitation or pulmonary rehabilitation.

Physiotherapy is a branch of medicine that treats diseases and health conditions with exercise and manual therapy. Physiotherapists may also use radiation, sound waves, electric therapy, prosthesis and assistive devices. The aim here is not to cure the disease but to improve lung functioning and the patient s quality of life. Pulmonary rehabilitation can help in a number of ways.

It reduces breathlessness: As the lung muscles weaken, their ability to pump oxygen and transport it to the other parts of the body reduces. This can make a person feel breathless even with the slightest exertion. Lung rehabilitation works on strengthening the lung muscles to reduce this breathlessness.
It increases muscle strength in the arms and legs: When oxygen does not reach the limbs, they, in turn, get weaker. By strengthening the lungs, lung rehabilitation increases the muscle strength in the patient s arms and legs.
It increases stamina and endurance: Stamina is directly linked to lung functioning. By helping the patient breathe more comfortably, lung rehabilitation increases the patient s stamina and helps him or her endure more physical exercise.
It helps patients understand your condition: Physiotherapy is part exercise and part education. By helping patients get an insight into their condition, physiotherapy helps them come to terms with their limitations and motivates them to work harder towards overcoming them.
It increases self-confidence: Feeling breathless and tired all the time can make people feel frustrated. This is especially so because these things cannot be controlled without help. Physiotherapy teaches patients how to deal with these issues and thus increases their confidence in dealing with their medical issues.
It makes patients more independent: A lack of energy can make people dependent on others. Even simple tasks like getting a bottle of water from the fridge can seem like a tiring task. Physiotherapy improves lung functioning and hence makes the person feel less tired doing everyday tasks. This makes the person more independent and improves their quality of life.

Lung Rehabilitation With Physiotherapy!

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!

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