Avenue X-ray Clinic

The uterus is a muscular structure held in place inside your pelvis with the help of muscles, ligaments, and tissues. These muscles weaken in women due to pregnancy, childbirth or delivery complications and can lead to severe complications. One such complication is a uterine prolapse. Uterine prolapse occurs when the uterus sags or slips from its normal position into the vaginal canal.

The causes of uterine prolapse are varied and include:

- Delivering a large baby
- Pregnancy
- Difficulty in labor and delivery
- Reduction in estrogen levels post menopause
- Traumatic childbirth
- Loss or weakening of the pelvic muscle
- Conditions which lead to increased pressure in the abdominal area such as a chronic cough, straining, pelvic tumors or accumulation of fluid in the abdomen
- Loss of external support due to major surgery in pelvic area

Uterine prolapse can be complete or incomplete depending on how far the uterus sags into the vagina. Women who have minor uterine prolapse may not have any visible symptoms. However, if the condition worsens, it manifests itself in visible signs.

Symptoms of moderate or severe prolapse are:

1. A feeling of fullness or pressure in your pelvis when you sit
2. Seeing the uterus or cervix coming out of the vagina
3. Vaginal bleeding or increased discharge
4. Painful sexual intercourse
5. Recurrent bladder infections
6. Continuing back pain with difficulty in walking, urinating and moving your bowels

Without proper attention, the condition can cause impairments in the bowel, and can also affect bladder and sexual function. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

Are you experiencing excessive uterine bleeding? Excessive uterine bleeding may occur between a woman’s periods or before the periods, after having sex, or due to the development of spotting or bleeding after attaining menopause. Any menstrual cycle, which lasts longer than 21–35 days is called excessive, and this is an abnormal form of uterine bleeding.

Causes of Excessive Uterine Bleeding:

The various causes of excessive uterine bleeding are as follows:

1. One of the main causes is hormonal imbalance, as the balance between estrogen and progesterone gets disrupted. This balance is required for the regulation and development of the lining of endometrium or uterus lining. Because of the hormonal imbalance, the endometrium develops excessively causing heavy bleeding.

2. Uterine fibroids, which are non cancerous tumours, may lead to prolonged and excessive uterine bleeding.

3. Polyps are small benign developments on the uterus lining which cause heavy bleeding. They occur because of high levels of hormones.

4. Adenomyosis is a condition which develops when the endometrium glands get embedded in the uterine muscle, leading to excessive uterine bleeding.

5. Using intrauterine devices or IUDs may cause side effects as well.

6. Several pregnancy complications may also lead to excess bleeding. Ectopic pregnancy is a common cause.

7. Several uterine cancers, ovarian cancers and cervical conditions may be responsible as well. Inherited bleeding disorders such as von Willebrand’s disease is another likely cause.

8. Several medicines and drugs, including NSAIDs and anticoagulants are a common cause.

9. Medical conditions such as pelvic inflammatory disease, endometriosis, liver and kidney disease or thyroid problems can also cause excessive uterine bleeding.

Treatment:

There are different ways of treating excessive uterine bleeding, depending upon the cause of bleeding and the patient’s age.

1. Medications: Several medicines are used for the treatment of abnormal uterine bleeding. Hormonal medicines and birth control pills are used to improve the regularity of periods. Non steroidal anti-inflammatory drugs are also used to manage excessive uterine bleeding. Several antibiotics are also used.

2. Surgery: In many cases, a woman has to undergo a surgery for the removal of polyps and fibroids, which cause excessive bleeding. Certain fibroids are removed via hysteroscopy and other techniques for treatment are used as well. Endometrial ablation can be carried out to manage the bleeding. This treatment aims at permanent reduction of the excess bleeding. Hysterectomy has to be carried out when other treatments are unsuccessful. This is a serious surgery and after it, a woman will no longer have periods, and she will not be able to conceive a child.

In case of excessive uterine bleeding, you must consult a doctor as soon as possible. This will enable early treatment and prevent the development of further complications.

जिगर शरीर में सबसे बड़ा ग्रंथियों वाला अंग है और शरीर को विषाक्त पदार्थों और हानिकारक पदार्थों से मुक्त रखने के लिए विभिन्न महत्वपूर्ण कार्य करता है। पेट के दाहिने ऊपरी चतुर्भुज मंर स्थित है, पसलियों के ठीक नीचे। लिवर पित्त के उत्पादन के लिए जिम्मेदार है, जो एक पदार्थ है जो आपको वसा, विटामिन, और अन्य पोषक तत्वों को पचाने में मदद करता है। यह ग्लूकोज जैसे पोषक तत्वों को भी स्टोर करता है और दवाओं और विषाक्त पदार्थों को तोड़ता है। 

लिवर कैंसर, जिसे हेपेटिक कैंसर भी कहा जाता है, एक कैंसर होता है जो लिवर में शुरू होता है। जब कैंसर लिवर में विकसित होता है, तो यह लिवर कोशिकाओं को नष्ट कर देता है और सामान्य रूप से कार्य करने के लिए लिवर की क्षमता में दखल देता है। लिवर कैंसर के दो प्रकार होते हैं। प्राथमिक लिवर कैंसर, जो लिवर की कोशिकाओं में शुरू होता है। जबकि, कैंसर जो कि कहीं और से शुरू होता है और अंततः जिगर तक पहुंच जाता है, उन्हें जिगर मेटास्टेसिस या द्वितीयक लिवर कैंसर कहा जाता है।

प्राथमिक लिवर कैंसर के विभिन्न प्रकार
विभिन्न प्रकार के प्राथमिक लिवर कैंसर लिवर के विभिन्न कोशिकाओं से उत्पन्न होते हैं। प्राथमिक लिवर कैंसर लिवर में एक गांठ के रूप में, या एक ही समय में लिवर के भीतर कई स्थानों में शुरू हो सकता है।

1. हेपैटोसेलुलर हेपैटोसेलुलर:
हेपेटोसेल्यूलर कार्सिनोमा (एच.सी.सी), जिसे हेपेटामा भी कहा जाता है, सबसे सामान्य प्रकार का लिवर कैंसर है। एचसीसी मुख्य प्रकार के लिवर कोशिकाओं में शुरू होता है, जिसे हेपोटोसेल्यूलर कोशिका कहा जाता है। एचसीसी के अधिकांश मामले हेपेटाइटिस बी या सी, या शराब के कारण जिगर के सिरोसिस के संक्रमण का नतीजा है। 

2. फाइब्रोलैमेलर एचसीसी:
फाइब्रोलामेरेलर एचसीसी एक रेअर प्रकार का एचसीसी है, जो आम तौर पर अन्य प्रकार के लिवर कैंसर की तुलना में उपचार के लिए अधिक संवेदनशील होता है।        

3. कोलेंजियोकार्सिनोमा:
कोलेंजियोकार्सिनोमा, जिसे आमतौर पर पित्त नली के कैंसर के रूप में जाना जाता है, लिवर में छोटे, ट्यूब जैसे पित्त नलिकाओं में विकसित होता है। पाचन में मदद करने के लिए, ये नलिकाएं पित्ताशय में पित्त को ले जाने के लिए जिम्मेदार हैं। जब कैंसर लिवर के अंदर नलिकाएं के खंड में शुरू होता है, तो इसे इंट्राहेपेटिक पित्त नलिका कैंसर कहा जाता है। यद्यपि, जब लिवर के बाहर नलिकाओं के अनुभाग में कैंसर शुरू होता है, तो एक्स्ट्राहेपाटिक पित्त वाहिका कैंसर कहलाता है। 

4. एंजियोसारकोमा:
एंजियोनेसकोमा लिवर कैंसर का एक रेअर प्रकार है जो लिवर के रक्त वाहिकाओं से शुरू होता है। इस प्रकार का कैंसर बहुत तेज़ी से प्रगति करता है, इसलिए यह आमतौर पर एक और अधिक उन्नत चरण में डिटेक्ट किया जाता है।

5. हेपेटोब्लास्टोमा:
हेपोटोब्लास्टोमा एक अत्यंत असामान्य प्रकार का लिवर कैंसर है। 

लिवर कैंसर के लक्षण
ज्यादातर लोगों के प्राथमिक जिगर कैंसर के शुरुआती चरणों में लक्षण नहीं होते। जिसके परिणामस्वरूप, लिवर कैंसर बहुत देर से डिटेक्ट किया जाता है। लिवर कैंसर के लक्षणों में शामिल हैं:

1. पीलिया
2. भूख में कमी
3. वजन घटना
4. एबडोमीनल पेन
5. बुखार
6. मतली और उल्टी
7. सामान्य खुजली
8. हेपटेमेगाली (बढ़े हुए जिगर)
9. बढ़े हुए स्प्लीन

चूंकि लिवर कैंसर के लिए कोई व्यापक रूप से अनुशंसित नियमित स्क्रीनिंग टेस्ट नहीं हैं, इसलिये बीमारी के परिवार के या अन्य जोखिम कारकों के इतिहास वाले लोगों को उनके डॉक्टर से बात करनी चाहिए ताकि वे अपने जोखिम को मॉनिटर करने या कम करने के लिए सही कदम उठा सकें।

लिवर कैंसर के जोखिम कारक
प्राथमिक लिवर कैंसर के खतरे को बढ़ाने वाले कारकों में शामिल हैं:

1. मधुमेह
2. अफ्लाटॉक्सिन
3. उपचय स्टेरॉयड्स
4. आर्सेनिक
5. धूम्रपान
6. सिरोसिस
7. कम प्रतिरक्षा और मोटापा

The thought of going under the knife to treat your spine problem may give rise to a range of emotions; make you ponder over a number of things such as the recovery period, procedure and techniques involved and so on. Nonetheless, before opting for the surgery, there are certain points that you should go over and these are:

• Be well aware of the cause of your pain - Identifying the cause that is behind your pain is vital in order to decide whether the surgery is going to prove beneficial in the long run or not. If the cause is not identified as the right one, the surgery may prove futile and you may not get the pain relief that you're looking for.
• Gather detailed information about your spine surgeon - Before visiting the spine surgeon, you should collect detailed information about the specialist so as to be able to come up with appropriate questions concerning the surgery. From questions concerning about the surgeon's success and complication rates, numbers of surgeries performed to qualifications of the surgeon, these and much more should be part of your evaluation process.
• Prepare yourself before a consultation - It's good to prepare yourself before a medical consultation. Whether it's researching about the surgery and your condition or being well aware of your family's medical history, or details about the pain that you experience, or your expectations from the surgery, every aspect should be covered so that you derive the maximum benefit from your meeting.
• Carry out your own research - Carrying out your own research on the alternatives before opting for the surgery can put you on a better footing. It's imperative to compare the opinion put forward by the surgeon from genuine sources so that you're better able to understand the merits and demerits of the treatment. If you wish to discuss about any specific problem, you can consult an Orthopedist.

If you are concerned about liver cancer, you should know that most people do not experience signs and symptoms of the cancer in the early stages. Liver cancer is a form of cancer which occurs in the cells of the liver. There are various types of cancer which can develop in the liver. Hepatocellular carcinoma (HCC) is the most common liver cancer which begins in the hepatocyte, which is the main liver cell.

Symptoms-

Usually there are no specific primary stage symptoms of liver cancer. Some symptoms which may develop include the following:

1. Unusual weight loss is observed

2. Loss of appetite and developing food aversion

3. Pain in the upper abdomen

4. Nausea followed by vomiting

5. General weakness with intense fatigue

6. Swelling in the abdomen

7. The skin may become yellow

8. White and chalky stools are likely

Causes-

In most cases, the causes of liver cancer cannot be clearly determined. In some cases, the cause is known, such as chronic infection with the hepatitis virus, which may lead to liver cancer. Liver cancer occurs when the liver cells undergo changes or mutations in their DNA structure. DNA mutations lead to changes in instructions of chemical processes taking place in the body. The cells may grow out of control and develop into a cancerous tumour.

Risk Factors-

There are several factors which enhance the risk of liver cancer. They are as follows:

1. Chronic infection with hepatitis B or hepatitis C increases the risk of liver cancer.

2. A progressive and irreversible condition known as cirrhosis leads to scar tissue formation in the liver, increasing the risk of liver cancer.

3. Certain inherited liver diseases such as Wilson’s disease and hemochromatosis also increase the chances of liver cancer.

4. People with diabetes are also at a greater risk of having liver cancer.

5. Non-alcoholic fatty liver disease (NAFLD), which is the accumulation of fat in the liver, also increases the chances of getting this condition.

6. Excessive alcohol consumption is another factor which causes irreversible damage to the liver and the chances of getting liver cancer get boosted.

7. Exposure to aflatoxins, which are poisons produced by molds growing on poorly stored crops, make you more likely to get liver cancer.

Several tests and procedures are carried out for the diagnosis of liver cancer. These include blood tests for diagnosing liver function problems, and imaging tests such as ultrasound, CT scan and MRI scan.

Medical science constantly challenges the boundaries by finding not only the cures to the most dangerous diseases, but finds a way to prevent them even before they occur. With years of research, practice and data available for analysis, scientists are using advanced technology in combination with years of research to create a predicting mechanism for often fatal diseases like cancer.

Breast cancer screening has always been done with mammography. The fact is that this method is only 75% accurate, laden with false positives and misses a whole set of women totally- and that too when cancer has already developed. Part of the problem comes from the dense breast tissue which one in three women have. This tissue masks the lumps, which makes it difficult for mammograms to accurately screen cancer.

Some breakthrough scientific methods are changing this by drawing on years of research to predict this deadly disease, years before it can manifest itself.

A genetic test to predict cancer 10-11 years ahead of time. This test was performed to see how environmental factors could influence cancer, along with habits like smoking, abusing alcohol or hormones, genetic changes that occur and are put a large percentage of the women at a high risk of developing this disease.

A simple blood test is used for the genetic analysis of hereditary cancer. Researchers found a biological marker, methylation of the ATM gene, which has a very high ability to predict the risk of developing cancer, several years before diagnosis. 'Methylation' concluded that when one biological indicator is exposed to carcinogenic substances, or other abusive substances like tobacco and alcohol, it may trigger the development of cancer.  On the flip side, this test will take time to reach the commercial market and even then cannot give an exact timeline as to when someone may develop the disease.

A simple blood test to predict breast cancer 5 years before it develops. This is the kind of medical miracle the world is looking for. Last year in April, researches in Denmark identified a simple blood test that can predict breast cancer five years before it actually develops with an accuracy of a whopping 80%.

It works by "measuring all of the compounds in the blood to build a 'metabolic profile' of an individual, in order to detect changes in the way chemicals are processed, during a pre-cancerous stage," says Laura Donnelly, health editor at The Telegraph, which covered this development. Danish researchers observed 57,000 participants over 20 years, gathering blood samples along the way, specifically comparing a set of 800 women who remained healthy or developed breast cancer within 7 years of their first blood sample. The researchers found they were able to predict, with 80 percent accuracy, which patients would be affected by the disease, just by looking at the metabolic profiles they built from the participants' blood samples. The results have been published in Metabolomics.

Breast cancer is a type of a cancerous infection that develops in the skin cells of the breast. This condition is more commonly diagnosed after you have skin cancer and is more common in women than men. There are certain signs to identify this disease, which are as follows.

1. Breast lumps - Lumps are patches of skin that occur due to the thickening and swelling of the skin. Breast lumps is a very common phenomenon for women but that does not always lead to a breast cancer; however, frequent and reoccurring instances of the same increases the risk of breast cancer. A breast lump is easily identifiable through the naked eye as it looks different from the surrounding tissues.

2. Blood discharge - The nipple is one of the most sensitive areas in the human body. In case of women, it is meant to emit milk during pregnancy, in order to feed the infant externally. A probable symptom of breast cancer can also be a frequent discharge of blood from the nipple without any visible damage or injury.

3. Breast changes - If you are experiencing any visible changes in the size, appearance or shape of the breast, then it is an indicative sign that you may have breast cancer. Thus, it is of paramount importance that you observe, touch and physically examine your breast regularly for changes. If there is any major change detected then it is advisable to consult a doctor.

4. Inverted nipple - The tip of the nipple is generally bulging and pointing outwards both in cases of men and women. But sometimes the tip of the nipple is pushed inside due to excessive suction caused by the skin tissues present inside the breast around the nipple area. This suction forces the nipple to grow inwards which is abnormal and might harm the breast and skin in various ways.

However, apart from these main symptoms, some other signs are also there that increase your chances of being diagnosed with breast cancer. They are redness or pitting of the skin over your breast like an orange, peeling or scaling of the pigmented area around the nipple, dimpling of the skin on the breasts, and such others. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

स्तन वसा, संयोजी ऊतक, और लोब में विभाजित ग्रंथि ऊतक से बना होता है। स्तन कैंसर तब शुरू होता है जब स्तन में कोशिकाएं नियंत्रण से बाहर निकलने लगती हैं। नलिकाएं का एक नेटवर्क लोब से निपल तक फैलता है। एक स्तन आमतौर पर दूसरे से छोटा होता है। महीने में अलग-अलग समय पर आपके स्तन अलग-अलग महसूस कर सकते हैं स्तनों के लिए आपकी अवधि के ठीक पहले लंपट महसूस करना आम बात है। आपके स्तन महीने में अलग-अलग समय पर अलग-अलग महसूस हो सकते हैं। स्तनों का आपकी अवधि के ठीक पहले लंपट महसूस होना आम बात है। 
स्तन कैंसर सामान्यतः कोशिकाओं जो स्तन के नलिकाएं होती हैं, में शुरू होता है। स्तन कैंसर तब शुरू होता है जब स्तन में कोशिकाएं नियंत्रण से बाहर बढ़ने लगती हैं। कोशिकाओं का यह उत्परिवर्तन एक ट्यूमर को जन्म देता है, जिसे एक गांठ के रूप में महसूस किया जा सकता है। अगर अनुपचारित छोड़ दिया जाता है, तो घातक कोशिका अंततः शरीर के अन्य भागों में फैल सकती हैं, एक प्रक्रिया जिसे मेटास्टैसिस कहा जाता है। 
स्तन कैंसर के लक्षण
स्तन में एक गांठ आमतौर पर स्तन कैंसर से जुड़ा है, लेकिन अधिकतर समय, स्तन में गांठ कैंसर नहीं होता। किशोरावस्था में हार्मोनल परिवर्तन से लेकर क्षतिग्रस्त वसा ऊतक तक, महिलाओं में शुरुआती 20 से लेकर शुरुआती 50 की उम्र तक सभी स्तन गांठों में से 90 प्रतिशत से ज्यादा गैर-कर्कश (सौम्य) हैं। 
स्तम्भों में लंप्स स्तन संक्रमण, फाइब्रोकाइसटिक स्तन रोग (ढेलेदार स्तन), फाइब्रोएडीनोमा (गैर-कन्सेसर ट्यूमर), वसा-परिगलन (क्षतिग्रस्त ऊतक) जैसे कई अन्य कारणों के कारण हो सकते हैं।
यद्यपि अधिकांश स्तन गांठ कम गंभीर स्थितियों के कारण होते हैं, नए, पीड़ारहित गांठें फिर भी स्तन कैंसर का सबसे आम लक्षण हैं। एक महिला अपने स्तन में बदलाव देख सकती है, और मामूली असामान्य दर्द जो दूर जाता प्रतीत नहीं होता। इन परिवर्तनों के लिए देखें:

1. स्तन या निपल का अलग महसूस होना:
- निपल कोमलता, या स्तन या अंडरआर्म क्षेत्र में या उसके पास एक गांठ या मोटा होना।
- त्वचा की बनावट में परिवर्तन या स्तन की त्वचा में छिद्रों का इज़ाफ़ा
- स्तन में एक गांठ

2. दिखने में बदलाव:
- स्तन के माप या आकार में कोई भी अस्पष्टीकृत परिवर्तन
- स्तन पर कहीं भी गढ़ा
- स्तन की अस्पष्ट सूजन (खासकर अगर यह केवल एक तरफ है)
- स्तन का अस्पष्ट संकुचन (खासकर अगर यह केवल एक तरफ है)
- निप्पल जो थोड़ा सा आवक हो जाता है, या उलटा हो गया है

3. निपल निर्वहन:
किसी भी प्रकार के निप्पल निर्वहन, विशेष रूप से साफ़ निर्वहन या खूनी निर्वहन स्तन कैंसर का संकेत हो सकता है। एक दूधिया निर्वहन जब महिला स्तनपान नहीं कर रही है, हालांकि स्तन कैंसर से जुड़ा नहीं है, लेकिन एक डॉक्टर द्वारा जांच कराया जाना चाहिए।
इन लक्षणों में से एक या अधिक होने का मतलब यह नहीं है कि आपको स्तन कैंसर है। यदि आप इन संकेत और लक्षणों में से किसी का अनुभव करते हैं, तो एक पूर्ण मूल्यांकन के लिए अपने चिकित्सक को देखें।

Breast cancer begins when cells in the breast(s) start to grow out of control. It is understood as being the most common cancer, seen predominantly in females, globally. It is reasonably treatable and often curable.

1. Type: Adenocarcinomas constitute more than 95% of breast cancers with infiltrating ductal carcinoma (IDC) being the most common form of invasive breast cancer.

Frequently occurring breast cancers present as one of the following types mainly

1. Ductal Carcinoma In Situ (DCIS): Is the most common type of non-invasive breast cancer and is confined to the milk ducts of the breast. There is no invasion in the basement membrane. Pure DCIS metastasizes rarely. Non comedo cribrioform carcinoma is the most common DCIS found which, when compared to the comedo type, is mostly non-aggressive.

2. Infiltrating Ductal Carcinoma (IDC): Represents majority (about 3/4th) of the breast cancers, and is known to metastasize commonly to bones, lungs and liver.

3. Lobular Carcinoma In Situ (LCIS): Develops in multiple lobules of the breast (bilaterally). LCIS is less commonly seen, compared to DCIS.

4. Infiltrating Lobular Carcinoma (ILC): Represent about a tenth of all breast cancers and tends to metastasize to other regions of the body.

Less commonly occurring breast cancers such as

5. Inflammatory Breast Cancer: Is relatively uncommon and are caused probably owing to viral infections. The breast is warm, red and swollen.

6. Paget’s disease of the nipple: Is a rare form of breast cancer. It begins in the milk ducts and spreads to the nipple and areola.

7. Medullary Carcinoma

8. Mutinous Carcinoma

9. Tubular Carcinoma

10. Phylloides tumor etc all.

2. Gender: Affects the female populace predominantly. However, a small percentage of breast cancer is attributable to the male populace as well.

3. Etiology: No definite cause is known. However, diet, lifestyle, environment, hormonal/ reproductive factors, personal or family history of breast cancer especially in first degree relatives and also any benign breast disease history etc all are known to increase the risk of breast cancers. Specifically, excessive fatty diet, obesity, type 2 diabetes mellitus, benign breast disease, heredity/ inheritance of mutated breast cancer genes 1 (BRCA1) and 2 (BRCA2), smoking, alcohol intake, infertility, estrogen therapy/ hormone replacement therapy (long term) in post menopausal women, delayed age at first pregnancy, nulliparity (not having child), early menstruation, delayed onset of menopause, lactating mothers not breast feeding, exposure to ionizing radiation, sedentary lifestyle, depression, exposure to MMTV virus etc all can potentially increase the risk for breast cancer.

4. Features: Signs & symptoms, of breast cancer, manifest majorly in the following ways

1. Lump/ nodule in the breast that gets attached to the skin of the breast over time. The lump / nodule could be hard and painless with irregular edges or it could also be soft, rounded, tender and painful.

2. Enlarged lymph nodes in the axilla which are palpable.

3. Swelling of whole or a part of a breast. This is even if there is no distinct lump felt.

4. Retraction or thickening of the nipple(s).

5. Pain in the breast or nipple.

6. Discharge from nipple other than breast milk.

7. Irritation/ scaliness of skin over the breast.

8. Redness of nipples

9. Rarely, red, swollen and tender breast.

5. Screening: Is generally recommended for asymptomatic populations goal of which, as usual, is to be able to detect & diagnose breast cancer at an early stage which is potentially curable. It is mostly radiologic with mammography/ USG being instrumental in raising suspicions for further diagnostics (i.e. biopsy) that help detect breast cancer, if any, early.

6. Diagnosis: A self-examination/ clinical exam of the breast(s)/ axilla that reveals a palpable mass prompts the following diagnostics. Abnormal blood test results may be indicative of malignancy, but a follow up imaging/ biopsy is always the gold standard for accurate diagnosis.

1. Blood: ER/ PR/ HER2/neu, uPA, PAI-1, CA15-3, CA27.29 etc all tumor markers are helpful.
2. Imaging: Mammography/ USG Scan usually, as relevant. Again, CT Scan of abdomen & pelvis and chest, PET CT scan, bone scan etc all help detect metastasis, if any, for cancers in stage III & above.
3. Biopsy: either excisional, incisional, fine needle aspiration (FNA) or core biopsy technique, as contextually appropriate, is frequently employed and a histopathological examination (HPE) thereof clinches the diagnosis and the nature of the disease.

7. Treatment: Conventional treatment includes surgery, radiotherapy, hormone therapy/ chemotherapy as deems appropriate. Simultaneously, an adjunctive or integrative naturopathic treatment with suitable complementary & alternative medicines (CAM) too can help improve clinical outcomes and facilitate recovery as would be feasible contextually.

8. Prognosis: Preventive measures, earlier diagnosis and right early treatment is key for an effective therapeutic management & better prognosis. Like most other cancers, the chances of cure for an early stage breast cancer are more. The cure/ recovery chances are influenced by the type, grade, stage of cancer, recurrence and the patient’s general health & vitality etc all. Above-mentioned apart, age, menopause status, lymph node status, ER/ PR/ HER-2/ neu status, size & extent of breast cancer etc all also influence the treatment outlook in breast cancer. The five year survival rate is strongly correlated with the stage of breast cancer.

9. Prevention: Rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an increased focus on protective factors and avoidance of the risk factors can be of help. An adherence to a Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising (for at least 30 minutes daily), de-stressing and relaxation is highly recommended for reducing the risks of breast cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. It is advisable to limit milk/ dairy, preferably of low fat content, to 1 to 2 servings max daily. Although alcohol is optional and is not for everyone, the consumption of the same, if any, has to be strictly in moderation, and is best avoided. Smoking is to be avoided as well. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly or are best avoided too. Limiting dosage/ duration of hormone therapy, if any, especially to counteract post menopausal symptoms and also avoiding exposure to radiation and environmental pollution can help reduce the risks of breast cancer. Apart from the above-mentioned, for high risk cases, a prophylactic oophorectomy, prophylactic radical mastectomy, long term hormone therapy etc all can help reduce the chances/ risks of developing breast cancer significantly. Breastfeeding is known to confer protection against breast cancer risk too.

Uterine fibroids are referred to as benign, abnormal growths which tend to develop in the uterine walls of a woman. The size of such growths can range from a few centimeters to even excess of a few inches. As such, they can cause the uterus to increase to the size of a five month pregnancy. Although, the symptoms of fibroids are not always apparent, they often cause heavy bleeding and pain in women. A recent research concluded that around 60 to 75 percent women contract such fibroids by the age of 50, at least once in their life.

Depending on the site of formation, uterine fibroids are distinguished into different types. Intramural fibroids in the lining of the uterus and subserosal fibroids which develop outside the uterus are the most commonly observed fibroids.

What causes Uterine Fibroids?
Although, the exact reason for the formation of fibroids are obscure, medical professionals have determined certain factors that may affect their formation. Some of them are:
1) Hormones: Progesterone and estrogen, produced by the ovaries regenerate the uterine lining during each menstrual cycle and trigger the growth of fibroids.
2) Family history: If you have had a family history of uterine fibroids, then you are likely to develop the condition yourself as well.
3) Pregnancy: The production of progesterone and estrogen increases during pregnancy which increases the likelihood of fibroids.

What are the signs of this condition?
Depending on the location and size of the tumors, symptoms of such fibroids include:
1) Heavy bleeding and blood clots during periods
2) Pain in the pelvis
3) Frequent menstrual cramps
4) Pressure and pain in the lower abdomen
5) Swelling in the abdomen
6) Pain while intercourse

What is the procedure of treatment?
Ultrasound and pelvic MRI are common diagnostic procedures to check for uterine fibroids. After diagnosis, depending on your age, size of the fibroid and your comprehensive health, the doctor would prescribe you with appropriate medications. Only after medications prove futile, doctors opt for minimally invasive surgeries.

Breast cancer is one of the most common cancers in women about 1 in 8 women in the USA develop invasive breast cancer. The incidence of breast cancer has increased with changes in lifestyle including smoking, drinking and loss of physical activity. The risk factors are age, ethnicity and family history cannot be changed. However, there are some risk factors that can definitely be acted upon to reduce the chances of developing breast cancer.

1. Weight management: Obesity is one of the major risk factors for breast cancer and managing weight and a good body mass index will help reduce the risk of developing breast cancer. This is especially important in women undergoing menopause.
2. Reducing smoking: The benefits of quitting it are manifold and reducing the risk for breast cancer is one of them. This will, as a byproduct, also result in a host of other benefits including improved quality of life, reduced chances of heart disease, stroke, and other cancers.
3. Physical activity: In addition to helping in weight management, this also helps reduce the risk of breast cancer. Ideal recommendation is 30 minutes of physical activity per day, plus strength training.
4. Breastfeeding: This helps in reducing the risk of breast cancer. Prolonged feeding is shown to have a greater protective benefit.
5. Hormone replacement therapy: When possible, limit the use of hormone replacement therapy for prolonged periods of time. Explore options of non-hormonal substitutes or use the least permissible or required dose. Be sure to get periodic check-ups when on hormone therapy.
6. Reduce exposure to environmental pollution: Higher levels of pollutants are linked to a higher incidence of breast cancer. When possible, avoid getting exposure to environmental pollutants.
7. Screening: If there is a strong family history or other risk factors, then screening can help detect breast cancer very early in the process. Recommended ages for mammography are as follows:
   • If you are age 40 – 44: Go for annual mammograms after discussing risks and benefits with the doctor.
   • If you are age 45 – 54: Go for annual mammogram.
   • If you are age 55 or over: Mammograms are recommended every other year. You can choose to continue to have them every year. Self-breast exams are not sufficient. However, if being done, they can also be an input to an abnormality.
8. Cautious use of birth control pills: Birth control pill usage to be discussed with your gynaecologist if you are above 35 years of age and smoke. The good news is that the risk associated with it disappears slowly after the pill is stopped.

These will help reduce the risk of developing breast cancer, early detection, and improved prognosis.

Symptoms, causes and treatment for Breast Cancer Patients

Breast cancer is on the rise in india. Surveys show that every 4 out of 5 Indian women who have breast cancer, suffer from an advanced stage of the disease by the time they reach the doctor. Urban women are at two times more risk of being diagnosed with breast cancer than rural women. Being overweight, eating unhealthy food, and consuming excessive alcohol or tobacco are some of causes that can make you susceptible to this disease.

How you can avoid breast cancer?

1. Every woman should do a self-breast examination every month after the periods. You should check for any abnormal lump, change in skin texture or any abnormal discharge from the nipples. Any abnormality above aspects should be promptly investigated by a doctor's appointment, and an ultrasound or Mammography, as required.
2. Apart from self-examining your breasts every month for a lump, going for a mammography (an X-Ray of the breast) is vital for early detection of the problem.
3. Consult a gynaecologist before going for the test as its frequency depends on your age and risk factor. About 80-90% of tumours can be traced through this screening.

Breast cancer may run in family. If there is no family history of breast cancer, you start doing mammogram at 40 yrs of age but if there is a family history you start even earlier as advised by your gynaecologist.

The symptoms caused due to herniated disc can be very severe and can also cause a bit of disability. The disc of the spine is like a cushion and separates the set of bones on the backside. The discs are shock absorbers of the spine and are mainly composed of 2 parts, a soft jelly-like centre called the nucleus and a tough outer covering called the annulus.

Effects of Herniated Disk

A herniated or cracked disc is a severe condition and it seems to happen most commonly in the lower back or neck.  It happens when a fraction of the soft centre gets pushed through the destabilized area due to degeneration, trauma or by putting pressure on the spinal column. 

Nerves located at the back of every disc are responsible for transmitting pain, motor impulse, bladder control etc. in our body. While a disc gets herniated, the external covering of the disc tears and creates a bulge. The soft jelly gets shifted from the centre of the disk to the region where the damage has occurred on the disc. Most commonly, the bulge occurs in areas where the nerve is located and it causes strain and irritation of the affected nerve. It has been observed that individuals may or may not feel any painful sensations even if their disc gets damaged. Other symptoms may be weakness of muscle groups or difficulty in controlling the bladder.

When is surgery recommended for herniated disc?

Surgery for herniated disc is recommended only after options like rest and pain relievers do not work. If the pain persists even after these options, then it becomes important to go for surgery. Surgery is also considered early if there is weakness of muscle groups or acute problem in bladder control. At times, emergency surgery is also required to avoid paralysis in a patient.

However, there are certain risks involved in this surgery like infection, bleeding or nerve damage.  There are chances that the leftover disc may bulge out again. If you are a patient suffering from degenerative disc disease, then there are chances that problem occurs in other discs. It is very important that a patient maintains healthy weight to prevent any further complications.

The main factor that increases the risk of herniated disc is excess body weight, which causes a lot of stress on the lower back. A few people become heir to a tendency of developing this condition. Even individuals with physically demanding jobs are prone to this condition. 

Activities like bending sideways, pushing, twisting, repetitive lifting can increase the risk of a herniated disk. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.

Breast Cancer is the most common cancer of females in urban cities. It is a curable disease if detected early. The usual age of presentation is usually after 40 to 50 years of age, though it is becoming common in earlier age as well. This could be due to many factors like late marriages, older age of pregnancy, diet and lifestyle, etc. The usual presentation is a swelling or lump in the breast, not associated with pain. That is the reason why females are advised regular self-breast examination, clinical breast examination and annual mammograms for screening purpose in order to detect early breast cancers. Many times, the breast lump is associated with blood stained discharge from the nipple. There can be skin changes on the breast like thickening, crusting or sometimes itching. If the skin lymphatics get blocked, there may be pitting and or dimpling of the skin too. There may be lumps felt in the armpit felt too. Many times the lump is not noticeable or felt and felt by chance during a bath. These are some of the commonest presentations. The lady should immediately consult a doctor and get evaluated in such scenario. Many women are at increased risk of developing breast cancer like those who have a positive family history especially first degree relatives like mother& sister. Breast cancer is usually a disease of women but 1% of cases are also seen in men.

If a lady feels any such lump she should immediately bring it to the attention of a doctor or oncologist who can do the necessary evaluation and investigations. Breast cancer is curable if detected early, hence the importance!

The primary modality of treatment is surgery followed by chemotherapy and or radiotherapy and or hormonal treatment depending on the report of the specimen after the surgery. Many times if the lump cannot be operated upfront, initially chemotherapy and or targeted therapy can be given to shrink the tumor for better resectability.

People should be aware that having cancer is not the end of life. It can be treated like many other diseases and the most important thing is awareness and early detection for a durable cure.