Dilation and curettage procedure which is commonly referred to as D&C is a minor surgical procedure where the cervix is dilated while a special instrument is used for scraping out the lining of the uterus. It is important to know what you can expect before, after and during the process so that you can stay ahead of unnecessary worries and help the process to be smooth and fruitful.

When do doctors recommend dilation and curettage process?
You may be required to undergo the dilation and curettage procedure for one of many reasons. It can be used for removal of tissues in the uterus during or after an abortion or miscarriage or to remove little pieces of placenta after delivery. This process aids in preventing infection as well as heavy bleeding. On the other hand, it can help in diagnosing and treating abnormal uterine bleeding including polyps, fibroids, hormonal imbalances and even uterine cancer. A sample of the tissues in the uterus is tested under a microscope to check if there is any abnormal cell present.

What can you expect during the dilation and curettage process?
The D&C procedure is a minor one and takes about 15 minutes even though you will have to spend about 4 to 5 hours in the healthcare facility. Before the procedure, your doctor would check complete history, and at this point, you should tell your doctor if you suspect that you are pregnant, you are sensitive to latex or any medicines or if you have a history of bleeding disorders. You will then be given anesthesia so that you don t feel any pain or discomfort during the procedure. Before this procedure, you will have to empty your bladder.

The D&C procedure comprises two main steps, dilation, and curettage.
Dilation involves opening of the lower part of the uterus or the cervix for allowing insertion of a slender rod. This is done to soften the cervix so that it opens and allows curettage to be performed. Curettage involves scraping of the lining and removal of the uterine contents with the help of a spoon-like instrument known as a curette. This may cause some amount of cramping, and a tissue sample would be taken out for examination in the laboratory.

After the completion of the procedure, you may experience slight bleeding and cramping. In some rare cases, adhesions or scar tissues may start forming inside the uterus, and this condition is termed as Asherman s syndrome which can cause changes in the menstrual cycle along with infertility. This problem, if arises, can be solved with the help of surgery and therefore, you should report any abnormality in your menstrual cycle to your doctor.

Dilation & Curettage Process - What To Expect From It?

Chemotherapy has been the remedy for cancer since the late 90s. But in today s world the medical field has been improved so much that new methods have been invented. One of them is Hormonal therapy. It is used to cure some types of breast cancer that are affected by hormones. Receptor proteins in the breast cancer cells attach to estrogen and help the cells grow. This therapy stops the receptors attaching to estrogen in various ways.

When it is used?
Hormonal breast cancer therapy is performed after surgery to prevent the cancer from coming back. It is also applied to treat the cancer that has come back or to prevent the cancer from spreading to other parts of the body. Sometimes, if needed, it starts before the surgery. It takes five years, generally.

How it works?
Hormonal therapy mainly stops estrogen from acting on the cancer cells or lowers the estrogen level. There are different ways to do that.

Blocking Estrogen Receptors: These drugs stop estrogen from helping breast cancer cells.
Tamoxifen: It acts as anti-estrogen in the breast cells, but acts like estrogen in other cells. It lowers the risk of breast cancer and also stops cancer from coming back.
Toremifene: It works in a similar way, but it is only used in metastatic breast cancer. It also decreases the pain and swelling in the muscles and bones.
Fulvestrant: It blocks and damages estrogen receptors. It is given by injections after other drugs stop working.
Lowering Estrogen Levels: These drugs slow the growth of cancer by lowering estrogen levels.
Aromatase Inhibitors: These drugs stop estrogen production in women whose ovaries are not working due to menopause or other treatments. There are three types of this drug- Letrozole, Anastrozole and Exemestane.
Ovarian Suppression: In this method, ovaries are removed or shut down to turn pre-menopausal women to post-menopausal. There are several ways to do this, and they are- Oophorectomy or surgery, LHRH analogs and applying chemotherapy drugs.
There are some other types of hormone therapy that are less common. They were used more in the past. They are:

Megestrol acetate
Androgens
High doses of estrogen
Side Effects:
Unfortunately, Hormonal breast cancer therapy has lots of side effects. They are-

Hot flashes
Mood swings
Vagina discharge or dryness
Developing uterine cancer
Blood clots
Stroke
Night sweat
Headache
Mild nausea
Bone pain
Injection site pain
Muscle pain and joint stiffness and pain
Bone thinning
Menopause
Although hormonal therapy has lots of side effects, they are limited to different kinds of hormonal therapies and it is not necessary that they will surely happen. But it is best to undergo any kind of treatment with a doctor s advice. So patients should consult the doctor first.

Breast Cancer - New Advancements That Can Help!

While you cannot cure breast diseases, family history and maturing, but there are some hazards or risks that you can control. Keeping in mind the fact that there is no certain approach to forestall breast cancer, there are things you can do that may bring down the hazard. Here are five approaches to ensure your breast's well-being:

Watch your weight: Being overweight or hefty expands breast cancer chances. This is particularly true after menopause and for women who have put on weight as grown-ups. After menopause, the vast majority of your estrogen originates from fat tissue. Having more fat tissue can heighten your chances of getting breast cancer by raising the estrogen levels. Additionally, women who are overweight have a tendency to have more elevated amounts of insulin, than other hormones. Higher insulin levels have been associated with a few tumors, including breast cancer.
Exercise routinely: Many reviews have found that exercise is the sign of having a healthy breast. Studies show that one to two hours of energetic walking each week, lessened a woman s cancer risk by eighteen percent. Walking ten hours seven days decreased the hazard all the more.
Constrain liquor: Women who have two to five mixed beverages every day have a higher danger of breast cancer than women who have just one drink a day or none . As much as three to six glasses of wine seven days have been found to somewhat increase breast cancer chances. It is not clear how or why liquor raises the hazard. In any case, constraining liquor is particularly essential for women who have other hazard variables for breast cancer, like, breast cancer running in their families.
Restrain time spent sitting: Research has shown that sitting time, regardless of how much exercise you get when you are not sitting, increases the probability of growing cancer, particularly for women. Women who sit six hours or more a day outside of work have a ten percent more serious risk for breast cancer compared to the ladies who sit under three hours a day, and an increased hazard for other cancer types as well.
Stay away from or confine hormone substitution treatment: Hormone Replacement Treatment (HRT) was utilized frequently in the past to control night sweats, hot flashes, and other troublesome manifestations of menopause. In any case, specialists now realize that postmenopausal ladies who take a blend of estrogen and progestin might probably create breast tumors or cancer. Breast cancer disease seems to come back within five years in the wake of ceasing the blend of hormones. Therefore, get a breast cancer test even if you feel a small lump.

5 Ways to Decrease The Chance of Breast Cancer 

Kidney cancer or renal cancer is when kidney cells grow uncontrollably and form a tumour. Kidney cancer often begins in the tubules (tiny tubes in the kidneys). The prognosis may depend on the stage of the kidney cancer.

Different Stages of Kidney Cancer
The TNM system helps to categorize each stage of the kidney cancer.
Tumour (T)   Describes the size and location of the tumour.
Node (N)   Describes the spread of cancer to lymph nodes.
Metastatis (M)   Describes the spread of cancer to other body parts.

These results combined with the five stages (0 and 1 to 4) can help to identify the right treatment option for every patient. Zero stage describes no cancer presence. For instance  
Stage 1   Here the tumour is confined to kidneys and its size is smaller than 7 centimetres. (T1 or T1, N0, M0)
Stage 2   Here the tumour is confined to kidneys and its size is more than 7 centimetres. (T2)
Stage 3   Here the tumour is in kidneys or blood vessels or fatty tissues but also a lymph node; cancer spreads to major veins but doesn t extend beyond renal or Gerota s fascia (connective tissues surrounding adrenal glands and kidneys). (T3)
Stage 4   Here the cancer is in the fatty tissues surrounding kidneys and adjacent lymph nodes; has spread to other nearby organs and beyond renal fascia. (T4)

Treatment and management of kidney cancer
Once your doctor has determined the staging of your kidney cancer, a treatment plan can be formulated for you.

Surgery
Simple nephrectomy removes the affected kidney.
Radical nephrectomy is a common surgery for kidney cancer. It removes all affected parts such as the kidneys, adrenal gland, lymph nodes and surrounding tissues.
Partial nephrectomy is for small tumours and removes the kidneys and the surrounding tissues.
Interventional radiology: This is a surgery aided by real-time images. An advanced surgery using a nano knife is minimally-invasive and is effective for inoperable kidney tumours.
Targeted therapy: Drugs target specific tumour cells and destroy them.
Immunotherapy: Used for kidney cancer that has spread to other organs, this therapy may use different types of drugs to either help immune cells find cancer growth or regulate the immune system activity to stop or slow cancer growth.
Arterial embolization: It is a procedure to stop blood supply to the kidney tumour, in order to shrink it in size prior to surgery.
Cryotherapy: This procedure involves using extreme cold to kill cancer cells.
Chemotherapy is not very effective for treating kidney cancer. Talk to your doctor about all possible treatment options for your cancer. You can lower your risk of kidney cancer by eating healthy, maintaining your ideal body weight and managing your blood pressure.

Stages Of Kidney Cancer - How They Can Be Managed?

Peripheral arterial disease or commonly known as PAD is a common cardiovascular disease. Despite having the power to cause painful symptoms and severe health risks, it is overlooked by many. This particular arterial disease may lead to life-threatening consequences if left untreated for long. Read on to know more about the condition.

What is PAD?
PAD refers to the situation where in the peripheral arteries to the arms, head, stomach, and legs become narrow. Often referred to as the peripheral vascular disease, here, the arteries start to grow narrower due to the slow but constant buildup of fatty deposits on the artery walls. Though it can affect all the arteries in a person s body, except those that supply blood to the heart, in the majority of cases, it affects the arteries in the leg.

What are the threats it poses?
PAD is indeed a life-threatening disease, as the blockages, it creates in the peripheral arteries prevent normal blood circulation to the different organs, legs, and brain. And when the blood flow is restricted, or the vital organs of the body fail to receive necessary blood flow, then the legs, brain and all the vital organs suffer severe damage. And when PAD continues to harm the blood flow for a long time, then it leads to tissue infection or tissue death, which is known as gangrene.

Additional health issues it causes
PAD also creates various other health concerns, such as atherosclerosis. Atherosclerosis is a chronic disease of fatty materials  build up. In the case of atherosclerosis, the entire blood circulatory system gets damaged, including the arteries leading to the heart. The risk of blood clot build ups and vascular inflammation are also common additional threats posed by the fatty deposits.

Probable symptoms
Depending on the part of the body that is affected, the PAD symptoms vary from one to another. However, painful cramping in the muscles of one s legs is the most common symptom of this condition. The pain, originating in the legs often goes up to the muscles in the thighs or hips too. Except this, weakness or numbness in the legs, ulcers or open sores on the feet or legs, skin color changing into bluish or pale are some of the other symptoms of PAD.

Possible treatments
The peripheral arterial disease can be diagnosed easily, painlessly and straightforwardly under proper medical attention. Both prescribed medications and a lifestyle change are considered to be the best treatment for controlling PAD. Including a healthy diet and adopting a healthy lifestyle have often been successful in preventing PAD in its early stage.

The moment any signs or symptoms of PAD is noticed one should not be late in seeking immediate medical attention.

Peripheral Arterial Disease- A Serious Threat To Life Worth Being Concerned About!

It is perfectly normal for women to experience the periodic monthly bleeding cycle. However, if a woman experiences uterine bleeding which is abnormal and dysfunctional, it could be a symptom of infection. Other causes of abnormal uterine bleeding include hormonal imbalance, infection in cervix and cancer of the uterus. Many women can also experience abnormal uterine bleeding during first trimester of pregnancy.

The following are considered to be abnormal or dysfunctional uterine bleeding:

A menstrual cycles occurs between 21 to 35 days, anything shorter or longer than this is abnormal
No period for 3 6 months (amenorrhea) is abnormal
Spotting or bleeding between periods
Spotting or bleeding after intercourse
Bleeding that is heavier or lasts longer than usual
Spotting or bleeding after menopause
What can cause such a situation?

Some of the common causes leading to abnormal bleeding are as follows:

Miscarriage
Ectopic pregnancy
Pregnancy
Cervical or uterine infections
Fibroids
Hormonal imbalances
Problems with blood clotting
Polyps
Polycystic ovarian
Endometrial hyperplasia
Cancer of the reproductive tract
How to Diagnose it?

Most women tend to ignore abnormal bleeding, taking it as something to do with age or hormones. A detailed physical examination and history is done to understand menstrual cycle patterns and family history. In addition, the following would be used.

Ultrasound: The pelvic organs are examined through sound waves to locate the problem area
Hysteroscopy: Through a thin device that is inserted into the vagina, the doctor takes a look at the inside of the organs and identify the cause for the bleeding
Endometrial biopsy: The uterine lining tissue is removed and examined under microscope to look for tissue changes that could be causing the bleeding
How Best to Treat It?

This would depend on the reason for the abnormal bleeding. However, in most cases, combinations of the following are useful in treatment.

Hormone replacement can be done depending on the age and gynecological history, the type and the dose of the hormone would be decided upon. These could be in the form of tablets, vaginal creams, injections, or through an intrauterine device
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are useful in reducing bleeding and controlling cramps during excessive menstrual bleeding.
Antibiotics may be useful if there is infection of the pelvic organs.
Polyps, cysts, cancers, and other growths can be removed via hysteroscopy and sent for biopsy to confirm they are not cancerous.
Endometrial ablation where the endometrial tissue is treated with heat can be used to control bleeding permanently.
Hysterectomy would be done if other forms of treatment have failed. This could depend on their gynecologic history and other considerations as she cannot get pregnant after this.
Do not ignore if you see a change in the pattern of your uterine bleeding. It definitely calls for medical attention and if identified early, can be managed in much simpler ways. 

Abnormal Uterine Bleeding - How Best to Diagnose It?

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