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Hi. From last few days I am experiencing some small tumours or masses in my mouth. Which is not paining or increasing. What may be this due to?
My father has been diagnosed with Non-Small Cell Lung Cancer, Stage 4 with primary tumour in his Left Upper Lung and metastasis in Liver and Bone. The biopsy report has confirmed it to be adenocarcinoma. The cancer was detected while he was admitted at a hospital in Mumbai and was undergoing treatment for Acute Paraplegia which happened on 02 Nov 16, due to arteries-Venous Fistula at D-10 level resulting in oedema/ ischemia of the spine from D-5 to Conus. After two failed attempts of embolization, towards treatment of the AVF, surgical clipping of the fistula was undertaken on 10 Nov 16. As part of post-operative rehabilitation therapy for his paraplegia, he was given 65 session of Hyper-basic Oxygen Therapy at 2.4 ata pressure for about two and a half month and about two hour of Physiotherapy for the same duration. My father was recovering well and had started walking with the help of support (walker). MRI of the spine taken in mid Jan & Mid June 2017 indicates that the spinal cord oedema had improved significantly, although atrophy of the spine cord is still present. He complained of wheezing and breathing difficulty and towards ascertaining the cause a X-ray was taken on 23 Feb 17 which showed massive pleural effusion in his left lungs. A series of tests followed with the ultimate result as NSCLC Stage 3B. He was started with CCRT treatment which concluded on 05 May 17. During the treatment he was given daily dose of radiation therapy using IGRT (60 Gy/ 30 #/6 weeks) and weekly chemotherapy with paclitaxel (150 mg) & Carboplatin (300 mg) for 6 weeks. Despite the treatment, the cancer is advancing and has now spread to Liver and Bones as brought out in his latest PET CT report. Lung tissue which was obtained during CT guided biopsy conducted in the month of Mar 17, before the CCRT treatment was started, has tested positive for EGFR mutation – “E746_A750del is detected in EXON 19 of EGFR gene”. The medicine oncologist has however said that the gene profiling of the primary tumour tissue is not sufficient for starting Targeted Therapy and gene profiling of a tissue obtained from any of the metastatic site is necessary for the same. Three procedures have been undertaken to obtain tissue sample from the metastases site, twice from the liver and once from the pleural deposits, and all the three times the cancerous tissue could not be obtained. Due to non-availability of conformed cancerous tissue from the metastases site, a firm treatment plan has yet not been made for my father. In the meantime, the doctor has recently started my father on Erlotinib 150 mg OD as there has been considerable delay in his next phase of treatment due to non availability of metastases cancerous tissue. Could you please help me by answering the following:- 1.Can you suggest anything towards treatment of my father? 2.Is gene profiling of tissue from a metastases site absolutely necessary for starting targeted therapy for my father? 3.I read online that Erlotinib or Afatinib can be used as Targeted Therapy for patient with EGFR Lung cancer mutation. Is this true? If yes, will a daily tablet of these drugs be sufficient for his next phase of treatment, or a concurrent conventional chemotherapy is also required? 4.Can 65 session of Hyper-basic Oxygen Therapy at 2.4 ata given at a stretch of about 80 days, with a daily dose of 02 hour be a cause of his cancer? I have read it online that the oxygen free radical produced during HBOT treatment can cause cancer.
Dear sir, Please advise me, my mother have got cancer in small intestine. Tumor size is 5*4*3 Pathological stage - pT3N0Mx Please tell us what I do.
Sir i m suffering from prostatic problem since 2010.Prostate size was 77 gms in 2010.It got reduced to 35 gms in 2012 after taking flotral D combo for 1 year.Since 2012 i am having flotral 10 tab (one tab in night) daily & been advised to continue till death.Sir tell me am i being treated in correct way?
Evening doctors .am coming from the doctor to do a pap smear she said she can not find the cervix my womb has turned back so is it a bad thing and can I be able to have kids as I want them and can my womb be fixed.
One of the most common issues with old age in men is the enlarged prostate. Any difficulty with urination (no constant stream, difficulty initiating, or incomplete emptying of the bladder for instance), and the first suspect is an enlarged prostate. These symptoms are followed by a digital rectal exam to check for an enlarged prostate. Once confirmed, the next step is to check for levels of prostate-specific antigen (PSA). If both the exam and the PSA are positive, it could mean prostate cancer. As with any cancer, it is believed that sooner it is diagnosed and the treatment is started, the better.
Historically, the best way to rule out the prostate cancer had been to do a prostate biopsy. This is a minor invasive procedure, wherein biopsies are taken from various regions of the prostate which are known to develop cancer (about 12). A disadvantage of this procedure includes missing out on the front part of the prostate which can also develop cancer. Secondly, it is not a very pleasant experience and given a chance, most men would not want to have it done.
There is good news for these men who would like to avoid prostate biopsies. The first is the multiparametric MRI which uses no x-rays and is considered very safe with extremely accurate results. This MRI exam requires about an hour, and once the images are obtained, the doctor will analyse these images and check for several parameters to assess for prostate cancer. The absence of cancer can be confirmed with up to 90% accuracy, which is far greater than with usual biopsies. If there is a possibility of cancer, then a biopsy can be done to confirm it.
Also, these images indicate the exact region where cancer likely is, and this guides the doctor to biopsy only where absolutely essential. The chances of false positive and false negative results are reduced drastically. The one disadvantage here is that MRI detected biopsies usually tend to be of a higher grade which requires immediate treatment.
Another way to reduce chances of the biopsy by 30% to 50% is by the 4K test. It helps detect a variety of prostate issues including cancer. It can be used once higher levels of PSA is identified and before going for a biopsy. It combined 4 prostate-specific biomarkers with clinical information to accurately provide men with a risk of developing prostate cancer. It can be used even after negative biopsies to confirm the diagnosis of prostate cancer.
These two measures can drastically reduce the incidence of prostate biopsies, which is neither pleasant for the patient nor very effective for the doctor.
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The cancer of the ovaries is known as ovarian cancer. In women there are two ovaries present on each side of the uterus. These ovaries are as big as an almond in size and produce egg also known as ova. They also secrete the hormones progesterone and estrogen.
Ovarian cancer goes undetected until it spreads to the abdomen and pelvis. When detected at this stage then it might be fatal and the treatment gets difficult. An early stage ovarian cancer where the cancer is restricted in the ovaries is much easier to treat with high success rates.
Risk Factors of Ovarian Cancer
1. Age - With increasing age the risk of ovarian cancer is higher and is more common in women who are 60 and above. It is less common in women below 40 years of age and develops often after menopause.
Obesity Women who have a body mass index of 30 are at a risk of developing ovarian cancer.
2. History of Reproduction - It is believed that women who conceive before 26 and carry the full term have a lower risk of ovarian cancer. However, the risk is higher in those women who get pregnant after 35 or who do not have a full term pregnancy. Also, breastfeeding the baby lowers the risk.
3. Gene Mutation - Inherited gene mutation causes some percentage of ovarian cancer. These genes are called breast cancer genes 1 and 2 (BRCA1 and BRCA2). These were initially found in cases with breast cancer but also pose great risk for ovarian cancer. Also, gene mutation leading to Lynch syndrome plays an important role in increasing the risk of ovarian cancer.
4. Family History - If a woman's mother, sister or daughter is suffering from ovarian cancer then she is at a higher risk of developing the same. The risk also increases if someone from the father&amp;#x2019;s side also has ovarian cancer.
5. Fertility Drugs - Drugs like clomiphene citrate, if used for more than a year can increase the risk of the cancer. The risk is even higher if a woman taking the drug does not get pregnant.
6. Hormone Therapy and Estrogen Therapy - Long term use and large doses of estrogen can cause an increased risk. However, if estrogen is used in combination with progesterone then the risk is less.
7. Age of menstruation and menopause - If menstruation starts before 12 and menopause occurs before 52 then there is a higher risk of getting the cancer.
8. Diet - A low fat vegetarian diet has less risk of the disease. Fresh fruit and vegetables should be included in diet along with pulses, rice, pasta, beans, cereals and breads. If you wish to discuss about any specific problem, you can consult a gynaecologist.