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Good morning, I am Dr Dinesh Singh I am director predation oncology at Max hospital, Vaishali and today I will be talking about the most common cancer of women in India, it is breast cancer and there is no age bar. We have seen patients as young as 17 to 18 years and as old as 80 to 90 years. So every woman is at risk of getting the breast cancer, now which are the ladies which are more prone to get breast cancer when those ladies who do not have the breastfed their child, those who are very obese or those who have history of a breast cancer in their first relative like in the father, mausi, sister they are at higher risk, but then any population is at risk of developing cancer. What we need to understand is that we should be aware about our body and we should do a self breast examination every month, so that we know the change which happens in our breast over a period of time and once you notice that there is a lump in the breast, usually, pain is not initial symptom of Cancer any cancer in the body and whenever you notice that there is a lump in the breast then it has to be further investigated. The age is less than 40 years we go for an ultrasound of the breast which is more than 40 years we go for mammography of the breast. And then further investigation like a biopsy of the lump and if it is found cancerous, then we do for the test to see whether it is spread to another part of the body or not. Well, that tells us about the stage the breast cancer is and then depending upon the stage the treatment is decided. That let us say that we diagnose breast cancer at a very early stage that means it is less than 3 to 4 cm and at that time we do not need to remove the entire breast of the person to cure the person, we can remove only a portion the cancerous portion plus a little bit of arching around the tumor and in the axilla we have to do surgery to get out the nodes. For that now it is a sentinel node biopsy is done what happens in that is that we identify the draining lymph nodes we take them no we study them then and there when the patient is still under anaesthesia and if they are not cancerous then we do not take out the further lymph nodes of the axilla, if they are cancerous then we take them out. After that then the further treatments depends upon the final histopathology report of the tumor, if the tumor is very small If in case very sensitive to hormones these patients don't need any chemotherapy, radiotherapy becomes a part of the every breast conservation surgery and if that tumor is larger or it is not sensitive to hormones then we have to give chemotherapy. In chemotherapy now very latest medicines are available there are called targeted therapy and the cure rates have become very high. All the cancers especially breast cancer the side effects are very minimal, we have all the medicines which can take care of the vomiting, the infection and other side effects which are happening along with the chemotherapy. And regarding radiotherapy, the latest technology is targeted radiation or image-guided radiation along with other things we are able to do a very pinpoint radiation to the area where it should go. So that it saves the underline normal structures from getting exposed to radiations the cure rates become very high and the side effects are very low. So I will say that all the girls and all the ladies they should do a self-examination try to be familiar with their normal body oncology, diagnose cancer early to treat it properly and be the cure of cancer. Thank you.
Hi doctor, What are the chances of me getting breast cancer if my mom has got it during her menopause? I am getting married soon and this has raised a concern in my fiance's mind.
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.
Usually there are no specific primary stage symptoms of liver cancer. Some symptoms which may develop include the following:
Unusual weight loss is observed
Loss of appetite and developing food aversion
Pain in the upper abdomen
General weakness with intense fatigue
Swelling in the abdomen
The skin may become yellow
White and chalky stools are likely
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.
There are several factors which enhance the risk of liver cancer. They are as follows:
A progressive and irreversible condition known as cirrhosis leads to scar tissue formation in the liver, increasing the risk of liver cancer.
Certain inherited liver diseases such as Wilson’s disease and hemochromatosis also increase the chances of liver cancer.
People with diabetes are also at a greater risk of having liver cancer.
Non-alcoholic fatty liver disease (NAFLD), which is the accumulation of fat in the liver, also increases the chances of getting this condition.
Excessive alcohol consumption is another factor which causes irreversible damage to the liver and the chances of getting liver cancer get boosted.
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.
I am 51 yrs. I am suffering from neck pain and headache last two years. My mri report says that c5-6 disc shows diffuse asymmetric bulge[more towards left side], causing effacement of anterior subarachnoid space and indentation of bilateral c6 nerve roots[left>>right]. Along with posterior osteophytes, it constitutes hard disc. What should I do? please help me.
Are you experiencing excruciating headache? you probably didn't know but you could be suffering from brain aneurysms. It is described as bulge formation in the blood vessel in the brain. It is a totally asymptomatic condition as one does not display any symptoms until the bulge vessel ruptures which may result in blood releasing in the skull which may further lead to a stroke. The bulge is often formed in the gaps between the tissues covering the brain and brain itself.
Most common treatment options for ruptured aneurysm
There are two common treatment options for a ruptured brain aneurysm endovascular coiling and surgical clipping. Both these procedures have certain risk factors, therefore it is best to discuss the details with a neurologist. The endovascular coiling is a less invasive process where the surgeon inserts a hollow tube or catheter into an artery and threads it through the body to reach an aneurysm. Then a guide wire is sent to push a soft platinum wire through the catheter. This coils up and disrupts the flow of blood into the aneurysm and leads to blood clotting. The clotting is essential in sealing off the aneurysm from the artery.
The surgical clipping is a process used for closing off the aneurysm, and a section of the skull is required to be removed for assessing the affected part. It also helps in locating the blood vessel that is responsible for the problem. Finally, a metal clip is placed on the neck of the aneurysm to stop the flow of blood. Though endovascular coiling is less invasive and said to be safer, adequate post-treatment care is necessary to minimize risks.
To treat larger aneurysms, a treatment called flow diverters may be useful. Since, the treatment is decided based on the size, location, apperance and your health condition, your doctor will be the best person to take the final call.
Other procedures to treat symptoms
Other than the surgical procedures several treatments might be prescribed to treat the symptoms and to manage complications. A few commonly advised treatments are:
- Pain relievers: To manage headaches
- Calcium channel blockers: One of the most common complications that may arise with an aneurysm is calcium entering the walls of blood vessels which may result in narrowing of walls. Calcium channel blockers are medications may be prescribed by the doctors to deal with the complication
- Anti seizure medications: Medications such as levetiracetam, phenytoin, valproic acid, and others are prescribed to treat seizures associated with aneurysms
- Procedures to prevent stroke: An insufficient blood flow may result in a stroke and to prevent it, the drug vasopressor is injected intravenously, or angioplasty is performed.
- Rehabilitative therapy: Damage to the brain may require the patient to undergo several physical and occupational therapy.
If you suffer from the condition, it is advised to keep a check on the blood pressure and quit smoking as they can help in reducing the risks associated with aneurysms.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Symptoms, causes and treatment for Breast Cancer Patients
Hello friends. My name is Dr. Gayatri Juneja. I’m a practicing gynecologist in Model Town for the last 20 years. I’m a visiting consultant in Apollo Cradle Hospital Moti Nagar, and Fortis Hospital Shalimar Bagh, and Sunder Lal Hospital Ashok Nagar. It’s a great pleasure for me to talk to you about certain problems which I think is becoming very important for all of us to know. I am going to talk about Breast Cancer.
Unfortunately, even in India, cancer breast is becoming very common. And it is not that it is a cancer which we cannot pick up at time. The only thing we need is to be aware of it. Only if we know what is happening with our body, is only then we can do what is normal, only then we can see what is not normal, right? It is one of the breast cancer is one of the easiest cancers to pick up. How? My body is my own. I should know what’s happening to me. So minimum a lady can do is do a self examination. Teach your daughters how to do a self examination for the breast. If you find any lump, any time, if you feel there is some pain, which was not there, if you see the nipple is not in the normal position, it is retracted inside, if you see there is skin changes on your breast, if you see any size difference. See minor size difference will be there. That is a natural thing. But if you see there is drastic change, and if you are not comfortable with something, do not neglect it. It’s not at all a normal thing. Go, see a gynaecologist.
It is a confidential thing between you and your doctor. Let her examine you. Let her guide you. You give her a proper history, if you have taken any contraceptive pills, even I-pill is very dangerous. I’ll come to it later how. The thing is…your doctor has examined you, then she will guide you what has to be done. There are various ways of diagnosing cancer of breast. First step is, you do a self examination. First step is over. You find the lump, you go to a doctor. Your doctor will ask for a sonography, that is ultrasound of the breast. And another part of it is an x-ray of the breast. Sometimes in younger age group the breast is very dense, and you cannot diagnose anything on mammogram.
You still are suspecting something, then your doctor might ask for an MRI. MRI is very effective in diagnosing, but we do not suggest it as first line treatment, first line of diagnosis. Once it is confirmed that yes, there is a lump, then what we do is, we ask for a biopsy. Now biopsy can be in 2 forms. It can be taken through the needle, which we call FNAC – Fine Needle Aspiration Cytology, and other is open biopsy, where we remove the whole lump, and send it for testing. If the test comes negative, good, fine, everything is fine. If it comes positive, then further treatment depends upon the type. Then they will do a special CT scan for you, where the will diagnose if any lymph nodes are involved.
Depending on preliminary staging, your doctor will ask for a surgery. Now the surgery will…it is better that the whole breast gets removed. Or what has to be done will be diagnosed, because it is not a single person specialty, it is going to be a multi-specialty treatment then. Now let’s come down to who are the people who are at higher risk. Why should I consider that I am at higher risk? What…who are those people? First, specially after menopause, obesity. If your lifestyle is not at all healthy, your food habits you eat lot of non-veg and processed food, like pizzas and burgers and frozen food, yes you are at risk. Then comes genetics.
If you have a family history of cancer in your nani, dadi, your bua, maasi, cousin, ya sister ya brother, or even cancer of ovaries, you are at high risk. But that doesn’t mean who all have had the history of cancer will also develop this. You are at higher risk, but it is better only to be careful. Then comes very tall ladies it has been seen they are also prone for diabetes. Obesity, and people who have had hormonal replacement therapy with…and once you’re diagnosed don’t get scared. It is a curable cancer, and life expectancy with variable modalities these days is quite good.The quality of life is also good.
So my suggestion would be, to conclude, that please be aware of what is happening with you, and take good care of yourself. If you are healthy, only then you can look after your family. Thank you so much.
Hi, My father aged 68 has been prescribed TB medicines for Pott's disease. He has been taking the first line AKT4 medicines from govt. Hospital for the past 2 months. Now they have changed the medicine to continuation phase with AKT3. He had been taking 4 of AKT4 tablets post breakfast. Should he continue taking 4 of the AKT3 tablets as well and after breakfast? What is the dosage for him in the continuation phase for his weight 64 kg and the best time to take the medicines? The AKT4 tablet dosage and timing of the tablet was told to us by the RNTPC doctors. Finally, I want to know one more thing. He has been in bed rest for these last 2 months as he was in severe back pain (low back pain near the pelvis) though the abscess location was around the portion where the ribcage ends in the spine. He says the pain has reduces immensely to the point that he can move and even sit. He says standing is painless right now. Sitting gives him some pain. Overall he is a bit weak now. Recently I saw that his MRI shows a disc bulge around the pelvis but the doctors didn't tell us so. They focused entirely upon the spinal abscess. Could the current pain be from this disc bulge?
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. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.
My wife is suffering from slip disc I already have consulted orthopedic surgeon now, will homeopathy be more effective than doctors medicine. Please advise.?
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. If you wish to discuss about any specific problem, you can consult a Gynaecologist.