Breast cancer begins when cells in the breast(s) start to grow out of control. It is understood as being the most common cancer, seen predominantly in females, globally. It is reasonably treatable and often curable.

1. Type: Adenocarcinomas constitute more than 95% of breast cancers with infiltrating ductal carcinoma (IDC) being the most common form of invasive breast cancer.

Frequently occurring breast cancers present as one of the following types mainly

1. Ductal Carcinoma In Situ (DCIS): Is the most common type of non-invasive breast cancer and is confined to the milk ducts of the breast. There is no invasion in the basement membrane. Pure DCIS metastasizes rarely. Non comedo cribrioform carcinoma is the most common DCIS found which, when compared to the comedo type, is mostly non-aggressive.

2. Infiltrating Ductal Carcinoma (IDC): Represents majority (about 3/4th) of the breast cancers, and is known to metastasize commonly to bones, lungs and liver.

3. Lobular Carcinoma In Situ (LCIS): Develops in multiple lobules of the breast (bilaterally). LCIS is less commonly seen, compared to DCIS.

4. Infiltrating Lobular Carcinoma (ILC): Represent about a tenth of all breast cancers and tends to metastasize to other regions of the body.

Less commonly occurring breast cancers such as

5. Inflammatory Breast Cancer: Is relatively uncommon and are caused probably owing to viral infections. The breast is warm, red and swollen.

6. Paget s disease of the nipple: Is a rare form of breast cancer. It begins in the milk ducts and spreads to the nipple and areola.

7. Medullary Carcinoma

8. Mutinous Carcinoma

9. Tubular Carcinoma

10. Phylloides tumor etc all.

2. Gender: Affects the female populace predominantly. However, a small percentage of breast cancer is attributable to the male populace as well.

3. Etiology: No definite cause is known. However, diet, lifestyle, environment, hormonal/ reproductive factors, personal or family history of breast cancer especially in first degree relatives and also any benign breast disease history etc all are known to increase the risk of breast cancers. Specifically, excessive fatty diet, obesity, type 2 diabetes mellitus, benign breast disease, heredity/ inheritance of mutated breast cancer genes 1 (BRCA1) and 2 (BRCA2), smoking, alcohol intake, infertility, estrogen therapy/ hormone replacement therapy (long term) in post menopausal women, delayed age at first pregnancy, nulliparity (not having child), early menstruation, delayed onset of menopause, lactating mothers not breast feeding, exposure to ionizing radiation, sedentary lifestyle, depression, exposure to MMTV virus etc all can potentially increase the risk for breast cancer.

4. Features: Signs & symptoms, of breast cancer, manifest majorly in the following ways

Lump/ nodule in the breast that gets attached to the skin of the breast over time. The lump / nodule could be hard and painless with irregular edges or it could also be soft, rounded, tender and painful.

Enlarged lymph nodes in the axilla which are palpable.

Swelling of whole or a part of a breast. This is even if there is no distinct lump felt.

Retraction or thickening of the nipple(s).

Pain in the breast or nipple.

Discharge from nipple other than breast milk.

Irritation/ scaliness of skin over the breast.

Redness of nipples

Rarely, red, swollen and tender breast.

5. Screening: Is generally recommended for asymptomatic populations goal of which, as usual, is to be able to detect & diagnose breast cancer at an early stage which is potentially curable. It is mostly radiologic with mammography/ USG being instrumental in raising suspicions for further diagnostics (i.e. biopsy) that help detect breast cancer, if any, early.

6. Diagnosis: A self-examination/ clinical exam of the breast(s)/ axilla that reveals a palpable mass prompts the following diagnostics. Abnormal blood test results may be indicative of malignancy, but a follow up imaging/ biopsy is always the gold standard for accurate diagnosis.

Blood: ER/ PR/ HER2/neu, uPA, PAI-1, CA15-3, CA27.29 etc all tumor markers are helpful.
Imaging: Mammography/ USG Scan usually, as relevant. Again, CT Scan of abdomen & pelvis and chest, PET CT scan, bone scan etc all help detect metastasis, if any, for cancers in stage III & above.
Biopsy: either excisional, incisional, fine needle aspiration (FNA) or core biopsy technique, as contextually appropriate, is frequently employed and a histopathological examination (HPE) thereof clinches the diagnosis and the nature of the disease.
7. Treatment: Conventional treatment includes surgery, radiotherapy, hormone therapy/ chemotherapy as deems appropriate. Simultaneously, an adjunctive or integrative naturopathic treatment with suitable complementary & alternative medicines (CAM) too can help improve clinical outcomes and facilitate recovery as would be feasible contextually.

8. Prognosis: Preventive measures, earlier diagnosis and right early treatment is key for an effective therapeutic management & better prognosis. Like most other cancers, the chances of cure for an early stage breast cancer are more. The cure/ recovery chances are influenced by the type, grade, stage of cancer, recurrence and the patient s general health & vitality etc all. Above-mentioned apart, age, menopause status, lymph node status, ER/ PR/ HER-2/ neu status, size & extent of breast cancer etc all also influence the treatment outlook in breast cancer. The five year survival rate is strongly correlated with the stage of breast cancer.

9. Prevention: Rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an increased focus on protective factors and avoidance of the risk factors can be of help. 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 reducing the risks of breast 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. Limiting dosage/ duration of hormone therapy, if any, especially to counteract post menopausal symptoms and also avoiding exposure to radiation and environmental pollution can help reduce the risks of breast cancer. Apart from the above-mentioned, for high risk cases, a prophylactic oophorectomy, prophylactic radical mastectomy, long term hormone therapy etc all can help reduce the chances/ risks of developing breast cancer significantly. Breastfeeding is known to confer protection against breast cancer risk too.

Breast Cancer - In A Nutshell

If you are concerned about liver cancer, you should know that most people do not experience signs and symptoms of the cancer in the early stages. Liver cancer is a form of cancer which occurs in the cells of the liver. There are various types of cancer which can develop in the liver. Hepatocellular carcinoma (HCC) is the most common liver cancer which begins in the hepatocyte, which is the main liver cell.

Symptoms-

Usually there are no specific primary stage symptoms of liver cancer. Some symptoms which may develop include the following:

Unusual weight loss is observed

Loss of appetite and developing food aversion

Pain in the upper abdomen

Nausea followed by vomiting

General weakness with intense fatigue

Swelling in the abdomen

The skin may become yellow

White and chalky stools are likely

Causes-

In most cases, the causes of liver cancer cannot be clearly determined. In some cases, the cause is known, such as chronic infection with the hepatitis virus, which may lead to liver cancer. Liver cancer occurs when the liver cells undergo changes or mutations in their DNA structure. DNA mutations lead to changes in instructions of chemical processes taking place in the body. The cells may grow out of control and develop into a cancerous tumour.

Risk Factors-

There are several factors which enhance the risk of liver cancer. They are as follows:

Chronic infection with hepatitis B or hepatitis C increases the risk of liver cancer.

A progressive and irreversible condition known as cirrhosis leads to scar tissue formation in the liver, increasing the risk of liver cancer.

Certain inherited liver diseases such as Wilson s disease and hemochromatosis also increase the chances of liver cancer.

People with diabetes are also at a greater risk of having liver cancer.

Non-alcoholic fatty liver disease (NAFLD), which is the accumulation of fat in the liver, also increases the chances of getting this condition.

Excessive alcohol consumption is another factor which causes irreversible damage to the liver and the chances of getting liver cancer get boosted.

Exposure to aflatoxins, which are poisons produced by molds growing on poorly stored crops, make you more likely to get liver cancer.

Several tests and procedures are carried out for the diagnosis of liver cancer. These include blood tests for diagnosing liver function problems, and imaging tests such as ultrasound, CT scan and MRI scan.

Top 4 Symptoms Of Liver Cancer

Brain mapping is a technique where the biological quantities of a human brain are represented as spatial quantities resulting in maps. As with many other medical technologies, brain mapping is fast-evolving as well. Among several uses, brain mapping is chiefly used while performing surgery on the brain.

When surgery is to be performed on the brain such as surgery for epilepsy, the surgeon would want to comprehend how the brain areas are affected by seizures. The surgical intervention is meant for removing as much as seizure focus as possible while preserving crucial functions like understanding, speech, vision, movement, and sensation.

Why is brain mapping performed?
Brain mapping is a process which helps in identification of functions of various parts of the brain. Mapping the brain by stimulating different areas of the brain areas can aid in creating a map for a particular person. The map allows the doctor in understanding what parts of the brain are responsible for performing critical functions including sensation, movement, speech and other functions.

Which functions of the brain can be mapped electrically?
Typical areas of the brain which have motor, language, visual and sensory functions are needed to be mapped. When current is applied to a single area at a time, the doctor understands which part of the brain is responsible for which function.
When the patient is not able to speak due to the current, then the area is likely to be crucial for language function. If the limbs, face or trunk of the patient stop moving as the current passes, the area that is tested is responsible for movement. On the other hand, if the individual experiences tingling, numbing, and other sensations when the current is applied, it means that a sensory region is discovered.

How is electrical brain mapping performed?
Electrical brain mapping for guiding brain surgery for epilepsy can be performed in two distinct processes: directly during the surgery or in a two-stage procedure.

Two-stage procedure:
In the first stage of the process, the surgeon creates an opening in the skull which helps in exposing the surface of the brain. Small electrical contacts or electrodes are placed on the brain surface even though no brain tissue is removed. As soon as the electrodes are in the right position, the scalp is closed. The electrodes not only record the seizure of the patient electrically but also allow mapping of various areas of the brain. The last stage is surgery where abnormal brain tissues are removed.

Brain mapping process during surgery:
Electrical brain mapping may also be performed during the surgery which exposes part of the brain. This is termed as intraoperative brain mapping since it occurs while performing the main operation. The process of mapping may last for an hour to several hours at a stretch.

Brain mapping is also used to diagnose neurodegenerative diseases like Alzheimer s and Parkinson s. In these cases, the brain map shows extreme shrinkage of the brain due to tissue loss.

Brain Mapping Surgery - Why It Is Performed?

Cancer that originates in the bones of a human body is referred to as bone cancer. Any bone could come under the threat of this disease, but generally the longer bones of your body, so to say the bones of your limbs, are at a greater risk. 

A few factors that might push you an inch closer to bone cancer are:

 Genes could jinx your health: a few typical genetic syndromes could increase a person's chances of contracting bone cancer. These syndromes could have been active in any person belonging to your lineage. One such syndrome is li-fraumeni.
 Treatment for one kind of cancer can make you prone to some other kind: radiation affects your bones adversely. A patient of breast cancer might be undergoing radiation therapy that further increases his or her risk of contracting bone cancer in future. 
 Paget's disease can have unfavorable implications: paget's disease is a disease that affects elderly people. This condition, if left untreated, can turn into bone cancer at a later stage. 

Several symptoms of bone cancer can be found below:

 Sudden loss of weight: if you lose a considerable amount of weight in a few weeks time without having made any effort at all, you should probably be worried about the health of your bones. Bone cancer can result in sudden and unintentional weight loss. 
 Unexpected bone fracture or breakage: cancer of the bones is known to gnaw at the strength of your bones. Weakened and diseased bones can break or get fractured very easily. An unexpected fracture should not be overlooked so as to prevent chances of anything more harmful.
 Long spans of unyielding exhaustion: constant fatigue and sleepiness might be hinting at a more serious underlying problem. The bones in your body hold you together; cancerous bone cells can make you feel exhausted without much exertion as your bones lose their inherent potency.
 Persistent pain in the bones: excruciating cramps or pangs of stinging pain in a person's bones either continuously or at odd hours, could be indicative of bone cancer. Such instances require the advice and guidance of an experienced oncologist.
 Bone swelling: the area affected by bone cancer can grow big and tender or the bone itself can swell up.

All About Bone Cancer

Ultra sound is commonly known as sonography. It is a process of reproducing ultrasound images of soft tissues of a particular body part and other organs on the computer screen with the help of the echoes of the sound waves produced by the transducer, a high-frequency generating instrument.
Ultra sound is commonly used during the different stages of pregnancy to denote the foetal health, the foetal sex, date of delivery, birth defects etc. However, in recent times, the ultra sound has also been associated with the diagnosis of other body parts such as the eyes, heart, gall bladder, liver, ovary, uterus, kidney, uterus, testicles, and ovaries. Ultra sound has also been useful in conducting biopsies for suspecting cancer patients, although not all of the cancers are detected by this imaging process. 3D & 4D ultrasound imaging are useful for looking at a particular body portion with much more precision and in slow motion respectively.

The advantages of ultra sound are:
1. The process of ultrasound imaging is a painless and a fast one. It does not require any insertion of needles or similar objects to denote the problems of the concerned body part.
2. The process is more convenient as compared to other similar imaging processes like MRI, mammogram and x-rays as they can capture images of the soft tissues, blood flow & cysts more clearly than the other processes.
3. The process is free of any harmful effects as there are no chances of exposure to radiation as compared to similar processes such as CT scans or X-rays.

Ultrasound - How it is Beneficial over Other Imaging Techniques?

The human body has 206 bones and bone cancer can affect any of these bones. This condition starts when healthy bone marrow cells mutate and grow out of control to form a tumor. There are many different types of bone cancer. Treatment of bone cancer varies from case to case and depends on factors such as, type of cancer, stage at which it is diagnosed and the patient s overall health amongst other factors.

Surgery, chemotherapy, and radiation are the three most common types of treatments favored for bone cancer. Surgery is usually used for low-grade tumors. This involves the removal of tumor and the surrounding healthy cells and tissues to ensure that that cancer does not recur. For high-grade tumors, surgery may be accompanied by chemotherapy, radiation or a combination of the two. 

Chemotherapy involves the delivery of medication to destroy cancer cells orally or intravenously. Radiation involves the use of high energy X rays to kill cancer cells. This is often used to treat patients with a tumor that cannot be surgically removed.

Apart from these standard forms of treatment, bone cancer patients are often advised to take part in clinical trials for their treatment. This can be described as a research study to test the efficiency of new approaches to the treatment of bone cancer. A clinical trial can be used to treat the safety and efficacy of a new drug, the new dosage of standard drugs or a new combination of treatment types. As a member of a clinical trial, you may be one of the first few people to benefit from treatment even before it is available to the general public. 

Some of the new options available through clinical trials are:

Immunotherapy: This is also known as biologic therapy. It is designed to boost the patient s immune system to fight cancer cells. Mifamurtidesi one of the types of immunotherapy being tested. Immune checkpoint inhibitors such as monoclonal antibodies are also being tested for their ability to block specific molecules.
Targeted therapy: This type of therapy targets the genes and proteins that contribute towards the growth and survival of cancer cells. Targeted therapy limits the damage caused to healthy cells and tissues and only blocks the growth of cancer cells.
Myeloablative therapy: This involves an intense regimen of chemotherapy. High doses of chemotherapy aim at destroying all the cancer cells. Unfortunately, in the process, healthy cells may also be killed. This may be followed by introducing stem cells through a bone marrow transplant to the patient s body to renew blood cells.
Intraoperative radiation therapy: These trials evaluate the use of radiation given inside the patient s body during a surgery. In cases where tumor is in a distant location of the body, stereotactic body radiotherapy and radiofrequency ablation may be used.


Bone Cancer - Understanding The New Approaches For Treatment!

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