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Dr. S.B.Gandhi

Radiologist, Delhi

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Dr. S.B.Gandhi Radiologist, Delhi
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I want all my patients to be informed and knowledgeable about their health care, from treatment plans and services, to insurance coverage....more
I want all my patients to be informed and knowledgeable about their health care, from treatment plans and services, to insurance coverage.
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Dr. S.B.Gandhi is a popular Radiologist in Janakpuri, Delhi. Doctor is currently practising at Dr. S.B.Gandhi@Mata Chanan Devi Hospital in Janakpuri, Delhi. Book an appointment online with Dr. S.B.Gandhi and consult privately on Lybrate.com.

Lybrate.com has an excellent community of Radiologists in India. You will find Radiologists with more than 25 years of experience on Lybrate.com. You can find Radiologists online in Delhi and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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The 4 Stages Of Uterine Cancer

DNB (Obstetrics and Gynecology), MD - Obstetrtics & Gynaecology, MBBS
Gynaecologist, Delhi
The 4 Stages Of Uterine Cancer

The uterus is a very important organ within the human reproductive system as this is the chamber where an embryo grows into a baby. Due to a multitude of factors, the incidence of uterine cancer has been on the rise. Let's look at some of its symptoms.

Symptoms of uterine cancer
When cells within the uterus grow abnormally and turn malignant, it may be termed as uterine cancer. This may be in the form of a fibroid or tumor or be part of the uterine tissue itself. It may be caused due to a multitude of factors such as late menopause, radiation exposure, estrogen treatments and many others. Some of the common symptoms for uterine cancer could be:

a. Pain in the abdomen, lower back and especially the pelvic area.
b. Pain during urination,
c. Weight loss without any apparent reason
d. Vaginal bleeding with or without discharge
e. Pain during sex

Stages of uterine cancer:
Before we understand the stages of uterine cancer you need to know how doctors diagnose the various stages. This is done by the three following steps in the TNM method:

Tumor - Doctors try and search for tumors and locate them within the uterus, estimate its size and whether it is malignant or not.

Node - If the tumor is malignant, then doctors try to find out whether the tumor has reached the lymph nodes or not.

Metastasis - Doctors look for Metastasis which is whether the cancer has spread to other organs within the body and to what extent.

Stages of cancer - Cancer is primarily grouped in five stages from 0 to V according to the T, N and M stages mentioned below.

Stage 0 - This is a very early stage of cancer where the cells have malignant growth but are still small in number and haven't spread anywhere.

Stage I - If the cancer has developed a little but is restricted within the uterus, it is considered as stage one. This is also further divided into Stage 1A and 1B.

Stage II - When the cancer has started spreading but only to some parts of the cervix from the uterus, it is diagnosed as stage 2 uterine cancer.

Stage III - Categorized into Stage IIIA, Stage IIIB, Stage IIIC1 and Stage IIIC2, it is primarily where the cancer has spread to other organs but it is only limited to the pelvic area.

Stage IV A - When the cancer has gone beyond the pelvic area and also spread to the rectum and balder area.

Stage IV B - This is where the cancer has metastasized in the groin area or gone to other organs within the body as well.

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

2749 people found this helpful

Brain Mapping Surgery - Why It Is Performed?

MCh - Neurosurgery, MBBS
Neurosurgeon, Chennai
Brain Mapping Surgery - Why It Is Performed?

Brain mapping is a technique where the biological quantities of a human brain are represented as spatial quantities resulting in maps. As with many other medical technologies, brain mapping is fast-evolving as well. Among several uses, brain mapping is chiefly used while performing surgery on the brain.

When surgery is to be performed on the brain such as surgery for epilepsy, the surgeon would want to comprehend how the brain areas are affected by seizures. The surgical intervention is meant for removing as much as seizure focus as possible while preserving crucial functions like understanding, speech, vision, movement, and sensation.

Why is brain mapping performed?
Brain mapping is a process which helps in identification of functions of various parts of the brain. Mapping the brain by stimulating different areas of the brain areas can aid in creating a map for a particular person. The map allows the doctor in understanding what parts of the brain are responsible for performing critical functions including sensation, movement, speech and other functions.

Which functions of the brain can be mapped electrically?
Typical areas of the brain which have motor, language, visual and sensory functions are needed to be mapped. When current is applied to a single area at a time, the doctor understands which part of the brain is responsible for which function.
When the patient is not able to speak due to the current, then the area is likely to be crucial for language function. If the limbs, face or trunk of the patient stop moving as the current passes, the area that is tested is responsible for movement. On the other hand, if the individual experiences tingling, numbing, and other sensations when the current is applied, it means that a sensory region is discovered.

How is electrical brain mapping performed?
Electrical brain mapping for guiding brain surgery for epilepsy can be performed in two distinct processes: directly during the surgery or in a two-stage procedure.

Two-stage procedure:
In the first stage of the process, the surgeon creates an opening in the skull which helps in exposing the surface of the brain. Small electrical contacts or electrodes are placed on the brain surface even though no brain tissue is removed. As soon as the electrodes are in the right position, the scalp is closed. The electrodes not only record the seizure of the patient electrically but also allow mapping of various areas of the brain. The last stage is surgery where abnormal brain tissues are removed.

Brain mapping process during surgery:
Electrical brain mapping may also be performed during the surgery which exposes part of the brain. This is termed as intraoperative brain mapping since it occurs while performing the main operation. The process of mapping may last for an hour to several hours at a stretch.

Brain mapping is also used to diagnose neurodegenerative diseases like Alzheimer’s and Parkinson’s. In these cases, the brain map shows extreme shrinkage of the brain due to tissue loss. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.

3381 people found this helpful

5 months ago My father total serum cholesterol was 391, after getting through the report doctor prescribed Statins tablets to him. Now after 5 months his (my father) total serum cholesterol is 116, and serum LDLcholesteol is 44. Is is too low? It can be harmful? Or can leads to other disease? My father is also a patient of coronary artery disease.

MBBS, Dip.Cardiology, Fellowship in Clinical Cardiology(FICC), Fellowship in Echocardiology
Cardiologist, Ghaziabad
5 months ago My father total serum cholesterol was 391, after getting through the report doctor prescribed Statins ta...
No issues. Low cholesterol has no problems. But yes you can decrease the dose of the statins by half and recheck the lipid profile after 3 months. Long term statins treatment also has side effects. Also you need to understand about cholesterol Cholesterol is a waxy, fat-like substance that occurs naturally in all parts of the body. Your body needs some cholesterol to work properly. But if you have too much in your blood, it can combine with other substances in the blood and stick to the walls of your arteries. This is called plaque. Plaque can narrow your arteries or even block them. High levels of cholesterol in the blood can increase your risk of heart disease. Your cholesterol levels tend to rise as you get older. There are usually no signs or symptoms that you have high blood cholesterol, but it can be detected with a blood test. You are likely to have high cholesterol if members of your family have it, if you are overweight or if you eat a lot of fatty foods. You can lower your cholesterol by exercising more and eating more fruits and vegetables. You also may need to take medicine to lower your cholesterol. High LDL high cholesterol put you on a higher risk of atherosclerotic diseases and heart attacks especially if you have other is factors including hypertension diabetes or a history of smoking so I would advise you to start taking statins which are cholesterol medications the dose of which depends upon your cholesterol levels also you need to start changing your dietary habits and include a regular physical exercise at least 45 minutes a day 5 days a week into your schedule nonetheless you have to stop taking fatty and junk food good luck Check out - Simplified health explanation videos on my YouTube channel And Do not forget to Subscribe for upcoming videos.
1 person found this helpful
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We are planning for PLDD surgery for my mother. I wanted to know if it's safe and a lifetime surgery. Also what's the cost included in this if it's done in india.

FMAS, MS
General Surgeon, Gandhinagar
Hello dear lybrate-user, hi Warm welcome to Lybrate.com I have evaluated your query for your mother thoroughly.* Still PLDD surgery is in development phase in India, can get it with expert spine surgeon in Delhi at AIIMS.* Cost has to be worked out with telephonic consultation. Hope this clears your query. Wishing her fine recovery. Welcome for any further assistance. Regards take care.
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An Overview Of Bone Cancer

MD - Oncology
Oncologist, Hubli-Dharwad
An Overview Of Bone Cancer

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:

  1. Osteosarcoma: In this case, the malignant tumour arises from the osteoid bone tissue. This occurs mainly in the upper arm and knee areas.

  2. Chondrosarcoma: In this case the cancerous cells form in the cartilaginous tissues, causing a lot of pain. This occurs mostly in the pelvic area.

  3. 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.

Causes-

There aren’t many clear defined causes; however, several factors have been identified by researchers.

  1. Osteosarcoma is seen to occur more frequently in people who have been through a high external radiation therapy dose.

  2. In people who have frequently been treated with anticancer medications, children tend to be most affected.

  3. Heredity may be an adding cause, although the percentage of hereditary transfer of cancer cells is very low.

  4. People with hereditary bone defects or implants have a higher chance of acquiring bone cancer.

Symptoms-

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.

Diagnosis-

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.

Treatment-

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.

Survival-

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.

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

3256 people found this helpful

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.

MBBS, Dip.Cardiology, Fellowship in Clinical Cardiology(FICC), Fellowship in Echocardiology
Cardiologist, Ghaziabad
In coronary artery disease (CAD), the arteries that supply blood and oxygen to your heart muscle grow hardened and narrowed. You may try treatments such as lifestyle changes, medicines, and angioplasty, a procedure to open the arteries. If these treatments don't help, you may need coronary artery bypass surgery. The surgery creates a new path for blood to flow to the heart. The surgeon takes a healthy piece of vein from the leg or artery from the chest or wrist. Then the surgeon attaches it to the coronary artery, just above and below the narrowed area or blockage. This allows blood to bypass (get around) the blockage. Sometimes people need more than one bypass. The results of the surgery usually are excellent. Many people remain symptom-free for many years. You may need surgery again if blockages form in the grafted arteries or veins or in arteries that weren't blocked before. Lifestyle changes and medicines may help prevent arteries from becoming clogged again.
1 person found this helpful
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How Can You Prevent Breast Cancer?

MD - Oncology
Oncologist, Hubli-Dharwad
How Can You Prevent Breast Cancer?

If you are concerned about breast cancer, you should know about the steps you can take to prevent the condition. Breast cancer is a type of cancer developing from the breast tissue. Symptoms such as a lump in the breast, fluid flowing from the nipple, changes in the shape of the breast and occurrence of red scaly patches on the breast denote breast cancer.

You need to make certain lifestyle changes in order to prevent breast cancer. The ways you should adopt include the following:

  1. Limit your alcohol intake: The more you consume alcohol, the more you put yourself at the risk of getting breast cancer. It is recommended for you not to drink more than one drink per day. Small amounts of alcohol increase the risk of breast cancer as well.

  2. Abstain from smoking: There is a direct link between tobacco smoking and breast cancer, and the risk is even more in premenopausal women. You should quit smoking to reduce the risk of breast cancer along with many other conditions, which can develop because of the ill-effects of smoking.

  3. Control your weight: Obese women are more prone to breast cancer when compared with women with a healthy weight. This is especially true when obesity occurs at a later stage in life, after menopause.

  4. Keep physically active: Regular physical activity is essential for you to maintain a healthy weight, which is important for preventing breast cancer. 150 minutes of moderate aerobic exercises or 75 minutes of vigorous exercises are recommended along with strength training.

  5. Breastfeed: Breastfeeding plays an important role in preventing breast cancer. The more you breastfeed your baby, the more protected you are from breast cancer.

  6. Limit the dosage and duration of hormone therapy: If you undertake combination hormone therapy for more than three to five years, you are at a higher risk of developing breast cancer. In case you are taking hormone therapy for menopausal symptoms, you should talk to your doctor about alternative options such as non-hormonal therapy and medications. If you still require hormonal therapy, you must use the lowest dose that will be effective.

  7. Avoid exposure to radiation and pollution: Certain medical imaging procedures like computerized tomography involves radiation of high doses. There is a link between breast cancer and radiation exposure. Thus, you should abstain from getting exposed to radiation and avoid taking such tests if it is not very urgent.

Maintaining a healthy diet also helps in reducing your risk of developing breast cancer. You should include food items which are plant based in your regular diet, such as fruits, vegetables, nuts, whole grains and legumes. Also, consume healthy fats such as olive oil instead of red meat and butter. If you wish to discuss any specific problem, you can consult an oncologist.

3020 people found this helpful

Breast Cancer - Is Homeopathy Helpful In Treating It?

MD - Homeopathy, BHMS
Homeopath, Jaipur
Breast Cancer - Is Homeopathy Helpful In Treating It?

The incidence of breast cancer is increasing worldwide, especially in the western world due to a variety of factors like diet, genetics and lifestyle, including body weight. Other predominant factors are ovarian function and oestrogen exposure, pregnancy, and lactation. It is the second most common carcinoma in women and it occurs mostly after the age of 30. It’s most commonly seen in the age group of 40-60. Even though there is so much of awareness about this cancer, there is a high incidence of this cancer going undetected.

This cancer is treatable if detected early. For this, we need to know its common symptoms, which are

  1. Lump in breast i.e. presence of a hard mass in the breast with no defined margins
  2. Bleeding from nipple
  3. Nipple retraction
  4. Redness and pain

If left undetected, cancer in the breasts can spread to the bones, liver and even the brain.

Homeopathic treatment
We all know that Homeopathy, a popular holistic system of medicine cures by using the principle of ‘Like cures like’. Homeopathy relies on a specialised remedy based on the physical, psychological and emotional symptoms of a patient. This is the reason that self-medication fails abysmally in homoeopathy. The homoeopathic medicines for breast cancer in this article thus should be used just as a reference and you should consult a good homoeopath for a complete cure. Several proven homoeopathic remedies are available to treat symptoms of breast cancer like:

  1. Conium Mac: It is an excellent cure for breast cancer, especially when the breasts are hard and tender. The breast becomes rock-hard and there is a stinging pain in this type of breast cancer which starts in the milk ducts and spreads to outer regions. This type of breast cancer is tackled by Conium Mac.
  2. Baryta Carb: This homoeopathic drug is used when the breast is enlarged and inflamed. The mammary gland is also hard and stony plus sensitive to touch. The milk glands in this type of cancer become enlarged and tender. Blood from the nipple is another indication for use of Baryta carb.
  3. Hydrastis Can: The patient has to swell of the mammary glands and complains of pain and tenderness. Her nipples are engorged, have cracks and a watery discharge.
  4. Iodine: This homoeopathic remedy works mostly on the enlargement of the breasts which may be malignant or malign. In this type of cancer, the mucous membrane of the mammary glands as well as the breast tissue gets inflamed. The breast tissue becomes enlarged and hard and presents with nodes.
  5. Phytolacca: A hard, irregular tumour with retracted nipples is the main indication for this homoeopathic remedy. A sore that extends from the breasts to the arms is another predominant feature. In case you have a concern or query you can always consult an expert & get answers to your questions!
4806 people found this helpful

Breast Cancer Prevention:

Homeopath,

Breast Cancer Prevention:

  1. Anything that increases your chance of developing cancer is called a cancer risk factor; anything that decreases your chance of developing cancer is called a cancer protective factor.

  2. Some risk factors for cancer can be avoided, but many cannot. For example, both smoking and inheriting certain genes are risk factors for some types of cancer, but only smoking can be avoided. Regular exercise and a healthy diet may be protective factors for some types of cancer. Avoiding risk factors and increasing protective factors may lower your risk but it does not mean that you will not get cancer. Different ways to prevent cancer are being studied, including:

  3. Changing lifestyle or eating habits. Avoiding things known to cause cancer. Taking medicine to treat a precancerous condition or to keep cancer from starting.


 

General information about breast cancer:

Key points:

  1. Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. Breast cancer is the second most common type of cancer in india

  2. Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast.

  3. The breast is made up of lobes and ducts. Each breast has 15 to 20 sections called lobes, which have many smaller sections called lobules. Lobules end in dozens of tiny bulbs that can make milk. The lobes, lobules, and bulbs are linked by thin tubes called ducts.

  4. Enlarge Drawing of female breast anatomy showing the lymph nodes, nipple, areola, chest wall, ribs, muscle, fatty tissue, lobe, ducts, and lobules.

  5. Anatomy of the female breast. The nipple and areola are shown on the outside of the breast. The lymph nodes, lobes, lobules, ducts, and other parts of the inside of the breast are also shown.

  6. Each breast also has blood vessels and lymph vessels. The lymph vessels carry an almost colorless fluid called lymph. Lymph vessels lead to organs called lymph nodes. Lymph nodes are small bean-shaped structures that are found throughout the body. They filter lymph and store white blood cells that help fight infection and disease. Clusters of lymph nodes are found near the breast in the axilla (under the arm), above the collarbone, and in the chest.

     

Avoiding risk factors and increasing protective factors may help prevent cancer. The following are risk factors for breast cancer:

  1. Older agea personal history of breast cancer or benign (noncancer) breast diseasea family history of breast cancerinherited gene changesdense breasts

  2. Exposure of breast tissue to estrogen made in the bodytaking hormone therapy for symptoms of menopause radiation therapy


 

The following are protective factors for breast cancer:

  1. Less exposure of breast tissue to estrogen made by the bodytaking estrogen-only hormone therapy after hysterectomy,

  2. Estrogen-only hormone therapy after hysterectomyselective estrogen receptor modulatorsaromatase inhibitors and inactivators

  3. Risk-reducing mastectomy ovarian ablationgetting enough exercise


 

It is not clear whether the following affect the risk of breast cancer:

  1. Oral contraceptives

  2. Factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk


 

Older age:

  1. Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.

  2. A personal history of breast cancer or benign (noncancer) breast disease

     

Women with any of the following have an increased risk of breast cancer:

  1. A personal history of invasive breast cancer, ductal carcinoma in situ (dcis), or lobular carcinoma in situ (lcis). A personal history of benign (noncancer) breast disease.

  2. A family history of breast cancer

  3. Women with a family history of breast cancer in a first-degree relative (mother, sister, or daughter) have an increased risk of breast cancer.


 

Inherited gene changes:

  1. Women who have inherited changes in the brca1 and brca2 genes or in certain other genes have a higher risk of breast cancer, ovarian cancer, and maybe colon cancer. The risk of breast cancer caused by inherited gene changes depends on the type of gene mutation, family history of cancer, and other factors.

  2. Men who have inherited certain changes in the brca2 gene have a higher risk of breast, prostate, and pancreatic cancers, and lymphoma.


 

Dense breasts:

  1. Having breast tissue that is dense on a mammogram is a factor in breast cancer risk. The level of risk depends on how dense the breast tissue is. Women with very dense breasts have a higher risk of breast cancer than women with low breast density.

  2. Increased breast density is often an inherited trait, but it may also occur in women who have not had children, have a first pregnancy late in life, take postmenopausal hormones, or drink alcohol.

  3. Exposure of breast tissue to estrogen made in the body

  4. Estrogen is a hormone made by the body. It helps the body develop and maintain female sex characteristics. Being exposed to estrogen over a long time may increase the risk of breast cancer. Estrogen levels are highest during the years a woman is menstruating.


 

A woman's exposure to estrogen is increased in the following ways:

Early menstruation: beginning to have menstrual periods at age 11 or younger increases the number of years the breast tissue is exposed to estrogen. Starting menopause at a later age: the more years a woman menstruates, the longer her breast tissue is exposed to estrogen. Older age at first birth or never having given birth: because estrogen levels are lower during pregnancy, breast tissue is exposed to more estrogen in women who become pregnant for the first time after age 35 or who never become pregnant.

 

Taking hormone therapy for symptoms of menopause:

Hormones, such as estrogen and progesterone, can be made into a pill form in a laboratory. Estrogen, progestin, or both may be given to replace the estrogen no longer made by the ovaries in postmenopausal women or women who have had their ovaries removed. This is called hormone replacement therapy (hrt) or hormone therapy (ht). Combination hrt/ht is estrogen combined with progestin. This type of hrt/ht increases the risk of breast cancer. Studies show that when women stop taking estrogen combined with progestin, the risk of breast cancer decreases.


 

Radiation therapy to the breast or chest:

  1. Radiation therapy to the chest for the treatment of cancer increases the risk of breast cancer, starting 10 years after treatment. The risk of breast cancer depends on the dose of radiation and the age at which it is given. The risk is highest if radiation treatment was used during puberty, when breasts are forming.

  2. Radiation therapy to treat cancer in one breast does not appear to increase the risk of cancer in the other breast.

  3. For women who have inherited changes in the brca1 and brca2 genes, exposure to radiation, such as that from chest x-rays, may further increase the risk of breast cancer, especially in women who were x-rayed before 20 years of age.


 

Obesity:

Obesity increases the risk of breast cancer, especially in postmenopausal women who have not used hormone replacement therapy.


 

Drinking alcohol:

Drinking alcohol increases the risk of breast cancer. The level of risk rises as the amount of alcohol consumed rises.


 

The following are protective factors for breast cancer:

  1. Less exposure of breast tissue to estrogen made by the body

  2. Decreasing the length of time a woman's breast tissue is exposed to estrogen may help prevent breast cancer. Exposure to estrogen is reduced in the following ways:


 

Early pregnancy: estrogen levels are lower during pregnancy. Women who have a full-term pregnancy before age 20 have a lower risk of breast cancer than women who have not had children or who give birth to their first child after age 35. Breast-feeding: estrogen levels may remain lower while a woman is breast-feeding. Women who breastfed have a lower risk of breast cancer than women who have had children but did not breastfeed.

Taking estrogen-only hormone therapy after hysterectomy, selective estrogen receptor modulators, or aromatase inhibitors and inactivators


 

Estrogen-only hormone therapy after hysterectomy

Hormone therapy with estrogen only may be given to women who have had a hysterectomy. In these women, estrogen-only therapy after menopause may decrease the risk of breast cancer. There is an increased risk of stroke and heart and blood vessel disease in postmenopausal women who take estrogen after a hysterectomy.


 

Selective estrogen receptor modulators:

Tamoxifen and raloxifene belong to the family of drugs called selective estrogen receptor modulators (serms). Serms act like estrogen on some tissues in the body, but block the effect of estrogen on other tissues.


 

Treatment with tamoxifen lowers the risk of estrogen receptor-positive (er-positive) breast cancer and ductal carcinoma in situ in premenopausal and postmenopausal women at high risk. Treatment with raloxifene also lowers the risk of breast cancer in postmenopausal women. With either drug, the reduced risk lasts for several years or longer after treatment is stopped. Lower rates of broken bones have been noted in patients taking raloxifene.


 

Taking tamoxifen increases the risk of hot flashes, endometrial cancer, stroke, cataracts, and blood clots (especially in the lungs and legs). The risk of having these problems increases with age. Women younger than 50 years who have a high risk of breast cancer may benefit the most from taking tamoxifen. The risk of having these problems decreases after tamoxifen is stopped.


 

Taking raloxifene increases the risk of blood clots in the lungs and legs, but does not appear to increase the risk of endometrial cancer. In postmenopausal women with osteoporosis (decreased bone density), raloxifene lowers the risk of breast cancer for women who have a high or low risk of breast cancer. It is not known if raloxifene would have the same effect in women who do not have osteoporosis. Talk with your doctor about the risks and benefits of taking this drug.


 

Aromatase inhibitors and inactivators:

Aromatase inhibitors (anastrozole, letrozole) and inactivators (exemestane) lower the risk of a new breast cancer in women who have a history of breast cancer. Aromatase inhibitors also decrease the risk of breast cancer in women with the following conditions:

Postmenopausal women with a personal history of breast cancer. Women with no personal history of breast cancer who are 60 years and older, have a history of ductal carcinoma in situ with mastectomy, or have a high risk of breast cancer based on the gail model tool (a tool used to estimate the risk of breast cancer).

In women with an increased risk of breast cancer, taking aromatase inhibitors decreases the amount of estrogen made by the body. Before menopause, estrogen is made by the ovaries and other tissues in a woman's body, including the brain, fat tissue, and skin. After menopause, the ovaries stop making estrogen, but the other tissues do not. Aromatase inhibitors block the action of an enzyme called aromatase, which is used to make all of the body's estrogen. Aromatase inactivators stop the enzyme from working.


 

Possible harms from taking aromatase inhibitors include muscle and joint pain, osteoporosis, hot flashes, and feeling very tired.


 

Risk-reducing mastectomy:

Some women who have a high risk of breast cancer may choose to have a risk-reducing mastectomy (the removal of both breasts when there are no signs of cancer). The risk of breast cancer is much lower in these women and most feel less anxious about their risk of breast cancer. However, it is very important to have a cancer risk assessment and counseling about the different ways to prevent breast cancer before making this decision.


 

Ovarian ablation:

The ovaries make most of the estrogen that is made by the body. Treatments that stop or lower the amount of estrogen made by the ovaries include surgery to remove the ovaries, radiation therapy, or taking certain drugs. This is called ovarian ablation.


 

Premenopausal women who have a high risk of breast cancer due to certain changes in the brca1 and brca2 genes may choose to have a risk-reducing oophorectomy (the removal of both ovaries when there are no signs of cancer). This decreases the amount of estrogen made by the body and lowers the risk of breast cancer. Risk-reducing oophorectomy also lowers the risk of breast cancer in normal premenopausal women and in women with an increased risk of breast cancer due to radiation to the chest. However, it is very important to have a cancer risk assessment and counseling before making this decision. The sudden drop in estrogen levels may cause the symptoms of menopause to begin. These include hot flashes, trouble sleeping, anxiety, and depression. Long-term effects include decreased sex drive, vaginal dryness, and decreased bone density.


 

Getting enough exercise:

Women who exercise four or more hours a week have a lower risk of breast cancer. The effect of exercise on breast cancer risk may be greatest in premenopausal women who have normal or low body weight.


 

It is not clear whether the following affect the risk of breast cancer:

  1. Oral contraceptives

  2. Certain oral contraceptives contain estrogen. Some studies have shown that taking oral contraceptives (" the pill") may slightly increase the risk of breast cancer in current users. This risk decreases over time. Other studies have not shown an increased risk of breast cancer in women who take oral contraceptives.

  3. Progestin -only contraceptives that are injected or implanted do not appear to increase the risk of breast cancer. More studies are needed to know whether progestin-only oral contraceptives increase the risk of breast cancer.


 

Environment

  1. Studies have not proven that being exposed to certain substances in the environment, such as chemicals, increases the risk of breast cancer.

  2. Studies have shown that some factors do not affect the risk of breast cancer.


 

The following do not affect the risk of breast cancer:

  1. Having an abortion. Making diet changes such as eating less fat or more fruits and vegetables. Taking vitamins, including fenretinide (a type of vitamin a). Cigarette smoking, both active and passive (inhaling secondhand smoke). Using underarm deodorant or antiperspirant. Taking statins (cholesterol -lowering drugs). Taking bisphosphonates (drugs used to treat osteoporosis and hypercalcemia) by mouth or by intravenous infusion.

  2. Cancer prevention clinical trials are used to study ways to prevent cancer.

anxiety and depression

Herniated Disc - How Surgery Can Help You?

MCh - Neurosurgery , MS - Orthopaedics
Neurosurgeon, Bangalore
Herniated Disc - How Surgery Can Help You?

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 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.  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 cord. 

Nerves are located precisely at the back of every disc and are responsible for controlling everything 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 on the affected nerve. It has been observed that individuals do not feel any painful sensations even if their disc gets damaged.

When is Surgery Recommended for Herniated Disc?
Surgery for herniated disc is recommended only after options like steroid injections, pain relievers, exercise and non-steroid anti-inflammatory drugs do not work. If the pain persists even after these options, then it becomes important to go for surgery. There are certain risks involved in this surgery like infection, bleeding or nerve damage. 

There are chances that the disc may get ruptured again if it is not removed. 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. At times, emergency surgery is also required to avoid paralysis in a patient. In case you have a concern or query you can always consult an expert & get answers to your questions!

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