Is Breast Cancer preventable?

Sadly we don’t have any vaccine yet, and it’s not preventable. But with some measures, we can definitely catch the disease early, which is the key to a good outcome. However, it is important to know the risk factors. Apart from family history, your personal life choices like late or no pregnancy, not breastfeeding, smoking and drinking (alcohol) habits, obesity and sedentary lifestyle, early onset of periods and late menopause may play a role.

What can I do to protect myself?

If you have a family history of breast cancer, it is advisable to consult a specialist to understand the precautions you may need to take. It is advisable for all women beyond 30 to undergo regular screening. Breast self-explanatory is the first step. Look for any changes or abnormalities like lump, swelling, nipple discharge or puckering and talk to your Doctor.

How is breast screening done?

Screening means checking for lumps in your breast before they appear. breast screening involves getting a mammogram (X-ray of breast) for women above 40 years or an ultrasound breast for younger women.

What is the prognosis for breast cancer?

As compared to other cancers, breast cancer has a better prognosis if detected early. Early detection is the key. Chances of survival and cure greatly increase with timely diagnosis. Treatment would depend on the stage and type of cancer. Nowadays advanced treatment techniques ensure a better prognosis and much reduce chance of recurrence.

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With the rise in heart disease, there are many latest technology & research in cardiac treatment. Transcatheter  Aortic Valve Replacement (TAVR) is one such technology which is becoming increasingly popular in cardiac treatment

Why is TAVI / TAVR needed?

Human heart has got four valves. If one of these valves is narrowed, then it is called stenosis. Aortic stenosis is the narrowing of the left sided aortic valve due to ageing or birth defect which results in obstruction of blood flow from left ventricular chamber to vital organs of our body. Many patients suffer from this and ultimately die suddenly due to pump failure. Cardiac surgeons often do not want to treat elderly people, needing bypass surgery or opening of the chest for high risk of death during open heart surgery because of associated co-existing illness. In this high-group, nowadays, aortic valve can be treated by a stent in patient groin just like conventional balloon angioplasty, called a TAVI/TAVR (Trans aortic valve Implantation / replacement).

Advantage of TAVI / TAVR

There is no need for opening the chest or long stay in a hospital. Patients are usually discharge on the third day and they start their normal activity immediate after discharge. Though this stent is very costly device, but it is life saving in these in-operable high-risk patients.

Which patients should go for TAVR?

Currently the procedure is reserved for those people for whom an open-heart procedure poses intermediate /high risk. For that reason, most people who have this procedure are in their 70s or 80 and often have other medical conditions that makes them a better candidate for this type of surgery.

TAVR can be an effective option to improve quality of life in patients who otherwise have limited choices for repair of their aortic valve.

Case study

Mr BD was a 76 years old patient with past history of prolong smoking, was presented with shortness of breath on exertion and chest discomfort. His echocardiogram showed severe obstruction at aortic valve. Because of existing comorbidities Mr BD was falling in intermediate risk category for cardiac surgery and more so he had severe fright for any surgical procedure to him.

Considering all the aspects Hospital found him an appropriate candidate for the TAVR procedure which was done in 2019. Patient recovered and became ambulatory in next 48 hours. After the discharge he is doing well.

The first hour after the onset of a heart attack is called the golden hour. This concept is extremely important to understand because most deaths and cardiac arrests occur during this period. However, if the person reaches the hospital and gets treated within this period he/she can expect near-complete recovery. It is a critical time. Heart attack is caused when a clot completely blocks a blood vessel in the heart. Heart muscle starts to die within 80-90 minutes after it stops getting blood and within six hours almost all the affected parts of the heart could be irreversibly damaged. So, the faster normal blood flow is re-established, the lesser would be the damage to the heart. Once you are at the hospital, the doctors will try to get rid of the clot, either with the help of a very powerful clot buster medicine or with a procedure called primary angioplasty. Primary angioplasty is the preferred therapy in most scenarios. In primary angioplasty a stent is deployed in the blocked artery to open up the blood flow.

It’s not the heart attack itself that kills, it is also the time wasted when one is trying to decide whether or not to got to the hospital

 

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What is the role of navigation or computer assisted surgery in joint replacement?

Computer assisted joint replacement is supposed to increase the precision of the surgery but the single most important factor still remains the expertise of the surgeon and his or her experience.

What is the correct age of joint replacement?

Joint replacement is the surgery to uplift the quality if life and to restore painless and stable movement. It should be done whenever it is needed. One must understand that painless and stable movement is needed most for a person to continue his social, professional & personal life. Joint replacement are done on as young as 25 years and as old as 85 years. Mostly people who undergo joint replacement at young ages are people who have some kind of genetic arthritis like ankylosing, spondylitis, juvenile rheumatoid arthritis.

How long does joint replacement last?

Joint replacement last ranging from 20 to 25 years. In case of knee it is generally a cemented implant and in hip it can be both cemented and uncemented. Uncemented implants may last longer than cemented implants. Another thing that must be understood that longevity of any implant is technic dependent, precision dependent and hence the perfection of the surgery is of paramount importance.

Which is the best implant for knee replacement?

Whilst all implant that are used are of international quality. With follow-up and survivorship data there is probably nothing called best implant. ONE must understand that the performance of the implant and survivorship are much technique dependent and expertise of the surgeon.

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Combating Colorectal Cancer is easier with screening tests at regular intervals: Doctor

Colorectal cancer screening has become common and a good reason to prevent many lives from being lost. If people, who are 50 years of age or above, are screened regularly, about 60% of deaths from cancer could be avoided. Among cancer that effect both men and women, colorectal cancer (cancer of colon or rectum) is the third-most common cancer among men worldwide. Globally colon cancer cases are among the top five most frequent cases reported.

What are the symptoms of Colorectal cancer?

Precancerous polyps and colorectal cancer don’t always cause symptoms, especially at first. You could have polyps or colorectal cancer and not know it. That is why having a screening test is so important. Symptoms for colorectal cancer may include:

• Blood in or on the stool.
• Stomach pain, aches, or cramps that do not go away.
• Loosing weight and not know the reason

The symptoms may be caused by diseases other than cancer. If you have any of these symptoms, the only way to know what is causing them is to see your doctor.

SEVERAL TESTS ARE THERE TO SCREEN FOR CANCER OF THE COLON OR RECTUM. SOME ARE USED AS A SINGLE METHOD AND SOME AS A COMBINATION OF TWO

What are the screening tests for colorectal cancer?

Several tests are available to screen for colorectal cancer. Some are used as a single method while others are used in combination with two or more methods. Talk with your Doctor about which test or tests are best for you. The USPSTF recommends these tests:

• Colonoscopy (every 10 years)
• High sensitivity faecal occult blood test (FOBT), also known as a stool test (every year)
• Flexible sigmoidoscopy (every five years) with high-sensitivity FOBT (every 3 years)

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