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When the skin of a breast looks uneven, it is known as a dimpled skin. Sometimes the skin might appear to be red or inflamed. In this condition, the breast tissue gets affected and this can be a serious sign of concern for cancer. Moreover, this sign is hard to detect on your own. Usually when the sign occurs, it only occurs in one of the breasts. If a woman has it in both the breasts, then likely that it has not been caused by cancer.
Causes of breast cancer dimpling are as follows
1. Advanced breast cancer
2. Breast abscess: A hollow space in the breast that is filled with pus and is at times surrounded by an inflamed tissue.
3. Duct obstruction: The ducts that carry the milk from the nipple are obstructed causing rapid abnormal growth and functioning of the cells present in the breasts causing cancer.
4. Fat necrosis: In this condition, the neutral fats are split into glycerol and fatty acids because the adipose tissue tends to degenerate.
5. Inflammation: Inflammation in the fatty tissue of the breast
6. Mastitis: The breast tissue tends to swell up and get infected. This happens because of the bacteria that enter the breasts through the nipple and this may cause infection in the milk glands.
7. Genetic: Carrying the faulty gene is one of the main reasons why many women end up literally inheriting breast cancer. This can usually be tested with a mammography, especially if one has a history of breast cancer in the family. Yet, one must remember that it is not advisable to take this test too many times as it puts you at risk of contracting breast cancer even if you do not have it, when there is repeated exposure.
First, the doctor might perform certain tests to diagnose and determine the problem. Tests like an ultrasound, MRI or even a mammogram might be used. Depending on what the diagnoses is, the doctor might even want to perform a biopsy. In case breast cancer is diagnosed, there are certain treatments that are available. These include:
- Surgery: The cancerous tissue is removed from the breast or at times when the tissue is too big, the entire breast might have to be removed.
- Chemotherapy: Chemotherapy is a medication that uses a method to send fluids that tend to kill the cancerous cells or prevent them from growing. It is a three to four hour long session at times.
- Radiation: High beam x-rays are used in order to target and destroy the cancer cells present in the breasts.
- Hormonal therapy: In this treatment, the hormones that fuel the growth of cancerous cells are blocked either through medications or surgically. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
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.
Treatment for breast cancer depends on the type of cancer, hormone sensitivity, size, grade and stage of cancer. A doctor considers the overall health of the patient and the patient’s individual preference before recommending a treatment plan. While there are many treatments options available for breast cancer, surgery is by far the most popular option for most patients. Along with surgery, some other treatments that a patient undergoes include radiation, chemotherapy and hormonal therapy.
- Lumpectomy: This is a procedure wherein the surgeon cuts the tumour and removes some of the surrounding healthy tissue in order to ensure that cancer does not spread to the healthy cells after the surgery. This procedure is applicable for small tumours.
- Mastectomy: This is a procedure in which all tissues of the breast are removed. This includes lobules, fatty tissue, ducts, areola, and nipple. In a skin-sparing mastectomy, all of the breast skin, except the nipple and the areola, is preserved, which makes the reconstruction process easier.
- Sentinel node biopsy: Since the sentinel lymph nodes are the first place that cancer is likely to spread, a doctor might suggest a sentinel node biopsy if cancer has spread to the lymph nodes. If no trace of a cancer cell is found in the nodes, it is unlikely that any more nodes need to be removed.
- Removal of breasts: Many women who have cancer in one breast often choose to remove both the breasts in order to avoid the risk of cancer spreading. While a family history of breast cancer can greatly increase the chance of breast cancer in a woman, statistics show that most women who have cancer in one breast do not develop cancer in the other one.
- Radiation: This is a process where a high-powered beam of energy is directed at the cancer cells to kill them. This method is often used after a lumpectomy. Radiations are of two types—external beam and brachytherapy. Some side effects of this treatment include fatigue, hair fall, loss of appetite and rashes.
- Chemotherapy: Chemotherapy is the treatment of cancer by cytotoxic and other drugs. This is often recommended by doctors when there is a good chance of the cancer cells spreading to other locations of the body. This form of treatment is often recommended before the surgery to shrink a tumour or restrict the growth of cells.
- Hormone therapy: Hormonal therapy is used to treat cancers that have hormonal sensitivity. They can be used before or after the surgery in order to ensure that cancer does not reoccur. Some of the treatment methods in this section include medication that restricts hormones from getting attached to the cancer cells, medications that restrict the body to produce oestrogen post-menopause and a medication that destroys cancer receptors.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Umbilical hernia diet
An umbilical or belly button hernia occurs when a part of the intestines or the abdominal lining protrudes through an opening in the abdominal muscles. The protruding intestines may get squeezed or strangulated resulting in the blood supply getting cut off. Surgery may be required in serious cases of umbilical hernia. Doctors often suggest a special diet for umbilical hernia patients as this helps to prevent further complications.
Foods to avoid
Certain foods are not recommended for people with an umbilical hernia and should be avoided.
White refined flour foods made from white refined flour have a low fiber content. Eating these foods may cause constipation and should therefore be avoided. This is because constipation causes straining of the abdominal muscles during bowel movements and may cause further protrusion of the intestines through the abdominal muscles in the region of the belly button.
Low fiber fruits and vegetables the low fiber content in these foods can also lead to constipation. Examples of fruits and vegetables with low fiber content include skinless raw fruits, cooked fruits, and canned or cooked vegetables without seeds, hulls or skin.
Fatty foods foods with a high fat content should be avoided. This is because obesity results in greater pressure on the abdominal muscles and can increase the risk of umbilical hernia. Examples of foods with a high fat content include fatty meat such as pork, whole milk, butter, cream, margarine and fried foods.
Sugar limit your calorie intake by cutting down on foods such as pastries, cakes, chocolates and soda pop. Limiting your sugar intake will also help you to lose some weight, taking pressure off your abdominal region.
Foods to include
A special diet is required after umbilical hernia surgery. This will help you to minimize your convalescence time. The special dietary requirements include:
Fruits fresh fruits that have high fiber content and are rich in antioxidants should form a part of every meal. The high fiber content will ensure that you do not get constipated and the antioxidants will help protect your body and boost your immune system. Try to eat different types of fruits so as to get adequate amounts of different vitamins. Citrus fruits, berries, and apples are some examples of fruits with a high fiber and vitamin content.
Vegetables these too have a high fiber content that will guard against the dangers of constipation after an umbilical hernia surgery. They also have high levels of vitamins and minerals and should also be included with every meal.
Lean meat meat is a source of protein, which is essential to the repair of damaged tissue. Lean meat like poultry and fish is an excellent source of low fat protein. Have one good source of low fat protein with every meal.
Low fat dairy products these are a good source of protein and can be alternated with lean meats to provide your body with sufficient protein.
High fiber breakfast foods will aid digestion and so your breakfast should consist of foods made from whole wheat flour, wheat germ, oatmeal, or bran.
1. Eat calcium-rich foods
In addition to dairy products, choose fish with bones such as salmon, sardines or whitebait. For additional benefits, serve them with a side of dark leafy green vegetables or broccoli. Almonds, dried figs, fortified tofu and soy milk are also calcium-rich choices, says registered dietitian laura jeffers, med, rd, ld.
2. Take calcium supplements
The u. S. Recommended daily allowance for calcium is 1, 000 mg a day during your 20s, 30s and 40s. But your need rises as you age. Check with your doctor before starting supplements to find out what amount is right for you. For example, after menopause, most women need 1000 to 1, 500 mg a day unless they take hormone therapy. Your body only absorbs 500 mg of calcium at a time, Ms. Jeffers notes, so spread your consumption out over the course of the day.
3. Add d to your day
To help absorb calcium, most adults need 1, 000 to 2, 000 iu of vitamin d daily, combined calcium-vitamin d pills usually do not meet this requirement. And most of us who live north of atlanta do not get enough vitamin d the old-fashioned way — from the sun. Taking a vitamin d supplement will ensure you meet your daily needs.
4. Start weight-bearing exercises
To boost your bone strength, try exercise that “loads” or compresses your bones, says exercise physiologist heather nettle, ma. “running, jogging, high-impact aerobics, repetitive stair climbing, dancing, tennis and basketball are best for building bones. But if you have osteopenia, osteoporosis or arthritis, try walking or using an elliptical or other machine,” she says. Be sure to clear any exercise plans with your doctor first.
5. Don’t smoke, and don’t drink excessively
Bad news for bad habits: loss of bone mineral density is associated with tobacco use and excessive alcohol consumption, Dr. Sikon says. If you smoke, look into a program to help you quit. If you drink, stick to no more than one libation a day, she advises.
6. Get your bone mineral density tested
Doctors can get a quick and painless “snapshot” of bone health using a simple x-ray test called dxa. This test measures bone mineral density and helps determine risks of osteoporosis and fracture. Dr. Sikon recommends testing for women within two years of menopause. Earlier tests are recommended for men and women with certain diseases and for those taking medications that increase risk, such as long-term steroid therapy.
Perimenopausal women may consider hormone therapy to increase waning estrogen levels, which are linked to bone loss. And women and men diagnosed with osteopenia or osteoporosis can take various medications to prevent dangerous hip and spine fractures.
I am 22 year running. I am suffering from slip disc problem since last 1 & half year. My pain is increasing day by day. Its start with lower back and now its come in my left leg. I am done many things for it but still I am suffering for with this. What can I do I cant understood.
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.
Brain surgery involves several medical procedures, which incorporate fixing issues with the brain, including changes in the tissues of the brain, cerebrospinal fluid and brain blood flow. Brain surgery is quite a complicated method of surgery and the type of surgery to be conducted depends on the underlying conditions.
Reasons for Brain Surgery:
Brain surgery is performed for the correction of physical brain abnormalities. These abnormalities could occur because of diseases, birth defects and injuries. A brain surgery is required when the following conditions arise in the brain:
- Abnormal blood vessels
- Blood clots in the brain
- When the protective tissue or dura is damaged
- Due to nerve damage
- Parkinson's disease
- Any kind of pressure after an injury
- Skull fractures
- In case of stroke and tumors
A surgery may not be required for all the above mentioned conditions, but in case of many, a brain surgery is very important as the conditions may worsen health problems.
Types of brain surgeries:
- Craniotomy: During this open brain surgery, an incision is made in the scalp, and a hole is created in the skull, near the area, which is being treated. After this process is complete, the hole or bone flap is secured in its place using plates or wires.
- Biopsy: This form of brain surgery helps in the removal of a small amount of brain tissues or tumors. After removal, the tissues or tumors are examined under a microscope. The creation of a small incision and a hole in the skull is indicated as a part of this process.
- Minimally invasive endonasal endoscopic surgery: This form of brain surgery enables the removal or lesions and tumors via the nose and sinuses. Private parts of the brain can be accessed without creating an incision. An endoscope is utilized in the process which is used to examine tumors all across the brain.
- Minimally Invasive neuroendoscopy: This process is similar to the minimally invasive endonasal endoscopic surgery. This method also involves the use of an endoscope for removal of brain tumors. Small, dime sized holes may be made in the skull to access some brain parts.
Brain surgeries may be associated with several risks. They may be:
- Allergic reactions to anesthesia
- Blood clot formations
- Swelling of the brain
- A state of coma
- Impairment in speech, coordination and vision.
- Problems in memory
- Strokes and seizures
- Infections in the brain
A brain surgery is a serious and very complex surgery. There are different kinds of brain surgeries, which are conducted depending on the condition and severity of the disease.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Breast cancer is an abnormal growth of cells in the tissues of the breast. Mainly it occurs in females but less than 1% of all the breast cancer cases develop in males. The majority of breast cancers start in the milk ducts. A small number start in the milk sacs or lobules. It can spread to the lymph nodes and to the other parts of the body such as bones, liver, lungs and to the brain.
With more reliable early detection methods as well as the trend towards less invasive surgery, there is hope that even more women with breast cancer will be treated successfully and will go on to resume their normal lives.
Signs & Symptoms
It is painless, especially, during the early stage. Watch out for the following changes in the breast:
- A persistent lump or thickening in the breast or in the axilla.
- A change in the size or shape of the breast.
- A change in the colour or appearance of the skin of the breast such as redness, puckering or dimpling.
- Bloody discharge from the nipple.
- A change in the nipple or areola such as scaliness, persistent rash or nipple retraction (nipple pulled into the breast).
Consult a doctor immediately if you notice any of these changes.
Being a woman puts you at risk of getting breast cancer. There are certain factors that increase the risk of breast cancer. Some of them have been listed below:
- The risk increases with age; most cases of breast cancer develop after the age of 50
- Genetic alterations in certain genes such as BRCA1 and BRCA2
- Family history of breast cancer
- Being overweight
- Early menarche (onset of menstruation before the age of 12)
- Late menopause (after the age of 55)
- Never had children
- Late childbearing
- No breast feeding
- Excessive consumption of alcohol
- Use of hormonal replacement therapy (HRT) for a long period of time
However, most women who have breast cancer have none of the above risk factors. Likewise, not having any of these risk factors does not mean that you will not get breast cancer.
Early Detection and Screening
More treatment options are available when breast cancer is diagnosed at an early stage and hence the chances of recovery is also higher. So regular breast screening is important for early detection even if there are no symptoms. Following are the ways of screening:
- Breast Self-Examination (BSE): Perform BSE once a month about a week after your menses are over. If you no longer menstruate, choose a date each month which is easy to remember e.g. your date of birth or anniversary.
- Clinical Breast Examination: Get a breast specialist to examine your breast once a year if you are 40 years and above.
- Mammogram: Go for a screening mammogram once a year if you are 40 to 49 years old and once every two years if you are 50 years and above even if you do not have any symptom. It is not recommended for younger women (less than 40 years of age) as they have dense breasts, making it difficult for small changes to be detected on a mammogram. So ultrasonography of the breasts is advisable to them.
Types of Breast cancer
- Non-Invasive Breast cancer: These are confined to the ducts within the breasts. They are known as Ductal carcinoma in-situ (DCIS).
- Invasive Breast cancer: It occurs when cancer cells spread beyond the ducts or lobules. Cancer cells first spread to the surrounding breast tissue and subsequently to the lymph nodes in the armpit (Axillary lymph nodes). These cells can also travel to the other parts of the body such as bones, liver, lungs or brain and hence known as metastatic breast cancer.
Making A Diagnosis
If you notice any unusual changes in your breasts, you should see a doctor immediately. He will examine you clinically and may ask you to undergo some tests so that a definitive diagnosis can be made. Further, the staging work up is done to find out the stage of the disease and management accordingly.
Treatment of breast cancer may include various methods such as surgery with or without breast reconstruction, chemotherapy, radiation therapy, hormonal therapy and targeted therapy. Treatment options offered, depend upon the number of factors such as the stage of cancer and likelihood of cure, your general health and your preference. In case you have a concern or query you can always consult an expert & get answers to your questions!