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I have hypertension n slip disc issue in L4 n L5. need to reduce weight badly. Restriction of exercise. Non veg food habits. Suggest diet.
Good morning, I am Dr Dinesh Singh I am director predation oncology at Max hospital, Vaishali and today I will be talking about the most common cancer of women in India, it is breast cancer and there is no age bar. We have seen patients as young as 17 to 18 years and as old as 80 to 90 years. So every woman is at risk of getting the breast cancer, now which are the ladies which are more prone to get breast cancer when those ladies who do not have the breastfed their child, those who are very obese or those who have history of a breast cancer in their first relative like in the father, mausi, sister they are at higher risk, but then any population is at risk of developing cancer. What we need to understand is that we should be aware about our body and we should do a self breast examination every month, so that we know the change which happens in our breast over a period of time and once you notice that there is a lump in the breast, usually, pain is not initial symptom of Cancer any cancer in the body and whenever you notice that there is a lump in the breast then it has to be further investigated. The age is less than 40 years we go for an ultrasound of the breast which is more than 40 years we go for mammography of the breast. And then further investigation like a biopsy of the lump and if it is found cancerous, then we do for the test to see whether it is spread to another part of the body or not. Well, that tells us about the stage the breast cancer is and then depending upon the stage the treatment is decided. That let us say that we diagnose breast cancer at a very early stage that means it is less than 3 to 4 cm and at that time we do not need to remove the entire breast of the person to cure the person, we can remove only a portion the cancerous portion plus a little bit of arching around the tumor and in the axilla we have to do surgery to get out the nodes. For that now it is a sentinel node biopsy is done what happens in that is that we identify the draining lymph nodes we take them no we study them then and there when the patient is still under anaesthesia and if they are not cancerous then we do not take out the further lymph nodes of the axilla, if they are cancerous then we take them out. After that then the further treatments depends upon the final histopathology report of the tumor, if the tumor is very small If in case very sensitive to hormones these patients don't need any chemotherapy, radiotherapy becomes a part of the every breast conservation surgery and if that tumor is larger or it is not sensitive to hormones then we have to give chemotherapy. In chemotherapy now very latest medicines are available there are called targeted therapy and the cure rates have become very high. All the cancers especially breast cancer the side effects are very minimal, we have all the medicines which can take care of the vomiting, the infection and other side effects which are happening along with the chemotherapy. And regarding radiotherapy, the latest technology is targeted radiation or image-guided radiation along with other things we are able to do a very pinpoint radiation to the area where it should go. So that it saves the underline normal structures from getting exposed to radiations the cure rates become very high and the side effects are very low. So I will say that all the girls and all the ladies they should do a self-examination try to be familiar with their normal body oncology, diagnose cancer early to treat it properly and be the cure of cancer. Thank you.
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!
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.
A broken bone or a crack in the commonly known as a fracture. Any bone in the arm can be broken, but common areas for fractures in the arm is wrist, specifically the distal radius, forearm bones (radius and ulna), elbow, humerus and shoulder.
What causes fracture in bones?
- Fall: Falling an outstretched hand or elbow is the most common cause of a broken arm.
- Sports injuries: Direct blows and injuries on the field or court are a common cause of all types of arm fractures.
- Significant trauma: Any of your arm bones can break during a car accident, bike accident or other direct trauma.
- Abuse: In children, a broken arm may be the result of child abuse.
How to identify?
An audible snap or cracking sound may be your first indication you've broken an arm.
Signs and symptoms include:
- Severe pain, which may increase with movement
- Deformity, such as a bent arm or wrist
- Inability to turn your arm from palm up to palm down or vice versa
When to see a doctor?
If you have enough pain in your arm that you can't use it normally, see a doctor right away and do the same for your child. Delay in diagnosis and treatment of a broken arm, especially for children who heal faster than adults do, can lead to poor healing and deformity. In case you have a concern or query you can always consult an expert & get answers to your questions!
Sir, my mother aged 63 years undergone in 2015 surgery for right breast. Her condition is becoming worse day by day. Doctors told cancer is in advanced stage. In breast, liver and skin. Doctors said ERIBULINE chemo medicine may be most suitable medicine for breast cancer. Kindly advise is Eribuline is the best chemo medicine or is there any substitute for ERIBULINE? If Eribuline given. How much life extension we can expect.
Different methods to treat Disc problems
Hello friends, I am Dr Gaurav Khera. I am an orthopaedic surgeon, doing joint replacements and spine surgeries at the Access healthcare. Now today I will be talking about the lumbar degenerative disc disease. Now it sounds very big, but it is not as complicated as it sounds. It basically is what you people commonly know as a disc disease. So it is a fairly common problem that is seen in our population today. In fact about 30 or 40% of the patients who come to our OPD have lower back pains, some have other disc problems and very commonly seen after 40 years of age and this incidence gradually increases up to 60-70 years of age. The other ecological factors which are associated with this are, first of all smoking, secondly it is, mild to moderate trauma, thirdly its seen in people who lift heavy weights, fourth is obesity, especially central obesity, that is if you have a very heavy waistline.
Now what is Lumbar degenerative disc disease? Now, our spine is composed of multiple bones, which are starting from your neck and they come all the way down to your hip, divided into the cervical, dorsal, lumbar and sacral spine. And between these bones, there are these small pieces of discs, which act as cushions. When your body walks, these act as shock absorbers between your body’s bones. Now this discs, when these come out of their normal place, it gives or presses against the nerves which are passing through these areas and it causes pain. This is what happens in the disc disease. Basically, in the patient it will come as a lower back pain, and this pain will be travelling down to the hip, and it will also be coming down to the legs. Some people complain that as they walk, the pain increases.
They also complain of tingling numbness. They complain that sometimes their fingers or their toes are feeling numb. These are some of the very common symptoms which are being seen. Few people may have only lower back pain, and these are the people who do not have very significant disc disease. Now there are two main causes of the disc disease. First is an inflammatory reaction that occurs in the disc, and second is the micro motion instabilities that occur. Inflammatory reactions may occur as a result of some small traumas which may occur such as when you may injure your back. Such inflammatory reactions occur in the form of small swellings in the body. And micro motion instabilities are when the body ages, the disc which has an outer fibrous thick layer, that degenerates, and as it degenerates, the pulp which is there at the centre, of the discs, tends to degenerate. What I mean is it comes out of its normal space. And as it comes out of the normal place, it comes and tends to press on the nerves and these are the two most common causes.
All disc patients are not to be operated. When we get these patients, the first and foremost investigation that we do is a X-Ray. And if required, we go in for a MRI. Frankly MRI is the known standard to diagnose the disc disease. The findings of a MRI are always coordinated with the clinical findings. Once we have diagnosed that it is a disc problem, we have to establish that what the compression on the nerves is. If the nerve compression is a lot, and if we think that we cannot do anything other than surgery, then we take the patient for a surgery.
If not, we take the patient fro physiotherapy, lifestyle changes and few medications. These medications may carry on for few weeks to few months. And a lot of exercise has to be carried on regularly. Lifestyle changes such as weight loss, stoppage of smoking is very important. And if you can achieve this, then your problems are very easily solved. If you have any queries regarding your disc problems or back pains, then you can get in touch with me for the same.
You can reach me in my clinic, which is there in Indrapuri, by the name of Dr Khera’s Wellness Clinic or you can also contact me through Lybrate for the same. Thank You.