Uterine cancer of cancer of the uterus is a fairly common type of cancer. In fact, this is the fourth most common type of cancer to affect women. This type of cancer is usually diagnosed in its early stages and hence can be easily treated. However, did you know that this type of cancer can be prevented? This is primarily because most cases of uterine cancer are caused by an increased amount of estrogen as compared to progestin. Here are a few tips to keep in mind.

Birth control pills: The regular use of birth control pills for at least a year is believed to reduce the risk of uterine cancer by at least 50%. The longer these contraceptives are used for, the more effective they are. The protection provided by them lasts for 15 years after their use has been discontinued.
Reduce weight: Being overweight not only increases the risk of lifestyle diseases such as diabetes and high blood pressure but can also increase a woman s risk of suffering from uterine cancer. This is because fat cells produce estrogen that further dis-balances the estrogen to progestin ratio. Reducing weight can thus help lower the estrogen levels in the body and prevent cancer. To lose weight, one must keep a strict control over portion sizes, eat nutritious food and exercise regularly.
Use an IUD: Some methods of contraception not only prevent unwanted pregnancy but also reduce the risk of uterine cancer. Many IUDs or Intrauterine Devices contain progestin. This helps balance the estrogen and progestin levels in the body. Additionally, it also reduces the risk of hyperplasia. This is a condition marked by the abnormal thickening of the lining of the uterus. In many cases, this condition is a precursor to uterine cancer.
Question Your Family: Genetics can also influence the risk of developing uterine cancer. For example, people carrying the gene responsible for Lynch Syndrome or hereditary nonpolyposis colorectal cancer have a much higher risk of uterine cancer as compared to others. Thus, if you know of family members who have suffered or are suffering from uterine or colon cancer, it is a good idea to undergo genetic testing.
Broccoli - A super food: Some foods can also help strengthen the immune system and reduce the risk of uterine cancer. Broccoli is one such vegetable. This is known as a super food that can prevent cancer. The best way to eat broccoli is by steaming it. This has the higher amounts of glucosinolate as compared to fried or boiled broccoli.

Uterine Cancer - 5 Tips To Help You Keep It At Bay!

Kidney Cancer, more commonly known as renal cancer, first presents itself in the lining of the kidney. It then grows malignant and forms a tumor. The good news is that renal cancer rarely spreads to other organs. The bad news is that the tumors grow quite large before they can be detected.

Causes-
Kidney cancer has been found to occur most often in people who are older than 40 years of age. Though the cause of the cancer is not definitively known, there are a few factors that might increase the risk of developing kidney cancer. These include-

1. Obesity- Obesity can cause hormonal changes which in turn can increase the risk of cancer.

2. Smoking- As with any other kind of cancer, nicotine consumption, in the form of smoking cigarettes, increases the risk of developing the disease. In the case of renal cancer, it can, in fact, double the chances.

3. Pain Medications- A prolonged use of pain relievers over a period of time can increase the risk of renal cancer. Certain components of the medication can lead to kidney damage.

4. Genetic history- A medical history of family members, especially siblings, with the disease can significantly increase the risk of kidney cancer.



Symptoms-
In its early stages, kidney cancer remains asymptomatic, but as the tumor grow in size, symptoms begin to present themselves. These symptoms might include the following-

1. Blood in the urine.

2. A gradual loss of appetite leading to weight loss.

3. A persistent pain in your abdomen in conjunction with a lump.

4. A fever that is neither a result of an infection nor a cold, and one that lasts for weeks.

5. Swelling of the legs and ankles.

Treatment
Treatment for kidney cancer will depend on the size and location of the tumour and whether it has spread to other organs or parts of the body. Therefore, to determine the stage of cancer, diagnostic tests such as biopsy, are performed along with urine and blood tests. After determination of your cancer stage, the doctor will perform either a radical or a partial nephrectomy, where the cancerous tumor is removed along with additional tissues. Often, kidney surgery is followed by kidney transplant if both the kidneys need to be removed in nephrectomy. However, if nephrectomy does not cure your kidney cancer, then your oncologist may recommend cryotherapy, radiofrequency ablation or arterial embolization.

Kidney cancer in its advanced stage is often treated with either biological therapy where your body s immune system is utilized to fight cancer cells or targeted therapy where drugs are used stop the multiplication of cancer cells by blocking their signals. Due to such advancement in cancer treatment, the rate of success has gone up in recent years but you also need to follow a healthy lifestyle to make sure that the treatment can bring out the desired positive outcomes.

Kidney Cancer - What Causes It?

A set of cartilage discs present between the vertebrae, ensures that the spinal column can withstand the weight of the upper body. If these discs tear or get injured, the condition is commonly known as slipped disc. In medical terms the same condition is known as prolapsed intervertebral disc. Here is a look at the causes, symptoms and treatment for this painful condition.

Causes for Prolapsed Disc
Intervertebral cartilage discs undergo normal wear and tear with age. However, there are other underlying causes for a slipped disc.

Sitting for prolonged period of time may lead to the disorder
Repeatedly lifting weight in such a manner that all the pressure is exerted on the vertebrae may also lead to a prolapsed intervertebral disc. Example   Exercising with incorrect posture
Alcohol consumption and smoking
Sedentary lifestyle and lack of exercise
Accidental trauma to the spinal region
Diet not consisting of all the essential nutrition
Family history of the same condition
Tweaking one s lifestyle is generally enough to ensure that people are not affected by the condition.

Symptoms of prolapsed intervertebral disc

Patients claim to feel pain radiating from their spinal region to the calves of their feet. This sciatic nerve may get compressed due to the disorder, leading to such a pain.
Tingling sensation in the lower and upper back regions. This sensation may also spread to the arms and legs.
Patients complain of a weakness or numbness in the buttock area, feet and legs.
Treatment for prolapsed intervertebral disc

Limited activity is advised after diagnosis, but complete bed rest is not recommended.
Ice packs should be applied at first. After the pain resides, heat should be applied on the region.
Physical therapy and certain exercises are prescribed by the physician
Anti inflammatory drugs can help control the condition and relieve some of the pain.
Surgery is considered only if the condition does not subside after 4-6 weeks. However, such a surgery is risky and may cause permanent nerve damage.
If you feel that you are at risk of prolapsed intervertebral disc, consult a physician immediately. Follow the recommendations of the doctor, so that you do not have to go through the pain associated with the condition.

Prolapsed Disc - What Causes It?

Breast cancer is a form of cancer which develops from the breast tissue. Breast cancer is indicated by signs such as a lump in the breast, changes in breast shape, fluid flowing from the nipple, dimpling of skin, or the development of red scaly patches. Breast cancer is a fatal form of cancer in women and immediate diagnosis is required on observing the symptoms.

Diagnosis of breast cancer
Other than the regular breast screening, the diagnosis of breast cancer involves the following steps and methods:

Seeing your general practitioner (GP): It is very important to visit your GP soon after noticing the symptoms of breast cancer. Your GP will examine you properly and in case your symptoms need more assessment, he/she will refer you to a breast cancer clinic.
Mammogram and breast ultrasound: You will be required to have a mammogram, as recommended by a specialist breast unit. This is an X-ray of the breasts. An ultrasound scan may also be required. Breast ultrasound should be undertaken only if you are less than 35 years of age. This is because, young women have denser breasts and a mammogram is not as effective as ultrasound in the diagnosis of breast cancer. In ultrasound, high frequency sound waves are used for obtaining an image of your breasts. It is observed to notice any abnormality or lumps. A breast ultrasound is also important for determining whether a lump is solid or contains liquid.
Biopsy: In this diagnosis process, a sample of the tissue cells is taken from the breasts and tested under a microscope to find out if it is cancerous. A scan and needle test for the lymph nodes present in your armpit is also done to check whether they have also been affected. A biopsy is undertaken in several ways, depending upon the condition and severity. A needle aspiration biopsy is used for testing a sample of your breast cells without the removal of the tissues. This is the most common form of biopsy and it is also used for draining a small fluid-filled lump or benign cyst. During the process, you will be given a local anesthetic. Usually, a needle biopsy is carried out guided by an X-ray, ultrasound and an MRI scan as well. This helps in distinguishing it from non-invasive changes such as ductal carcinoma in situ.
Another form of biopsy used for the diagnosis of breast cancer is called vacuum assisted biopsy or mammotome biopsy. In this process, a needle gets attached to a suction tube, which helps in obtaining the sample and for clearing the bleeding.

How Is Breast Cancer Diagnosed?

As life expectancy is increasing so is the incidence of vertebral body (VB) fractures now being the commonest fracture of the body. PVP is an established interventional technique in which bone cement is injected under local anaesthesia via a needle into a fractured VB with imaging guidance providing instant pain relief, increased bone strength, stability, decreasing analgesic medicines, increased mobility with improved quality of life and early return to work in days.

In this era of minimally access surgery replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression fracture spine.

Morbidity & consequences of spinal fracture:

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory & GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc element
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Results / Outcome

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral.
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Percutaneous Vertebroplasty (PVP) is an emerging interventional technique in which surgical polymethyl methacrylate bone cement is injected under local anaesthesia via a large bore needle into a vertebral body (VB) under imaging guidance providing increased bone strength, stability, pain relief, decreased analgesics, increased mobility with improved QOL and early return to work. Started in 1984 by Galibert PVP is done in host of indications.

Senile osteoporotic compression remains the commonest Indication. Other indications are Metastatic VB, Multiple myeloma VB, VB haemangioma, Vertebral osteonecrosis & for strengthening VB before major spinal surgery. The benefit has been extended to the traumatic stable uncomplicated VB compression (VCF) which is commoner in younger age group with active life profile and prime of their career where strict bed rest and acute or chronic pain are unacceptable and they are more demanding for proactive treatment approach so as to be back to work ASAP.

Discovering the fact that VB is the commonest of body, its incidence >the hip, it becomes imperative to take it more seriously. With increasing life-span there is more of aged osteoporotic population, more so due to sedentary indoor lifestyle and post menopausal osteoporosis. Diabetics, smokers & alcoholics are at higher risk of developing osteoporosis. I have seen such alcoholic patient developing six spine fractures in just three months time from a single fracture being on complete bed rest.

Quick fix of fracture spine makes patient walk back same day instead of bed rest of months together avoiding morbidity & mortality of prolonged bed rest, making bedridden patient walk, in a way bringing patient back to normal life.

In this era of MAS replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression.

Morbidity & consequenses of spinal 

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly.
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory &
GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc elements.
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics.
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Morbidity and complication of spinal surgery 

Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Preparation & Procedure:
X-ray spine in a/p & lat view. CT is more informative of bone & morphology. MRI is good for soft tissue injuries. Ask for pedicle size in all dimensions and construct a 3D image aiming needle placement and cement filling in scan room itself as rehearsal of PVP. This reduces operative time & gives better results. Conventionally PVP is done by hammering the vertebroplasty needle through the bone. Here we use light weight drill to bore through the vertebra. It is important to set the needle at exact entry site & side with right trajectory aiming the defects.

In lateral view needle should go through middle of the pedicle going up to anterior 1/3 of VB. In P/A view the needle can be in midline or paramedian depending upon & if uni/bipedicular approach is planned. Approach varies as per location of vertebra, anterolateral in cervical, costotransverse/parapedicular in thoracic & transpedicular in lumbar vertebra.

Do bone biopsy if there is any doubt about lession. Do dye test (vertebral venography). Make cement more radiopaque by adding barium /or tungsten. Inject cement with 1or2 ml luerlock syringes strictly under fluoroscope in lateral view & cross checking in P/A view. Stop injecting either there is adequate filling or at the first sight of ectopic cement leak. Keep sample cement to see for hardening. Remove needle with rotational movement before cement hardens.

Pain relief is by virtue of different mechanisms postulated :

Cementing of fragments.
Thermal neurolysis of VB nerve ending due to heat of polymerization.
Washing away of nociceptor chemicals.
Neurolytic action of liquid monomer.
By allowing early ambulation decreasing pains of immobility & bed rest.
Complications 

PVP is generally safe with low risk.
Ectopic cement leak is frequent but generally inconsequential.
Outcome 

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty.
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

Breast reduction or breast reduction surgery is a form of cosmetic surgery where the size of disproportionately large breasts is reduced.

Extra large breasts may cause neck pain, back pain and several other physical symptoms. Many women undergo a breast reduction to make life easier. This surgery provides effective results.

The procedure of breast reduction surgery-

Breast reduction surgeries can be conducted in an outpatient facility. You may have to stay for one night at a hospital as well. While performing this surgery, a patient is given general anaesthesia, which will make the patient asleep during the process.

Breast reduction surgery requires about two to five hours to be completed successfully. During the process, the surgeon will create a cut around the nipple and then on the breast. The cut is made in the shape of a keyhole. Extra skin, tissue and fat will be removed from the breast through the keyhole-shaped incision. Drainage tubes are also utilized for removal of excess skin and fat. After the removal is complete, and enough skin has been removed, the breasts are stitched. They are then wrapped in a special gauze. Sometimes, a surgical bra is required to be worn by the patient during the surgery.

Recovery from breast reduction surgery-

After a breast reduction surgery is performed, the patient must take a minimal one week off from any kind of work or school. Some women require two weeks or more to recover. However, this varies from patient to patient, but not more than three weeks are required for recovery.

You will be having a follow-up appointments with your surgeon, where the bandages and stitches on the breasts are removed.

As a part of the recovery process, a woman must abstain from all kinds of physical activities for one month following the surgery. After the surgery, it is likely for a patient to feel tired and experience breast pain. However, this is normal and you can have oral pain killers prescribed by your surgeon to get relief and ease. Heavy lifting should be strictly restricted.

Breast reduction surgery is an efficient cosmetic surgery, which enables women to reduce their breast size and volume. The results of such a surgery are quite satisfactory.

Breast Reduction - Know The Procedure and Recovery!

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