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My age is 28 and I am suffering from back pain due to L3, L4, L5 Disc bulging. Kindly suggest me a solution to over come from back pain without surgery.
Breast cancer is on the rise in india. Surveys show that every 4 out of 5 Indian women who have breast cancer, suffer from an advanced stage of the disease by the time they reach the doctor. Urban women are at two times more risk of being diagnosed with breast cancer than rural women. Being overweight, eating unhealthy food, and consuming excessive alcohol or tobacco are some of causes that can make you susceptible to this disease.
How you can avoid breast cancer?
- Every woman should do a self-breast examination every month after the periods. You should check for any abnormal lump, change in skin texture or any abnormal discharge from the nipples. Any abnormality above aspects should be promptly investigated by a doctor's appointment, and an ultrasound or Mammography, as required.
- Apart from self-examining your breasts every month for a lump, going for a mammography (an X-Ray of the breast) is vital for early detection of the problem.
- Consult a gynaecologist before going for the test as its frequency depends on your age and risk factor. About 80-90% of tumours can be traced through this screening.
Breast cancer may run in family. If there is no family history of breast cancer, you start doing mammogram at 40 yrs of age but if there is a family history you start even earlier as advised by your gynaecologist.
I am suffering from sciatica for the last 6 months. Tried back exercises and muscle relaxants. The condition is due to L4/L5 disc herniation. Kindly advice.
I am having slip disc. I want to know to cure it with exercises and what are the precautions to took for this?
What is ECMO?
Like dialysis for unfunctional kidney, Ecmo for unfunctional lung.
Ecmo stands for extracorporeal membrane oxygenation. It is a method of giving oxygen for the body when icu pateint lungs and/or heart are not able to supply oxygen on their own.
Why ICU pateint put on ECMO?
Doctors place ICU patients on ECMO when patients are not able to supply oxygen to the body.
ICU patients’ lungs fail for a number of reasons including pneumonia, lung cancer, pulmonary edema, pulmonary embolism and COPD.
When a patient’s lungs fail, he/she first is intubated (breathing tube) and hooked up to a ventilator (breathing machine).
However, sometimes lungs are so damaged that providing oxygen through intubation is not enough.
This is when doctors turn to v-v ecmo.
A heart can fail for many reasons including heart attack, pulmonary embolism, bad valve disease, or worsening heart failure. When a heart fails, doctors try to fix the underlying problem. They may also start medications (called ionotropes) to help improve the pump function of the heart. If medications are not enough, doctors will turn to v-a ecmo.
How long can someone stay on ecmo?
That is a complicated question. Due to the risks of ecmo discussed above, doctors try to keep patients on ecmo for as short a time as possible. Often patient will be on ecmo for several days up to 1-2 weeks. Every day, several blood and imaging tests are done to determine if a patient is ready to come off ecmo. As the technology of ecmo improves, hopefully side effects will decrease and patients can remain on ecmo for longer periods of time.
What is the difference between ecmo and a ventilator (breathing machine)?
Both ecmo and a ventilator aim to provide oxygen to the body when the patient’s own lungs and breathing are failing. The ventilator assists the patient’s own lungs by pushing oxygen with pressure into the lungs. Ecmo instead provides oxygen directly via a catheter placed in a patient’s vein or artery. We almost always try oxygenating a patient with a ventilator first. However, when a patient’s lungs are too sick for this, we turn to ecmo to assist in providing oxygen to the body. V-v ecmo provides oxygen through a vein. This blood then has to travel to the heart and be pumped around the rest of the body through arteries. Therefore, with v-v ecmo or with a ventilator, a patient must have a well-functioning heart to get the oxygen pumped throughout the body. V-a ecmo has the additional advantage of pumping blood directly to arteries. This “by-passes” the heart and is therefore the method of ecmo we use when a patient’s heart is failing.
I have diagnosed with infiltrating ductal carcinoma, NOS, in right breast (in biopsy report, triple negative (ER-negative, PR-NEGATIVE, HER 2-NEGATIVE). The tumor measures 4 cm* 3 cm mammographically. After giving 3 no. Of chemo My doctor suggest me for modified radical mastectomy. Please tell me if I go for complete breast removal & subsequent chemotherapy Radiotherapy is must or optional?
My dad has a disc problem and in morning time he suffers from stiffness in lower back area. What should he do?
Mri report- mild diffuse disc bulge at l4-l5 level causing the cal sac indentation and bilateral mild neural formalin narrowing (l> r). Please advice.
I am suffering from slipped disc in cervical spine from 6 months. So my question is that I am a dance choreographer should I continue with my dance or not can you suggest me and how this problem Will be cured.
Fibroid tumour is the abnormal cell growth in the uterus and they are mostly benign. Fibroids usually affect women in the age bracket of 30 - 40. Fibroid tumours are of three types, depending on their location:
- Submucosal fibroids: The tumour develops under the lining of the uterus
- Intramural fibroids: The growth is found amongst the muscles in the wall of the uterus
- Subserosal fibroids: The growth develops on the wall of the uterus right in the pelvic cavity
Causes behind it
The exact cause of fibroids in not known clearly. But certain factors have been discovered that might influence their formation. These factors include:
- Hormones: Progesterone and estrogen are the hormones responsible for recreating the uterine lining during every menstrual cycle. These hormones might trigger the formation of tumour.
- Family history: If any member in your family; your mother, grandmother or sister has/had fibroids in their uterus, you may also develop it.
- Pregnancy: Your body produces excessive progesterone and estrogen when you are pregnant, which may cause an increase in the size of a pre-existing small fibroid. Myomectomy can be done by giving incision on the abdomen or by laparoscopy depending on the size and location of the fibroids.
Signs You are suffering from it
- Heavy bleeding along with blood clots during or between your periods
- Lower back or pelvic pain
- Elevated menstrual cramping
- Frequent urination
- Pain during sex
- Longer than normal periods
- Bloating or pressure in lower abdomen
- Enlargement or swelling of the abdomen
How it can be treated?
Your doctor will formulate the right treatment depending on your age, the mass of the fibroids and your overall health. Your doctor may choose a combination of treatment to cure your fibroids, and they include:
- Medication: Gonadotropin releasing hormones (GnRH) agonists, birth control pills and ibuprofen (anti-inflammatory medicine) are prescribed. GnRH agonists reduce the level of progesterone and estrogen in your uterus.
- Surgery: Myomectomy and hysterectomy are two common surgical procedures to treat fibroids. Myomectomy is performed by removing the fibroids only by making an incision on the abdomen. But hysterectomy completely removes the uterus. The latter is reserved for serious cases.
- Non-invasive surgery: Forced ultrasound surgery, myolysis (shrinking fibroids with laser or electric current), cryomyolysis (fibroids are frozen) and endometrial ablation (an instrument uses heat, hot water, microwaves or electric current to destroy fibroids) are some non-invasive surgical procedures. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
Breast cancer is a type of a cancerous infection that develops in the skin cells of the breast. This condition is more commonly diagnosed after you have skin cancer and is more common in women than men. There are certain signs to identify this disease, which are as follows.
1. Breast lumps - Lumps are patches of skin that occur due to the thickening and swelling of the skin. Breast lumps is a very common phenomenon for women but that does not always lead to a breast cancer; however, frequent and reoccurring instances of the same increases the risk of breast cancer. A breast lump is easily identifiable through the naked eye as it looks different from the surrounding tissues.
2. Blood discharge - The nipple is one of the most sensitive areas in the human body. In case of women, it is meant to emit milk during pregnancy, in order to feed the infant externally. A probable symptom of breast cancer can also be a frequent discharge of blood from the nipple without any visible damage or injury.
3. Breast changes - If you are experiencing any visible changes in the size, appearance or shape of the breast, then it is an indicative sign that you may have breast cancer. Thus, it is of paramount importance that you observe, touch and physically examine your breast regularly for changes. If there is any major change detected then it is advisable to consult a doctor.
4. Inverted nipple - The tip of the nipple is generally bulging and pointing outwards both in cases of men and women. But sometimes the tip of the nipple is pushed inside due to excessive suction caused by the skin tissues present inside the breast around the nipple area. This suction forces the nipple to grow inwards which is abnormal and might harm the breast and skin in various ways.
However, apart from these main symptoms, some other signs are also there that increase your chances of being diagnosed with breast cancer. They are redness or pitting of the skin over your breast like an orange, peeling or scaling of the pigmented area around the nipple, dimpling of the skin on the breasts, and such others. If you wish to discuss about any specific problem, you can consult a Gynaecologist.
Hello doctor plzz say me is surgery essential for Diffuse annular disc bulge seen at l4 and l5 level causing indentation over thecal sac with bilateral recess narrowing and significant nerve decompression.
I have slip disc problem in l4 n l5. Is it possible to get relief with problem by exercise only. I have this problem from last 5 years. My age is 30 years.
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. If you wish to discuss about any specific problem, you can consult an oncologist.
What is Bone cancer?
Bone cancer is malignant tumour of the bones which can spread to lungs or other parts of the body. It may have arisen primarily from the bone itself (primary bone cancer) or more commonly, may have spread to the bones (secondary bone cancer) from cancer of some other body organ like Breast cancer, Prostate cancer etc.
Primary bone cancer usually occurs in growing children and young adolescents, whereas, secondary bone cancer usually occurs in older age group. Usually, the patient experiences pain in the affected area, which over the time, gets worse and continuous. There may also be swelling in the involved region. It can cause weakening of bones resulting in fracture. Some patients may attribute these symptoms to any prior antecedent trauma. Unintentional weight loss may also be seen. Sometimes, these patients are wrongly being treated for infection, thus delaying the correct treatment which may have a bearing on the final outcome.
How common is bone cancer?
Secondary bone cancer is the most common type of bone cancer with bone being the third most common site of cancer spread (metastasis) from other organs. However, primary bone cancers are rare accounting for less than 1% of all cancers.
Causes of bone cancer?
There are no known environmental or other hereditary factors which cause bone cancer, however, certain patients are at a greater risk for bone cancer which include:
- Patients who have received prior radiation therapy
- Patients with a history of Paget’s Disease
- Patients with hereditary retinoblastoma - a type of eye cancer that most commonly affects very young children
- Patients with Li-Fraumeni syndrome - a rare genetic condition
How is it diagnosed?
A patient suspected with bone cancer needs to be investigated thoroughly with blood tests, Xrays, MRI to look for local extent of disease. Since bone cancer can spread to lungs and other bones, staging of the disease is done either with whole body PET CT or a bone scan with CT Chest. Alongwith that, a biopsy (usually with a needle) is required to establish the diagnosis. It’s important to do biopsy from the correct site since wrong biopsy site can be detrimental in limb salvage and can result in amputation (cutting the limb). Therefore, it’s recommended that the biopsy should always be done by the surgeon (Orthopaedic Oncologist) who will be doing the final surgery for bone cancer.
Treatment of bone cancer is a multidisciplinary approach requiring an Orthopaedic Oncologist (Bone & Soft tissue tumour specialist), Medical Oncologist (Chemotherapy Specialist), Radiation Oncologist (Radiotherapy specialist) and Pathologist (Specialist in tissue diagnosis).
Usually in primary bone cancers, chemotherapy is given to the patient followed by surgery to remove the diseased bone which is further followed by adjuvant chemotherapy. Limb salvage surgery is possible nowadays for bone cancers in which the part of the bone involved with tumour is removed surgically (rather than cutting the whole limb) and the defect is reconstructed with artificial joint, thereby saving the limb. In some cases, the cancerous bone so removed is given very high dose of radiation so as to kill all the cancer cells and the sterilised bone so formed is fixed back to the parent bone with the help of plates and screws, a technique commonly called as Extra Corporeal Radiation Therapy (ECRT). In children, since the artificial joint will not grow as the child grows leading to unequal limb lengths over a period of time, the defect can be reconstructed with expandable joint which can be lengthened as the child grows which allows to maintain limb length equality at the time of skeletal maturity.
Is cure possible in bone cancer?
With the current chemotherapy regimes and advanced surgical technology, cure is possible in upto 70-75% patients with primary bone cancer. In patients with secondary bone cancer, cure can still be achieved depending upon the primary cancer and the extent of disease. In advanced cases also, a lot can be done to control the disease and give a quality of life to the patient.
Is it possible to prevent bone cancer?
Since the exact cause of bone cancer is not known, as of now it’s not possible to prevent bone cancer.
Whom to consult?
First chance is the best chance when it comes to curing bone cancers. So, it’s advisable to seek treatment from a trained Orthopaedic Oncologist when confronted with a bone cancer to achieve maximum beneficial outcome.