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Dr. Suresh

Radiologist

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I pride myself in attending local and statewide seminars to stay current with the latest techniques, and treatment planning....more
I pride myself in attending local and statewide seminars to stay current with the latest techniques, and treatment planning.
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Is Surgery The Best Option For Treating Breast Cancer?

MBBS, MS- General Surgery
General Surgeon,
Is Surgery The Best Option For Treating Breast Cancer?

Breast cancer is the most common cancer that affects women. It is also deemed to be one of the major reason of death among women, though lung cancer is the leading cause of this. The chances that a woman may die of breast cancer is about 2.7% of the women who are suffering. Breast cancer is known to affect men as well, in certain cases. Breast cancer may be genetic but, in certain cases, it is caused due to excess intake of alcohol. Surgery is an option, but treatments also include therapies like radiation and chemo.

Treatment for breast cancer
Breast cancer can be treated in several ways; however, the treatment depends upon many factors. These factors include the type of breast cancer, its stage, sensitivity of a person to the hormones, age of the patient, health of the patient and most importantly, preferences of the patient. The most common treatment options for breast cancer are radiation therapy, biological therapy, chemotherapy, hormone therapy, and surgery.

Chemotherapy
Cytotoxic drugs are important medications that are used to eliminate cancer cells. This medication is used if the chances of the cancer cells spreading are high. This process is known as the adjuvant chemotherapy.
Many a time, the tumor increases in size and surgery becomes essential. This is when the chemotherapy is administered to reduce the tumor size and make it easier for the surgeons to remove the tumor. This process is referred to as neoadjuvant chemotherapy. Chemotherapy can treat metastasized cancer or cancer that has affected other body parts, thereby reducing the symptoms, mostly in the advanced stages.

Radiation Therapy
Radiation is targeted towards the tumor in controlled doses so that the cancer cells are destroyed. Radiation therapy is mostly advised to the patients after they go through surgery, to eliminate the cancer cells that may still be there.

Hormone blocking therapy
Most people go through breast cancer that is hormone sensitive. The hormone blocking therapy helps in preventing the recurrence in this type of breast cancer. The hormone blocking therapy is also used to reduce the size of the tumor, but this method is also suggested after a person goes through surgery.

Biological treatment
There are some drugs that fall under this category that is used for destroying the various types of the breast cancer.

Surgery
If at all the patient requires surgery, it depends on his or her diagnosis reports and his or her will to undergo surgery. The types of surgery include Lumpectomy, Sentinel node biopsy, Mastectomy, Axillary lymph node dissection, and Reconstruction. Reconstruction is the method which the doctors make use of to make both the breasts look similar after the surgery is complete. There are several treatment options available to treat breast cancer, and it depends on the choice of the patient to opt for surgery. Surgery helps in eliminating the risk of the spreading of the cancer cells, and it is one of the most effective treatments for breast cancer.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2918 people found this helpful

Test to Screen for Breast Cancer

Homeopath,

Test to screen for breast cancer:

 

Mammogram:

  1. Mammography is the most common screening test for breast cancer. A mammogram is an x-ray of the breast. This test may find tumors that are too small to feel. A mammogram may also find ductal carcinoma in situ (dcis). In dcis, there are abnormal cells in the lining of a breast duct, which may become invasive cancer in some women.

  2. Mammograms are less likely to find breast tumors in women younger than 50 years than in older women. This may be because younger women have denser breast tissue that appears white on a mammogram. Because tumors also appear white on a mammogram, they can be harder to find when there is dense breast tissue.


 

Enlarge Mammography:

  1. The left breast is pressed between two plates. An x-ray machine is used to take pictures of the breast. An inset shows the x-ray film image with an arrow pointed at abnormal tissue.

  2. The breast is pressed between two plates. X-rays are used to take pictures of breast tissue.


 

The following may affect whether a mammogram is able to detect (find) breast cancer:

  1. The size of the tumor. How dense the breast tissue is. The skill of the radiologist.

  2. Women aged 40 to 74 years who have screening mammograms have a lower chance of dying from breast cancer than women who do not have screening mammograms.


 

Clinical Breast Exam (CBE):

  1. A clinical breast exam is an exam of the breast by a doctor or other health professional. The doctor will carefully feel the breasts and under the arms for lumps or anything else that seems unusual. It is not known if having clinical breast exams decreases the chance of dying from breast cancer.

  2. Breast self-exams may be done by women or men to check their breasts for lumps or other changes. It is important to know how your breasts usually look and feel. If you feel any lumps or notice any other changes, talk to your doctor. Doing breast self-exams has not been shown to decrease the chance of dying from breast cancer.

  3. Mri (magnetic resonance imaging) in women with a high risk of breast cancer

  4. Mri is a procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (nmri). Mri does not use any x-rays.


 

MRI is used as a screening test for women who have one or more of the following:

  1. Certain gene changes, such as in the brca1 or brca2 genes. A family history (first degree relative, such as a mother, daughter or sister) with breast cancer. Certain genetic syndromes, such as li-fraumeni or cowden syndrome.

  2. Mris find breast cancer more often than mammograms do, but it is common for mri results to appear abnormal even when there isn't any cancer.

  3. Other screening tests are being studied in clinical trials.


 

Thermography:

  1. Thermography is a procedure in which a special camera that senses heat is used to record the temperature of the skin that covers the breasts. A computer makes a map of the breast showing the changes in temperature. Tumors can cause temperature changes that may show up on the thermogram.

  2. There have been no clinical trials of thermography to find out how well it detects breast cancer or if having the procedure decreases the risk of dying from breast cancer.


 

Tissue sampling:

Breast tissue sampling is taking cells from breast tissue to check under a microscope. Abnormal cells in breast fluid have been linked to an increased risk of breast cancer in some studies. Scientists are studying whether breast tissue sampling can be used to find breast cancer at an early stage or predict the risk of developing breast cancer. Three ways of taking tissue samples are being studied:


 

Fine-needle aspiration: a thin needle is inserted into the breast tissue around the areola (darkened area around the nipple) to take out a sample of cells and fluid.


 

Nipple aspiration: the use of gentle suction to collect fluid through the nipple. This is done with a device similar to the breast pumps used by women who are breast-feeding.


 

Ductal lavage: a hair-size catheter (tube) is inserted into the nipple and a small amount of salt water is released into the duct. The water picks up breast cells and is removed.

I am 24yr old male and have backache for 7 month. My mri report is mild annular disc bulge is seen at l4-5 level with subtle anterior thecal sac impression. What should I do?

Diploma in Radio-Diagnosis
Radiologist, Shimla
At this age only excersises-lumber and sacral, har, bed rest, avoid jjerky movements, and sitting posture normal advised.
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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.

DNB (Orthopaedics), Diploma In Orthopaedics (D. Ortho), MBBS
Orthopedist, Gurgaon
Herniated disc is likely to have a course with repetitive episodes of back and leg pain. It is important to avoid postures that may complicate the situation. Surgery is usually recommended, if there is any evidence of neurologic deficit, such as weakness of toes, persistent numbness or bladder/ bowel dysfunction. Most such cases can be managed conservatively with a combination of medication and physio.
1 person found this helpful
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How Herniated Disk Effects Your Health?

IFAANS, DNB (Neurosurgery), MBBS
Neurosurgeon, Ghaziabad
How Herniated Disk Effects Your Health?

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 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.  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 cord. 

Nerves are located precisely at the back of every disc and are responsible for controlling everything 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 on the affected nerve. It has been observed that individuals do not feel any painful sensations even if their disc gets damaged.

When is Surgery Recommended for Herniated Disc?
Surgery for herniated disc is recommended only after options like  pain relievers, exercise and non-steroid anti-inflammatory drugs do not work. If the pain persists even after these options, then it becomes important to go for surgery. There are certain risks involved in this surgery like infection, bleeding or nerve damage. 

There are chances that the disc may get ruptured again if it is not removed. 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. 

Surgery for herniated disc is recommended only after options like pain relievers, exercise and non-steroid anti-inflammatory drugs do not work. If the pain persists even after these options, then, needs to be removed as steroid injections is not advisable per se.

Activities like bending sideways, pushing, twisting, repetitive lifting can increase the risk of a herniated disk. At times, emergency surgery is also required to avoid paralysis in a patient. In case you have a concern or query you can always consult an expert & get answers to your questions!

1 person found this helpful

For few days when seating for a long time then suddenly arise tiny pain in lower of hip the where end of spine please suggest me sir.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
Extension Exercises x 15 times x twice daily - lying on tummy, take left arm up for 3 seconds, then bring it down, right arm up for 3 seconds, bring down. Bring right leg up, hold for 3 seconds, bring it down. Then right leg up and hold for 3 seconds and bring it down. Repeat twice a day- 10 times. Bhujang Asana -- Lie flat on your stomach, keeping the palms out, bend the neck backward, take a deep breath and while holding it for 6 seconds, raise the chest up. Release breath and relax your body. Repeat the exercise 15 times twice daily. Core Strengthening Exercises- Straight Leg Raised With Toes Turned Outward, repeat 10 times, twice a day.
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I have some disc problem, in MRI report L5S1, how can I remove this problem, which exercise is useful in this problem.

D.A.M.S( A. M.), D.AC/B.E.M.S
Acupressurist, Mumbai
I have some disc problem, in MRI report L5S1, how can I remove this problem, which exercise is useful in this problem.
You should take acupressure treatment and take biochemic kali phos 12x + calc. Flour12x. 4 tab each thrice a day with warm water and take it 5 day's
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Bone Cancer: Breaking The Myths

Fellowship Orthopaedic Oncology, MS - Orthopaedics
Oncologist, Mohali

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.

Symptoms:

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

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.

4 people found this helpful

I have been suffering from disk problem since 7 months. I have consulted a doctor. I took x-Ray as per his advice. He said disk has been narrowed. He prescribed some painkillers and vitamin tablets. Could anyone please prescribe some medicine for me. I am really unable to sit without any support.

Diploma in Orthopaedics
Orthopedist, Morena
Dear, do the following things. 1. Hot fomentation for 1/2 hrs with lukewarm water. 2. Back extension excercises. 3. Pavan muktasan yoga 4. Bujangasan 5. Muscle relaxant tablets for 5-7 days. 6. Local application of analgesic ointment. 7 vitamin d in form of capsules/sachets under guidance of doctor. Check your vit. B12 level.
1 person found this helpful
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