Dr. Rajan Sahu

Bladder cancer can be caused by a variety of factors, which include genetic factors, inheritance, drugs, chemicals, environment related factors and smoking. In fact, smoking tobacco is one of the major causes of bladder cancer around the world. The chemicals present in tobacco can irritate the bladder lining which ultimately leads to bladder cancer. Besides smoking other important environmental factors might be chemotherapy, exposure to chemicals from newspaper, dye, leather, paints industries.

Symptoms of bladder cancer are as follows:

Most often it occurs in people more than 50 years of age. It can present in different ways, but common symptoms being :

1. Painless hematuria - reddish or brownish colored urine with or without clots Increased frequency of urination Pain while passing urine .
2. Difficulty in passing urine

Diagnosis:

The diagnosis requires a proper imaging workup including ultrasound, CT scan and urine examinations. Following the initial imaging, a biopsy is required to confirm the diagnosis and stage the disease. This is done by cystoscopy under anesthesia.

Treatment Options:

Treatments for bladder cancer.depend on the stage of cancer. Broadly bladder cancers can be categorised into Non-invasive and Invasive cancers.

1. For non-invasive cancers: It requires recurrent cystoscopic surveillance and resection. For those with high risk of tumor recurrence or progression, intravesical chemotherapy or immunotherapy might be required.
2. For invasive cancers the various treatment choices are:
   1. Surgery: For localised tumor which are amenable to resection perhaps surgery is the best possible treatment. This is a major undertaking where in whole of bladder along with accessory organs is removed. The surgeon may offer choices for reconstruction between neobladder (refashioning bladder with patient's gut) or ileal conduit (fashioning a stoma over which bag can be worn to collect urine). Following surgery a regular follow up is required and the prognosis is good.
   2. Chemotherapy: This modality is reserved for patient's where surgery is not possible or they have metastatic disease (disease spread to other body parts).In this method, medications are used to target and destroy cancer cells.
   3. Radiation Therapy: This might be and option for patient's that are not suitable for surgery. Radiation therapy uses gamma rays to destroy cancer cells in the body The key to good prognosis in bladder cancers is early detection timely intervention and good follow up. If you wish to discuss about any specific problem, you can consult a Urologist.

Are you suffering from cancer? Your diet plays an important part when you are a undergoing cancer treatment. There are several types of food items, which are actually beneficial for healing cancer. By including these items in your regular diet, there are chances of better healing. Here are 10 food items that help in healing cancer:

1. Green leafy vegetables: You must consume green leafy vegetables, such as spinach, collard greens, kale, watercress and arugula salad as they contain vitamins, minerals, enzymes and antioxidants. Also they are low in calories, sodium, fat and toxins and are a storehouse of antibacterial plus antiviral components, which inactivate carcinogens and help in killing program cancer cells. The formation of tumor is prevented. The chemicals turn into biological compounds and break down cancer cells.
2. Cruciferous vegetables: These vegetables are capable cancer killers and are rich in vitamin C. All vegetables belonging to the brassica family of cruciferous vegetables contain isothiocyanates, which help in the prevention of cancer. Vegetables like broccoli and cauliflower also contain sulforaphanes and indoles, which protect the DNA structure.
3. Berries: Berries contain antioxidants and proanthocyanidin antioxidants. These are capable of reducing free-radical damage. You should add blueberries, strawberries, goji berries and cherries to your diet.
4. Fresh herbs and spices: Turmeric contains curcumin, which helps in reducing the tumor size and fighting breast and colon cancer. Its properties help in fighting inflammation. Other herbs such as ginger, garlic, oregano, basil and parsley help in boosting the body’s immunity.
5. Organic meats: Organic meats such as chicken or beef liver are considered effective for cancer patients. This is because they are dense in nutrient content and contain vitamin B12 in high quantity. Consuming organic meat helps in the cleansing of your liver and removing toxins from the digestive tract.
6. Cultured dairy products: Cultured dairy products contain probiotics or good bacteria. These help in promoting a natural bacterial balance in the intestinal microflora and increasing immunity. These food products prevent tumor growth and help with cell regeneration. You should have raw milk products like yoghurt, cheese and kefir.
7. Nuts and seeds: Chia seeds and flax seeds provide omega-3 fatty acids and important minerals. Hemp seeds, pumpkin seeds and sunflower seeds are also essential for a cancer patient.
8. Healthy unrefined oils: Oils such as coconut, flax, extra-virgin olive oil and cod-liver oil nourish the gut and your immune functions are boosted.
9. Mushrooms: Mushrooms are of different types and offer different benefits. In general, all mushrooms increase a body’s immunity to fight with cancer. You should add reishi, maitake and cordyceps mushrooms to your diet.

For consuming an ideal diet, which comprises cancer preventing and cancer-fighting foods, you should consult a dietitian. 

The above food help in prevention and recovery from cancer. In any case, rest is equally important and also fluids. Diet to regular chemo session, one might feel anorexic with persistent nausea, so having them in small portions in advisable. One can opt for organic versions of these, to ensure good quality. Try avid consuming them absolutely raw, stir fry, boiled are some recommendable methods. Cancer can be patience testing disease to cope up with it best is to have a positive attitude for better recovery.  If you wish to discuss about any specific problem, you can consult a Dietitian/Nutritionist.

Symptoms, causes and treatment for Cervical Cancer

Namashkar. Hello, I’m Dr. Shalini Tiwari. I’m a gynaecologist practicing at East Delhi Surya Hospital. Aaj main apko cervical cancer ke bare mein kuch batana chahti hoon.

Today in India, there are so many women who are dying due to cervical cancer. It is one of the most common cancers in the world due to which women are affected. Why today I’m talking about cervical cancers? Today, sexual relations are on rise. Even young women like 16, 17, 18 year old are going for sexual relationship. I’m not saying that sexual relationship is wrong, but why I am talking about cervical cancer is because sexual relationships are one of the highest factors of cervical cancers. So let’s understand what actually cervical cancer is. To understand this, we need to know what cervix is. So I’d like to tell you that we have a uterus where our baby is grown and then born afterwards.

See, this is the uterus, and this is the cervix. So just as we have our face, as we have our lips, so our uterus has lips which is known as cervix. It is this portion which is affected most. Why? Because during sexual intercourse, due to repeated infections, and anything which is outside and which is externally entering into the vagina, first it will infect or affect this part of the uterus. This is known as cervix. So any infection, any erosion, any bleeding, any white discharge, anything which is affecting the cervix can give rise to cervical cancer. This is a very broad statement, there are definite…there are definitely some definite reasons, definite viruses which give rise to this cancer.

Coming on to symptoms of cervical cancer. So many of us have irregular menstrual bleeding, but we tend to ignore it. We should not. Abnormal menstrual bleeding is one of the finest and one of the earliest symptom of cervical cancer. So please don’t ignore it and visit your gynaecologist. Now you would like to know what abnormal bleeding is? So abnormal bleeding would be bleeding after intercourse, abnormal bleeding would be bleeding in between menstrual cycles, abnormal bleeding can be excessive bleeding during regular cycles. So any three of them, if it is there, you please visit your doctor, and get yourself checked.

Why so much of a hush-hush over cervical cancer all over the world? Because, number 1, it is common, number 2, it is a preventable cancer. It is a very slow growing cancer. It starts from the cervix, and then gradually gradually gradually it involves all of the uterus. But this gradual is so much that if we diagnose it, it can be actually cured 100%. That’s why we really need to be careful. You should be having a regular checkups, all women, specially all sexually active women. You should have regular checkups.

So what are the preventive checkups for cervical cancer?

•  Pap test. All of us know Pap test. It is being advertised in TV, it is being advertised by WHO off and on. So every sexually active woman should get a Pap test every three years.
• Similarly there is a virus called HPV virus, i.e, Human papillomavirus. This virus is a sexually transmitted virus. And if this virus is there, there are high chances that patient will develop cervical cancer. Though once infected with this virus, it doesn’t mean that it will be there throughout your life. Because it titles goes down in one year or two years, but then there are two specific types, like 16 type and 18 type of HPV virus, which can really give your body a potentiality to grow into cervical cancer. So you should get your HPV testing also done.
• Third is colposcopy. Colposcopy is a screening test, and through colposcopy we see the cells of cervix directly under acetic acid, which really helps us to diagnose if the cells can grow into cancers, or these cells are benign cells. And these three tests are absolutely noninvasive tests, non-painful tests, and just OPD procedure for two to three or five minutes maximum. So you should…all of you should get these tests dine regularly. Number three, supposing we do these tests, and we diagnose that element of cancer is there. So if it is in initial stages, like we call it carcinoma, you won’t believe, to treat this we don’t even need to do hysterectomy. This is just we need to do a cryo, ye ek prakar ki thandi si  jo layman ki bhasha mein bolte hain, or use puri tarah ye erosion theek ho jata hain. Uske baad use jo cervical cells hote hain cancer waale, wo bhi mar jaate hain. And the chances of progressing into a frank carcinoma becomes almost negligible.

That’s why cervical cancer is everywhere. So we need to be very careful, we need to be very vigilant. Our health is in our hands. So if we are not vigilant about our health, no one else is going to tell us, please go to the doctor. Humein pata hona chahiye ki hamare mein infection ho raha hain, white discharge humein zyaada ho raha hain, bleeding humein zyaada ho rahi hain, so ;et’s viosit the doctor.

In the end, agar apko dikhana hain, aap chahte hain ki aap cervical cancer se bachein rahein, please come to me. I sit as Surya Hospital in East Delhi, or you can contact me through Lybrate. Thank you.

Ovarian cancer is a broad term used to describe cluster of different types of cancers occurring in a single organ i.e. ovary. It can occur at any age- from infancy till old age , even though ovarian carcinoma in younger/childhood comprises only 20% of all ovarian cancers. Majority of ovarian cancers are epithelial - arising from the covering from ovary or from the fallopian tube or the lining of the peritoneum of the abdominal cavity.

The Silent Killer:

Ovarian cancer is called a silent killer as majority of patients report any symptoms when the disease is in the advance stage. Hardly 2-3% of all ovarian cancers cause bleeding or hirsutism, thereby seeking prompt treatment. Majority of ovarian cancer occurs in peri/postmenopausal women which reflect change in interior milieu in terms of hormones.

Since the symptoms are non-specific, women tend to ignore them due to growing age/menopause. Also, mostly women normally don't consult physicians for such non-gynecological complaints, thereby further delaying the diagnosis. It is recommended that women remain involved in their overall health and keep themselves updated to report any abnormality immediately to a specialist.

The main symptoms associated with Ovarian Cancer are:

• Bloating sensation especially after heavy meals.

• Increasing abdominal girth (especially if no change in diet or if regularly exercising).

• Increasing heaviness (fullness) in lower abdomen.

• Increasing constipation.

• Persistent Gastritis, if previously absent.

• Inability to eat proper meal.

• Increasing tiredness.

• Increased frequency of urination.

• Painful contact.

Further, if there is family history of breast/uterine/ovarian cancer in first and second degree relatives, this increases the risk of developing ovarian and breast cancer. Such females should remain vigilant for above-mentioned symptoms and should report promptly.