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Uterine cancer is also known as endometrial cancer. It is a cancer which begins in the lining of the uterus. The uterus is the part of a woman's body where the fetus develops. Uterine cancer is one of those rare cancers in India, which can be diagnosed in its early stages. This is because excessive vaginal bleeding occurs, thus making it a very serious and an apparent symptom. It is also one of the few forms of cancer which can be cured as removing the uterus is often more than enough to cure the patient of uterine cancer.
Here are the causes, diagnosis and treatment of uterine cancer:
The exact cause of uterine cancer is not yet known, however, there is a theory on what causes uterine cancer. Hormones in a woman's body have been thought to increase the chances of getting uterine cancer. This is because it has long been thought that having high levels of estrogen is the cause of uterine cancer. Increased estrogen thickens the endometrium and thus, increases the likelihood of uterine cancer.
1. Pelvic exam: This is an examination in which the vagina, bladder, rectum and uterus are scanned for lumps. If they are found, it might be due to uterine cancer.
2. Pap test: A pap test is a special test designed to scan for uterine cancer.
3. Transvaginal ultrasound: A transvaginal ultrasound uses high-intensity sound waves so that pictures of the uterus can be taken.
4. Biopsy: During a biopsy, the doctor will remove tissue from the endometrium and it will then be analyzed for cancerous growths.
1. Surgery: This is the most common treatment as it removes the entire uterus and prevents the spreading of the cancer.
2. Chemotherapy: Chemotherapy involves giving drugs which kill cancerous cells. They are given through either an intravenous line or even in pill form.
3. Hormone therapy: This is a therapy in which either progesterone levels are increased or estrogen levels are decreased.
4. Radiation therapy: In this treatment, high energy laser beams are used to destroy cancerous cells. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
I have some disc problem, in MRI report L5S1, how can I remove this problem, which exercise is useful in this problem.
My wife is suffering from slip disc in spine after mri doctor diagnosis that she also suffering bone tb with unbearable pain in lower portion. Now as per doctor advice completely she is in bed rest. Now she cannot able to stand. Kindly advice.
My age is 28 and I am suffering from back pain due to L3, L4, L5 Disc bulging. Kindly suggest me a solution to over come from back pain without surgery.
Age 51 years male. Slip disc happened jan'2010 and get to normal after 4 years doing only exercise till now and used lumbo scrarol belt when out of home. Due to filling uneasy during walking, a tmt brace protocol suggested. Is it ok to do the test.
Hello Dr. My mother facing the problem regarding slip disk in the year of 2012 now she is fine but some time he faced pain what I will do so he will get normal.
Sir my mom suffering from pain in almost all of the body specially in the backside, headache is there and also some sort of problem in breathing. Her protein is 9.8,albumin is 3.0,globulin 6.8,crp, alp,creatinine, vit D all are normal. Her MRI report says "study revels central & bilateral paracentral disc herniations with annular tear at L4-L5 and L5-S1 levels with thecal compression & bilateral traversing nerve root impingement. Mild retrolisthesis of L4 over L5 vertebral body is noted. There are degenerative osteophytes & disc desiccation as described in the text. Sir please tell me how can I treated her, doctor advice her tab maxgalin and accuvin what is the problems she can relief or not or any serious concern. Please help Sir.
My MRI report of LS Spine is as: Diffuse Disc bulge at L3 /L4 indenting the thecal sac Partial desiccation of L4 / L5 with diffuse posterior disc bulge Indenting the thecal sac encroaching bilateral neural foramina (left>right) Partial desiccation of L5 / S1 Please tell. Me the seriousness of the problem with precautions Is this normal.
Q1. What exactly is Laparoscopy?
Laparoscopy is an alternative to 'Open' surgery wherein the abdomen is opened by tiny 'key hole' incisions and surgery is done. 'Scopy' means the use of an endoscope or telescope to see inside the abdomen. This is attached to a camera and a light source and the inside of the abdomen is projected on to a monitor. The surgeon performs surgery looking at this screen. The surgeon makes a total of 2-4 small cuts on the abdomen ranging from half to 1 cm through which the telescope and other thin surgical instruments are passed into the abdomen. When the uterus is removed , known as hysterectomy, there is also a cut at the top of the vagina where the uterus is attached.
Q2. What kind of gynaecological surgeries can be performed by Laparoscopy?
Most surgeries done in gynaecology can now be performed by Laparoscopy and do not require the large incision as for open surgery. Laparoscopy can be done sometimes only for diagnosis and is called Diagnostic Laparoscopy, as in checking whether the tubes are open or not and to look for any causes of infertility or pain outside the uterus. In women who are unable to conceive, Diagnostic Laparoscopy is often combined with Hysteroscopy (endoscope inside the uterus, inserted from below, via the vagina). When laparoscopy is done to perform some surgical procedure inside the abdomen it is called Operative Laparoscopy. This may be for simple procedures like sterilization, minor adhesions, drilling ovaries; or for intermediate or major reasons like fibroids, endometriosis, removal of ovaries or tubes or both or removal of uterus, for staging of cancers or radical surgeries for cancer. However, about 5% of all surgeries including those for cancer or very large tumours may benefit from open surgery.
Q3. Why does an expert surgeon recommend Laparoscopy over Open Surgery?
Laparoscopic surgery has many advantages above open surgery: the incisions are much smaller (open surgery incisions are 8-10 cms long), therefore pain is much less; requirement for pain killers (which can have side-effects like sleepiness, impaired judgement) is lesser; hospital stay is shorter; complications fewer; requirement for blood transfusions infrequent; recovery in terms of physical, emotional and mental state is much better and quicker; return to work is faster with consequent lesser loss of working and earning days. Surgery with laparoscope is more precise because it is magnified view. Further vision is much better because it's like having your eye behind the structure because you can see with the telescope at places where the surgeon's eye cannot reach.
Q4. If the cuts on the abdomen are so small in Laparoscopic surgery, how do you remove the uterus or a large tumour from inside the abdomen?
Quite often if the tumour is not malignant and contains fluid, it is punctured to collapse it into a smaller size. If it is solid, it can be cut into smaller pieces inside the abdomen using a special instrument. The collapsed or cut structures can be removed gently through the 1 cm cut on the abdomen which may be increased a bit if required. After hysterectomy, the uterus can be removed easily from below, through the vagina.
Q5. Will there be much pain or discomfort after Laparoscopic Surgery?
There may be some pain and discomfort in lower abdomen for one day to few days after Laparoscopic surgery but this is much less as compared to open surgery because the incisions on the abdomen are much smaller and there is much less tissue handling inside the abdomen by fine instruments instead of rough, big, gloved hands which can cause tissue injury in open surgery. There may be some pain in the shoulder following laparoscopy. This is not serious and is due to the gas used in the surgery to make space for instruments.
Q6. When can I be discharged from hospital?
Following Diagnostic Laparoscopy or with simple Operative Laparoscopy you can expect to be discharged from hospital latest by the morning after surgery. In most other cases of intermediate or even major surgery, discharge is generally 1-2 days following the surgery unless there is some health issues prior to the surgery or any complication during the surgery. The complication rates for Laparoscopic surgery are not more than for open surgery and depend upon patient factors like anaemia, diabetes, obesity and skill of the surgeon.
Q7. When can I perform routine household activities or return to work after Laparoscopic Surgery?
Recovery after surgery depends upon many factors: presence of health problems before surgery; why the surgery is required; what surgery is being done; problems or complications of surgery, anaesthesia or blood transfusions. If all is well, one can perform routine household activities by 1 week, provided one doesn't feel tired. Although there may not be any harm, it may be unwise to be normally active within 48 hours of procedure. Following Diagnostic Laparoscopy or Operative Laparoscopy for simple procedures, one can return to work in 1 week. For other procedures, a 2-3 week off from work is reasonable. It depends on the type of work you are returning to. Avoid too rapid return to work if it is manually hard or requires standing for long durations of time. Sometimes a surgical procedure brings on a well needed rest and break from a lifetime of work. Mostly, when you return to work depends upon your own body and its signals of tiredness. You need to listen to those signals.
It is perfectly normal for women to experience the periodic monthly bleeding cycle. However, if a woman experiences uterine bleeding which is abnormal and dysfunctional, it could be a symptom of infection. Other causes of abnormal uterine bleeding include hormonal imbalance, infection in cervix and cancer of the uterus. Many women can also experience abnormal uterine bleeding during first trimester of pregnancy.
The following are considered to be abnormal or dysfunctional uterine bleeding:
- A menstrual cycles occurs between 21 to 35 days, anything shorter or longer than this is abnormal
- No period for 3–6 months (amenorrhea) is abnormal
- Spotting or bleeding between periods
- Spotting or bleeding after intercourse
- Bleeding that is heavier or lasts longer than usual
- Spotting or bleeding after menopause
What can cause such a situation?
Some of the common causes leading to abnormal bleeding are as follows:
- Ectopic pregnancy
- Cervical or uterine infections
- Hormonal imbalances
- Problems with blood clotting
- Polycystic ovaries
- Endometrial hyperplasia
- Cancer of the reproductive tract
How to Diagnose it?
Most women tend to ignore abnormal bleeding, taking it as something to do with age or hormones. A detailed physical examination and history is done to understand menstrual cycle patterns and family history. In addition, the following would be used.
- Ultrasound: The pelvic organs are examined through sound waves to locate the problem area
- Hysteroscopy: Through a thin device that is inserted into the vagina, the doctor takes a look at the inside of the organs and identify the cause for the bleeding
- Endometrial biopsy: The uterine lining tissue is removed and examined under microscope to look for tissue changes that could be causing the bleeding
How Best to Treat It?
This would depend on the reason for the abnormal bleeding. However, in most cases, combinations of the following are useful in treatment.
- Hormone replacement can be done depending on the age and gynecological history, the type and the dose of the hormone would be decided upon. These could be in the form of tablets, vaginal creams, injections, or through an intrauterine device
- Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are useful in reducing bleeding and controlling cramps during excessive menstrual bleeding.
- Antibiotics may be useful if there is infection of the pelvic organs.
- Polyps, cysts, cancers, and other growths can be removed via hysteroscopy and sent for biopsy to confirm they are not cancerous.
- Endometrial ablation where the endometrial tissue is treated with heat can be used to control bleeding permanently.
- Hysterectomy would be done if other forms of treatment have failed. This could depend on their gynecologic history and other considerations as she cannot get pregnant after this.
Do not ignore if you see a change in the pattern of your uterine bleeding. It definitely calls for medical attention and if identified early, can be managed in much simpler ways.
Please advice some treatment for bulging of disc I tried everything possible. Visited all type of doctor, did physical exercise and massage as well but still pain persists.
Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips.
Here's what you should look for:
Breasts that are their usual size, shape, and color
Breasts that are evenly shaped without visible distortion or swelling
If you see any of the following changes, bring them to your doctor's attention:
Dimpling, puckering, or bulging of the skin
A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out)
Redness, soreness, rash, or swelling
Step 2: now, raise your arms and look for the same changes.
Step 3: while you're at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood).
Step 4: next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with the first few finger pads of your hand, keeping the fingers flat and together. Use a circular motion, about the size of a quarter.
Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage.
Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your fingers up and down vertically, in rows, as if you were mowing a lawn. This up-and-down approach seems to work best for most women. Be sure to feel all the tissue from the front to the back of your breasts: for the skin and tissue just beneath, use light pressure; use medium pressure for tissue in the middle of your breasts; use firm pressure for the deep tissue in the back. When you've reached the deep tissue, you should be able to feel down to your ribcage.
Step 5: finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in step 4.
Symptoms, causes and treatment for Breast Cancer Patients
Hello friends. My name is Dr. Gayatri Juneja. I’m a practicing gynecologist in Model Town for the last 20 years. I’m a visiting consultant in Apollo Cradle Hospital Moti Nagar, and Fortis Hospital Shalimar Bagh, and Sunder Lal Hospital Ashok Nagar. It’s a great pleasure for me to talk to you about certain problems which I think is becoming very important for all of us to know. I am going to talk about Breast Cancer.
Unfortunately, even in India, cancer breast is becoming very common. And it is not that it is a cancer which we cannot pick up at time. The only thing we need is to be aware of it. Only if we know what is happening with our body, is only then we can do what is normal, only then we can see what is not normal, right? It is one of the breast cancer is one of the easiest cancers to pick up. How? My body is my own. I should know what’s happening to me. So minimum a lady can do is do a self examination. Teach your daughters how to do a self examination for the breast. If you find any lump, any time, if you feel there is some pain, which was not there, if you see the nipple is not in the normal position, it is retracted inside, if you see there is skin changes on your breast, if you see any size difference. See minor size difference will be there. That is a natural thing. But if you see there is drastic change, and if you are not comfortable with something, do not neglect it. It’s not at all a normal thing. Go, see a gynaecologist.
It is a confidential thing between you and your doctor. Let her examine you. Let her guide you. You give her a proper history, if you have taken any contraceptive pills, even I-pill is very dangerous. I’ll come to it later how. The thing is…your doctor has examined you, then she will guide you what has to be done. There are various ways of diagnosing cancer of breast. First step is, you do a self examination. First step is over. You find the lump, you go to a doctor. Your doctor will ask for a sonography, that is ultrasound of the breast. And another part of it is an x-ray of the breast. Sometimes in younger age group the breast is very dense, and you cannot diagnose anything on mammogram.
You still are suspecting something, then your doctor might ask for an MRI. MRI is very effective in diagnosing, but we do not suggest it as first line treatment, first line of diagnosis. Once it is confirmed that yes, there is a lump, then what we do is, we ask for a biopsy. Now biopsy can be in 2 forms. It can be taken through the needle, which we call FNAC – Fine Needle Aspiration Cytology, and other is open biopsy, where we remove the whole lump, and send it for testing. If the test comes negative, good, fine, everything is fine. If it comes positive, then further treatment depends upon the type. Then they will do a special CT scan for you, where the will diagnose if any lymph nodes are involved.
Depending on preliminary staging, your doctor will ask for a surgery. Now the surgery will…it is better that the whole breast gets removed. Or what has to be done will be diagnosed, because it is not a single person specialty, it is going to be a multi-specialty treatment then. Now let’s come down to who are the people who are at higher risk. Why should I consider that I am at higher risk? What…who are those people? First, specially after menopause, obesity. If your lifestyle is not at all healthy, your food habits you eat lot of non-veg and processed food, like pizzas and burgers and frozen food, yes you are at risk. Then comes genetics.
If you have a family history of cancer in your nani, dadi, your bua, maasi, cousin, ya sister ya brother, or even cancer of ovaries, you are at high risk. But that doesn’t mean who all have had the history of cancer will also develop this. You are at higher risk, but it is better only to be careful. Then comes very tall ladies it has been seen they are also prone for diabetes. Obesity, and people who have had hormonal replacement therapy with…and once you’re diagnosed don’t get scared. It is a curable cancer, and life expectancy with variable modalities these days is quite good.The quality of life is also good.
So my suggestion would be, to conclude, that please be aware of what is happening with you, and take good care of yourself. If you are healthy, only then you can look after your family. Thank you so much.
Dear sir, I am 33 year old. I have back ache since 2010 mri also have been done it shown herniated slip disk and doctor has advised me surgery. But I am not willing to get surgery please advise me what should I do.
The uterus or womb, is a muscular structure and is held in place by ligaments and pelvic muscles. If these muscles or tendons become weak, they cause prolapse and are no longer able to hold the uterus in its place.
Uterine prolapse happens when the uterus falls or slips from its ordinary position and into the vagina or birth waterway. It could be complete prolapse or even incomplete at times. A fragmented prolapse happens when the uterus is just hanging into the vagina. A complete prolapse depicts a circumstance in which the uterus falls so far down that some tissue rests outside of the vagina. Likewise, as a lady ages and with a loss of the hormone estrogen, her uterus can drop into the vaginal canal. This condition is known as a prolapsed uterus.
Risks: The risks of this condition are many and have been enumerated as follows:
- Complicated delivery during pregnancy
- Weak pelvic muscle
- Loss of tissue after menopause and loss of common estrogen
- Expanded weight in the stomach area, for example, endless cough, constipation, pelvic tumors or accumulation of liquid in the guts
- Being overweight
- Obesity causing extra strain on the muscles
- Real surgery in the pelvic zone
Symptoms: Some of the most common symptoms of prolapse involve:
- Feeling of sitting on a ball
- Abnormal vaginal bleeding
- Increase in discharge
- Problems while performing sexual intercourse
- Seeing the uterus coming out of the vagina
- A pulling or full feeling in the pelvis
- Bladder infections
Nonsurgical medications include:
- Losing weight and getting in shape to take stress off of pelvic structures
- Maintaining a distance from truly difficult work
- Doing Kegel workouts, which are pelvic floor practices that strengthen the vaginal muscles. This can be done at any time, even while sitting down at a desk.
- Taking estrogen treatment especially during menopause
- Wearing a pessary, which is a gadget embedded into the vagina that fits under the cervix and pushes up to settle the uterus and cervix
- Indulging in normal physical activity
Some specialists use the following methods to diagnose the problem:
- The specialist will examine you in standing position keeping in mind you are resting and request that you to cough or strain to build the weight in your abdomen.
- Particular conditions, for example, ureteral block because of complete prolapse, may require an intravenous pyelogram (IVP) or renal sonography. Color is infused into your vein, and an X-ray is used to view the flow of color through your urinary bladder.
- An ultrasound might be utilised to rule out any other existing pelvic issues. In this test, a wand is used on your stomach area or embedded into your vagina to create images of the internal organ with sound waves. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
Hello sir. I have lower back pain since 2 months back. I have done mri there is disk problem. What is permanent solution is surgery kindly help me.
What should I be doing to releave the pain for two herniated disc's one above and one below a fusion surgery of the cervical spine.
Collectively grouped under the Ewing sarcoma family of tumors, Ewing's sarcoma is the second most common form of bone cancer, which is commonly seen in children and adolescents. Very rarely is it experienced in adults above the age of 30.
Typically forming in the bones of the chest, pelvis, head, back or trunk and in the long bones of the arms and legs, Ewing's sarcoma is believed to originate in certain kinds of primitive cells. When it begins to affect similar kind of cells found outside the bone, it is usually called an extraosseous Ewing's sarcoma.
1. Similar to all types of Ewing tumors, Ewing's sarcoma is generally caused by an alteration in a certain cell compelling a gene named EWS found on chromosome no. 22 to move over to a DNA section on any one of the surrounding chromosomes resulting in the activation of the EWS gene.
2. While it is not a hereditary condition, it usually occurs after childbirth, but no substantial evidence has been found as to why it happens so.
Symptoms of Ewing's sarcoma may include:
1. Swelling and pain especially in the arms, legs, back, chest or pelvis
2. Swelling accompanied by joint immobility
3. A bone breaks having no apparent cause
4. Swelling which may or may not be accompanied by a warm, tingling sensation
5. Fever resulting from unknown causes
6. Lumps or bumps which do not subside over time
7. Abnormal weight loss
8. High levels of fatigue
9. Tumors which have spread over to the lungs may cause shortness of breath
10.Tumors spread over to the spine may cause weakness or even paralysis.
Because the symptoms of Ewing's sarcoma can hardly be distinguished from symptoms caused by other infections or injuries, an early diagnosis is absolutely necessary for a successive treatment. If you wish to discuss about any specific problem, you can consult an oncologist and ask a free question.