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Patient Review Highlights
Cancer today is not as rare as it once was. Today, cancer affects the young and old alike. One of the reasons for this is the pollution in particular air and water pollution that we are exposed to on daily basis.
The air we breathe in today is a mixture of smoke, particulate matter and noxious gases that causes great harm to our bodies. Amongst these, particulate matter that is smaller than 2.5 millionths of a metre is the worst.
These particle matters are emitted into the air from car exhausts, industrial exhausts, coal fires, wood stoves etc. While the body’s natural defences help keep larger particle matter out of the system by sneezing or coughing it out, smaller particle matter enters the body easily. These then get trapped in the lungs and enter the bloodstream. Particle matter has in particular been linked to increasing number of lung cancer cases. Apart from lung cancer, coal tar particle matter has been linked to bladder cancer, soot to oesophageal cancer and benzene and other pesticides to leukaemia.
Radon is another source of air pollution that is emitted from the ground. In some cases, radon can also be emitted through the water. As this gas decays, it releases tiny particles that when inhaled bombard the lung cells with radiation that can cause radiation. Smoking can worsen this effect and increase a person’s risk of suffering from lung cancer. Both first-hand and second-hand smoking have also been linked to breast cancer. Apart from trying to reduce emissions to lower air pollution, it is also important to clean filets of air conditions, etc. regularly to lower indoor air pollution. Preventing the smoking of tobacco in public spaces can also help improve air quality.
All pollutants emitted by us eventually find their way into the water we drink. Even if you are not drinking contaminated water, merely, showering or swimming in contaminated water can make your body more vulnerable to the carcinogens in it. Common water pollutants include arsenic, hazardous waste, animal waste, radon, chemicals and asbestos. Drinking water with concentrated amounts of arsenic has been linked to cancer of the lungs, liver, kidney and bladder while the chlorine used to treat drinking water increases the risk of bladder and rectal cancer.
To reduce the risks of cancer caused by polluted water, it is essential to reduce disinfectant by products by keeping water treatment facilities updated and promote green chemistry and alternative assessments to reduce pollution as a whole. If you wish to discuss about any specific problem, you can consult an oncologist.
Lung cancer is the cancer killer of both men and women in the U.S. When you think of risk factors for lung cancer, what comes to mind? Most of us think about the risk associated with smoking cigarettes, but did you know that air pollution can also cause lung cancer? Overwhelming evidence shows that particle pollution in the outdoor air we breathe—like that coming from vehicle exhaust, coal-fired power plants and other industrial sources - can cause lung cancer. Particle pollution increases the risk of dying early, heart disease and asthma attacks, and it can also interfere with the growth and function of the lungs.
What is Particle Pollution?
Particle pollution is a mix of tiny solid and liquid particles in the air and can be made up of a number of components, such as acids, organic chemicals, metals, soil and dust particles. It can be emitted directly from wood stoves, forest fires, vehicles and other sources, and it can also form from other types of pollution that come from sources like power plants.
Why does particle pollution harm our bodies?
While breathing in larger sizes of particle pollution can be harmful to our health, smaller particles are more dangerous. Bigger particles can irritate your eyes, nose and throat, but our natural defenses help us to cough or sneeze them out of our bodies. Unfortunately, those defenses don't keep out smaller particles, which get trapped deep in the lungs and can even get into the bloodstream, causing damage to our health.
Who is most at risk?
As for who is at risk for health problems from breathing in particle pollution. Those who live where particle pollution levels are high is at risk. Some people face higher risk, including children, the elderly, people with lung and heart disease and diabetes, people with low incomes, and people who work or exercise outdoors.
How do we protect ourselves from particle pollution?
Check the air quality index forecast for the day and limit your activity if pollution levels are high. Avoid exercising along heavily traveled highways regardless of the overall forecast.
As individuals, we can play our part in reducing air pollution levels by trying to avoid creating more of it. Choosing ‘active travel’ options where possible, like walking and cycling, can help reduce pollution levels from transport and is also a great way to be more active, which is linked to a reduced risk of cancer and other diseases. If you wish to discuss about any specific problem, you can consult a oncologist and ask a free question.
Dear Doctor, I am 30 years old unmarried girl, doctor advised me do mammogram of both breasts as it was discharging fluid for some time, report is as follows- Few mammary ductules near nipple dilated and measured 2.3 mm in diameter. Axillary lymphadenopathy seen Breast mass at right breast is identified and measured 0.6 cm Breast Microcyst are identified in both breasts. Secretory tissues of both breasts in all quadrant appears normal and comparable to each other Fat lobules well formed and appears normal. No focal lesion seen Rectoareolar region appears normal No abnormal collection or calcification Underlying muscles and ribs appears normal No dilated ductiles are seen impression- Few dilated mammary ductiles seen in both breast. Secretory tissue and fatty tissues of both breast appears normal and comparable. Breast mass at right breast is identified and measured 0.6 cm Underlying muscles appears normal. Axillary lymphadenopathy seen. please advise.
3 Ways to practice safe sex
Deciding to have sex can be a big step for many in a relationship. It can be scary, nerve-wracking and at the same time enjoyable. Practicing safe sex ensures that you will be able to enjoy it more with your partner, being confident that you are protecting your body and health, and exploring your sexuality with a partner you trust. Here are 3 ways of having safe sex:
1. Staying safe against STDs
Visit a doctor regularly to get screened for HIV and other sexually transmitted diseases or infections. Go for the check up with your partner before entering a new relationship to be on the safe side, and also if you feel nervous. If your partner is not willing to practice safe sex, its best to try and counsel him/her on the importance of protection. Get vaccinated against HPV and HBV to reduce the risk of getting a STD.
2. Use latex condom
Use a latex condom while you have sex of any kind, including vaginal, anal or oral sex. Latex condoms are easy to use, efficient, cheap and widely available at all locations. Consistently and correctly using latex condoms during sex can reduce the risk of STD and pregnancy up to 99%. If your skin is allergic to latex condom you can use polyurethane condoms, which offer protection against STIs. Natural condoms are reliable against pregnancy but the material is not fine enough to ensure protection against STDs, making them less reliable for that purpose.
3. Consider using hormonal birth control
The hormonal contraception method regulates a woman’s fertility cycle to prevent pregnancy. The most common type of hormonal birth control is referred to as “pill” and is taken orally every day. If taken consistently and correctly, a pill is 99% effective when it comes to protection against unwanted pregnancies.
Hormonal patches and implants can also last for several weeks and are equally effective. Injections of estrogen and progestin can also be used. Vaginal hormone rings can also be worn during the month and removed during menstruation, offering 99% reliability.
My in law has been diagnosed with ductal carcinoma. Breast./stage. 1a. T1c NO Mx/luminal B.(. ERPR- POSITIVE/Her 2 neu-negative). How many chemotherapy sessions approximately may be needed for this condition. Will this condition may require radiation therapy?
With the modernization of all economies around the world, one health hazard that has become one of the largest perils within both developed and developing nations is the incidence of cancers of the female reproductive system, especially cervical and breast cancer.
Breast cancer is the formation of malignant tumors within the breast tissues of a woman. Usually, breast cancer affects women in the age range of 40 to 50, but there have been many reports of it occurring earlier. About 48 % percent of the Indian women having breast cancer have been reported to be under 50. This is an almost 17 percent jump compared to figures 25 years earlier.
Alarming Signs of Breast Cancer:
- The most common symptom of breast cancer is a new lump or mass. A painless, hard mass that has irregular edges is more likely to be cancerous, but breast cancers can be tender, soft, or rounded.
- Swelling of all or part of a breast (even if no distinct lump is felt)
- Skin irritation or dimpling
- Breast or nipple pain
- Nipple retraction (turning inward)
- Redness, scaliness, or thickening of the nipple or breast skin
- Nipple discharge (other than breast milk)
Screening Guidelines for Breast cancer:
- Mammography: US Preventive Services Task Force (USPSTF) recommends mammography once in every 2 year for females between age group 50-75 years. Women with a family history has a benefit of starting at age 40 years. After 75 years there are insufficient evidence of benefit of screening mammography.
- Breast Self Examination and annual Clinical examination: breast self examination is easy to learn and and any abnormality should be reported to the oncologist.
- For High Risk/ Genetic risk factors: screening should start by age 25 or 10 years earlier of youngest relative affected. Annual mammogram and MRI or Doppler ultrasound alternating at 6 month interval can be considered.
Some of the common treatment options for breast cancers are:
- Breast conservation surgery - This is where the tumors are removed without cutting out too much of the surrounding breast tissue.
- Mastectomy - If the cancer has spread too far then large amounts of breast tissue has to be removed along with the tumor to stop its spread any further.
- Sentinel lymph node Biopsy - it's part of both surgical procedures, it decreases morbidities of lymph node dissection first draining lymph nodes only are removed in patients with clinically negative axilla. If negative on frozen section further axillary dissection is avoided. It avoids the morbidity of complete axillary clearance.
Cervical cancer ( Carcinoma Cervix)
Cervical cancer is the cancer of the cervix, which is the opening of the uterus and connects the uterus to the vagina. Indian women in particular are susceptible to cervical cancer as more than 1/3rd of the cervical cancer related deaths in the entire world happens here in India, which is about 74000 deaths annually. The leading cause for cervical cancer is HPV or Human Papillomavirus infection, which if left untreated and unchecked will result in cancer.
Alarming Signs of Cervical Carcinoma:
- Early lesions and precancerous lesions have no symptoms
- Abnormal vaginal bleeding such as bleeding after vaginal intercourse, bleeding after menopause, bleeding and spotting between periods or longer/heavier periods
- Abnormal vaginal discharge
- Pelvic pain
- Late stage disease may cause lower extremity swelling, problem with urine and/or stool passage
- Cervical cancer screening is most effective screening programme of any cancer disease resulting in significant decrease in mortality from carcinoma cervix
- United state preventive services task force (USPSTF) recommend cervical cancer screening starting at age 21 yrs.
- Between age 21-30 years cytology recommended at 3 year interval and HPV testing is not recommended.
- Between 30-65 years cytology every 3 year or cytology +HPV testing every 5 year.
- If previously adequately screened screening can be discontinued after 65 years.
- Women with prior total hysterectomy and no CIN can discontinue screening.
Apart from breast and cervical cancers, certain other cancers have also reported an alarming increase such as:-
Ovarian cancer (Carcinoma Ovary)
Starting in the ovaries, diagnosis of this type of cancer is usually delayed due to lack of visible symptoms in the initial stages. About 85% to 90% of ovarian cancers are epithelial ovarian carcinomas. Epithelial ovarian cancers tend to spread to the lining and organs of the pelvis and abdomen (belly) first. This may lead to the buildup of fluid in the abdominal cavity (called ascites). As it advances, it may spread to the lung and liver, or, rarely, to the brain, bones, or skin. The main treatments for ovarian cancer are surgery and chemotherapy.
Cancer of the endometrium (Carcinoma Endometrium)
Endometrium is the lining of the uterine wall and has along with ovarian, uterine and cervical cancer is also increasing in occurrences throughout India and the world.
The grade of an endometrial cancer is based on how much the cancer forms glands that look similar to those found in normal, healthy endometrium.
- Grade 1 tumors have 95% or more of the cancerous tissue forming glands.
- Grade 2 tumors have between 50% and 94% of the cancerous tissue forming glands.
- Grade 3 tumors have less than half of the cancerous tissue forming glands. Grade 3 cancers tend to be aggressive and have a poorer outlook than lower-grade cancers.
Cervical cancer along with Ovarian, uterine and endometrial cancer can be treated using the following methods:
1. Surgery: Radical Hysterectomy primarily preferred option for early stage disease. Both open and minimal invasive approaches are suitable.
- For precancer high grade lesion conisation is also option for compliant patient.
- In young suitable patient willing for childbearing trachelectomy is also possible in very early lesion.
- Depending on risk factors after surgery adjuvant treatment may be advised.
2. Radiation therapy or Combined Radiation therapy+Chemotherapy: Alternative to surgery in early stage and choice in late stage.
Certain prevention techniques that would be advisable to detect cancer in its early stages would be,
- Regular Pap smear tests for cervical cancer
- Taking vaccines for cervical cancer
- Regular mammograms and checkups for breast cancer
- Changing lifestyles to reduce stress
- Changes in diet to reduce risks
- Leading a healthy lifestyle with regular exercise
Related Tip: Can Ayurveda Really Treat Cancer? Find Out.
- Worldwide colorectal cancer is second most common cancer of women and third most common cancer in men.
- More common with western lifestyle
- prognosis has improved over time
- Changes in bowel habits such as diarrhoea, constipation or narrowing of stools , that lasts for longer durations
- Rectal bleeding, dark colored stools
- Pain abdomen
- Fatigue/ pallor
- increasing constipation