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What are the alternatives to avoid surgery for my brother aged 47 identified with Listhesis with foot drop and disc extrusion. In fact I had disc bulge (L3 L4 L5) at the age of 41 in 2013 and took oil massage in Kerala for 15 days and I am doing good now.
Are you experiencing excessive uterine bleeding? Excessive uterine bleeding may occur between a woman’s periods or before the periods, after having sex, or due to the development of spotting or bleeding after attaining menopause. Any menstrual cycle, which lasts longer than 21–35 days is called excessive, and this is an abnormal form of uterine bleeding.
Causes of Excessive Uterine Bleeding:
The various causes of excessive uterine bleeding are as follows:
One of the main causes is hormonal imbalance, as the balance between estrogen and progesterone gets disrupted. This balance is required for the regulation and development of the lining of endometrium or uterus lining. Because of the hormonal imbalance, the endometrium develops excessively causing heavy bleeding.
Uterine fibroids, which are non cancerous tumours, may lead to prolonged and excessive uterine bleeding.
Polyps are small benign developments on the uterus lining which cause heavy bleeding. They occur because of high levels of hormones.
Adenomyosis is a condition which develops when the endometrium glands get embedded in the uterine muscle, leading to excessive uterine bleeding.
Using intrauterine devices or IUDs may cause side effects as well.
Several uterine cancers, ovarian cancers and cervical conditions may be responsible as well. Inherited bleeding disorders such as von Willebrand’s disease is another likely cause.
Several medicines and drugs, including NSAIDs and anticoagulants are a common cause.
There are different ways of treating excessive uterine bleeding, depending upon the cause of bleeding and the patient’s age.
Medications: Several medicines are used for the treatment of abnormal uterine bleeding. Hormonal medicines and birth control pills are used to improve the regularity of periods. Non steroidal anti-inflammatory drugs are also used to manage excessive uterine bleeding. Several antibiotics are also used.
Surgery: In many cases, a woman has to undergo a surgery for the removal of polyps and fibroids, which cause excessive bleeding. Certain fibroids are removed via hysteroscopy and other techniques for treatment are used as well. Endometrial ablation can be carried out to manage the bleeding. This treatment aims at permanent reduction of the excess bleeding. Hysterectomy has to be carried out when other treatments are unsuccessful. This is a serious surgery and after it, a woman will no longer have periods, and she will not be able to conceive a child.
In case of excessive uterine bleeding, you must consult a doctor as soon as possible. This will enable early treatment and prevent the development of further complications.
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.
- 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. In case you have a concern or query you can always consult an expert & get answers to your questions!
The symptoms caused due to herniated disc can be very severe and can also cause a bit of disability. The disc of the spine is like a cushion and separates the set of bones on the backside. The discs are shock absorbers of the spine and are mainly composed of 2 parts, a soft jelly-like centre called the nucleus and a tough outer covering called the annulus.
Effects of Herniated Disk
A herniated or cracked disc is a severe condition and it seems to happen most commonly in the lower back or neck. It happens when a fraction of the soft centre gets pushed through the destabilized area due to degeneration, trauma or by putting pressure on the spinal column.
Nerves located at the back of every disc are responsible for transmitting pain, motor impulse, bladder control etc. in our body. While a disc gets herniated, the external covering of the disc tears and creates a bulge. The soft jelly gets shifted from the centre of the disk to the region where the damage has occurred on the disc. Most commonly, the bulge occurs in areas where the nerve is located and it causes strain and irritation of the affected nerve. It has been observed that individuals may or may not feel any painful sensations even if their disc gets damaged. Other symptoms may be weakness of muscle groups or difficulty in controlling the bladder.
When is surgery recommended for herniated disc?
Surgery for herniated disc is recommended only after options like rest and pain relievers do not work. If the pain persists even after these options, then it becomes important to go for surgery. Surgery is also considered early if there is weakness of muscle groups or acute problem in bladder control. At times, emergency surgery is also required to avoid paralysis in a patient.
However, there are certain risks involved in this surgery like infection, bleeding or nerve damage. There are chances that the leftover disc may bulge out again. If you are a patient suffering from degenerative disc disease, then there are chances that problem occurs in other discs. It is very important that a patient maintains healthy weight to prevent any further complications.
The main factor that increases the risk of herniated disc is excess body weight, which causes a lot of stress on the lower back. A few people become heir to a tendency of developing this condition. Even individuals with physically demanding jobs are prone to this condition.
Activities like bending sideways, pushing, twisting, repetitive lifting can increase the risk of a herniated disk. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.
Breast cancer is a form of cancer which develops from the breast tissue. Breast cancer is indicated by signs such as a lump in the breast, changes in breast shape, fluid flowing from the nipple, dimpling of skin, or the development of red scaly patches. Breast cancer is a fatal form of cancer in women and immediate diagnosis is required on observing the symptoms.
Diagnosis of breast cancer
Other than the regular breast screening, the diagnosis of breast cancer involves the following steps and methods:
- Seeing your general practitioner (GP): It is very important to visit your GP soon after noticing the symptoms of breast cancer. Your GP will examine you properly and in case your symptoms need more assessment, he/she will refer you to a breast cancer clinic.
- Mammogram and breast ultrasound: You will be required to have a mammogram, as recommended by a specialist breast unit. This is an X-ray of the breasts. An ultrasound scan may also be required. Breast ultrasound should be undertaken only if you are less than 35 years of age. This is because, young women have denser breasts and a mammogram is not as effective as ultrasound in the diagnosis of breast cancer. In ultrasound, high frequency sound waves are used for obtaining an image of your breasts. It is observed to notice any abnormality or lumps. A breast ultrasound is also important for determining whether a lump is solid or contains liquid.
- Biopsy: In this diagnosis process, a sample of the tissue cells is taken from the breasts and tested under a microscope to find out if it is cancerous. A scan and needle test for the lymph nodes present in your armpit is also done to check whether they have also been affected. A biopsy is undertaken in several ways, depending upon the condition and severity. A needle aspiration biopsy is used for testing a sample of your breast cells without the removal of the tissues. This is the most common form of biopsy and it is also used for draining a small fluid-filled lump or benign cyst. During the process, you will be given a local anesthetic. Usually, a needle biopsy is carried out guided by an X-ray, ultrasound and an MRI scan as well. This helps in distinguishing it from non-invasive changes such as ductal carcinoma in situ.
Another form of biopsy used for the diagnosis of breast cancer is called vacuum assisted biopsy or mammotome biopsy. In this process, a needle gets attached to a suction tube, which helps in obtaining the sample and for clearing the bleeding. If you wish to discuss about any specific problem, you can consult a general-surgeon.
Breast Cancer can be detected at various stages. Some women might feel a difference in their breast area, with a lump or kind of a skin rash around the nipple or they could see that their nipple has become inverted, so then the treatment procedures would be different. The different stages of cancer and their respective treatment procedures are discussed below:
Stage I Breast Cancer - Treatment
In this case, breast cancers are at their nascent stage, either they have not spread to the lymph nodes or might have spread to only a small area. Treatment options are as follows:
- Surgery: The main treatment for breast cancer in stage I is surgery. These types of cancers get treatment with either breast-conserving surgery or mastectomy. There are some cases when breast reconstruction can also be done along with the surgery to get rid of cancer.
- Radiation therapy: When doctors feel the need to do a breast construction surgery, then radiation therapy is normally given after surgery. This helps in lowering the chance of cancer getting relapsed. Older women, aged close to 70 years, should go for breast reconstruction surgery without radiation therapy, provided the following conditions are true:
- The lump was 2cm or less across and it has been completely removed.
- None of the lymph nodes removed contained cancer.
- The cancer is either ER or PR-positive and hormone therapy is conducted.
- Chemotherapy and other drugs: Women who have either ER or PR-positive hormone receptor, doctors would recommend them to go for hormone therapy. The therapy is given for 5 years. In case the tumor is larger than 1cm across, adjuvant chemotherapy is recommended.
Stage II Breast Cancer-Treatment
This is the stage when cancer has spread to some nearby lymph nodes. The treatment methods followed are:
- Surgery and radiation therapy: This second stage of cancer gets treated with breast-conserving surgery or mastectomy. The lymph nodes nearby get checked either with a sentinel lymph node biopsy or an axillary lymph node dissection. Women, on whom BCS have been conducted, get treated with radiation therapy after surgery.
- Neoadjuvant and adjuvant systemic therapy: This is another method followed for treating stage II cancer. It is a good option for women with large tumors as they shrink the tumor before conducting surgery. Chemotherapy, HER2 targeted drugs and Hormone therapy all form part of treatment in this stage II.
Stage III Breast Cancer – Treatment
In stage III breast cancer, the size of a tumor is more than 5 cm, with cancer spreading on to the nearby lymph nodes. The treatment procedures followed are:
- Neoadjuvant therapy: Generally the stage III cancers are treated with neoadjuvant chemotherapy. Radiation therapy is also given after surgery, followed by breast reconstruction surgery.
- Starting off with surgery: Another treatment option for this stage is to get started off with surgery. The tumors are quite large and they even grow on to nearby tissues, which means women need to get a mastectomy. Women having large breasts can even go for Breast Reconstruction Surgery, in case cancer has not spread on to the nearby tissues.
In case you have a concern or query you can always consult an expert & get answers to your questions!
A mammogram is an imaging test where an X-ray is taken to recreate the internal imagery of your breasts. This is a screening test that is widely used to find the earliest signs of cancer. There have been instances where the early signs of cancer have been found up to three years before the actual development of the same. There are a number of benefits and risks in this screening method. So let us find out more about getting a mammogram, and whether or not you should get one.
- Procedure: A special X-ray machine is used for conducting a mammogram. There is a clear plastic plate on which the specialist will place the breast while another plate will press on the breast from above. While both the plates serve to flatten the breast and hold it still, the X-ray will be taken. Some pressure will be felt and the same steps will be repeated so as to get the side view of the breasts. The same procedure will be repeated for the other breast. Meanwhile, once it is done, you will need to wait so that the technician can check for clarity, and whether or not the procedure needs to be done again. The results of this procedure cannot be relayed by the technician, and all the images will be different because all breasts are slightly different from each other.
- Preparation: You will need to remember that the process can be a slightly painful one, especially once the pressure gets applied. Many women complain of discomfort and pain. Yet, this discomfort gets over before you know it. The pressure and pain will depend on the size of your breasts and how much they will have to be pressed in order to get a picture. The skill of the technician will also come into play here. One must remember not to get this procedure done a week or so before or after the menstrual cycle, as the breasts tend to be tender around this time, and the pain will be much more.
- Radiologist: Within a few weeks after the procedure, the radiologist will usually deliver the result. This is the professional who does an accurate reading of the X-ray.
- Normal and Abnormal Readings: If your mammogram result has a normal reading, then you can resort to getting one done every once in a while. But an abnormal reading will require further X-ray and tests so as to be able to tell for sure.
- Why should I get one: If you are over 40 and have a family history of such ailments, then you will have to get a mammogram done regularly. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
Noncancerous growths of the muscle tissue surrounding the uterus are known as uterine fibroids. This is a common disease which about 70 to 80% of women contract by the time they are 50 years of age. The uterine fibroids can sometimes be very big and cause heavy periods as well as severe abdominal pain while at other times, uterine fibroids give no signs or symptoms whatsoever and go away on their own. This is why it is crucial to know what type of uterine fibroids you have and how to diagnose them. Here are the types of uterine fibroids and how to diagnose them;
There are three main types of uterine fibroids. They are;
- Intramural fibroids: The most common type of uterine fibroids are intramural fibroids. They typically appear in the endometrium and may grow larger which results in your womb getting stretched.
- Subserosal fibroids: Subserosal fibroids are called so because they form on the serosa. The serosa is the outside of your uterus. Sometimes, Subserosal fibroids may grow so large that your uterus appears bigger on one side.
- Pedunculated fibroids: Pedunculated fibroids tumors are basically Subserosal fibroids with a stem. A base which supports the tumor is called the stem.
There are a number of tests done to diagnose uterine fibroids. They are;
- Pelvic exam: A pelvic exam is a thorough inspection of a woman’s pelvic area. The organs which are in the pelvic area include the cervix, ovaries, uterus and vagina. Normally, this and the next test in this article are enough to diagnose uterine fibroids.
- Medical history: The history of your periods as well as the other symptoms you have will often be enough to diagnose the uterine fibroids. If your medical history is not enough, then you might need to undergo a pelvic exam.
- Pelvic ultrasound: An ultrasound is when high-intensity sound waves are used to produce images of the pelvic area. This is only done when a pelvic exam and your medical history are not enough to diagnose uterine fibroids. If you wish to discuss any specific problem, you can consult a general surgeon.