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Breast cancer begins when cells in the breast(s) start to grow out of control. It is understood as being the most common cancer, seen predominantly in females, globally. It is reasonably treatable and often curable.
1. Type: Adenocarcinomas constitute more than 95% of breast cancers with infiltrating ductal carcinoma (IDC) being the most common form of invasive breast cancer.
Frequently occurring breast cancers present as one of the following types mainly
1. Ductal Carcinoma In Situ (DCIS): Is the most common type of non-invasive breast cancer and is confined to the milk ducts of the breast. There is no invasion in the basement membrane. Pure DCIS metastasizes rarely. Non comedo cribrioform carcinoma is the most common DCIS found which, when compared to the comedo type, is mostly non-aggressive.
2. Infiltrating Ductal Carcinoma (IDC): Represents majority (about 3/4th) of the breast cancers, and is known to metastasize commonly to bones, lungs and liver.
3. Lobular Carcinoma In Situ (LCIS): Develops in multiple lobules of the breast (bilaterally). LCIS is less commonly seen, compared to DCIS.
4. Infiltrating Lobular Carcinoma (ILC): Represent about a tenth of all breast cancers and tends to metastasize to other regions of the body.
Less commonly occurring breast cancers such as
5. Inflammatory Breast Cancer: Is relatively uncommon and are caused probably owing to viral infections. The breast is warm, red and swollen.
6. Paget’s disease of the nipple: Is a rare form of breast cancer. It begins in the milk ducts and spreads to the nipple and areola.
7. Medullary Carcinoma
8. Mutinous Carcinoma
9. Tubular Carcinoma
10. Phylloides tumor etc all.
2. Gender: Affects the female populace predominantly. However, a small percentage of breast cancer is attributable to the male populace as well.
3. Etiology: No definite cause is known. However, diet, lifestyle, environment, hormonal/ reproductive factors, personal or family history of breast cancer especially in first degree relatives and also any benign breast disease history etc all are known to increase the risk of breast cancers. Specifically, excessive fatty diet, obesity, type 2 diabetes mellitus, benign breast disease, heredity/ inheritance of mutated breast cancer genes 1 (BRCA1) and 2 (BRCA2), smoking, alcohol intake, infertility, estrogen therapy/ hormone replacement therapy (long term) in post menopausal women, delayed age at first pregnancy, nulliparity (not having child), early menstruation, delayed onset of menopause, lactating mothers not breast feeding, exposure to ionizing radiation, sedentary lifestyle, depression, exposure to MMTV virus etc all can potentially increase the risk for breast cancer.
4. Features: Signs & symptoms, of breast cancer, manifest majorly in the following ways
Lump/ nodule in the breast that gets attached to the skin of the breast over time. The lump / nodule could be hard and painless with irregular edges or it could also be soft, rounded, tender and painful.
Enlarged lymph nodes in the axilla which are palpable.
Swelling of whole or a part of a breast. This is even if there is no distinct lump felt.
Retraction or thickening of the nipple(s).
Pain in the breast or nipple.
Discharge from nipple other than breast milk.
Irritation/ scaliness of skin over the breast.
Redness of nipples
Rarely, red, swollen and tender breast.
5. Screening: Is generally recommended for asymptomatic populations goal of which, as usual, is to be able to detect & diagnose breast cancer at an early stage which is potentially curable. It is mostly radiologic with mammography/ USG being instrumental in raising suspicions for further diagnostics (i.e. biopsy) that help detect breast cancer, if any, early.
6. Diagnosis: A self-examination/ clinical exam of the breast(s)/ axilla that reveals a palpable mass prompts the following diagnostics. Abnormal blood test results may be indicative of malignancy, but a follow up imaging/ biopsy is always the gold standard for accurate diagnosis.
- Blood: ER/ PR/ HER2/neu, uPA, PAI-1, CA15-3, CA27.29 etc all tumor markers are helpful.
- Imaging: Mammography/ USG Scan usually, as relevant. Again, CT Scan of abdomen & pelvis and chest, PET CT scan, bone scan etc all help detect metastasis, if any, for cancers in stage III & above.
- Biopsy: either excisional, incisional, fine needle aspiration (FNA) or core biopsy technique, as contextually appropriate, is frequently employed and a histopathological examination (HPE) thereof clinches the diagnosis and the nature of the disease.
7. Treatment: Conventional treatment includes surgery, radiotherapy, hormone therapy/ chemotherapy as deems appropriate. Simultaneously, an adjunctive or integrative naturopathic treatment with suitable complementary & alternative medicines (CAM) too can help improve clinical outcomes and facilitate recovery as would be feasible contextually.
8. Prognosis: Preventive measures, earlier diagnosis and right early treatment is key for an effective therapeutic management & better prognosis. Like most other cancers, the chances of cure for an early stage breast cancer are more. The cure/ recovery chances are influenced by the type, grade, stage of cancer, recurrence and the patient’s general health & vitality etc all. Above-mentioned apart, age, menopause status, lymph node status, ER/ PR/ HER-2/ neu status, size & extent of breast cancer etc all also influence the treatment outlook in breast cancer. The five year survival rate is strongly correlated with the stage of breast cancer.
9. Prevention: Rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an increased focus on protective factors and avoidance of the risk factors can be of help. 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 reducing the risks of breast 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. Limiting dosage/ duration of hormone therapy, if any, especially to counteract post menopausal symptoms and also avoiding exposure to radiation and environmental pollution can help reduce the risks of breast cancer. Apart from the above-mentioned, for high risk cases, a prophylactic oophorectomy, prophylactic radical mastectomy, long term hormone therapy etc all can help reduce the chances/ risks of developing breast cancer significantly. Breastfeeding is known to confer protection against breast cancer risk too.
Hi sir my mother 72 year old she is suffering slip disk problem mri report conclusion/impression- Mr. Imaging reveal degenerative changes affecting lumbar spine with disc bulge-herniation at l1-2, l3-4, l4-5 and l5-si levels, more at l2-3, l3-4, l4-5 and l4-s1 level (protrusion), together with ligamentum flavum hypertrophy and facetal arthropathy are producing secondary canal stenosis with narrowing of bilateral neural foraming. Canal stenosis is most sever at l4-5 level.
My dad had arteries blockage which TVD (triple vessel disease) all 3 arteries are blocked 2 major and one minor doctors are suggesting for by pass surgery however I am afraid of that is there any treatment or cure for this? So that he be well soon.
Breast Cancer - What exactly is it?
‘Breast cancer’ is a term that is used to refer to a malignant tumour, which has developed from cells present in the breast. Generally, all tumours can be divided into two categories i.e. benign and malignant and it is the malignant tumour that is responsible for causing cancer. Breast cancer generally originates in the cells the milk producing glands of the breast's or the passage, which carries milk from the glands to the lobules. Additionally, breast cancer can also originate in the stromal tissues, including the fibrous and fatty connective breast tissues.
Breast Cancer: Treatment Options
Treatment for breast cancer depends upon two things: the exact type of the cancer and how advanced the cancer is. Treatment options for breast cancer can thus be broadly divided into two categories as Local treatments and Systemic treatments.
Treatments that target the tumour without having any effect on the rest of the body are called local treatments. The following types of local treatment options are available for treating breast cancer:
- Surgery: Surgical breast cancer treatment involves removal of the malignant cancerous tumour in an operation. Smaller tumours can be removed using a surgical process referred to as ‘lumpectomy’, wherein the tumour along with a small amount of healthy tissue surrounding the tumour is removed. For larger tumours, removal of the entire breast becomes mandatory, in a surgical process known as ‘mastectomy’. Women who undergo mastectomy can choose to undergo reconstructive plastic surgery for reconstruction of the removed breast(s).
- Radiation Therapy: This basically involves using radiation to kill cancer cells present in the body. Radiation therapy is a long-drawn process that usually involves a set number of treatments administered over a long period of time. Radiation therapy is also generally the follow-up procedure after a lumpectomy, or more rarely, a mastectomy.
Treatments involving drugs that are administered via either the mouth or direct injection into the bloodstream are called systemic treatments. These include:
- Chemotherapy: This includes using drugs to destroy the cancer cells present in the body by stopping the cancer cells from growing and dividing. Chemotherapy can be administered using either an IV (intravenous) tube or via pills that can be swallowed.
- Hormone Therapy: This treatment option is used for treating tumours which have tested positive for progesterone or oestrogen receptors. Blocking hormones that fuel the tumour’s growth is the basis of this therapy.
- Targeted Therapy: This targets specific proteins and genes which contribute to growth and survival of the cancer cells. Targeted therapy is an extremely focused treatment, and is very effective in blocking the growth and division of cancer cells, as well as minimizing damage to surrounding healthy cells.
Bone cancer is a cancerous tumour in the bone, destroying the normal bone tissues. Tumours on bone tissues are not always cancerous or malignant, they are mostly benign. Primary bone cancer is when the malignant tumour begins to form in the tissues of the bones, but when these cancerous cells spread to other body parts like breasts, prostate or lungs, it is called metastatic cancer. Primary bone cancer is less common than metastatic cancer.
Bone cancer can be of three different types:
Osteosarcoma: In this case, the malignant tumour arises from the osteoid bone tissue. This occurs mainly in the upper arm and knee areas.
Chondrosarcoma: In this case the cancerous cells form in the cartilaginous tissues, causing a lot of pain. This occurs mostly in the pelvic area.
The Ewing sarcoma generally arises in the bone but it can also form in the soft tissues. Other kinds of soft tissues affecting cancerous cells are known as soft tissue sarcomas.
There aren’t many clear defined causes; however, several factors have been identified by researchers.
Osteosarcoma is seen to occur more frequently in people who have been through a high external radiation therapy dose.
In people who have frequently been treated with anticancer medications, children tend to be most affected.
Heredity may be an adding cause, although the percentage of hereditary transfer of cancer cells is very low.
People with hereditary bone defects or implants have a higher chance of acquiring bone cancer.
The most common and saddening symptom of bone cancer is painful, although not all bone cancers cause pain. Unusual or persistent swelling or pain around a bone maybe a red flag for bone cancer. In case of a situation like this, immediate doctor’s opinion is required.
Usually, diagnosis of a bone cancer can be made using X-rays; for example, a bone scan, a computed tomography scan, a magnetic imaging procedure—positron emission tomography, and an angiogram. Biopsy and blood tests are also helpful in bone cancer diagnosis.
The size, location and stage of cancer, age, and health of the person decide the kind of treatment that should be given to the patient. Various treatment options include chemotherapy, radiation therapy and cryosurgery.
The combined survival rate of all sorts of bone cancers is 70%. This percentage may vary with the type of bone cancer and also its stage.
I am a male aged 52 yrs. I have slip disc problem because of which my left hand becomes senseless as soon as I do some work with it. This problem is there for past 8- 10 yrs. I also have severe back pain from time to time. Please suggest remedy, if any.
Lung cancer occurs at slightly younger age in women than in men. Adenocarcinoma is the commonest type of lung cancer in women. It warrants testing for some molecular markers which form the basis of targeted therapies. Thus lung cancer in women behaves biologically and clinically different from that in men
Women should take care of their health, stay away from tobacco and think positive
Breast cancer(स्तन कैंसर) is on the rise in india. Surveys show that every 4 out of 5 Indian women who have breast cancer, suffer from an advanced stage of the disease by the time they reach the doctor. Urban women are at two times more risk of being diagnosed with breast cancer than rural women. Being overweight, eating unhealthy food, and consuming excessive alcohol or tobacco are some of causes that can make you susceptible to this disease.
How you can avoid breast cancer?
- Every woman should do a self-breast examination every month after the periods. You should check for any abnormal lump, change in skin texture or any abnormal discharge from the nipples. Any abnormality above aspects should be promptly investigated by a doctor's appointment, and an ultrasound or Mammography, as required.
- Apart from self-examining your breasts every month for a lump, going for a mammography (an X-Ray of the breast) is vital for early detection of the problem.
- Consult a gynaecologist before going for the test as its frequency depends on your age and risk factor. About 80-90% of tumours can be traced through this screening.
Breast cancer may run in family. If there is no family history of breast cancer, you start doing mammogram at 40 yrs of age but if there is a family history you start even earlier as advised by your gynaecologist.
I have a herniated disk (bulged disk/slip disk) at c7 and the c7 nerve is compressed for last 2 months. Do you have treatment in ayurveda ?
I am 19 years old and I am having lower back pain (disc herniation l4-l5. I suffer pain everyday. What shall I do?
MRI IMPRESSION 29 August 2016 -Posterior diffuse disc herniation at L4 -5 level with bilateral ligamentum flavum hypertrophy causing narrowing of bilateral neural recesses with compression of bilateral traversing nerve roots at same level. -Posterior diffuse disc bulge at L5-S1 level indenting ventral thecal space at same level -Changes of lumbar spondylosis I was having pain at my right hip joint on 15/8/16. It went unbearable extending to RT leg. On 3rd September night as usual on bed all the 24 hours trying to sleep on 4th at 5 am all my pain went. Till then no pain but having burning sensation on right foot, tingling, falling rt foot asleep when I sit on chair. Please advise:- 1. Surgical intervention required? Or 2.Pregabalin,Tolperisone, methylcobalamin,Calcium and D3 with rest will cure me fully? Or 3. Somekind of spinal exercises also required? ERODHA.
Sir I am 62 l have got disc prolapse of my spine spine. Backpain- radiated toy right leg causing severe pain please give remedy.
L4-l5 and l5-s1 between disk problems years-44-women. Please give advise operation after disk moving
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 ovaries
- 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.