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Diagnostic X- Ray
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MY WIFE RECENTLY HAD A CT SCAN & THE IMPRESSIONS ARE AS FOLLOWS: * Bilateral vocal cord palsy (more prominent on left side) * Few enlarged left supraclavicular lymph nodes * ~3 x 2 cm irregular mass in medial aspect of right upper lobe of lung, infiltrating the mediastinal pleura-suggestive of malignancy (metastases - known carcinoma of left breast) * I11 defined soft tissue rind measuring ~1 cm in thickness in superior mediastinum, encasing the mediastinal structures- suggestive of malignancy (spread from pleura / metastatic lymphodes) * ~2 cm right perihilar mediastinal lesion. * Multiple nodules measuring about 2 mm to 5 mm in both lungs- suggestive of metastases. * Moderate pericardial effusion. * Thin layer of left pleural effusion. I KNOW IT IS RELATED TO CANCER, BUT I WANT TO KNOW EXACTLY WHAT TYPE OF CANCER IT IS & WHAT IS THE SURVIVAL CHANCE (PERIOD) FOR PATIENT TAKING TREATMENT & PATIENT NOT TAKING ANY TREATMENT. KINDLY GIVE YOUR VALUABLE SUGGESTION. Thanks & Regards
I am having problem in my spinal cord disc L4 -L5. With some loss of fluid. Now my knee joint also getting pain. What you wil suggest.
A mastectomy is surgical removal of a breast. The surgery depends on various factors and choosing a type of mastectomy best suited for an individual suffering from breast cancer requires experience and expertise. With advancing technology, there are more options available for women to opt for surgeries, which are minimally invasive and conserving in nature. Following are the various types of mastectomies and the factors, which influence them:
Types of Mastectomy
1. Total or simple mastectomy
This is a surgical procedure which involves complete removal of the breast including the nipple. The lymph nodes, which are small glands, are an important part of your immune system and are kept intact during the surgery. This form of surgery is most suitable if the cancer has not spread to the lymph nodes.
2. Preventive mastectomy
Preventive mastectomy, also known as prophylactic mastectomy, is an option for women who have a high risk of developing breast cancer. Preventive mastectomy reduces the risk of breast cancer by a huge margin. In certain cases, removal of the entire breast along with the nipple is advisable. Women who develop cancer on one breast often opt for preventive mastectomy and remove the other unaffected breast as well.
3. Partial mastectomy
Women who are in stage I or stage ii of breast cancer can choose this procedure. It is a breast conserving technique where the tumor is removed along with the tissue that surrounds it. It is followed up by radiation therapy on the remaining breast tissue, which terminates the cancer cells and stops them from spreading. There are two types of partial mastectomy, namely, lumpectomy and quadrantectomy.
4. Radical mastectomy
Although this procedure is almost out of use, it is still considered in case the cancer has spread to certain areas like the chest muscle. In this form of surgery, the breast is removed entirety along with muscles beneath it and the lymph nodes.
5. Modified mastectomy
It is a more commonly used procedure characterized by complete removal of the breast including underarm lymph nodes. The chest muscles are untouched in the procedure, therefore allowing a breast reconstruction to follow.
Factors influencing the type of mastectomy:
• Age of the individual
• Health in general
• Size of the tumor
• The spread of the tumor
• The rate of progression of the tumor
• Whether lymph nodes are affected or not
If you wish to discuss about any specific problem, you can consult a doctor.
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.
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.
Breast Cancer can be detected at various stages. Some women might feel a difference in their breast area, with a lump or kind of a skin rash around the nipple or they could see that their nipple has become inverted, so then the treatment procedures would be different. The different stages of cancer and their respective treatment procedures are discussed below:
Stage I Breast Cancer - Treatment
In this case, breast cancers are at their nascent stage, either they have not spread to the lymph nodes or might have spread to only a small area. Treatment options are as follows:
- Surgery: The main treatment for breast cancer in stage I is surgery. These types of cancers get treatment with either breast-conserving surgery or mastectomy. There are some cases when breast reconstruction can also be done along with the surgery to get rid of cancer.
- Radiation therapy: When doctors feel the need to do a breast construction surgery, then radiation therapy is normally given after surgery. This helps in lowering the chance of cancer getting relapsed. Older women, aged close to 70 years, should go for breast reconstruction surgery without radiation therapy, provided the following conditions are true:
- The lump was 2cm or less across and it has been completely removed.
- None of the lymph nodes removed contained cancer.
- The cancer is either ER or PR-positive and hormone therapy is conducted.
- Chemotherapy and other drugs: Women who have either ER or PR-positive hormone receptor, doctors would recommend them to go for hormone therapy. The therapy is given for 5 years. In case the tumor is larger than 1cm across, adjuvant chemotherapy is recommended.
Stage II Breast Cancer-Treatment
This is the stage when cancer has spread to some nearby lymph nodes. The treatment methods followed are:
- Surgery and radiation therapy: This second stage of cancer gets treated with breast-conserving surgery or mastectomy. The lymph nodes nearby get checked either with a sentinel lymph node biopsy or an axillary lymph node dissection. Women, on whom BCS have been conducted, get treated with radiation therapy after surgery.
- Neoadjuvant and adjuvant systemic therapy: This is another method followed for treating stage II cancer. It is a good option for women with large tumors as they shrink the tumor before conducting surgery. Chemotherapy, HER2 targeted drugs and Hormone therapy all form part of treatment in this stage II.
Stage III Breast Cancer – Treatment
In stage III breast cancer, the size of a tumor is more than 5 cm, with cancer spreading on to the nearby lymph nodes. The treatment procedures followed are:
- Neoadjuvant therapy: Generally the stage III cancers are treated with neoadjuvant chemotherapy. Radiation therapy is also given after surgery, followed by breast reconstruction surgery.
- Starting off with surgery: Another treatment option for this stage is to get started off with surgery. The tumors are quite large and they even grow on to nearby tissues, which means women need to get a mastectomy. Women having large breasts can even go for Breast Reconstruction Surgery, in case cancer has not spread on to the nearby tissues.
In case you have a concern or query you can always consult an expert & get answers to your questions!
I am bodybuilder I had a disc replacement due to bulge in my disc. Is it possible to continue bodybuilding. Lifting weights etc. Plzz help me.
She has a desk job and feeling pain in right leg the mri shows reduced space in intervertebral disc.
Dilation and curettage procedure which is commonly referred to as D&C is a minor surgical procedure where the cervix is dilated while a special instrument is used for scraping out the lining of the uterus. It is important to know what you can expect before, after and during the process so that you can stay ahead of unnecessary worries and help the process to be smooth and fruitful.
When do doctors recommend dilation and curettage process?
You may be required to undergo the dilation and curettage procedure for one of many reasons. It can be used for removal of tissues in the uterus during or after an abortion or miscarriage or to remove little pieces of placenta after delivery. This process aids in preventing infection as well as heavy bleeding. On the other hand, it can help in diagnosing and treating abnormal uterine bleeding including polyps, fibroids, hormonal imbalances and even uterine cancer. A sample of the tissues in the uterus is tested under a microscope to check if there is any abnormal cell present.
What can you expect during the dilation and curettage process?
The D&C procedure is a minor one and takes about 15 minutes even though you will have to spend about 4 to 5 hours in the healthcare facility. Before the procedure, your doctor would check complete history, and at this point, you should tell your doctor if you suspect that you are pregnant, you are sensitive to latex or any medicines or if you have a history of bleeding disorders. You will then be given anesthesia so that you don’t feel any pain or discomfort during the procedure. Before this procedure, you will have to empty your bladder.
The D&C procedure comprises two main steps, dilation, and curettage.
Dilation involves opening of the lower part of the uterus or the cervix for allowing insertion of a slender rod. This is done to soften the cervix so that it opens and allows curettage to be performed. Curettage involves scraping of the lining and removal of the uterine contents with the help of a spoon-like instrument known as a curette. This may cause some amount of cramping, and a tissue sample would be taken out for examination in the laboratory.
After the completion of the procedure, you may experience slight bleeding and cramping. In some rare cases, adhesions or scar tissues may start forming inside the uterus, and this condition is termed as Asherman’s syndrome which can cause changes in the menstrual cycle along with infertility. This problem, if arises, can be solved with the help of surgery and therefore, you should report any abnormality in your menstrual cycle to your doctor. Consult an expert & get answers to your questions!