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Dr. Dipen C. Nandu

Radiologist, Mumbai

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Dr. Dipen C. Nandu Radiologist, Mumbai
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My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them....more
My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them.
More about Dr. Dipen C. Nandu
Dr. Dipen C. Nandu is an experienced Radiologist in Kandivali West, Mumbai. He is currently associated with Dr Dipen Pradyuman Parikh Clinic in Kandivali West, Mumbai. Save your time and book an appointment online with Dr. Dipen C. Nandu on Lybrate.com.

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Wing A , Flat No 1, Nilkanth Apartment, Fateh Baug , S V Road, Landmark: Opposite Kandivali Telephone Exchange, Kandivali West, Mumbai - 400067, MumbaiMumbai Get Directions
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Annular tear with right paracentral, foramina extrusion of L1-S1 intervertebral disc causing significant compression of the traversing right S1 nerve root Kindly suggest treatment and Medicines.

MS - Orthopaedics
Orthopedist, Surat
You must consult orthopaedic surgeon, get mri done than we can decide whether you can be treated conservatively treated or to get operated.
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Hello, Due to C5 & C6 disc buldge in neck I have severe neck pain. Please tell me a remedy. I have gone under dr treatments, pills & psychotherapy but still have a severe pain

Dip. SICOT (Belgium), MNAMS, DNB (Orthopedics), MBBS
Orthopedist, Delhi
Hi , This is Dr Akshay from Fortis Hospital. Please upload latest x rays and MRI images for me to opine. Thanks & Regards Dr Akshay Kumar Saxena
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Breast Cancer - The Truth !

MBBS, DNB ( Radiation Oncology)
Oncologist, Mumbai

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.

Left paracentral L5-S1 disc protrusion causing compression of left traversing nerve roots associated with diffuse L1-L2 Disc bulge. Now what is best treatment for me.

MBBS
General Physician, Mumbai
Best treatment is to do go for laparoscopic surgery and treatment depends on the symptoms and if there are bearable symptoms than we can do ESWT through a physiotherapist.
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My MRI INDICATE 1. Lumbosacral transitional Vertebra with complete socialization of L5 2. Disc desiccation with diffuse disc bulge and broad based posterior central disc protrusion at L4-L5 level causing ventral thecal sac indentation and significant compromise of bilateral neural forminal (right>left). Mild ligamentum flavum thickening is also seen at this level with maintained spinal canal dimensions. 3. Cervical spondylitis changes with disc osteophyte complexes at C4-C5 and C5-C6 levels. Broad based left paracentral disc protrusion at C4-C5 level causing ventral thecal sac indentation and moderate compromise of left sided neural forminal. 4. Mild disc bulge at d5-d6 (screening of rest of spine revealed) I am confused. Dr. Said physio will fix it. I read too many damages. Please guide and suggest sustainable solutions. I am willing to take prolonged treatment. What does this report mean?

Radiologist, Delhi
Hello Mr. lybrate-user. The report says that there is significant compression of nerves at L4-5, C4-5 and C5-6 vertebral levels. You need to wear lumbar hot belt on regular basis, have to take medicines, you have to undergo physiotherapy and take precautions like no forward bending, no lifting weight, using ortho matress to keep spine straight. I would advise you to meet an orthopedician and discuss your symptoms in detail. Clinical examination and some further tests are required before prescribing medicines.
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I am having neck pain radiating to my right thumb which started around oct'2014. I am working in it sector and prolonged hours I have to sit infront of computers. I took some treatment in ayurveda for almost one month. Then later shifted to idd therapy which showed hood results and I was able to get back into my job after 1-2 months treatment. There's a disc prolapse in c5 c6 region and that's the reason. So, now the pain again started to come back although not severe and I am afraid I have to quit my job and go for surgery. Can any body help me send a suggest a solution without surgery.?

DNB (Radiodiagnosis), DMRD, MBBS
Radiologist, Bangalore
Hi, thanks for writing in to us. Your mri scan shows disc problem at c 5 - c 6 level. This requires rest, physical therapy and pain relief as first line of treatment. Maxgalin er is a good medicine and will treat nerve related pain. The condition you have might be due to trauma or degeneration. It is unlikely to heal completely. You can try a rehabilitation and treatment with nerve pain reliever like maxgalin er. Please do not stress your neck for a long duration and avoid sudden neck movement. Go slow on your job. Non surgical pain relief options are best. They might be steroid shots or rf ablation. Regards,
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Brain Stroke: Things You Must Know

BHMS
Homeopath, Ajmer
Brain Stroke: Things You Must Know

A brain stroke can affect anyone at any point of time when the supply of blood to the brain is interrupted. It can threaten major physical functions and can prove to be fatally dangerous at times. The brain stem which is placed right above the spinal cord controls the breathing, heartbeat and levels of blood pressure. It is also in charge of controlling some elementary functions such as swallowing, hearing, speech and eye movements

What are the different types of strokes?
There are three main kinds of stroke: ischemic strokes, hemorrhagic strokes and transient ischemic attacks. The The most common type of brain stroke is the ischemic stroke is caused by narrowing or blocking of arteries to the brain, which prevents the proper supplyof of blood to the brain. Sometimes it so happens that the blood clot that has formed elsewhere in the body have travelled via the blood vessels and has been trapped in the blood vessel which provides blood to the brain. When the supply of blood to a part of the brain is hindered, the tissue in that area dies off owing to lack of oxygen. The other variant of brain stroke is termed as hemorrhagic stroke is caused when the blood vessels in and around the brain burstor or leak. Strokes need to be diagnosed and treated as quickly as possible in order to minimize brain damage.

What are the common symptoms of a brain stroke?
The symptoms of the brain stroke are largely dependent on the area of the brain that has been affected. It can interfere with normal functioning, such as breathing and talking and other functions which human beings can perform without thinking such as eye movements or swallowing. Since all the signals from the brain as well as other parts of the body traverse through the brain stem, the interruption of blood flow often leads to numbness or paralysis in different parts of the body.

Who is likely to have a stroke?
Anyone is at a risk of developing brain stroke although ageing is directly proportional to the risk of having a stroke. Not only that an individual with a family history of brain stroke or transient ischemic attack is at a higher risk of developing stroke. People who have aged over 65 accounts for about 33 percent of all brain strokes. It is important to point here that individuals with high blood pressure, high blood sugar, cholesterol, cancer, autoimmune diseases and some blood disorders are at a higher risk of developing brain stroke.

There are a few factors which can increase the risk of developing stroke beyond any control. But there are certain lifestyle choices as well which aids in controlling the chances of being affected by stroke. It is crucial to refrain from long-term hormone replacement therapies as well as birth control pills, smoking, lack of physical activity, excessive use of alcohol and drug addiction. A brain stroke is a life-threatening medical condition, and when an individual has symptoms that resemble that of stroke, it is crucial to seek immediate medical help.

Treatment for stroke:

  • Treatment depends on the type of stroke.
  • Ischemic strokes can be treated with 'clot-busting' drugs.
  • Hemorrhagic strokes can be treated with surgery to repair or block blood vessel weaknesses.
  • The most effective way to prevent strokes is through maintaining a healthy lifestyle.

What is TPA?
TPA is a thrombolytic or a “Clot Buster” drug. This clot buster is used to break-up the clot that is causing a blockage or disruption in the flow of blood to the brain and helps restore the blood flow to the area of the brain. It is given by intravenous (IV). This can be given only within 45.5 hrs of the onset of symptoms

Time is brain

Remember Every second Loss means brain cells die.

Rush to the nearest Stroke Centre whenever you experience such symptoms.

You can save the brain cells dying if you reach within 4.5 hrs by the CLOT BUSTER. 

Endovascular procedures:
Another treatment option is an endovascular procedure called mechanical thrombectomy, strongly recommended, in whichtrained  trained doctors try  removing a large blood clot bysending sending a wired-caged device called a stent retriever, to the site of the blocked blood vessel in the brain

Stroke prevention:
The good news is that 80 percent of all strokes are preventable. It startswith with managing keyrisk risk factors, including 

  • High blood pressure,
  • Cigarette smoking,
  • Diabetes Atrial fibrillation and
  • Physical inactivity.

More than half of all strokes are caused by uncontrolled hypertension or high blood pressure, making it the most important risk factor to control. 

Rehabilitation:
The best way to get better after a stroke is to start stroke rehabilitation ("rehab"). In stroke rehab, a team of health professionals works with you to regain skills you lost as the result of a stroke. If you wish to discuss about any specific problem, you can consult a neurologist. Homoeopathic Remedies which may be helpful during stroke or after stroke: Creategus, Terminalia Arjuna, Arnica, Glonoine, Glycyrrhiza Glabra, Lachesis, Opium, Staphysagria, Gelsemium, Phosphorous etc. 

Note : Do not take any Homoeopathic medicine without consulting any Homoeopath.

I am 33 and my body has became very stiff due to no physical exercise. I have slip disk and neck ailments. Also mental tension getting worse. But need to come over this. What could be the starter guidelines for getting started with Yoga/Meditation.

B.Sc. - Dietitics / Nutrition, Nutrition Certification,Registered Dietitian
Dietitian/Nutritionist, Delhi
I am 33 and my body has became very stiff due to no physical exercise. I have slip disk and neck ailments. Also menta...
The best way to get started is with pranayam. Do daily breathing exercises for half an hour and then start with suryanamaskar. Do atleast 21 cycles of suryanamskar. You will start seeing the results within 15 days.
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I am 26 years old boy, I am suffering fron hip disorder problem, Avn. How to get rid out of this, I do not have money for operation,

Fellowship of the Royal College of Surgeons (FRCS), Membership of the Royal College of Surgeons (MRCS)
Orthopedist, Trichy
AVN of the hip at this age is usually due to either Alcohol intake or Steroid intake. Once AVN has developed then it depends on the stage of the disorder. if its advanced then only hip replacement will help.
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Doctor I have a compressed Disc that is L4 and l5 which is pressing my nerve and I find it very Difficult to stand straight or walk. And the pain is coming under the Thigh is there a cure either than Surgery Thanks expecting a Response soon thanks a lot. I am Diabetic and 55 years old.

MD Internal Medicine, MBBS
General Physician, Delhi
Doctor I have a compressed Disc that is L4 and l5 which is pressing my nerve and I find it very Difficult to stand st...
Being a diabetic, it's important to get your weight under control, for nerve compression you could try non surgical treatment, you need however to be aware that progression of the nerve pressure can result in paralysis of the legs.
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I have cervical small disc bulge and disc protrusion inserting thecal sac. Is there any permanent cure in ayurveda?

MD - Homeopathy, BHMS
Homeopath, Vadodara
I don't know about the ayurvedic but I know homoeopathy can help a lot in such conditions... You may try taking Nux Vomica 1 hourly in the evening..
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I am 29 years old. I am from bangladesh. I have a problem with my backbone. I have slipped disc. I have been suffering from this since 2011. I consulted with some local doctors. They prescribed me with some exercise but no improvement till now. I feel that a bone or two is/are displaced somewhere my waist. I need expert suggestion.

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
I am 29 years old. I am from bangladesh. I have a problem with my backbone. I have slipped disc. I have been sufferin...
Ok as your requirement avoid all exercise for 3 days and do rest tk physiotherapy treatment for few days swd ift ultrasonic therapy it will help you and giving you relief after 3 days you can start spine extension exercise with treatment. For future avoid forward bending, heavyweight, long sitting and standing keep your posture straight.
2 people found this helpful
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I have back pain L4. L5 problem fast in 5 years. I want to reduce pain with out operation is possible. Please Inform

M.Ch, DNB (Orthopedics), MBBS
Orthopedist, Mohali
You should do a proper regime of medicaton and Exercises for 3 months. the kind of exercises depend on your x-ray and mri reports. Only of this fails completely then we think of other measures like injections to the spine, surgery etc. the basic principle of spine therapy is minimal intervention.
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When Is Surgery Recommended For Herniated Disc?

DNB NEUROSURGERY, M.B.B.S.
Neurosurgeon, Durgapur
When Is Surgery Recommended For Herniated Disc?

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.

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I am 19 years old and I am having lower back pain (disc herniation l4-l5. I suffer pain everyday. What shall I do?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Kindly show me a photograph of the affected part. Rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful use no pillow under the head. Do hot fomantation. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck, back & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. If it does not give relief in 4-5days, contact me again. Do not ignore. It could be beginning of a serious problem.
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My age is 22 I have slip disk my disk dislocated into 6 mm back so I have heavy pain when I bend or doing any work and long time sitting any home remedies to cure fast.

BPTh/BPT
Physiotherapist, Delhi
Some days do full bad rest after this don't sitting longer time its do bed effect on back pain, sitting but short time like 1-2 hour then you do rest like walking either 10-15 min. On bad you can use heating paid at two time in a day and some exercise also do you can take physiotherapy also some days like 10-15 day a after all this you feel batter you can do all your work but Physio. Live care fully live not sitting long time between a week do full rest all this do you u can do yoga also it's batter OK.
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Breast Cancer Prevention:

Homeopath,

Breast Cancer Prevention:

  1. Anything that increases your chance of developing cancer is called a cancer risk factor; anything that decreases your chance of developing cancer is called a cancer protective factor.

  2. Some risk factors for cancer can be avoided, but many cannot. For example, both smoking and inheriting certain genes are risk factors for some types of cancer, but only smoking can be avoided. Regular exercise and a healthy diet may be protective factors for some types of cancer. Avoiding risk factors and increasing protective factors may lower your risk but it does not mean that you will not get cancer. Different ways to prevent cancer are being studied, including:

  3. Changing lifestyle or eating habits. Avoiding things known to cause cancer. Taking medicine to treat a precancerous condition or to keep cancer from starting.


 

General information about breast cancer:

Key points:

  1. Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. Breast cancer is the second most common type of cancer in india

  2. Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast.

  3. The breast is made up of lobes and ducts. Each breast has 15 to 20 sections called lobes, which have many smaller sections called lobules. Lobules end in dozens of tiny bulbs that can make milk. The lobes, lobules, and bulbs are linked by thin tubes called ducts.

  4. Enlarge Drawing of female breast anatomy showing the lymph nodes, nipple, areola, chest wall, ribs, muscle, fatty tissue, lobe, ducts, and lobules.

  5. Anatomy of the female breast. The nipple and areola are shown on the outside of the breast. The lymph nodes, lobes, lobules, ducts, and other parts of the inside of the breast are also shown.

  6. Each breast also has blood vessels and lymph vessels. The lymph vessels carry an almost colorless fluid called lymph. Lymph vessels lead to organs called lymph nodes. Lymph nodes are small bean-shaped structures that are found throughout the body. They filter lymph and store white blood cells that help fight infection and disease. Clusters of lymph nodes are found near the breast in the axilla (under the arm), above the collarbone, and in the chest.

     

Avoiding risk factors and increasing protective factors may help prevent cancer. The following are risk factors for breast cancer:

  1. Older agea personal history of breast cancer or benign (noncancer) breast diseasea family history of breast cancerinherited gene changesdense breasts

  2. Exposure of breast tissue to estrogen made in the bodytaking hormone therapy for symptoms of menopause radiation therapy


 

The following are protective factors for breast cancer:

  1. Less exposure of breast tissue to estrogen made by the bodytaking estrogen-only hormone therapy after hysterectomy,

  2. Estrogen-only hormone therapy after hysterectomyselective estrogen receptor modulatorsaromatase inhibitors and inactivators

  3. Risk-reducing mastectomy ovarian ablationgetting enough exercise


 

It is not clear whether the following affect the risk of breast cancer:

  1. Oral contraceptives

  2. Factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk


 

Older age:

  1. Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.

  2. A personal history of breast cancer or benign (noncancer) breast disease

     

Women with any of the following have an increased risk of breast cancer:

  1. A personal history of invasive breast cancer, ductal carcinoma in situ (dcis), or lobular carcinoma in situ (lcis). A personal history of benign (noncancer) breast disease.

  2. A family history of breast cancer

  3. Women with a family history of breast cancer in a first-degree relative (mother, sister, or daughter) have an increased risk of breast cancer.


 

Inherited gene changes:

  1. Women who have inherited changes in the brca1 and brca2 genes or in certain other genes have a higher risk of breast cancer, ovarian cancer, and maybe colon cancer. The risk of breast cancer caused by inherited gene changes depends on the type of gene mutation, family history of cancer, and other factors.

  2. Men who have inherited certain changes in the brca2 gene have a higher risk of breast, prostate, and pancreatic cancers, and lymphoma.


 

Dense breasts:

  1. Having breast tissue that is dense on a mammogram is a factor in breast cancer risk. The level of risk depends on how dense the breast tissue is. Women with very dense breasts have a higher risk of breast cancer than women with low breast density.

  2. Increased breast density is often an inherited trait, but it may also occur in women who have not had children, have a first pregnancy late in life, take postmenopausal hormones, or drink alcohol.

  3. Exposure of breast tissue to estrogen made in the body

  4. Estrogen is a hormone made by the body. It helps the body develop and maintain female sex characteristics. Being exposed to estrogen over a long time may increase the risk of breast cancer. Estrogen levels are highest during the years a woman is menstruating.


 

A woman's exposure to estrogen is increased in the following ways:

Early menstruation: beginning to have menstrual periods at age 11 or younger increases the number of years the breast tissue is exposed to estrogen. Starting menopause at a later age: the more years a woman menstruates, the longer her breast tissue is exposed to estrogen. Older age at first birth or never having given birth: because estrogen levels are lower during pregnancy, breast tissue is exposed to more estrogen in women who become pregnant for the first time after age 35 or who never become pregnant.

 

Taking hormone therapy for symptoms of menopause:

Hormones, such as estrogen and progesterone, can be made into a pill form in a laboratory. Estrogen, progestin, or both may be given to replace the estrogen no longer made by the ovaries in postmenopausal women or women who have had their ovaries removed. This is called hormone replacement therapy (hrt) or hormone therapy (ht). Combination hrt/ht is estrogen combined with progestin. This type of hrt/ht increases the risk of breast cancer. Studies show that when women stop taking estrogen combined with progestin, the risk of breast cancer decreases.


 

Radiation therapy to the breast or chest:

  1. Radiation therapy to the chest for the treatment of cancer increases the risk of breast cancer, starting 10 years after treatment. The risk of breast cancer depends on the dose of radiation and the age at which it is given. The risk is highest if radiation treatment was used during puberty, when breasts are forming.

  2. Radiation therapy to treat cancer in one breast does not appear to increase the risk of cancer in the other breast.

  3. For women who have inherited changes in the brca1 and brca2 genes, exposure to radiation, such as that from chest x-rays, may further increase the risk of breast cancer, especially in women who were x-rayed before 20 years of age.


 

Obesity:

Obesity increases the risk of breast cancer, especially in postmenopausal women who have not used hormone replacement therapy.


 

Drinking alcohol:

Drinking alcohol increases the risk of breast cancer. The level of risk rises as the amount of alcohol consumed rises.


 

The following are protective factors for breast cancer:

  1. Less exposure of breast tissue to estrogen made by the body

  2. Decreasing the length of time a woman's breast tissue is exposed to estrogen may help prevent breast cancer. Exposure to estrogen is reduced in the following ways:


 

Early pregnancy: estrogen levels are lower during pregnancy. Women who have a full-term pregnancy before age 20 have a lower risk of breast cancer than women who have not had children or who give birth to their first child after age 35. Breast-feeding: estrogen levels may remain lower while a woman is breast-feeding. Women who breastfed have a lower risk of breast cancer than women who have had children but did not breastfeed.

Taking estrogen-only hormone therapy after hysterectomy, selective estrogen receptor modulators, or aromatase inhibitors and inactivators


 

Estrogen-only hormone therapy after hysterectomy

Hormone therapy with estrogen only may be given to women who have had a hysterectomy. In these women, estrogen-only therapy after menopause may decrease the risk of breast cancer. There is an increased risk of stroke and heart and blood vessel disease in postmenopausal women who take estrogen after a hysterectomy.


 

Selective estrogen receptor modulators:

Tamoxifen and raloxifene belong to the family of drugs called selective estrogen receptor modulators (serms). Serms act like estrogen on some tissues in the body, but block the effect of estrogen on other tissues.


 

Treatment with tamoxifen lowers the risk of estrogen receptor-positive (er-positive) breast cancer and ductal carcinoma in situ in premenopausal and postmenopausal women at high risk. Treatment with raloxifene also lowers the risk of breast cancer in postmenopausal women. With either drug, the reduced risk lasts for several years or longer after treatment is stopped. Lower rates of broken bones have been noted in patients taking raloxifene.


 

Taking tamoxifen increases the risk of hot flashes, endometrial cancer, stroke, cataracts, and blood clots (especially in the lungs and legs). The risk of having these problems increases with age. Women younger than 50 years who have a high risk of breast cancer may benefit the most from taking tamoxifen. The risk of having these problems decreases after tamoxifen is stopped.


 

Taking raloxifene increases the risk of blood clots in the lungs and legs, but does not appear to increase the risk of endometrial cancer. In postmenopausal women with osteoporosis (decreased bone density), raloxifene lowers the risk of breast cancer for women who have a high or low risk of breast cancer. It is not known if raloxifene would have the same effect in women who do not have osteoporosis. Talk with your doctor about the risks and benefits of taking this drug.


 

Aromatase inhibitors and inactivators:

Aromatase inhibitors (anastrozole, letrozole) and inactivators (exemestane) lower the risk of a new breast cancer in women who have a history of breast cancer. Aromatase inhibitors also decrease the risk of breast cancer in women with the following conditions:

Postmenopausal women with a personal history of breast cancer. Women with no personal history of breast cancer who are 60 years and older, have a history of ductal carcinoma in situ with mastectomy, or have a high risk of breast cancer based on the gail model tool (a tool used to estimate the risk of breast cancer).

In women with an increased risk of breast cancer, taking aromatase inhibitors decreases the amount of estrogen made by the body. Before menopause, estrogen is made by the ovaries and other tissues in a woman's body, including the brain, fat tissue, and skin. After menopause, the ovaries stop making estrogen, but the other tissues do not. Aromatase inhibitors block the action of an enzyme called aromatase, which is used to make all of the body's estrogen. Aromatase inactivators stop the enzyme from working.


 

Possible harms from taking aromatase inhibitors include muscle and joint pain, osteoporosis, hot flashes, and feeling very tired.


 

Risk-reducing mastectomy:

Some women who have a high risk of breast cancer may choose to have a risk-reducing mastectomy (the removal of both breasts when there are no signs of cancer). The risk of breast cancer is much lower in these women and most feel less anxious about their risk of breast cancer. However, it is very important to have a cancer risk assessment and counseling about the different ways to prevent breast cancer before making this decision.


 

Ovarian ablation:

The ovaries make most of the estrogen that is made by the body. Treatments that stop or lower the amount of estrogen made by the ovaries include surgery to remove the ovaries, radiation therapy, or taking certain drugs. This is called ovarian ablation.


 

Premenopausal women who have a high risk of breast cancer due to certain changes in the brca1 and brca2 genes may choose to have a risk-reducing oophorectomy (the removal of both ovaries when there are no signs of cancer). This decreases the amount of estrogen made by the body and lowers the risk of breast cancer. Risk-reducing oophorectomy also lowers the risk of breast cancer in normal premenopausal women and in women with an increased risk of breast cancer due to radiation to the chest. However, it is very important to have a cancer risk assessment and counseling before making this decision. The sudden drop in estrogen levels may cause the symptoms of menopause to begin. These include hot flashes, trouble sleeping, anxiety, and depression. Long-term effects include decreased sex drive, vaginal dryness, and decreased bone density.


 

Getting enough exercise:

Women who exercise four or more hours a week have a lower risk of breast cancer. The effect of exercise on breast cancer risk may be greatest in premenopausal women who have normal or low body weight.


 

It is not clear whether the following affect the risk of breast cancer:

  1. Oral contraceptives

  2. Certain oral contraceptives contain estrogen. Some studies have shown that taking oral contraceptives (" the pill") may slightly increase the risk of breast cancer in current users. This risk decreases over time. Other studies have not shown an increased risk of breast cancer in women who take oral contraceptives.

  3. Progestin -only contraceptives that are injected or implanted do not appear to increase the risk of breast cancer. More studies are needed to know whether progestin-only oral contraceptives increase the risk of breast cancer.


 

Environment

  1. Studies have not proven that being exposed to certain substances in the environment, such as chemicals, increases the risk of breast cancer.

  2. Studies have shown that some factors do not affect the risk of breast cancer.


 

The following do not affect the risk of breast cancer:

  1. Having an abortion. Making diet changes such as eating less fat or more fruits and vegetables. Taking vitamins, including fenretinide (a type of vitamin a). Cigarette smoking, both active and passive (inhaling secondhand smoke). Using underarm deodorant or antiperspirant. Taking statins (cholesterol -lowering drugs). Taking bisphosphonates (drugs used to treat osteoporosis and hypercalcemia) by mouth or by intravenous infusion.

  2. Cancer prevention clinical trials are used to study ways to prevent cancer.

I have a Acl tear in my left knee doctor advised for an operation should I go for it I am a athlete and 21 year old male.

BPT
Physiotherapist, Hyderabad
I have a Acl tear in my left knee doctor advised for an operation should I go for it I am a athlete and 21 year old m...
Hi, we physiotherapist and rehabilitation can restore the knee to a condition close to its pre-injury state and educate the patient on how to prevent instability. This may be supplemented with the use of a hinged knee brace.
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I am 43 years old and I have taken scan and in my report there is a small fibre on the both wall of the uterus, can you please tell me whether it is danger or not.

BHMS
Homeopath, Chennai
Homeopathy is much more effective in treatment of uterine fibroids. Out of all possible alternatives, Homeopathy is the best non surgical treatment for fibroids. The homeopathic medicines slowly but surely retard the growth of fibroids. Over a period of time, the fibroids disappear completely. This is a far more effective and the most convenient treatment of fibroids.
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