Dr. Usha Seth

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.

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!

Uterine fibroids, also known as leiomyoma or myoma, are benign growths on the uterus, occurring mostly during the years of childbearing. Few of the common symptoms of fibroids are leg pain or backache, constipation, difficulty in emptying the bladder, frequent urination, pain or pressure in the pelvic region, menstrual periods stretching over a week and excessive menstrual bleeding.

Causes:

1. Certain genetic changes of the uterus which are different from the ones normally present in the muscle cells of the uterus can cause this disorder.

2. Certain hormones such as progesterone and estrogen that prepare the body for pregnancy are even responsible for triggering the development of fibroids.

3. Substances which help the body maintain its tissues trigger fibroid growth as well.

4. Family history, excessive consumption of alcohol and red meat while going low on foods such as dairy products, fruits, green vegetables and vitamin D, obesity, usage of birth control pills and early onset of the menstruation cycle are other factors that may escalate the risks of one suffering from fibroids.

Treatment:

1. Be careful and take a closer look: Fibroids are fundamentally non-cancerous and they hardly interfere with pregnancy. Often, they do not exhibit notable symptoms and are prone to shrinkage after menopause. Hence giving them and yourself some time might be the best option.

2. Medications generally aim at the hormones controlling the menstrual cycle and treating symptoms such as pelvic pressure and excessive menstrual bleeding. However, they do not treat fibroids completely but work towards contracting them. They include-

   • Gonadotropin-releasing hormone (Gn-RH) agonists to block estrogen and progesterone production

   • Progestin-releasing intrauterine device (IUD) to alleviate severe bleeding caused due to fibroids

   • Tranexamic acid to ease excessive menstrual periods

   • Progestins or oral contraceptives to regulate menstrual bleeding

   • Nonsteroidal anti-inflammatory drugs (NSAIDs) to ease pain associated with fibroids

Surgeries to Treat Fibroids:

Depending on symptoms and whether medical therapy has failed, the patient may have to undergo surgery. The following surgical procedures may be considered:

1. Hysterectomy: removing the uterus. This is only considered if the fibroids are very large, or if the patient is bleeding too much. Hysterectomies are sometimes an option to prevent fibroids coming back.

2. Myomectomy: fibroids are surgically removed from the wall of the uterus. This option is more popular for women who want to get pregnant.

3. Endometrial ablation: removing the lining of the uterus. This procedure may be used if the patient's fibroids are near the inner surface of the uterus; it is considered an effective alternative to a hysterectomy.

4. UAE (Uterine artery embolization): this treatment cuts off the fibroid's blood supply, effectively shrinking the fibroid.

5. Magnetic-resonance-guided focused ultrasound surgery: an MRI scan locates the fibroids, and sound waves are used to shrink the fibroids.