Dr. Dinesh Singh

Cancer, be it in any part of the body, has an increased success rate of cure and survival, when it is diagnosed early. The same is true with uterine cancer, the most common form of female reproductive cancer. However, unfortunately, a limited section of the society is aware of the necessary information about this fatal disorder, which is incidentally treatable if caught at early stages. To help the cause, here is a brief note on what one should be aware of when it comes to uterine cancer.

What is uterine cancer?
Cancer which begins at the tissue lining of the uterus also referred to as the endometrium, is called uterine or endometrial cancer which occurs due to the abnormal growth of the cells that can invade the other parts of the body. Some people tend to confuse this with uterine sarcomas which start developing when there is cancer growth in the muscles and other supporting tissues in the uterus. Also, uterine sarcomas account for a small percentage of cancers in the uterus.

Who are at higher risk of being affected with uterine cancer?
It is presumed that post-menopausal women are at a higher risk of being affected by uterine cancer. The average women diagnosed with the disease is 60 years. It is very uncommon in women who are aged below 45 years, and the causes are not yet precisely known.

While menopausal and post-menopausal women are at a higher risk of developing uterine cancer, it is crucial to understand that women who don’t belong to any of the risk groups may also be diagnosed with the disease due to other factors such as obesity or hormone therapy for breast cancer.

What are the most common symptoms of uterine cancer?
Abnormal vaginal bleeding, which means bleeding after menopause or between periods, is the most common symptom of uterine cancer. Typically, the bleeding begins as a form of watery blood-streaked discharge that becomes bloodier with the passage of time.

Other signs and symptoms of uterine cancer include:

• Difficulty or painful sensation while passing urine
• Pain in the pelvic region
• Prolonged and heavy episodes of vaginal bleeding
• Thin and white vaginal discharge
• Unusual vaginal bleeding
• Feeling heaviness in the pelvic area

According to experts, a woman who undergoes any of these signs and symptoms should not ignore the condition and seek medical attention immediately. But it is important to note that these symptoms can indicate something more serious or less severe. You should always check with your doctor to know what’s bothering your body.

The good news is that endometrial or uterine cancer is treatable and there are several options for treatment when the diagnosis is made at an early stage. Treatment methods involve radiation therapy, chemotherapy, hormone therapy or surgical removal of the uterus depending on the particular scenario. To conclude, it can be said that being aware of the condition can help you in dealing with it. In case you have a concern or query you can always consult an expert & get answers to your questions!

Cancer occurs when there is an uncontrolled growth of cells in the body. Blood cancer affects three major components of the blood, namely white blood cells and marrow, the lymphocytes, and plasma. These are respectively known as leukemia, lymphoma, and myeloma. The most commonly affected are the white blood cells.

Symptoms for each of these types differ; the same have been listed below:

Leukemia: Leukemia can be acute or chronic. In acute cases, the symptoms are more pronounced than the chronic ones. If the white blood cells are affected, then it causes the following:

1. Shortness of breath
2. Anemia
3. Extreme tiredness and lack of energy
4. Profuse sweating
5. Increased susceptibility to infections
6. Profuse bleeding during menstruation in women
7. Swollen lymph nodes
8. Headache and blurring of vision
9. Bones and joint pain
10. Chills and night sweats

The acronym TEST helps remember the symptoms of leukemia – tiredness, excessive sweating, sore joints, and terrible cases of bleeding. As white blood cells are involved in fighting infections, these individuals are also prone to easily develop infections.

Lymphoma: A type of white blood cells, lymphocytes help in fighting infections. Excessive growth of these leads to enlarged lymph nodes, which is often painless. However, other typical symptoms include:

1. Severe coughing
2. Swollen lymph nodes which are often generalized
3. Severe weight loss, which is often unexplained
4. Fever
5. Sudden chills and night sweats
6. Extreme/severe fatigue, even with minimal activity
7. Abdominal fullness
8. Itching of the skin (again unexplained)

Myeloma: This form of cancer affects the plasma, which are responsible for carrying the blood cells throughout the body. Multiple myeloma is the most common cancer in this group, and this is generally a chronic condition. Symptoms are atypical and include:

1. Generalized weakness and fatigue
2. Increased incidence of infections
3. Shortness of breath
4. Chest pain
5. Pain in the back region
6. Kidney issues, which can be indicative to look for myeloma

When a patient presents with a combination of the above symptoms, a detailed history is very helpful to come to a sort of conclusion. The clinical findings are then corroborated with blood screening and tests which will help pin down the diagnosis.

There are about 130+ varieties of blood cancer, but the above three are the most common ones. Once suspected, it is very easy to diagnose blood cancer with blood tests. If a person has a family history, then they should watch out for early symptoms of blood cancer, and should immediately seek medical attention when in doubt. The most common form of therapy is chemotherapy as it is a generalized condition, and radiotherapy is more suitable for localized cancers.

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

The treatment options for bone cancer depends on the type of cancer one is suffering from, the general health of the patient, the stage of cancer and the general preference of the patient. Different treatment options are designed for different types of cancer, based on the diagnosis. Each treatment responds in a different way. An oncologist decides the treatment options considering all the factors mentioned above. For instance, some cancer is best suited to surgery, while some cancer needs radiotherapy or chemotherapy to curb them. In many cases, all three modes of treatment might be required to tackle the growth of the cancer cells.

Surgery:
The goal of surgery is to eradicate the cancer cells in totality along with some surrounding healthy tissues. This involves special techniques to remove a tumor in one piece. Following are the types of surgeries that are available:

1. Removing the cancer cells sparing the limb: At the very first sight, the surgeon tries to understand whether it is possible to separate cancer cells from the tissues and the nerves. If the same is possible, the surgeon tries to save the limb while getting rid of the cancer cells. For the sake of safety and to ensure that the surgery is effective, the surgeon removes some of the healthy bone from the body and may replace the same with tissue from other parts of the body. To achieve this, a doctor might seek the help from of a bone bank or use a special metal prosthesis.
2. Surgery that does not involve the limbs: If the bone cancer does not involve the legs and the arm, surgeons can remove the affected bone along with some healthy bone from the surrounding areas. Cancer of the ribs and the spine are good examples of this type.
3. Surgery that affects the limb: Bone cancer that has spread to a significant extent and is strategically located in such areas that it is very difficult to remove, requires amputation. While this form of treatment is being increasingly discouraged by the wider medical community, it still does exist. In such cases, patients are fitted with artificial limbs and trained to do their job without the use of natural limbs.

Chemotherapy:
This is a form of drug treatment that uses powerful chemicals to kill cancer cells throughout the body. This medication is mostly given through an IV and the medication kills whatever cancer cells it comes across. 

Radiation therapy:
Radiation therapy involves the use of special X-ray beams that have high power and can kill cancer cells. The patients are required to lie on a table, while a machine moves around the affected area and treats it with high energy X-rays, thereby killing the cancer cells. Radiation therapy is often used in conjunction with chemotherapy to reduce the size of a tumor before operating on it. Also, Brachytherapy is another kind of radiotherapy in which plastic tubes for introducing radioactive sources are placed over tutor bed during surgery, later it is connected with brachytherapy machine to give extra high dose to tutor bed to improve cure rates.

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

In the past, cancer was a disease that could not be cured. It was a threat to mankind. But as science has developed tremendously through all these years, today it is possible to fight cancer.
Cancer therapies have evolved with time. Until the late 90s, most of the drugs worked by killing the cancer cells. Some of the normal cells were also killed by them, but it was acceptable due to the huge effect on cancer cells.

In modern days, targeted therapies are being performed. Targeted therapy is a process of cancer treatment where instead of the cancer cells, the changes in the cells are targeted. Changes that help the cells grow, divide and thus spread cancer have been observed and so researchers can diagnose the right treatment that can block these affects and prevent cancer. This therapy uses drugs and it is different from traditional chemotherapy.

There are two types of Targeted therapy.

• Small-molecule drugs: These drugs are small so that they can enter cells easily and target the changes inside the cells. They are taken as pills. They work by keeping the tissue around the tumor and starve it by stopping blood vessels that bring it nutrients.
• Monoclonal antibodies: These are used to target the outer surface of cancer cells. They work like a plastic plug in an electric socket. They help chemotherapy and radiation therapy to cure cancer cells.

Targeted therapies are used in the fields below

• Breast cancer
• Lung cancer
• Colorectal cancer
• Melanoma
• Kidney cancers

How It Works:
Targeted therapy can be used as a treatment option for cancer in the following ways:

1. Destroy cancer cells: Cancer cells hide well from the immune system. This therapy points them out so that the immune system can destroy them. It also boosts the immune system to work better.
2. Stop cancer cells growth: This therapy interferes with the proteins that divides the cancer cells and thus controls their growth.
3. Kill the tumor: Blood vessels feed the cancer tumor. This therapy surrounds the tumor and stops the blood supply so that the tumor does not grow and remains small. And if the tumor already has blood supply, then it kills the blood vessels and causes the tumor to shrink.
4. Deliver cell-killing substances: It delivers the cell-killing substances to the cancer cells. They are the monoclonal antibodies that are combined with chemotherapy drugs, toxins and radiation.
5. Cause cancer cell death: Cancer cells avoid the dying process. These therapies cause them to go through the process.

Side Effects:
Targeted therapies are less toxic than standard chemotherapy. So it is a better option but it still has some side effects.

1. Diarrhea
2. Liver problems
3. Skin problems
4. Problems with wound healing
5. Difficulty with blood clotting
6. High blood pressure
7. Gastrointestinal perforation

Even though it has some side effects, it is still way better and much more effective than traditional chemotherapy. So, cancer patients are advised to go through this modern-day therapy.

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

Cancer in colon forms due to uncontrolled cell growth in the large intestine cells. Most colon cancers originate from the healthy cells in the lining of the colon that grow into tumors called adenomatous polyps. These polyps can be cancerous or benign. A cancerous tumor is malignant and may spread to the other parts of the body by traveling through blood and lymph systems, this process is known as metastasis. Whereas a benign tumor can grow but don’t necessarily spread to other parts of the body. It takes years for these changes to develop depending upon both genetic and environmental causes.

Causes and risk factors:
In a healthy body, the cells normally grow, divide and then die. Cancer is the result of uncontrollable cell growth where the cells do not die. Aging is one of the important risk factors for colon cancer; other risk factors include a family history of colon cancer. As per Johns LE and Houlston RS individuals with a family history of colon cancer have a high risk of developing this form of cancer as compared to those with no such history. A study conducted by Giovannucci and others in 1995, successfully established the relation between physical activity, obesity and colon cancer. As per the research lack of physical activities elevates the chance of getting colon cancer. Individuals who regularly smoke, are obese and use aspirin have a higher risk of developing this form of cancer. Diet is also an important factor, diets that are high in fat and low in fiber may elevate the risk.

Symptoms:
The symptoms of colon cancer vary, depending upon the condition of the tumor. At the early stage, patients may experience no symptoms. However, as cancer grows, symptoms arise.

Diarrhea or constipation are common and patients may see changes in stool consistency and narrower stool.

• Abdominal discomfort
• Bloating
• Fullness and cramps may also indicate colon cancer.
• Sudden weight loss
• Unexplained iron deficiency (anemia) are also associated with this form of cancer.

If these symptoms last for several weeks, don’t hesitate to consult your physician.

Treatment:

• Colon cancer is highly treatable and depends on the type and the stage of cancer along with health and other characteristics of the patient. However, there is no single treatment; the most common options are surgery, chemotherapy and radiation therapy.
• The surgery for colon cancer is known as colectomy and involves removing the affected part of the colon and the adjoining areas including nearby lymph nodes.
• Chemotherapy involves killing the cancer cells by utilizing certain chemicals that interfere the cell division process and damage the proteins or DNA. In the radiation therapy, high-energy gamma rays are used to target and destroy the cancer cells. Radiotherapy can be used both as a standalone treatment and also along with other treatments.

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

Minimally invasive surgery or laparoscopic surgery is increasingly becoming popular in all fields of surgery including gynecological oncology. Given its many advantages, it is easy to see why people prefer this form of surgery. The use of laparoscopy in the field of gynecological oncology began in the late 1980s. The first laparoscopic-assisted hysterectomy was performed in 1989.

Laparoscopy and Endometrial Cancer
The endometrium refers to the lining of the uterus. Endometrial cancer is rare are usually affect women over the age of 55 years. A hysterectomy is one of the forms of treatment for this condition. If detected in its early stages, this hysterectomy may be performed laparoscopically. As compared to traditional surgery, this reduces the hospital stay required and is associated with fewer postoperative complications. Laparoscopy may also be used to restage patients who have already undergone a hysterectomy.

Laparoscopy and Cervical Cancer
The lowermost part of the uterus is known as the cervix. A pap smear can help in the early detection of cervical cancer. This can be treated surgically in the form of a lymphadenectomy or a radical hysterectomy. One of the factors crucial to the management of this type of cancer is an evaluation of the lymph nodes. This is where laparoscopy is very useful. As in the case of endometrial cancer, laparoscopy may also be used for a hysterectomy procedure. A laparoscopic lymphadenectomy may also be performed to investigate the extent to which the cancer has spread. Advanced stages of cervical cancer can be treated with chemotherapy and radiation. In such cases, the role of laparoscopy may be limited to staging the patient before treatment.

Laparoscopy and Adnexal Masses
Adnexal masses refer to ovarian abnormalities and development of masses in the fallopian tubes, uterus and other organs in the pelvic cavity. Laparoscopy is routinely used to treat benign Adnexal masses. It can also be used in the management of malignant adnexal masses. However, its role is less clearly defined in such cases. When using laparoscopic procedures to address adnexal masses, it is important to identify benign masses beforehand.

Laparoscopy and Uterine Cancer
Laparoscopy can be used in a number of ways when it comes to the management and treatment of uterine cancer. These include staging apparent early stage cancer, determining the extent of the disease and resectability potential and to reassess a patient in cases of recurrent cancer. A hand assisted laparoscopy may also be used to resect the disease in some cases. 

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

Chemotherapy can be frightening, and the very thought of going through it can be an ordeal for most people. Many resources and tips can be used to minimize the discomfort and lessen the burden. Let us have a look at a few of these.

1. Support network: Chemotherapy can be physically daunting and more than the treatment a person needs all the emotional and moral support he/she can get. Have friends and family always by your side. You can have peace of mind when there is a person you can trust and bank upon in taking care of you.
2. Discuss the medication with your oncologist: Before understanding the treatments have a detailed discussion about the current medication you are undergoing, as this may hamper the chemotherapy treatment. The dosage has to be adjusted accordingly.
3. Keep the body hydrated: Your body gets dehydrated on the day of the treatment. Please ensure that the body is properly hydrated and plenty of fluids are there in the body.
4. Be comfortable: Taking chemotherapy can have an effect on your morale. Hence make sure that you are keeping yourself occupied with books and games or your favorite music to while away the time.
5. Wear comfortable clothes: This makes all the difference in the treatment as having loose fitting clothes can relive pressures in your mind. Always choose clothes that you are comfortable in.
6. Ask questions: Chemotherapy treatments can and will cause side effects. Hence ask and keep yourself updated as much as possible. More importantly after the treatment ask questions on the possible recuperation period and how best to go about it.
7. Symptoms of nausea and vomiting: It is natural that most of the patients feel light headed or have a vomiting sensation when undergoing the treatment. Always make sure that the doctor or the nurse knows about it. Make yourself as comfortable as possible. Some medications to prevent nausea can be had along with the chemotherapy drugs.
8. Avoiding infection: Chemotherapy affects the immune system of the body. Hence it can get easily susceptible to diseases. Have a general cleanliness around your surroundings. Avoid crowds if possible and keep your hands always clean and wear clean, comfortable clothes that don't stick to the body.
9. Right diet: Chemotherapy makes you prone to weight loss. Hence having the desired nutritional levels is mandatory. Consult a dietician and eat healthy. It is not advisable to gain weight either during or after chemotherapy.
10. Adequate Rest: Our body needs all the rest that it can get when undergoing chemotherapy. Make sure that the body gets proper sleep and is relaxed. You can try for meditation and simple yoga exercises that can help in rejuvenating the body.
11. Skin Care: Prolonged treatment can affect the moisture content in the skin. Have a good skin cream and lotions handy to take care of it. In some cases, chemotherapy causes hair fall. Make sure that a proper wig or a treatment plan is made beforehand to take care of the issues.

Chemotherapy treatment can be emotionally daunting. Having a few precautions like the ones stated above can make all the difference in how successful we are in coping with it.

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

Good morning, I am Dr Dinesh Singh I am the director of radiation oncology at Max hospital Vaishali. Today we are going to discuss about the lung cancer, what is lung cancer, how it happens and what a person should do when a lung cancer is diagnosed. Lung cancer is cancer which is developing in the lungs or into the channels of the respiration in the lungs. Majority of patients who have lung cancer they are smokers or alcoholics or then 80 to 90% of them and what happens the tobacco smoke it contains carcinogenic, which promotes cancer. Now it is like we are living in Delhi, Delhi is one of the most polluted cities in the world and the pollution it acts on to the damage which is done by the smoking and the alcohol. So one should totally abstain from the smoking either active or passive smoking, passive smoking is when someone else is smoking sitting with us in the same environment, in the same room, in the same vehicle or into the same compartment so that has to be avoided in totality. The commonest symptom of the lung cancer is a cough, normal khansi jo hoti hai, the patient starts coughing and it doesn't go away even after 2 to 3 weeks have passed. So any a cough which is persisting for more than 2 to 3 weeks it has to be investigated, the first investigation is chest X-Ray and if you suspect on that you can go for CT Scan of the chest or we go for a Bronchoscopic evaluation. When we see that there is an audio or there is an abnormality we have to go for a biopsy of that region either endobronchealy, bronchoscopically or CT guided biopsy is done and after that, once we confirm that it is lung cancer. Next step is to find out where all it has spread for that we do various investigation like PET-CT Scan is one investigation in which we examine from head to toe the entire body is screened and it will tell us which all areas cancer might have spread or we can go for CT Scan of the Thorax, abdomen and the neck to find out, if lung cancer is localised, if it is in the early stage to get operated then we have to go for surgery of the lung cancer and those patients of lung cancer who are able to undergo surgery they are in the curable stage. Another alternative treatment which has been tried and proved is giving a stereotactic radiotherapy to these patients. There was a study done in America which are shown that this stereotactic radiation in the same result as the operation or this surgery of the lung. In little-advanced stages we have to go for radiotherapy along with current chemotherapy this statement last for above 4 to 6 weeks and give good results and in those patients get cancer has spread even beyond that, those patients we go for chemotherapy treatment and if cancer has spread to the brain or to the bones then in these cases we go for radiotherapy of the patient. So I would say we have to avoid smoking and alcohol in totality, we have to do our bit to control pollution in our city, in our surroundings whenever you see any person burning leaves or any garbage we have to go and stop that person, we have to douse the fire and control that pollution so that we are able to contribute, diesel vehicles are polluting we should try to avoid using diesel vehicles and especially young children, school going they are very vulnerable for the diesel exhaust of the vehicles, they should be protected and when we get any symptoms like a cough or any other problem in those cases we have to take proper care proper investigation and proper treatment. Thank you.

Good morning, I am Dr Dinesh Singh I am director of Radiation Oncology at Max Hospital, Vaishali. Today we are going to discuss about cancer, the cancer is a group of about 100 disease different diseases and it is basically the cells they start developing, multiplying and then they do not stop first they grow locally and there and then they spread out to different parts and what are the different symptoms of the cancers, well it depends upon which part of the body the cancer is developing like we are discussing about the brain tumors that the patient might have difficulty in vision, he may be having headache, he may be having vomiting or he may be having fits. Then to further investigate we need do a contrast study of the MRI then we diagnosed and then we keep recording it. For head and neck cancers like they can wear ulcer or a soar which doesn't heal, there can be a change in the voice the person might have difficulty in swallowing or so these are the early symptoms of cancers originating into the head and neck area. Then we further investigate we take a biopsy and then we diagnose the patient. For breast cancer, the earliest symptoms is a painless lump usually in Cancer in early stages pain is not there, so whenever there is a lump in a breast it should be investigated to allowed cancer. More than 90% of the lump in the breast on cancerous but it should be evaluated and cure, when we come to the lung cancer the common symptom is a mild cough. So any cough which is not getting the cure for more than two weeks it should be taken seriously it can be tuberculosis, it can be cancerous, so it has to be evaluated and investigative. Talking about the GI cancers of the intestinal cancers, well it present like indigestion or the patient is not getting well some might discomfort in the abdomen. So any problem persisting more than 2 weeks should be investigated by ultrasound, by endoscopy and then we do it. Carcinoma of the rectum and anal canal usually present with a bleeding associated with the stools or without stool should not be confused with the piles because they have the same presentation. So any problem persisting for more than 2 weeks is the thumb rule has to be investigated diagnosed and they have to be treated. Once we see that there is a problem then what we do we have to do an investigation and the first investigation is the biopsy many times a general people they have a false notion that if a biopsy is done then cancer will spread, well it is absolutely wrong. The biopsy is a must and it does not spread cancer. Thank you.