Cancer refers to the uncontrolled growth of abnormal cells anywhere in a body. Anything that may cause a normal body cell to develop abnormally potentially can cause cancer. Although there are many tests to screen and presumptively diagnose cancer, the definite diagnosis is made by examination of a biopsy sample of suspected cancer tissue.read more
Mai Dr. Arun Kumar Goel, Max Super Speciality Hospital, Vaishali, Ghaziabad mein Cancer Surgery department ka head hoon, aur breast oncology unit ka director bhi hoon.
Mere main area of interest me breast cancer ka management ek pramukh area hai, breast cancer mahilaon ka sabse common cancer hai jo major cities hai metropolitan Delhi- NCR, Bombay aur aisi cities mein. Aur iska jo incidence hai woh badhta ja raha hai jiske kai karan hai, isme breast cancer ke ilaj mein pichle 30-40 saalon mein bahut tarakki hui hai aur aaj ke din hum dekhte hain ki breast cancer ke marijoo ka survival rate hai woh 90% se upar hai, lekin itna achha survival achieve karne ke liye hame jo hai uski diagnosis bahut jaldi karni padti hai. Toh yeh ek bahut sabse important baat hai, jo sabse common symptom hai breast cancer ka woh hai breast mein ek lump ya ganth ka hona. Ab breast ki ganthe kuch cancerous hoti hai kuch non-cancerous hoti hai, lekin jab bhi koi ganth ho toh yeh possibility zaroor sochna chahiye ki kahi cancer to nahi hai aur turant ek cancer specialist ya breast surgeon se opinion lena chahiye. Cancer ki diagnosis banane ke liye usme kuch janche hoti hai jisme mammography ya ultrasound hota hai, fine needle aspiration cytology ya biopsy hoti hai aur kabhi kabhi breast ka MRI bhi kiya jata hai. Toh agar cancer confirm hota hai toh phir uske baad kuch staging test karte hain yeh dekhne ke liye ki bimari sharir mein kahin faili toh nahi hai, jyadatar cases me bimari localised hoti hai aur uska ilaj jo hai sabse pehle operation ya surgery ke dwara kiya jata hai jo meri main feild hai. Jyadatar logo ko breast cancer surgery mein jo pareshani hoti hai ki pehle ilaj hota tha usme purye breast ko remove kiya jata tha jise hum log mastectomy kehte thye, lekin agar mareez early stage mein aata hai ganth bahut badi nahi hai to pura breast nikalna zaroori nahi hai, hum log breast conservation surgery ke dwara breast ko bchaa sakte hain. Isme aage aur kafi advances huye hai aur aaj kal hum log jo approach follow karte hain jis bolte hain oncoplastic breast conservation surgery, jisme jo cosmetic results pehle se bhi bheter hai. Agar kuch marijoo mein pura breast nikalna zaroori bhi hota hai toh reconstruction bhi kiya ja sakta hai. Aur ek nai approach jo surgery mein aaj kal hum log use kar rahe hai jise kehte hain Sentinel lymph Node Biopsy, yeh armpit ki jo ganthe hoti hain nodes unke management ke liye ek latest approach hai aur iss approach ka istemal karne se jo hathon mein sujan aane ka risk hai Lymphedema wo kafi kam ho jati hai. Toh surgery basically jo ho jati hai uske baad kuch marijoo mein additional treatment ki zaroorat ho sakti hai jaise chemotherapy hai, radiotherapy hai, ya kuch dawaiya hai jo hormonal intervention karti hain. Toh surgery ke baad kafi marijoo mein jo pehela ilaj hoga woh chemotherapy hota hai, jo 4 se 8 cycle tak diya ja sakta hai. Radiotherapy jin marijoo mein hoti hai woh bhi again aaj kal karib 3 hafte mein puri ho jati hai jo ki pehle usme 6 se 7 hafte lagte thye, aur nahi radiation technology ke through jo side effects hai radiation ke wo kafi kam ho gaye hain. Isi prakar hormonal therapy jo hai woh yeh radiation or chemo khatam hone ke baad di jati hai jis mein sirf ek tablet hoti hai jo marijoo ko ghar pe regular istemal karna padta hai aur wo 5 se 10 saal tak use ki ja sakti hai. Ek aur important cheez yeh hai ki jo bhi cancer ke marij hote hain unko ek regular follow up pe chalna padta hai, toh ilaj pura hone ke baad har 3 mahine baad unhe apne surgeon ke pass follow up ke liye jana chahiye, jisme examination jo hai woh ek bahut important part hai. Phir uske baad kuch testing ho sakti hai jaise chhati ka x-ray hai, ultrasound hai, mammography hai, aur agar koi aur takleef hoti hai tu Bol Scan, MRI, CT ya Pet Scan bhi kiya ja sakta hai. Iske alawa breast cancer ke marijoo mein jo ek aur cheez hoti hai hum log ek jo usko promote karte hain woh hai support group ka concept, jisme breast cancer ke survival aapas mein milte hain, ek doosre se cheeze discuss karte hain aur support bhi provide kar sakte hain aur isse unki jo future life hai wo kafi better rehti hai. Toh mein yahi kahunga ke cancer se aapko waise bhi nahi darna chahiye aur breast cancer ke jo aaj ke din success rate hai wo bahut hi acchi hai toh bina darre janch karaye aur apna ilaj pura kare.
Dhanyavad, Thank you.read more
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Cancer refers to the uncontrolled growth of abnormal cells anywhere in a body. Anything that may cause a normal body cell to develop abnormally potentially can cause cancer. Although there are many tests to screen and presumptively diagnose cancer, the definite diagnosis is made by examination of a biopsy sample of suspected cancer tissue.
Hi Sir, My wife is 32 years old and I wanted to know what test can I do to prevent or detect if there is any cancer in her body.
Ovaries are small structures present in the lower part of abdomen adjacent to the uterus. Cancers arising from ovaries can be of different types:
Germ cell type (these cancers arise from cells that produce ova or cells that grow into the new born upon fertilization), epithelial (these arise from the outer lining of the ovaries) and others (multiple types from remaining tissue in ovaries).
Epithelial ovarian cancer is the commonest type of ovarian cancers and is also the one associated with high fatality. High fatality is related to the aggressive behaviour of cancer but is also due to the fact that majority of epithelial ovarian cancers are diagnosed late.
In the early stages of ovarian cancer, very few symptoms may be present. Many women do not experience any symptoms at all. The symptoms that may be experienced can be associated with other conditions and hence often go unrecognized. However, in the case of ovarian cancer, these symptoms will gradually increase and worsen with time. Some of the symptoms of ovarian cancer are:
- Pain in the lower abdomen or pelvic area
- Back ache
- Frequent urge to urinate
- Painful intercourse
- Change in bowel habits (constipation usually)
- Loss of appetite or feeling full without eating too much
- Fullness or distension of the abdomen
Ovarian cancer usually affects women over the age of 50 but can occur in younger women also. Women with a family history of breast cancer or ovarian cancer have a higher risk of developing these tumours. Endometriosis and hormone replacement therapy could also increase one’s risk of ovarian cancer.
As with other types of cancer, treatment for ovarian cancer depends largely on how far it has advanced. The main forms of treatment include surgery and chemotherapy. Surgery is usually the first step of treating ovarian cancer. Surgery for early ovarian cancer is called “staging laparotomy” while surgery for advanced ovarian cancer is called “cytoreductive surgery”. Surgery involves complete hysterectomy with removal of both tubes and ovaries. In addition, lymph nodes in the pelvis and retroperitoneum are removed. Removal of omentum (a fatty layer of tissue attached to stomach and large intestine) is also done.
In addition, biopsy samples are collected from the peritoneal lining of the abdomen. If there are other sites of disease, they are also removed surgically. In very advanced cases, parts of intestine (large intestine, small intestine), spleen, liver etc. may also be removed. In some early stage ovarian cancer that are not very aggressive, uterus and one side fallopian tube and ovarian can be saved. This can permit child bearing and is called fertility sparing surgery.
Surgery is usually followed by chemotherapy. Usually six cycles of chemotherapy are used. For early stage ovarian cancer that is low grade, chemotherapy may not be required. Ovarian cancer can come back and all patients need regular follow up after surgery and/or chemotherapy. Physical examination, blood tests, ultrasound and/or CT scan of abdomen are used for follow up. If the disease comes back, chemotherapy may be repeated and sometimes additional surgery can be carried out. In case you have a concern or query you can always consult an expert & get answers to your questions!
- Seminomatous: These are less aggressive and respond very well to chemotherapy and radiation therapy
- Non-seminomatous: These grow and spread rapidly, and often require surgery and chemotherapy
While the exact causes for testicular cancer are not clear, the following are considered to be the possible risk factors:
- Family history
- Undescended testicles
- Prior history of testicular cancer
- Genetic abnormalities of some types
While testicular cancer is often diagnosed late, the patient can have early symptoms, which are often ignored.
- Painful swelling in one (or both) testicle(s)
- Pain in the lower abdomen and groin area
Often, this type of cancer originates in the testicles and spreads to the lymph nodes inside the abdomen. It can also reach distant organs like lungs, liver, and lymph nodes in chest, neck. If attention to paid to early symptoms such as testicular swelling with or without pain, testicular cancer can be diagnosed early. However, even if diagnosed in the late stages, treatment is quite effective and outcome is good.
Tumor Markers in Testicular Cancers
Tumor markers are very important for diagnosis of testicular cancers. Alpha feto protein (AFP) and human chorionic gonadotrophin (hCG) and lactate dehydrogenase (LDH) are very important markers that are testing in blood. They are very useful in diagnosis, staging and follow up of testicular cancer.
Stages of Testicular Cancer
There are three stages of testicular cancer – I to III, and treatment and prognosis would depend on the stage at which it is diagnosed.
Various modalities are used depending on the stage and extent of spread.
- Surgery: Removal of the testicle is usually the first step in testicular cancer treatment. Removal of testicle for cancer is done by a procedure called “high orchidectomy” or radical orchidectomy and not through the scrotum. This may need to be followed up by chemotherapy or radiation in most cases.
- Chemotherapy: Chemotherapy drugs are used to kill the existing cancer cells and arrest the further growth of testicular cancer. Chemotherapy can be given in early cancers to prevent recurrence of cancer and for advanced cancer to cure the advanced cancer. Chemotherapy is very effective in testicular cancer and cures majority of cases in advanced stages too.
- Radiation: External radiation can be used to target nodes in the abdomen. Radiation is very effective in seminomatous cancers. As is true of all cancers, surveillance and follow-up is very essential. History, examination and testing (blood tests for tumor markers) and scanning (CT scan of abdomen, thorax) are used for follow up.
In case you have a concern or query you can always consult an expert & get answers to your questions!
How and why of breast cancer?
Breasts have milk producing glands as well as connective tissue including fat, fibrous tissue, nerves, blood vessels, etc. Milk produced in the glands reaches the exterior through a network of ducts. Most cancers develop in milk producing glands and ducts and later continue to grow and spread to lymph nodes in armpit as well as distant organs.
Warning signs and symptoms:
Given the high incidence of breast cancer, knowing the symptoms helps in early identification. Read on to know more. Pay extra attention if there is a family history.
- Appearance of a lump in the breasts or the armpits
- Any change in the size, shape, or contour of the breasts
- Presence of a watery or bloody discharge from the nipple
- The breast or the nipple turning red
- Sudden thickening of breast tissue or skin that continues for a while
- Change in the feel or look of the skin (dimpling, puckering, scaliness, reddishness, warmth, etc.)
- Hardening of the tissue under the breast skin
- Difference in appearance or feel of one area in comparison with other areas
The presence of any of these or a combination of these symptoms should be an indication for a detailed check-up. As mentioned, early diagnosis helps in improving outcome. Treatment is also easier with early stage of disease. It is also good to know risk factors, which also indicate if you need to watch for symptoms.
- Family history: Breast cancer can run in families, and if you have close relative(s) with breast cancer, watch out for symptoms. Family member or self have a positive test for BRCA1 and BRCA2 Family history of other cancers Age Women over the age of 40 years are at an increased risk of developing breast cancer.
- Hormones: Increased use of estrogen increases the chances of developing breast cancer. Therefore, women who have used birth control pills for long time or are on hormone replacement therapy are at greater risk.
- Abnormal gynaecologic milestones: Women who have abnormal menstrual milestones are more predisposed to developing breast cancer. For instance, girls who have start of menstrual cycles before age of 12, get pregnant after 30, and reach menopause after 55. Women with menstrual irregularities including cycles earlier than 26 days and later than 29 days are also likely to have hormonal issues and are, therefore, at higher risk of breast cancer.
- Other factors: Smoking, alcohol consumption, and obesity also increase the chances of a woman developing breast cancer."
Cancer is a disease characterized by abnormal multiplication of cells in a particular part of the body. After starting in one body part, cancer cells spread to other body parts and lead to the formation of tumours (metastases) in other parts of the body. Throat cancer refers to the development of tumours in the different parts of the throat. Various parts of the throat include oropharynx (tonsil, soft palate, base of tongue), nasopharynx (part behind the nose), hypopharynx and larynx (voice box). Throat cancers are a common type of cancer in India. The most common causes of throat cancer are -
- Tobacco is the most important cause of throat cancer. Smoking in any form increases the risk of pharyngeal and laryngeal cancer greatly. Chewing tobacco can also increase the risk of pharyngeal cancers. No amount of tobacco exposure is safe.
- Alcohol: Alcohol is an important contributor to risk of pharyngeal cancer. Alcohol intake multiplies the risk of cancer that is due to tobacco exposure.
- Human Papilloma Virus: Human papilloma virus or HPV is famous as the cause of cancer of uterine cervix. However, in recent years it has been found to be an important cause of throat cancer. HPV infection is transmitted through sexual contact.
- Epstein Barr Virus (EBV) infection: EBV infection is responsible cancer of the nasopharynx or part of pharynx behind the nasal cavity.
The risk of throat cancer can be reduced by avoided tobacco and alcohol. HPV infection can be avoided through safe sexual practices. These practices can prevent large majority of throat cancers. Other that prevention, timely testing for early diagnosis and immediate treatment when cancer is diagnosed will lead to successful outcomes.
In case you have a concern or query you can always consult an expert & get answers to your questions!
I got a lump on the outer lip of the vagina, five days ago. And three day ago, I consult a doctor. She gave me medicine that are Asiklo-SP ,Hallmax-625 and a cream SUDIF CREAM. Bt since tomorrow the lump is becoming black and hard and the pain is unbearable. Please suggest anything.
Sir, I have 30 lipoma in my whole body mainly in hands and in abdomen. I am taking homeopathic medicine since 2 months. But lipomas are increasing what should I do for instant relief from all lipomas.
Gastric cancer is more commonly known as stomach cancer. It is usually diagnosed in later stages as symptoms are few in early disease and are often neglected by people. Feeling of fullness in upper abdomen, decrease in hunger, weight loss, weakness, vomiting, are some of the common symptoms. Like all cancers, stomach cancer is shrouded in a culture of myths and baseless facts. Here are some of these myths and actual facts to dispel any doubts:
- It’s not cancer if there is no pain: In the early stages of stomach cancer, symptoms are either absent or very mild so that they are usually neglected. This leads to delay in diagnosis. It needs to be stressed again that absence of pain does not mean that cancer can not be there. Slight fullness in the upper abdomen, decrease in appetite, etc. can be signs of stomach cancer.
- Sustained indigestion equals stomach cancer: While it is true that one of the symptoms of stomach cancer is indigestion, burping and/or acidity. But, indigestion doesn't always mean that it is stomach cancer. Most of the times, indigestion is not due to cancer. However, if there is recent onset of indigestion (from 2 weeks to a few months) with loss of appetite, weight loss and vomiting, possibility of cancer should be thought of and testing carried out.
- Stomach cancer is rare: Stomach cancer occurrence varies and it is more common in some areas and much less common in other areas. However, in totality, it is one of the very common cancer types. In India, stomach cancer is more common in southern and north-eastern parts of the country but it can occur in persons in any part of the country.
- Stomach cancer is not genetic: Even though it is not commonly seen as a hereditary disease, stomach cancer can be passed down through the genes, thereby increasing the chances of stomach cancer in people who possess it by 70 to 80 percent. Mutation in the CDH1 gene is usually the reason behind this. Sometimes also known to contribute to breast cancer in women.
- Stomach cancer has no cure: This is a misconception. Except for most advancer stage of cancer (stage IV), stomach cancer can be cured by proper treatment. Surgery is the mainstay of curative treatment for stomach cancer. Chemotherapy and radiation therapy are also required in addition to surgery in many cases." In case you have a concern or query you can always consult an expert & get answers to your questions!