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MRI SCAn report. There is a partial fusion of C5 C6 VERTEBRAL BODIES. C6 C7 BROAD BASED LEFT posture LATERAL DISC PROTRUSION is noted INDENTING the THECAL SAC CAUSING LEFT NEURAL forminal & impinging LEFT C7 Existing NERVE ROOT. What's the cure for this. Will physical therapy help?
I have slip disc l4, l5 Should I avoid carrying weights. More over what are the exercise I must follow?
I have a Acl tear in my left knee doctor advised for an operation should I go for it I am a athlete and 21 year old male.
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:
- Ectopic pregnancy
- Cervical or uterine infections
- Hormonal imbalances
- Problems with blood clotting
- 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. If you wish to discuss any specific problem, you can consult a gynaecologist.
I am 19 years old and I am having lower back pain (disc herniation l4-l5. I suffer pain everyday. What shall I do?
When the skin of a breast looks uneven, it is known as a dimpled skin. Sometimes the skin might appear to be red or inflamed. In this condition, the breast tissue gets affected and this can be a serious sign of concern for cancer. Moreover, this sign is hard to detect on your own. Usually when the sign occurs, it only occurs in one of the breasts. If a woman has it in both the breasts, then likely that it has not been caused by cancer.
Causes of breast cancer dimpling are as follows
1. Advanced breast cancer
2. Breast abscess: A hollow space in the breast that is filled with pus and is at times surrounded by an inflamed tissue.
3. Duct obstruction: The ducts that carry the milk from the nipple are obstructed causing rapid abnormal growth and functioning of the cells present in the breasts causing cancer.
4. Fat necrosis: In this condition, the neutral fats are split into glycerol and fatty acids because the adipose tissue tends to degenerate.
5. Inflammation: Inflammation in the fatty tissue of the breast
6. Mastitis: The breast tissue tends to swell up and get infected. This happens because of the bacteria that enter the breasts through the nipple and this may cause infection in the milk glands.
7. Genetic: Carrying the faulty gene is one of the main reasons why many women end up literally inheriting breast cancer. This can usually be tested with a mammography, especially if one has a history of breast cancer in the family. Yet, one must remember that it is not advisable to take this test too many times as it puts you at risk of contracting breast cancer even if you do not have it, when there is repeated exposure.
First, the doctor might perform certain tests to diagnose and determine the problem. Tests like an ultrasound, MRI or even a mammogram might be used. Depending on what the diagnoses is, the doctor might even want to perform a biopsy. In case breast cancer is diagnosed, there are certain treatments that are available. These include:
- Surgery: The cancerous tissue is removed from the breast or at times when the tissue is too big, the entire breast might have to be removed.
- Chemotherapy: Chemotherapy is a medication that uses a method to send fluids that tend to kill the cancerous cells or prevent them from growing. It is a three to four hour long session at times.
- Radiation: High beam x-rays are used in order to target and destroy the cancer cells present in the breasts.
- Hormonal therapy: In this treatment, the hormones that fuel the growth of cancerous cells are blocked either through medications or surgically. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
We have more than 200 bones in our body and each of them is susceptible to bone cancer. However, long bones in the arms and legs are most susceptible to this condition. Bone cancer can be primary or secondary. Primary bone cancer involves uncontrolled and abnormal cell division within the bones while secondary bone cancer refers to cancer that originated somewhere else in the body and later spread to the bones. While children and adults are equally at risk for primary bone cancer, adults and elderly people are more susceptible to secondary bone cancer. If diagnosed early enough, bone cancer can be treated and even cured with surgery, chemotherapy or radiation.
Hence it is essential to recognize the signs and symptoms of bone cancer. Here’s what you should look out for.
- Pain in Bones: Pain is one the primary symptoms of bone cancer. As the tumour grows larger, this pain can become more intense. In its early stages, the pain may be experienced as a dull ache inside the bone or the affected part of the body. It may also increase or decrease according to your activity level or may be experienced only at night. However, not all bone pains signify ‘cancer’ as this is also a symptom associated with osteoporosis.
- Swelling: In some cases, the abnormal growth of bone cells can result in the formation of a lump of mass that may be felt through the skin. In other cases, the affected area may also show signs of swelling.
- Breaking of the Bone: Cancer can weaken the bones and make them more brittle. This may make the bones more susceptible to fractures. A bone breaking in an area that has been painful or sore for a long period of time may be a sign of cancer. This is known as a pathologic fracture.
- Reduced Flexibility: If the tumour is located near a joint, it may affect the range of movements possible and make simple actions uncomfortable. For example, a tumour around the knee may make walking and climbing stairs a painful exercise.
Other symptoms to look out for are sudden and drastic weight loss, tiredness, excessive sweating at night, fever and difficulty breathing in case cancer has spread to other organs. Since many of these symptoms are common to other medical disorders, you should consult a doctor immediately if you notice any of them. A physical examination and a couple of tests along with a biopsy will be required to confirm a diagnosis of bone cancer.
What is Bone cancer?
Bone cancer is malignant tumour of the bones which can spread to lungs or other parts of the body. It may have arisen primarily from the bone itself (primary bone cancer) or more commonly, may have spread to the bones (secondary bone cancer) from cancer of some other body organ like Breast cancer, Prostate cancer etc.
Primary bone cancer usually occurs in growing children and young adolescents, whereas, secondary bone cancer usually occurs in older age group. Usually, the patient experiences pain in the affected area, which over the time, gets worse and continuous. There may also be swelling in the involved region. It can cause weakening of bones resulting in fracture. Some patients may attribute these symptoms to any prior antecedent trauma. Unintentional weight loss may also be seen. Sometimes, these patients are wrongly being treated for infection, thus delaying the correct treatment which may have a bearing on the final outcome.
How common is bone cancer?
Secondary bone cancer is the most common type of bone cancer with bone being the third most common site of cancer spread (metastasis) from other organs. However, primary bone cancers are rare accounting for less than 1% of all cancers.
Causes of bone cancer?
There are no known environmental or other hereditary factors which cause bone cancer, however, certain patients are at a greater risk for bone cancer which include:
- Patients who have received prior radiation therapy
- Patients with a history of Paget’s Disease
- Patients with hereditary retinoblastoma - a type of eye cancer that most commonly affects very young children
- Patients with Li-Fraumeni syndrome - a rare genetic condition
How is it diagnosed?
A patient suspected with bone cancer needs to be investigated thoroughly with blood tests, Xrays, MRI to look for local extent of disease. Since bone cancer can spread to lungs and other bones, staging of the disease is done either with whole body PET CT or a bone scan with CT Chest. Alongwith that, a biopsy (usually with a needle) is required to establish the diagnosis. It’s important to do biopsy from the correct site since wrong biopsy site can be detrimental in limb salvage and can result in amputation (cutting the limb). Therefore, it’s recommended that the biopsy should always be done by the surgeon (Orthopaedic Oncologist) who will be doing the final surgery for bone cancer.
Treatment of bone cancer is a multidisciplinary approach requiring an Orthopaedic Oncologist (Bone & Soft tissue tumour specialist), Medical Oncologist (Chemotherapy Specialist), Radiation Oncologist (Radiotherapy specialist) and Pathologist (Specialist in tissue diagnosis).
Usually in primary bone cancers, chemotherapy is given to the patient followed by surgery to remove the diseased bone which is further followed by adjuvant chemotherapy. Limb salvage surgery is possible nowadays for bone cancers in which the part of the bone involved with tumour is removed surgically (rather than cutting the whole limb) and the defect is reconstructed with artificial joint, thereby saving the limb. In some cases, the cancerous bone so removed is given very high dose of radiation so as to kill all the cancer cells and the sterilised bone so formed is fixed back to the parent bone with the help of plates and screws, a technique commonly called as Extra Corporeal Radiation Therapy (ECRT). In children, since the artificial joint will not grow as the child grows leading to unequal limb lengths over a period of time, the defect can be reconstructed with expandable joint which can be lengthened as the child grows which allows to maintain limb length equality at the time of skeletal maturity.
Is cure possible in bone cancer?
With the current chemotherapy regimes and advanced surgical technology, cure is possible in upto 70-75% patients with primary bone cancer. In patients with secondary bone cancer, cure can still be achieved depending upon the primary cancer and the extent of disease. In advanced cases also, a lot can be done to control the disease and give a quality of life to the patient.
Is it possible to prevent bone cancer?
Since the exact cause of bone cancer is not known, as of now it’s not possible to prevent bone cancer.
Whom to consult?
First chance is the best chance when it comes to curing bone cancers. So, it’s advisable to seek treatment from a trained Orthopaedic Oncologist when confronted with a bone cancer to achieve maximum beneficial outcome.
Herniated disks or bone spurs in the vertebrae of the neck may become the reason behind severe neck pain. They sometimes take too much space and compress the nerves branching out from the spinal cord.