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!

The spleen is a very important organ of the human body. A splenectomy is the process of removing the spleen from the human body. The spleen is a very small, fist-sized organ which is located under the rib cage, close to the stomach. The basic function of the spleen is removing the damaged or dead red blood cells. It also removes any kind of bacteria present in the bloodstream that can cause infections. When the spleen is removed, there are chances of infection that can be life-threatening if not treated. It is always better to prevent infections as soon as you see the symptoms.

Why do you need a Splenectomy?
There can be many reasons for the removal of the spleen from your body such as  

In case, the spleen is damaged due to an accident, injury or in the process of an abdomen surgery.
For treating some medical conditions such as lymphomas or leukemias.
Overactivity of your spleen.
In case any abnormalities found in the red blood cells of the body.
Collagen vascular diseases
In some rare cases, a person may be born without a spleen.
Sepsis:
The infection that is caused due to the removal of the spleen is called sepsis. This is a life-threatening condition where the bacteria that causes the infection keeps on spreading to the entire body and bloodstream. It is going to impact the normal functioning of the human body. Symptoms of sepsis include high fever, shivering, headache, confusion, drowsiness, severe pain in the abdominal area and increased heartbeat. But all this starts with a simple respiratory problem such as a respiratory tract infection.

Tips to prevent infections after a Splenectomy:
If you have had a splenectomy, then it is very important for you to take certain precautions such as:

You need to take certain vaccines such as HIB, pneumococcal or meningococcal and they will reduce the risk of getting an infection after the removal of the spleen.
You will have to take some additional doses of the above vaccines in order to maintain the effect on your body.
You need to take antibiotics on a daily basis to prevent a sepsis infection.
The first stage or symptoms start with chills or fever and hence you should make sure to maintain a set of antibiotics. Start taking them as soon as you see these symptoms.
If you are travelling to another country, then make sure you carry the antibiotics with you. If you notice any kind of symptoms, you need to take the medicine immediately.
You need to discuss the above-listed points with your doctor, especially if you require more information about how to prevent infection after the spleen is removed.

Tips To Prevent Infections After A Splenectomy!

Colorectal cancer is otherwise known as cancer of the colon or the rectum. This can affect both men and women with age being a major risk factor. Majority of such cancers are seen to occur after age of 50 years.

Type: colorectal cancers can present as one of the following types: 

Adenocarcinomas are the most common type of colorectal cancers. These cancers begin in the cells making mucous and other fluids. Certain colorectal cancers begin as adenomatous polyps (adenomas) that turn cancerous over a period of time. This is precisely why the adenomas are regarded as pre-cancerous or pre-malignant.

Gastrointestinal (GI) carcinoid tumors, GI stromal tumors, primary colorectal lymphoma, leiomyosarcoma, melanoma & squamous cell carcinoma are certain other colorectal cancers

Carcinoid tumors: start in specialized cells that produce hormones, in the intestine.

GI Stromal tumors: start in the interstitial cells of Cajal (ICC), in the wall of the colon.

Lymphomas: start typically in the lymph nodes but they may also start in colon or rectum.

Sarcomas: can start in the muscle and the connective tissue in the walls of the colon and rectum.

Gender: it affects both male and female populace.

Etiology: mostly, the factors that are associated with increased risk of colorectal cancer include the following  

Age exceeding 50 years.

Racial & ethnic background such as African Americans, in the USA, are known to have the highest incidence of colorectal cancer, and mortality rates.

Low fibre and high fat diet. Excessive consumption of red meat (e.g. goat meat, beef, pork, lamb, or liver), processed meats, butter, refined grains, sweets, sugary drinks etc all can increase the risk of colorectal cancer.

Personal history of inflammatory bowel disease (IBD) (e.g. ulcerative colitis), Crohn s disease, adenomatous colorectal polyps, colorectal cancer etc all.

Family history of colorectal cancer or adenomatous polyps etc all.

Inherited syndromes such as familial adenomatous polyposis (FAP) and Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC).

Sedentary lifestyle/ associated Obesity.

Type 2 diabetes.

Tobacco and alcohol abuse.

Features or symptoms can vary from person to person depending on the size and location of the tumour. Following are the signs & symptoms mainly -

Changes in bowel habits, diarrhea or constipation or an alternating diarrhea and constipation.

Occult/ blood in the stool, and 

Problems related to blood loss (e.g. anemia, weakness, fatigue, intolerance to exercise, shortness of breath, increased heart rate, chest pain etc all),

Abdominal discomfort (frequent gas/ flatulence, bloating, fullness, cramps, and pain), vomiting etc.

Unexplained weight loss,

Pain with bowel movement,

Feeling that bowel does not empty completely,

Stools are narrower than usual.

Diagnosis: Following are the diagnostics employed. Abnormal blood test results may be indicative of malignancy, but a follow-up imaging/ biopsy is always the gold standard for accurate diagnosis.
Blood: fecal occult blood test, Carcinoembryonic Antigen (CEA) assay values are raised, Hb/ RBC counts may be low.
Imaging: Colonoscopy, Endorectal Scan/ CT Scan followed by Biopsy clinches the diagnosis and the nature of the disease.
Apart from the above-mentioned barium enema X-Ray, USG, Chest X-ray, PET CT scan etc all help detect metastasis, if any. An increase in level of the serum tumor marker  CEA  is indicative of metastatic spread/ proliferation that can be ascertained through a PET CT scan.
Treatment: Conventional treatment includes surgery, radiation and chemotherapy as contextually appropriate. Simultaneously, an adjunctive/ integrative naturopathic treatment with suitable complementary & alternative medicines (CAM)/ therapies too can help improve clinical outcomes and facilitate recovery as feasible contextually.
Prognosis: preventive measures, earlier diagnosis and right early treatment is key for better prognosis and efficient/ effective therapeutic management. Usually, the chances of cure for an early stage cancer are more. Above-mentioned apart, recovery chances are influenced by the grade, stage of cancer, recurrence and the patient s general health & vitality etc all too.

Prevention: rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still 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 prevention or reducing the risks of colorectal 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. Apart from the generic preventive measures as mentioned above, certain pre-malignant conditions, of which adenomas are the most common, can be successfully treated with complementary and alternative medicines too.

Colorectal Cancer - In a Nutshell!

Bladder cancer refers to a  cancer, which arises from the epithelial lining or the urothelium of the urinary bladder. In the most common form of bladder cancer, the normal histology of the urothelium is recapitulated. It is called transitional cell carcinoma. Bladder cancer is a serious form of cancer that leads to many deaths too.

Treatment:
There are several modes of treatment for bladder cancer. They are:

1. Bladder cancer surgery: Surgeries are common for treating bladder cancer. 

2. Transurethral resection of bladder tumor or TURBT: This mode is used for determining the presence of bladder cancer and to find out if it has invaded the bladder wall muscle layer. This treatment mode is generally used in the early stages of bladder cancer.

3. Cystectomy: A cystectomy is undertaken when bladder cancer is very invasive and parts of the bladder or the whole of it has to be removed. There are two types of cystectomy.

Partial cystectomy is used when the cancer invades the bladder muscle layer in a small area. It can be removed without the whole bladder being taken out.
A Radical cystectomy is undertaken in case the cancer affects a large area and is present in multiple areas of the bladder. This surgery removes the bladder entirely and all its nearby lymph nodes.
4. Intravesical therapy: In intravesical therapy, a liquid drug is put directly into the bladder via a catheter instead of injecting it or consuming it orally. The cells lining the bladder are affected without causing any harm to other body parts. This therapy is usually used after TURBT in non-invasive cases of bladder cancer to prevent recurrence.

5. Chemotherapy: Chemotherapy is an effective treatment for bladder cancer. Chemotherapy may be used in two ways:

Intravesical chemotherapy, where the chemo drug is put directly into the bladder and is applicable only for early treatment stages.
Systematic chemotherapy, which involves the injection of chemo drugs into the vein or muscle and can also be administered in the form of pills. The drug reaches all parts of the body via the bloodstream and affects all cancer cells.
6. Radiation therapy: This treatment procedure for bladder cancer involves the use of high energy radiation for killing cancer cells. It is used in early phases of treatment and is the primary remedy for people who cannot have a surgery. It is combined with chemotherapy to make the radiation effective. The most common type of radiation therapy for treating bladder cancer is called external-beam radiation therapy where radiation occurs from an outside source.

Bladder cancer is a severe form of cancer. Proper and ideal treatment is required among the several treatment methods available.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Bladder Cancer and How It Can Be Treated

If the blood flow between left ventricle and aorta is obstructed, it is known as Aortic Stenosis.
Aortic stenosis can occur in newborn, infants, children and adolescents. It is more common among boys than in girls.
Mild cases of this disorder do not need treatment. However, if a child has a severe case of aortic stenosis, then it requires treatment.

Aortic stenosis: Causes-

Blockage in the valve, mainly in the form of bicuspid valve stenosis (Aortic valve stenosis)
Muscular/fibrinous obstruction beneath the aortic valve (Subaortic stenosis)
Narrowing above the aortic valve in aorta itself (Supravalvular aortic stenosis)
Aortic valves regulate blood flow to the body parts. When aortic valve opens, it allows blood to go forward then it closed down so that blood will not come back to left ventricle.
However, if there is a problem with the aortic valve, it cannot open entirely and that restricts the passage of blood. The heart has to work extra hard to ensure that the entire volume of blood flow through the faulty valve.

Sometimes babies are born with deformed aortic valve in the form of bicuspid aortic valve that is prone for obstruction as compared to normal trileaflet aortic valve.

Aortic Stenosis: Symptoms-

Symptoms due to aortic stenos is depends on age of the child and its severity.
If occurs in newborn babies, it is generally severe in intensity and babies are generally in shock like state due to low cardiac output.
Infants are generally tired easily during feeding.
Children show signs of easy fatigue, chest pain, loss of consciousness and in late stages with shortness of breath.
Diagnosis of Aortic Stenosis-

Pre-natal testing like a fetal echocardiogram can reveal aortic stenosis if moderate to severe in intensity. That is why as soon as the baby is born, treatment is initiated.
Even if the child was not born with a problematic valve, this condition can arise a few years later.
For diagnosing this disease pediatric echocardiogram by pediatric cardiologist needs to be done from the chest of the child
Treatment of Aortic Stenosis-

If aortic stenosis is mild to moderate in intensity then we need to do follow-up of the child at regular intervals.
However, in severe aortic stenosis, treatment needs to be done
In valvular aortic stenosis, treatment of choice is by doing ballooning of aortic valve (Balloon aortic valvuloplasty, BAV) in any age group.

Balloon Aortic Valvuloplasty - This is not open-heart surgery. It is done in cardiac cath lab under fluoroscopic guidance by using vessels in thigh. We cross the valve with wire and catheters and we inflate a balloon across the stenosed aortic valve.

Open heart surgery: In subvalvular and supravalvular aortic stenosis, treatment is by open heart surgery.

Valve Replacement - An artificial valve or a donor valve is surgically attached at aortic valve location when valve is not amenable for ballooning. It is generally done in adolescent or adult patients.
Parents need to be alert and attentive to any physical discomfort that their child is suffering because that could be a symptom of aortic stenosis. The right treatment at the right time is necessary whenever required.

Aortic Stenosis - All You Must Know About It!

Hectic lifestyle, unhealthy food habits, poor bowel movements, and stress can all add up to one condition called the GERD. Gastroesophageal reflux disease or GERD refers to a particular type of digestive disease, and mainly affects the LES or lower esophageal sphincter, which is a muscle ring between the stomach and the esophagus resulting in the symptoms such as burning sensation in the chest or difficulty in swallowing.

Treatment options
While the moderate or mild GERD can usually be treated with healthy lifestyle changes, diet, and medications, when the condition gets severe, surgery becomes the only option to prevent the issue from deteriorating further. Here are some of the common surgical options available for treating GERD:

Fundoplication: This surgical procedure is the most common and standard surgical option for treating GERD. It focuses on tightening and reinforcing the LES by wrapping the upper portion of the stomach around the outer side of the lower esophagus which strengthens the sphincter.
Transoral Incisionless Fundoplication: Transoral incisionless fundoplication or TIF is another surgical procedure available for treating GERD and can be performed when an open fundoplication cannot be performed. It is performed by creating a barrier between the esophagus and the stomach which prevents the stomach acid from reflux or going backwards.
Stretta: This surgical procedure is performed as an outpatient option using an endoscope. Here, a flexible tube is passed into the esophagus where the electrode present at the tip of the tube creates tiny cuts on the esophagus by heating the esophageal tissues. As a result, the scar tissues formed, block the nerves that are responsible for acid reflux.
Bard EndoCinch System: This surgical procedure also uses an endoscope to create stitches to make pleats in the lower esophageal sphincter, which strengthens the LES. However, this surgical treatment option is not as common as other GERD treating procedures.
Linx Surgery: In Linx surgery, a special device called Linx, a ring containing microbeads of magnetic titanium, is wrapped around the sphincter to make it strong. As the beads are magnetized, they help in keeping the opening between the esophagus and stomach closed, while letting the food pass normally.
Recovery
As long as the surgical option is laparoscopy, they are the least time-consuming as well as less painful with lesser downtime, but may not be ideal for everyone. When it comes to traditional surgical treatment options like fundoplication, it takes around minimum six weeks to resume the daily activities. However, for laparoscopic fundoplication, the downtime is one or two weeks. Linx surgery is a minimally invasive surgical option and therefore, the recovery time is shorter than other traditional surgeries for treating GERD. Depending on the patient's health conditions and response to surgery, the recovery time may vary for each surgical treatment options for GERD.

So, seek the advice of your gastroenterologist for the best possible treatment option to get completely cured of the condition.

Treating GERD: 5 Surgery Options That Can Help!

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