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!

The  Roux en Y Gastric Bypass  surgery was first performed by Professor Mason in 1966. Being done in the conventional way (i.e by open surgery) earlier and later laparoscopically, the Gastric Bypass has stood the test of time over the last 52 years.

Over 50 years the Gastric bypass surgery is being performed across the globe. It has given excellent results in terms of significant and long-standing weight loss in the morbidly obese, as well as remission of Type 2 diabetes in properly selected patients. Selection of the patient to undergo this procedure is paramount. 50 years of successful results are enough to term this procedure as the GOLD Standard.

Obesity and Diabetes have been a menace over the last 2 decades world over. In India obesity is growing in such a rampant way that we can equate it to an epidemic.

As we all know, India is considered to be the Diabetic Capital of the world. Type 2 diabetes contributes to the major chunk of diabetes affected population. We Indians get affected by diabetes at very early ages and hence complications are seen at very early ages among us. Strikingly important to notice is that Diabetes is seen not only in the obese category of people but also in the normal weight people.

Diabetes is feared of only because of the complications it is capable of causing affecting the vital organs like the brain, heart, eyes, kidneys.

Intermittent or elevated surges in the blood sugars levels during the course of the day are responsible for causing microangiopathies ( damage to the small vessels supplying blood to the vital organs).

We have seen that diabetes is accompanied by high blood pressure and dyslipidemia in most of the cases. So, when a person has diabetes, high blood pressure and dyslipidemia, we label them as having the metabolic syndrome.

Oral hypoglycemic agents (OHA) and insulin form the mainstay of treatment in getting sugars under control. But these are not able to avoid these surges in high sugar levels. This does not mean that OHA s and Insulin are not the right way to treat diabetes- they indeed are.

We are going a step higher, in an attempt to get control of diabetes without OHA and insulin. Not only this, we are trying to tackle not just diabetes, but the metabolic syndrome on the whole i.e one procedure that will take care of diabetes, dyslipidemia and hypertension. This procedure is popularly known and referred to as the  Gastric Bypass  or the  Roux en Y Gastric Bypass . Thus, In short, the gastric bypass surgery offers ICE BURG treatment.

Now, the first question is that  Is this possible . The answer is YES. The second question is that is this procedure applicable for all diabetics. The answer is NO. Only Type 2 diabetics are the beneficiaries of this procedure where insulin resistance has a major role to play. (This procedure does not benefit Type 1 diabetics) Reasons for this will be explained later. The third and important question is that,  Is the Gastric bypass going to give remission of diabetes in all type 2 diabetics?  The answer is NO.

There is strict selection criterion or eligibility criteria to select a patient for The Roux en Y Gastric Bypass surgery. Best results of the Gastric Bypass surgery are seen when it is confirmed that the person is suffering from Type 2 diabetes, duration of diabetes is less than 5 years, the pancreatic reserve is good and showing good levels of C -peptide in the blood, the person has a family history of diabetes, Insulin was not required to control sugar levels within the first 5 years of onset of diabetes and person should not be underweight( BMI > 27.5 preferred).

Losing weight is not easy and even if we lose weight, weight regain is very common. Most of us would have already experienced it. When we are tackling just the weight issue, we are talking into consideration only the morbidly obese people who have a BMI > 37.5. In the morbidly obese, at first, it is very difficult to lose significant weight by the normal method of diet and exercise. Even if weight loss does occur, weight regains or bouncing back is sure.

Here we bring in the trump card   The  Roux en Y Gastric Bypass  that helps the :

 Morbidly Obese  (BMI >37.5) to lose significant weight and reach their ideal weight.
 Obese  (BMI >32.5) who also have comorbidities (like diabetes, hypertension, dyslipidemia, sleep apnea, obesity-induced infertility) not only to lose significant weight and reach their ideal weight but also to get control of the associated comorbidities.
 Type 2 Diabetics  (BMI > 27.5) to get Remission from type 2 Diabetes.
 Metabolic Syndrome  (BMI > 27.5) to get remission from type 2 diabetes, dyslipidemia and Most cases hypertension.
Type 2 diabetics can be offered this procedure even if they are not morbidly obese, is what I would like to bring it to notice.

Exposure to Type 2 diabetes for long years can lead to potential complications like coronary heart disease, chronic kidney failure, brain stroke, gangrene of the lower limbs.

In some, in spite of talking OHA s, Insulin, sugars are not under control. In these cases, the gastric bypass can be offered to those who fulfil the eligibility criteria.

Remission of diabetes after the gastric bypass procedure is very quick, ranging from a week to a month in most of the cases. However, in some, The sugar levels come to normal the very next day after the surgery in some without the OHA and /or insulin.

Gastric bypass is done through laparoscopy i.e through tiny holes over the tummy, requiring 3 days hospital stay. Supplements need to be taken following the procedure on a daily basis. Following the procedure, intake is reduced to a great extent which increases over few months as the gastric pouch stretches.

Gastric Bypass - Be It Bariatric Or Metabolic Surgery, Get Amazing Results!

A gland that produces a liquid which mixes with sperm and is ejaculated as semen during sexual activity, is the prostate gland and is located under the bladder of a man. Cancer in the prostate is one of the most common cancers that occur among men.

The risk of developing prostate cancer increases progressively with age. Although there is no absolute prevention of prostate cancer, evidence and doctors suggest that a healthy diet can play a key role. Here are a few tips that can go a long way in prevention of prostate cancer:

Red Foods: Tomatoes, carrot, watermelon, and other red foods get their bright color from a powerful antioxidant called lycopene. Studies have proved that by having fruits that contain lycopene, you can reduce your risk of prostate cancer. Some findings suggest that cooking tomatoes make it easier for your body to absorb this antioxidant.
Fruits and Vegetables: Green vegetables contain compounds called carcinogens, which help your body in breaking down cancer-causing substances. Spreading of cancer can be slowed down through a nutrient-rich diet. Avoiding processed junk food and eating fruits and vegetables containing nutrients and vitamins may lower the risk of getting prostate cancer.
Feast on Fish: Fatty acid, also known as omega-3, is found in certain fish including sardines, tuna, mackerel, trout, and salmon. This may help in reducing the risk of developing prostate cancer.
Soy and Tea: Some studies suggest that men who drink green tea or take green tea extract supplements have a lower risk of developing prostate cancer. Many soy products and other foods contain a nutrient called isoflavones, which has been linked to a reduced risk of prostate cancer.
Coffee: Studies show that drinking three cups of coffee a day can reduce the chances of prostate cancer by 11 percent. There is a dose-response relationship between coffee and prostate cancer. The effects of prostate cancer go up or down with the amount of coffee you take. Someone who grabs an occasional cup only, may not have these effects. However, high doses of caffeine can result in major health issues.
Fat: Studies indicate that animal fats and an increased risk of prostate cancer are linked. It is advised to replace animal-based fats with any kind of plant-based fat. In addition to this, overcooking the meat produces carcinogens, therefore it is suggested to be strictly avoided.
Quit Smoking: Smokers are more likely to have an aggressive form of prostate cancer. The chances of a recurrence of the disease are more for people who smoke. It is never too late to quit smoking.
Exercise: Regular exercise and maintaining a healthy body can help you to increase your muscle mass and metabolism. Too much fat in the middle of your body is linked to an increased risk of prostate cancer. You can try walking, running, bicycling or swimming to reduce the weight to lead a healthy life.
It is important to look after yourself and start taking essential steps to prevent prostate cancer rather than trying to manage it once you get it.

8 Easy Ways By Which You Can Prevent Prostate Cancer!

The human body is an intricate mechanism that functions amazingly. And when there is any trouble it does not fail to show signs of trouble, and all we need to do is, to notice it and solve our problems. This is applicable to all types of health issues, including a perianal abscess.

What is Perianal abscess?
Perianal abscess is an extremely painful condition of anal abscess that occurs when one cavity in the anus starts getting filled up with pus. Very often it appears as a painful swelling similar to boil just near the anus. Usually, it appears red in color as well as slightly warm to touch. If the location of the anal abscesses is in the deeper tissue, then it might be less visible and it occurs in people suffering from inflammatory bowel disease.

The worst part is that in certain cases, anal abscesses might lead to more painful anal fistulas. Generally, fistulas occur only if the abscesses fail to heal and break open on the skin s surface. Therefore, it is important that the abscess heals properly or else it may lead to intolerable pain and may even require surgery.

Symptoms of Perianal Abscess
The immediately noticeable and probably the most common anal abscess symptom is constant and throbbing pain around the anal area. Swelling accompanies the pain and its rate increases during bowel movements.

Various common signs of Perianal abscess are:

bleeding or rectal discharge
constipation 
fatigue
Swelling or tenderness,
Skin irritation all around the anus.
Patients with deeper abscess might also show symptoms such as chills, fever, malaise, etc. Various reports state that certain people also feel a lump or nodule at their anus s rim. Facing difficulty while urinating might also be experienced by some people affected by perianal abscess.

HOW TO DIAGNOSE PERIANAL ABSCESS?
One must immediately seek medical if they experience any of the above-mentioned signs or symptoms. Clinical evaluation along with digital rectal exam is sufficient for the proper diagnosis. But, in some cases, patients might need other tests to screen for rectal cancer, diverticular disease, inflammatory bowel disease and sexually transmitted infections. Your physician might also suggest a CT scan, an MRI, or an ultrasound.

HOW DO YOU TREAT PERIANAL ABSCESS?
Just after the diagnosis, prompt surgical drainage would be carried out by the doctor before the abscess erupts. A deeper or larger abscess might require hospitalization as well as an anesthesiologist s assistance. In most cases, patients are prescribed certain medications for pain relief just after the procedure. Antibiotics are mainly given to those people who have comparatively weaker immunity or suffer from diabetes.

Know More About Perianal Abscess!

Gall bladder is a very important digestive gland, which is located on the right side of your abdomen, just beneath your liver. Its main function is to collect, store and release bile, a digestive fluid produced in your liver, essential for metabolizing fats, into your small intestine.

Sometimes, small hard stones comprising of cholesterol, bile pigments and calcium salts in the shape of a pebble, can form in your gall bladder. Gallstones may cause no symptoms but when the gallstone lodges in ducts and blocks the flow of bile, it can cause persistent high-intensity pain which requires gallstone surgery.

Surgery is then prescribed to remove the gall bladder. This surgery is called cholecystectomy. It s done when there are

Gallstones in the gallbladder
Gallstones in the bile duct
Gallbladder inflammation
Inflammation in pancreas
Gallstone surgery or cholecystectomy is a common surgery, and it comes with only a small risk of complications and you can walk out of the hospital on the day of the surgery itself.

Procedure

Minimally invasive or laparoscopic cholecystectomy
During this procedure, the surgeon makes 4 tiny incisions in your abdomen and inserts a tube with a tiny video camera inside it.
Through a video monitor, the surgeon watches while he inserts surgical tools through the other 3 incisions to remove your gallbladder.
After the surgery, the surgeon confirms that there are no gallstones left. Once this is done, he sutures your incisions and you are taken to the recovery area. A laparoscopic cholecystectomy takes just 2 hours or so.
But the problem with this procedure is that it  not appropriate for everyone. Sometimes, what happens is that, the surgeon may start with a laparoscopic surgery and then may decide to go for an open gallstone surgery because of scar tissue or complications.
Traditional or open cholecystectomy
This procedure requires a bigger incision of about 6-inches in your abdomen, below your ribs on the right side. The liver and gallbladder are exposed and the surgeon removes the gallbladder.
An open cholecystectomy takes one or two hours.
Single-incision Laparoscopy Surgery

Traditional laparoscopic surgeries use a telescopic rod attached to a video camera called a laparoscope, which is inserted through a small incision. Apart from this, 3 to 5 additional small cuts are made to insert the other surgical instruments to perform the surgery.

However, single-incision laparoscopy surgery (SILS) is a revolutionary minimally invasive surgical procedure conducted through a single incision. It provides a better cosmetic outcome, as a small incision is made through the patient s navel or belly button, resulting in an almost scarless outcome.

Indications

Most patients who are good candidates for laparoscopic surgery are eligible for single-port procedures. Some of the surgeries that single incision laparoscopy is indicated for include cholecystectomy (removal of gall bladder), appendectomy (removal of appendix), splenectomy (removal of spleen), hepatectomy (removal of liver) and adrenalectomy (removal of adrenal glands). SILS can also be used for diagnostic purposes.

However, patients who have previously undergone multiple major surgeries to the abdominal region and those who are morbidly obese are not considered for SILS.

Procedure

Single Incision Laparoscopy is usually performed as day surgery either in the hospital or outpatient surgery center under general, regional, or occasionally local anesthesia depending on the type of procedure performed and the surgeon s preference.

The patient is made to lie down in a tilted position so that the feet are placed higher than the head. The surgeon makes a single incision of about 3/4th of an inch at the belly button and injects a harmless gas to expand the area and obtain a clear view of the operative site. A tube called a trocar or port is placed through the incision, through which the laparoscope (a narrow telescope having a light source and camera) and tiny surgical instruments are inserted. The laparoscope guides your surgeon with images of the abdominal contents that can be viewed on a large screen. Once the diseased organ is excised, your surgeon removes the instruments, releases the gas, and closes the incision with a small bandage.

Recovery

Common post-operative guidelines following Single Incision laparoscopy include the following:

You will need someone to drive you home after you are released as the anesthesia may make you feel groggy and tired
Do not remove the dressing over the incision for the first two days and keep the area clean and dry.  No showering or bathing during this time.  The incision usually heals in about 5 days
Your surgeon may give you activity restrictions such as no heavy lifting. It is very important that you follow your surgeon s instructions for a successful recovery
You may feel soreness around the incision area. Your surgeon may give you a prescription pain medicine or recommend NSAID s (non-steroidal anti-inflammatory drugs) for the first few days to keep you comfortable
If the abdomen was distended with gas, you may experience discomfort in the abdomen, chest, or shoulder area for a couple days while the excess gas is being absorbed
Diet

You must be very careful with your diet after gallstone removal as your body will not be able to digest fats well. You will of course be sticking to a liquid diet for a week or two and then introduce solids back into your diet. When you do so, you have to stick to a low fat diet. Stay off fried foods and gas-forming foods. Also make sure that you consume no more than 60 gm of fats per meal to avoid discomfort. Stay off spicy foods to avoid bloats and abdominal pains.

Gallbladder Surgery - Aftercare Tips To Help You Recover Better!

Lumpectomy is a surgery where a cancerous or benign tumour is removed from a breast along with some surrounding tissues. The amount of tissue removed varies according to the nature of the tumour. It is a form of breast-conserving surgery. It is also called a partial mastectomy.

Lumpectomy is the first option of treatment for women diagnosed with early-stage breast cancer.

What is the goal of lumpectomy?

Lumpectomy aims to remove the cancerous cells from the breast and at the same time maintaining the appearance of the breast. Studies have proved that for early stage breast cancer, lumpectomy is as effective as mastectomy (complete removal of the breast).

Doctors may recommend lumpectomy to remove precancerous cells as well.

Pre lumpectomy measures-

If you are under any other medication or if you suffer from allergies, inform your doctor. Other pre-surgery measures include-

  Stop taking aspirins or any pain relieving medication

  Your doctor will recommend you to not drink or eat anything 8-12 hours prior to the surgery.

The procedure:

A mammogram and a biopsy reveal the exact location of a tumour. Lumpectomy is performed under general anaesthesia. The surgeon makes a small incision over a tumour to extract the cancerous cells and the surrounding tissues. Sometimes doctors have to perform sentinel lymph node surgery or axillary node dissection.

The surgeon then closes the incisions with sutures. The sutures may dissolve over time or may have to be extracted later by a doctor.

If you have undergone lumpectomy and sentinel node biopsy, you will be discharged on the same day as the surgery as soon as your blood pressure stabilizes.

However, after lumpectomy with axillary node extraction, you may have to stay in the hospital for 2-3 days.

Therapy after lumpectomy

Your oncologist will recommend a follow-up radiation therapy to destroy the mutated cells that may have remained in the area where a tumour had developed. Radiation reduces the risk of breast cancer recurrence.

You might also have to undergo hormone therapy. Some types of breast cancer need female hormones like estrogen and progesterone to grow. Hormone therapy inhibits the development of cancerous cells by not allowing these hormones to reach the cells.

Your doctor will advise you to avoid strenuous physical activities for at least a month after the surgery.

Lumpectomy is a safe surgical procedure that can root out tumours or precancerous cells from the breast without deforming the shape of it.

Breast Lumpectomy - All You Should Know!

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