User-agent: Google Allow: A Simple Guide to Medical Conditions: September 2007

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Saturday, September 29, 2007

A Simple Guide to Multiple Myeloma

A Simple Guide to Multiple Myeloma
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What is Multiple Myeloma?
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Multiple myeloma is cancer of the bone marrow which occurs from the uncontrolled growth of plasma cells, a form of immune-protective white blood cells.
Normally plasma cells make antibodies to fight infections.
The disease is called multiple myeloma because myeloma cells can occur in multiple bone marrow sites in your body.

What are the Risk factors in Multiple Myeloma?
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1.Age. The majority of people who develop multiple myeloma are older than 50, with most diagnosed around age 70.

2.Sex. Men are more likely to develop the disease than are women.

3.Exposure to radiation and working in petroleum-related industries.

4.History of a monoclonal gammopathy of undetermined significance.

5.Obesity. Your risk of multiple myeloma is increased if you're overweight or obese.

What are the causes of Multiple Myeloma?
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The exact cause of Multiple Myeloma is not known.
However doctors do know that multiple myeloma begins with one abnormal plasma cell in your bone marrow . This abnormal cell then starts to multiply. Because abnormal cells don't mature and then die as normal cells do, they accumulate slowly reducing the number of healthy cells.
Myeloma cells may circulate in low numbers in the blood, populating other bone marrow sites far from where they began. Uncontrolled plasma cell growth can damage bones and surrounding tissue.

What are the Symptoms of Multiple Myeloma?
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Common symptoms include:
1.Anemia or pallour can occur as myeloma cells replace oxygen-carrying red blood cells in your bone marrow,
2.fatigue
3.Bone pain.
4.Nausea
5.Loss of appetite
6.Mental confusion
7.Presence of abnormal proteins produced by myeloma cells in your blood or urine. These proteins which are antibodies are called monoclonal, or M, proteins.
8.High level of calcium in your blood. This can occur when calcium from affected bones dissolves into your blood. A high calcium level in your blood may cause symptoms such as:
9.Excessive thirst and urination
10.Constipation

How do you diagnose Multiple Myeloma?
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Multiple myeloma can be diaqgnosed before you ever have symptoms through blood and urine tests.Blood and urine tests
1.blood test called serum protein electrophoresis separates your blood proteins and can detect the presence of M proteins in your blood.
When found in urine, they're referred to as Bence Jones proteins.
2.Another blood test to check for beta2-microglobulin — another protein produced by myeloma cells
3. Imaging.
a.X-rays of your skeleton can show whether your bones have any thinned-out areas, common in multiple myeloma.
b. magnetic resonance imaging (MRI) or computerized tomography (CT) scanning.
4.Bone marrow examination is done by using a needle to remove a small sample of
bone marrow tissue. The sample is then examined under a microscope to check for myeloma cells.

What are the Complications of multiple myeloma?
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Multiple myeloma can result in several complications:
1.Impaired immunity. Myeloma cells inhibit the production of antibodies needed for normal immunity which may make you more likely to develop infections, such as pneumonia, sinusitis, bladder or kidney infection, skin infections and shingles.

2.Bone problems. Multiple myeloma also can affect your bones, leading to erosion of bone mass and fractures. The condition may cause compression of your spinal cord. Signs of this medical emergency include weakness, or even paralysis, in your legs.

3.Impaired kidney function.
Higher calcium levels in the blood related to eroding bones can interfere with your kidneys' ability to filter your blood's waste. The proteins produced by the myeloma cells can cause similar problems, especially if you become dehydrated.

4.Anemia. As cancerous cells crowd out normal blood cells, multiple myeloma can also cause anemia and other blood problems.

What are the Treatment of Multiple myeloma ?
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There is no cure for multiple myeloma.
However, with good treatment results you can usually return to near-normal activity.
The appropriate multiple myeloma treatment depends on the stage of the illness, medical status and general health.
Chemotherapy.
Chemotherapy involves using
1.Anti Cancer medicines taken orally as a pill or given through an intravenous (IV) injection to kill myeloma cells. Chemotherapy is often given in cycles over a period of months, followed by a rest period.
2.Corticosteroids. Corticosteroids such as prednisone and dexamethasone (Decadron) have been used for decades to treat multiple myeloma.
3.Thalidomide is currently FDA-approved in conjunction with the corticosteroid called dexamethasone for the treatment of newly diagnosed cases of multiple myeloma. This drug is given orally.

Radiation therapy.
This treatment uses high-energy penetrating waves to damage myeloma cells and stop their growth. Radiation therapy may be used to target myeloma cells in a specific area to more quickly shrink a tumor that's causing pain or destroying a bone.

Stem cell transplantation.
This treatment involves using high-dose chemotherapy usually high doses of melphalan along with transfusion of previously collected immature blood cells (stem cells) to replace diseased or damaged marrow. The stem cells can come from you or from a donor, and they may be from either blood or bone marrow

Treating complications
Back pain. Taking pain medication or wearing a back brace can help relieve the back pain you might experience with multiple myeloma.
Infections. Antibiotics may be necessary to help treat infections or to help reduce your risk of them.
Bone loss. You may take medications called bisphosphonates which bind to the surface of your bones and help prevent bone loss.
Anemia. If you have persistent anemia, your doctor may prescribe erythropoietin injections. Erythropoietin is a naturally occurring hormone made in the kidneys that stimulates the production of red blood cells. .
Kidney complications. People with severe kidney damage may need dialysis

A Simple Guide to Blood Cancer

A Simple Guide to Blood Cancer
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What are Blood Cancer?

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Blood cancer consists of mainly lymphoma, leukaemia and multiple myeloma.

These cancers developed either in the bone marrow or the lymphatic tissues of the body. These three types of blood cancers all involve an uncontrolled growth of abnormal cells within the blood and bone marrow.

Who is at risk of getting Blood Cancers?
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The risk of developing blood cancers increases with age.

Adults therefore are more prone to blood cancer than children.

The acute leukemia tends to affect children.

The chronic leukemia is more common in adults.

However children and adults can develop any kind of leukaemia.

In Multiple myeloma, the average onset is at age 60.

Lymphoma
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(refer to my blog on A Simple Guide to Lymphoma)

Lymphoma is a cancer of the lymphoid tissues which are composed of several types of immune-system cells that work together to fight infections.

Lymphoma usually begins in a lymph node as a primary cancer.

It can also begin in the stomach, intestines, skin or any other organ that contains lymphoid tissue.

Leukaemia
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Leukaemia is a cancer that affects the blood-forming system of the body which include the bone marrow and the lymphatic system.

Leukaemia can be classified as either acute or chronic.

The acute leukemia tends to affect children while the chronic leukemia is more common in adults.

Acute leukaemia
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In acute leukaemia, immature blood cells reproduce quickly in the bone marrow, slowly killing the normal cells.

These abnormal cells can also spread to other organs, ultimately leading to disruption and distortion of these organ functions.

Acute leukaemia can be further divided into two types according to the predominant type of cells affected:

1.Lymphoblasts are immature cells that normally develop into lymphocytes, a type of white blood cell

2.myeloblasts are immature cells that normally develop into other cells such as neutrophils, another type of white blood cell.

1. Acute lymphoid leukaemia (ALL) -
here the lymphoblasts reproduce without developing into normal blood cells.

These immature lymphoblasts block out the healthy blood cells and frequently congregate in the lymph nodes, causing a swelling in that area.

2. Acute myeloid leukaemia (AML) -

here the myeloblasts reproduce without developing into normal blood cells.

The immature blast cells gather in the bone marrow and upset the production of healthy normal cells.

Anaemia results due to lack of sufficient red blood cells.

Frequent infections occurs due to the low levels of white blood cells which fight infections.

Chronic leukaemia
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Chronic leukaemia occurs when there is over-production of blood cells that appear to be mature. Unfortunately these cells actually lack the normal functions of mature blood cells.

Chronic leukaemia usually has a slower, less dramatic course than acute leukaemia.

Chronic leukaemia can also be broken into two groups:

(a) Chronic lymphoid leukaemia (CLL) -
Here there is production of too many apparently mature lymphocytes in the bone marrow. The abnormal cells appear to be fully developed lymphocytes, but cannot fight infections as well as normal lymphocytes.

(b) Chronic myeloid leukaemia (CML) -
here the over-production of apparently mature but defective myeloid cells, reach a point where almost no healthy cells remain.


Multiple Myeloma
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(refer to my blog on A Simple Guide to Multiple Myeloma)

Multiple myeloma is cancer of the bone marrow which occurs from the uncontrolled growth of plasma cells, a form of immune-protective white blood cells.

Normally plasma cells make antibodies to fight infections.

In multiple myeloma, there is a malignant proliferation of plasma cells.

What are the Symptoms of Blood Cancer?
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All three blood cancers have similar symptoms.

Among the common warning signs are:

1.weight loss,

2.constant infections such as flu and diarrhoea,

3.bleeding of gums or nose and slow healing cuts or frequent bruises

In addition to the above,

4.severe kidney problems,

5.general numbness of the skin

6.pain in the bones
may indicate the existence of multiple myeloma and leukemia as the disease progresses.
The pain can radiate to the back, ribs and arms of the victims. The pain is a result of an increase in the number of myeloma cells where the bone marrow is being damaged.

7.swelling of lymph nodes in the neck, the armpits or in the groin may indicate more likely a diagnosis of lymphoma

8.Persistent fever

9.loss of appetite

10.generalised weakness and pallour

What are the Causes of Blood Cancer?
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1.Exposure to excessive radiation

2.hazardous chemicals like benzene, asbestos, herbicides and pesticides are known to be the primary causes of blood cancer. Avoid these harmful materials as much as possible.

3.certain genetic abnormalities, such as Down Syndrome and the inheritance of a particular chromosome called the Philadelphia chromosome, have also been linked to the development of specific forms of leukaemia. This is controversial.

How do you diagnose Blood Cancer?
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1.a full medical history and full examination especially for signs of:
anaemia,
enlarged liver and spleen,
bleeding tendencies in the skin such as petechie and ecchymoses
enlarged lymph nodes

2.a full blood and urine test should be done to examine the blood cells under the microscope for cancer cells as well as to assess the patient's kidney, liver functions and the severity of anaemia.

3.A bone marrow aspirate using a syringe and needle can be examined for further evidence of blood and bone marrow cell abnormailties.

The presence of the Philadelphia chromosome may suggest evidence of leukemia.

What is the Treatment of Blood Cancer?
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Before any cancer treatment is done, because of the patients's anaemia and bleeding tendency, blood transfusions are usually given to improve the general health and resistance of the patient.

Chemotherapy and radiation therapy have always been used to treat blood cancer effectively.

Besides these treatments, stem cells infusion and bone-marrow transplants also give patients and their families another source for a cure.
Unlike chemotherapy and radiation therapy that are used to treat all the three kinds of blood cancer, bone-marrow transplants are more frequently used to cure lymphoma and leukaemia only .

It is also more successful for younger patients and when the disease is in the early stage.
Patients shuold know that dangers and side effects of bone-marrow transplants exist.

In extreme cases when the transplant fail, death may occur.

What are the Prevention measures for Blood Cancer?
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1.When exposed to dangerous chemicals and radiation, take extra precautions by wearing protective and appropriate clothing.

2.The threat of contracting lymphoma can be reduced by avoiding the risk of HIV. Patients infected with HIV are known to have a higher rate of lymphoma because of their low immune-system cells to fight infections.

3.Any family member of a leukemia patient should go for genetic testing and regular check-ups to spot the symptoms early.

Friday, September 28, 2007

A Simple Guide to Lymphoma

A Simple Guide to Lymphoma
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What is Lymphoma?
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Lymphoma is a cancer of the tissue of the lymphatic system where there is a large number of abnormal white blood cells called lymphocytes causing swelling of lymph nodes or involvement of the other organs.
This can disrupt the immune-system cells and reduce a person's ability to resist infections and diseases. The lymph nodes become swollen forming painless lumps or tumours.
Although lymphomas usually begin in a lymph node, it also can originate in the stomach, intestines, skin or any other organ that contains lymphoid tissue.
Lymph nodes are found anywhere in the body, particularly in the neck, armpits, groin, above the heart and around the big blood vessels inside the abdomen.

Who are at risk of getting Lymphomas?
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1.Men are at a higher risk of getting lymphomas.
The disease is uncommon among younger men.
It often develops after the age of 50.

2. past history of severe viral infections which lowers your immune system eg. HIV virus

3.history of organ transplants and on immuno suppressive drugs

4.history of cancer and previous treatment with chemtherapy or radiation therapy

5. frequent exposure to chemicals, solvents,pesticides

6.family history of lymphoma

What are the types of Lymphoma?
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There are two main types of lymphoma.
They are:
Hodgkin's Disease
Hodgkin's disease is characterised by the presence of a specific type of abnormal cell called the Reed-Sternberg cell. This cancer can spread throughout the lymphatic system, affecting any organ or lymph tissue in the body.
Hodgkin's disease usually attack people in their late 20s or older than 50.

Non-Hodgkin's Lymphoma
Most lymph cancers are non-Hodgkin's lymphomas.
There are many types of non-Hodgkin's lymphomas.
Non-Hodgkin's lymphomas develops in the age group of 60 - 70.
Different types of lymphoma occur in different age groups.

1.Adult non-Hodgkin's lymphoma is classified by the size, shape and arrangement of the cancer cells in the lymph node. The appearance will determine the type of non-Hodgkin's lymphoma. The degree or seriousness of the disease is broken into three types (grades) -
1.low-grade (slower-growing),

2.intermediate grade and

3.high-grade (aggressive).

These grades are crucial in determining the treatment options to treat the cancer.

2.Childhood non-Hodgkin's lymphomas include lymphoblastic lymphoma, large cell lymphoma and small non-cleaved cell lymphoma (including Burkitt's and non-Burkitt's lymphomas).

What are the Symptoms of Lymphoma?
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The most common symptom associated with lymphoma is
1.lymph node swelling. A painless swelling initially surfaces in the early stages of the cancer. This swelling may persist or increase in size. The most common affected areas would be the neck, armpits or groin.
Other symptoms are:

2.unexplained constant fever,

3.sudden weight loss,

4. itchy skin or rashes,

5. night sweats and

6. abdominal pain

What are the causes of Lymphomas?
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There is no known cause for lymphomas.
However, it has been closely linked to several factors -
1) environmental influences, Environmental influences may take the form of extreme exposure to certain chemicals like herbicides and insecticides.

2) genetic factors
There are inherited immune-deficiency disorders from birth such as Wiskott-Aldrich syndrome which have been blamed for the cause of genetic factors that result in lymphomas.

3) viral infections. Viral infections such as the Epstein-Barr virus (EBV) and human immunodeficiency virus (HIV) have been associated with lymphomas.

What is the Treatment of Lymphoma?
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Hodgkin's Disease can only be treated with radiation therapy using high-energy X-rays to kill lymphoma cells in the affected area. This procedure may also be combined with chemotherapy.

Treatment for non-Hodgkin's lymphoma, can vary.
The treatment is based on the degree of grade of the disease.
1.Early stage and low-grade (slow-growing) lymphoma can be treated with radiation therapy and sometimes just simple observation is enough.

2. intermediate-grade lymphoma may be treated with chemotherapy.
The drugs are either injected directly into the bloodstream or swallowed as pills.
Each course of treatment is given at regulated intervals to kill cancer cells and allow the body to recover. The drugs circulate throughout the body and will reach cancer cells even when they are widespread.

Patients who are suffering from the more advanced stages and high-grade (aggressive) lymphomas will require a higher dosage of chemotherapy.
However, the high dosage has its own side effects.
Too much of it may kill healthy bone marrow that produces white and red blood cells and platelets (cells that prevent bleeding). Therefore, to assist patients tolerate the high dosage of chemotherapy treatment, stem cells or bone marrow from the patient or donor are collected beforehand. After a patient has received the chemotherapy, the stem cells or bone marrow are returned to the patient through a drip in a vein.

In addition to the above treatment methods, another option for treating lymphomas would be biological therapy. This procedure uses products such as immunoglobulin that boost the body's own immune system to fight cancer.
This therapy may be used alone or combined with chemotherapy.

In conclusion, the type of treatment sought or used depends very much on the stage, and grade of the lymphoma when diagnosed and the age and health of the patient.
Most doctors will advise their patients on the various treatment options that are the most beneficial and appropriate whilst considering the factors mentioned above.

What are the Prevention measures for Lymphomas?
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1.Where exposure to some toxins and chemicals which are known to cause lymphomas are possible, one should be properly attired and guarded from these chemicals, so as to decrease the risk of developing the disease.

2.Since HIV / AIDS carriers are also related to lymphomas, one should be aware of the importance of safe sex and should stay away from drugs, as far as possible.

3.regular visits to the family doctor helps in detecting any sign or symptom that may eventually lead to the cancer.

4.healthy lifestyle and proper balanced diet are always important in the prevention of any cancer.

Thursday, September 27, 2007

A Simple Guide to Stomach Cancer


A Simple Guide to Stomach Cancer
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What is Stomach Cancer?
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Stomach cancer (also called “gastric cancer”) is the growth of abnormal cells in the lining and wall of the stomach which mutates and proliferates giving rise to the stomach cancer .
Stomach Cancer can spread to the surrounding organs like liver,pancreas and colon.
Once in the blood stream it can spread to the brain, bones and kidneys.

Who is at risk of getting Stomach Cancer?
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1. Chronic Helicobacter pylori bacteria infection. This bacteria is found in the stomach and has been found to cause gastric ulcers and stomach cancer.

2. family history of stomach cancer

3. frequent consumption of preserved or smoked food such as salted vegetables,fish,meat. Cancer causing nitrosamines are released when these food are cooked.

4.previous stomach surgery with partial removal of stomach (gastric ulcers or polyps)

5. Pernicious anaemia- a rare blood disorder affecting the red blood cells

6. Smoking

7. Men are affected more than women

8. Age above 50 years of age

9.People with blood group A has a higher incidence

What are the symptoms of Stomach Cancer?
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In the early stages, stomach cancer may have no symptoms.

As it spread it can cause the following symptoms:

1.Indigestion, stomach discomfort or heartburn

2.A fullness feeling or bloating after eating a small meal

3. loss of appetite

4.Nausea or belching

5. Feeling tired

When the cancer is larger, it can cause the following symptoms:

1.Stomach pain

2.Vomiting

3.Blood in your stool or black tarry stools

4.Unexplained weight loss

5.pallour due to anaemia from loss of blood

Many of these symptoms can be caused by other conditions besides cancer.
So the earlier stomach cancer is found, the better are the chances of it being cured.

How do you diagnose Stomach Cancer?
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1.medical history and complete physical exam.

2.Abdominal X-ray for any other condition in the abdomen causing pain or swelling in the abdomen

3.Gastroscopy:
a thin, lighted tube is put into your mouth and passed down to your stomach.

4.Biopsy:
During gastrocopy, a small piece of your suspicious stomach tissue is taken to check for cancer cells. This is called a biopsy sample which is then examined under a microscope for cancer cells.

How is stomach cancer treated?
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Treatment for stomach cancer may include surgery, chemotherapy or radiation therapy, or a combination of these treatments. The choice of treatment depends on whether the cancer is just in the stomach or if it has spread to other places in the body. A person’s age and overall health will also affect the choice of treatment.

Surgery
Surgery is still the best form of treatment for stomach cancer.
For smaller cancers -partial removal of the stomach is done.
In early stages cure rate is about 90%.
For later stages of cancer, the whole stomach including the spleen and surrounding tissues may be removed.

Chemotherapy
Chemotherapy is used in conjunction with surgery in later stges of cancer.

Radiotherapy:
Radiation can help to kill the cancer cells surrounding the stomach cancer as well as to relieve pain.

Can I prevent stomach cancer?
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There is no way to prevent stomach cancer.
However, you can help reduce your risk of getting stomach cancer by:
Living a healthy lifestyle

Not drinking a lot of alcohol or smoking.

Avoid preserved food

Treat H.pyrori infections of the stomach early.

Eat a diet high in fresh fruits and vegetables, and vitamin C.
Vitamin C is found in foods such as oranges, grapefruit and broccoli.

AS IN ALL CANCERS, EARLY DETECTION IS THE BEST CURE!!

Wednesday, September 26, 2007

A Simple Guide to Liver Cancer




A Simple Guide to Liver Cancer
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What is Liver Cancer?
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Liver Cancer develops when the liver cells undergo abnormal changes to form cancer cells.
Most Primary cancer of the liver begins as mutated hepatocytes(liver cells).
Secondary cancer of the liver is due to spread from the stomach, colon, breast, lungs, ovaries etc

What is the incidence of Liver Cancer?
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Liver cancer is one of the most common cancer.
It occurs in men more than women.
It is more common in the 40s and 50s age groups.

What are the Risk Factors of Liver Cancer?
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The main risk factor for liver cancer is
1.Hepatitis B infection.

Other important risk factors include
2.Hepatitis C infection

3.alcoholic liver disease (disease of the liver caused by heavy alcohol consumption).

4.family history of liver cancer

5.Chemicals exposures such as nitrites,solvents, hydrocarbons,viny chloride

6.poisons (e.g. aflatoxin present in some spoilt or mouldy peanuts).

7.inherited liver diseases (alpha-1 anti-trypsin deficiency)

8.Drug abuse eg heroin


What are the Signs and Symptoms of Liver Cancer?
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During the early stages, most people with liver cancer do not show any signs or symptoms.
Signs and symptoms, when they do appear, include:

1.loss of appetite and weight

2.discomfort or swelling in the upper part of the abdomen on the right side

3.weakness and fatigue

4.nausea and vomiting

5.jaundice - yellowness of the skin and eyes

6.dark color urine

7.Persistent or swinging fever

How is the Diagnosis of Liver Cancer confirmed?
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1. full medical history especially history of Hepatitis B and alcohol

2. full examination especially of the liver

3.an ultrasound scan of the liver and gallbladder, if possible the whole abdomen.
4.CT scan or MRI of the liver and surrounding tissues


5.blood tests (a protein present in blood called the alpha- fetoprotein or AFP may be found to be raised in liver cancer)

6.needle liver biopsy into the liver swelling as detected by ultrasound or MRI (to confirm the liver cancer).

With the diagnosis confirmed, the doctor will proceed with further tests to find out how advanced the liver cancer is. This will help the doctor to plan the treatment.

What is the Treatment of Liver Cancer?
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As in all cancers, treatment includes surgery, radiation therapy, chemotherapy.

In Liver cancer percutaneous ethanol (alcohol) injection is injected directly into the tumour, by means of a small needle, to kill the cancerous cells.

Liver transplant can also be carried out in selected cases where the size of the cancer is not too massive but surgery is not feasible due to the patient's limited liver reserve(provided a suitable liver donor can be found).

Treatment depends on the the stage of the cancer as well as health of the affected person.

The goal of treatment is complete cure.

However, where this is not possible, treatment is aimed at
preventing the tumour from spreading or growing.
Helping to
eliminate uncomfortable symptoms is also an important aspect of liver cancer treatment.

How to Protect yourself from Liver Cancer?
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Prevention from getting liver cancer is by taking steps to reduce your risk factors.

1. Reduce your risk of Hepatitis B by getting vaccinated. The Hepatitis B vaccine is safe and effective.
Both Hepatitis B and C are spread through infected blood or sexual fluids as well as intravenous drug abuse. It is therefore important to avoid activities that put you at risk:

2.Avoid multiple sex partners and having sex with commercial sex workers, strangers or anyone with multiple sex partners.

3.Do not abuse drugs or share injection needles.

4.Never share personal items like razors, toothbrushes or other items that may cause breaks in the skin.

5.Visit only reliable operators for ear/body piercing, tattooing or acupuncture.

6.It is also important that you limit your consumption of alcohol as excessive drinking can give rise to liver disease and increase your risk of liver cancer.

The liver is one of the largest and most important organs in your body. It performs many essential functions including:
making and storing of essential nutrients
making important hormones and enzymes
breaking down harmful substances.

Do not abuse Your LIVER by excessive drinking or taking drugs!


Tuesday, September 25, 2007

A Simple Guide to Bladder Cancer


A Simple Guide to Bladder Cancer
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What is Bladder Cancer?

-----------------

Bladder cancer is a growth of abnormal cells forming a malignant tumour in the bladder. Most bladder cancers start in the inner lining of the bladder.


What are the different types of Bladder Cancer?

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There are 2 main types of Bladder Cancer:

1.superficial cancer

the cancer is contained on the inner lining of the bladder.

They may occur as a small, wart-like growths on the inside of the bladder, which can be removed in a simple operation and usually will never recur.

2.invasive cancer

where the cancer has spread into the muscle wall of the bladder.

Examples are:

a.large growth in the muscle wall of the bladder, which requires major surgery to remove.

b.mushroom-like growths( papillary cancers)on the inside lining of the bladder. They have a short stem attached to the lining of the bladder and can spread into the wall of the bladder.

Treatment is different for these two types of bladder cancer.

What are the causes of Bladder Cancer?

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There are a few factors which increase the risk of getting bladder cancer:

1.Smoking

chemicals in a cigarette have been found to contribute to bladder cancer. The more cigarettes smoked, the greater the risk.

2.Exposure to harmful, cancer-causing chemicals

Certain chemicals at the workplace, for example, those used in dye factories, rubber, gasworks, plastics and other chemical industries, can cause a higher risk of contracting bladder cancer in workers.

It can take about 25 years after exposure to these chemicals before bladder cancer develops.These chemicals may have been banned in some countries.

3.Frequent bouts of cystitis

Cystitis caused by repeated bacterial infections and bladder stones can lead to the development of bladder cancer.

4.Age and Gender

Bladder cancer occurs mostly among people aged between 50 - 70 years.

It is twice as common in men as in women.

It is rare in people below age 40.


What are the symptoms of Bladder Cancer?

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The most common symptom is

1.blood in the urine which usually occurs suddenly and is generally not painful.

The blood may not be present constantly but eventually it does recur.

In some cases, blood clots can form and these may cause painful muscle spasms in the bladder. The amount of blood present is however not related to the extent of the cancer.

2. burning feeling when they pass urine.

3. frequency of urination.

While these are also symptoms of bladder irritation, further tests would be necessary if they persist and do not clear with antibiotics.

How can Bladder Cancer be treated?

------------------------------------------

The treatment for bladder cancer depends on the type of cancer, the stage and grade.

It also depends on the health of the patient.

Superficial cancers:

Superficial cancers, which can be single or multiple, are usually removed using a cystoscope. Anti-cancer drugs (chemotherapy or immunotherapy) may be instilled into the bladder to try to prevent the cancer recurring.

Invasive cancers

the options are as follows:

Surgery

The most common treatment method is surgery to remove a part of the bladder.

A new bladder is sometimes constructed if it has to be removed.

Radiotherapy

Radiotherapy may be used instead of surgery to avoid removal of the bladder. Radiotherapy may also be used before surgery in cases of large tumours to facilitate the tumour removal or if there is a high risk of cancer cells left behind after surgery.

Chemotherapy

In some cases, chemotherapy is given before surgery or radiotherapy to shrink the tumour so that it can be treated more effectively. Chemotherapy is also applied after surgery to reduce the recurrence of the tumour.The drug can be instilled into the bladder to maximise contact with the cancer cells.

Once the cancer has spread outside the bladder, the main treatment is chemotherapy.

Removal of bladder

------------------------

In a small proportion of people with bladder cancer, the bladder may completely removed.

The surgeon will then give the patients an urostomy - an artificial opening from the urinary tract.The opening is usually formed on the abdomen, to the right of the navel. Wrinkles, scars and prominent underlying bones must be avoided, as placing the opening near them may cause problems with leakage later on.

Ensure that the bag is emptied and changed as often as necessary.

At first the opening will be slightly swollen.

It may take several weeks for it to reduce to its normal size.

There may also be mucus (a thick white substance) from the opening. The amount of mucus will gradually reduce over time but will never disappear completely.
Most people with an urostomy live a normal life. Many return to their jobs and take up their favourite pastimes again, including swimming.
Now with advancement of plastic surgery a new bladder can be constructed easily and the days of urostomy may be over.

Monday, September 24, 2007

A Simple Guide to Ovarian Cancer


A Simple Guide to Ovarian Cancer
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What is Ovarian Cancer?
----------------

Ovarian Cancer is a disease which cause abnormal cells in the ovary to proliferate and spread to the rest of the ovary or outside the ovary.

What are the different types of Ovarian Cancer?
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Most experts group ovarian cancers within three major categories, according to the kind of cells from which they were formed:

1.epithelial tumors arise from cells that line or cover the ovaries;

2.germ cell tumors originate from cells that are destined to form eggs within the ovaries; and

3.sex cord-stromal cell tumors begin in the connective cells that hold the ovaries together and produce female hormones.

The most common type, the epithelial carcinoma, that begins from the surface of the ovary is discussed here.

Who is at risk of Ovarian Cancer?
---------------------------------------

The cause of cancer of the ovary is unknown.
However, studies show that certain factors may increase the chance of developing this disease. 1.family history of ovarian cancer.

2.history of cancer of the breast or colon.

3.age over 60 years.

4. Infertility or not having children. The more children you have, the lesser your risk is.

5.Early menstruation before the age of 12

6.late menopause

7.high fat diet

8.Use of fertility drugs, or Hormone Replacement Therapy (HRT).

Attempts are being made to detect early stages of ovarian cancer, especially among women who have an increased risk. A blood test is done to check for a substance called CA 125.
If the sample contains raised amounts of CA 125, an ultrasound scan may be done to see if your ovaries appear abnormal in any way.

What are the Symptoms of Ovarian Cancer?
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Ovarian cancer is the most dangerous of gynaecological cancers because it is often silent and difficult to detect.There is no early detection method, so you must be vigilant and take note of persistent warning signs seriously.


If you are having some of the following symptoms persisting for more than a week or so, see your doctor.
1.Vague gastrointestinal symptoms such as gas, indigestion, nausea and a bloated feeling

2.Swelling in the abdomen, unexplained weight gain

3.Pelvic or abdominal pain or discomfort, and/or feeling of fullness

4.Urinary symptoms e.g. frequency and/or urgency of urination in the absence of an infection

5.Unexplained or changes in bowel habits

6.Loss of appetite/loss of weight

7.backache or pain inthe legs

8.Abnormal vaginal bleeding, although this is rare

If you do have any of the above symptoms you must have them checked by your doctor. Remember, they are non specific and most women with these symptoms will not have cancer.

How do you make the diagnosis of Ovarian Cancer?
-----------------------------------------------------------

If you are at risk of ovarian cancer, see your gynaecologist regularly.

The following may be done:
recto-vaginal bimanual pelvic exam,

Pap smear,

blood test for CA-125

transvaginal ultrasound

What are the treatment of Ovarian Cancer?
---------------------------------------------------

Treatment depends on a number of factors, including the stage of the disease (the extent of spread of the disease) and the general health of the patient.
Surgery, chemotherapy and various types of radiotherapy may be used alone, or in combination to treat ovarian cancer.

Surgery
Surgery is normally the first choice of treatment for ovarian cancer, and may sometimes also be needed to make the diagnosis. If detected is in the early stages, surgery is all the treatment that may be required. The ovaries, fallopian tubes, uterus and cervix are usually removed. The omentum and lymph nodes in the abdomen are often removed too.
If the surgeon feels the cancer may be difficult to remove, a few cycles of chemotherapy may be applied first and surgery carried out thereafter, in the hope that the tumour would have been reduced.

Chemotherapy
Chemotherapy may be given to destroy any cancerous cells that may remain in the body after surgery, to control cancer growth or to relieve symptoms of the disease. Sometimes a few cycles of chemotherapy may have to be applied before surgery is carried out.

Radiotherapy
Radiotherapy is less commonly used in this cancer but may sometimes be used to treat individual areas of cancer which have recurred after surgery and chemotherapy.
Hormone Therapy
There have been many reports of the potential benefits of hormone treatments in patients with ovarian cancer that does not respond to conventional therapy.
Some patients with treatment-resistant (refractory) epithelial cancers have been treated with:
1.progestins - crude forms of the female sex hormone progesterone;
2.estrogens - for example, diethylstilbestrol
3.combination estrogen/progestin therapy;
4.antiestrogens - tamoxifen;
5.androgens - male sex hormones for example, Halotestin
6.gonadotropin-releasing hormone (GnRH) - a hormone of the hypothalamus that stimulates the release of ovary-related hormones from the pituitary gland.
Gene Therapy
Gene therapy eventually may provide some control over cancer susceptibility and its treatment. Ovarian cancer, like all cancers, is believed to result from a build-up of genetic defects within the cells.Genetic engineers hope to correct such damage by transplanting copies of normal genes into cells with genetic defects. However at the moment gene therapy is still experimental.

Sunday, September 23, 2007

A Simple Guide to Nasopharyngeal Cancer


A Simple Guide to Nasopharyngeal Cancer
----------------------------

What is Nasopharyngeal Cancer ?
------------------------

Nasopharyngeal cancer, commonly referred to as NPC, occurs when the cells lining the nasopharynx(area behind the nose and above the back of the throat) become abnormal and proliferates giving rise to cancer cells.
It affects more men than women.

What are the causes of Nasopharyngeal Cancer?
--------------------------------------------------------

Various causes may be involved:
1.Genes. -males between the ages of 20-50 from southern China and Southeast Asia are at higher risk.

2.Diet. such as preserved foods ( salted fish, vegetables and meat) can cause a higher risk of NPC. Cooking of such food releases toxic substances called nitrosamines into the fumes that we breathe.
Many NPC patients consumed much less fresh fruit and vegetables.

3.Virus. There is evidence that NPC patients have higher levels of the Epstein-Barr virus in their blood. The Epstein-Barr virus activating substances have been detected in a number of these preserved foods.

4.Smoking. People who smokes have a higher risk

What are the signs and symptoms of Nasopharyngeal Cancer?
------------------------------------------------------------------------

The following are symptoms of nasopharyngeal cancer:

1.A painless lump in the neck-usually a lymph node infiltrated by cancer cells

2.Nosebleed or blood stained sputum

3.Blocking of one or both nostrils

4.Loss of hearing, or ringing in the ear

5.Discharge from the ear

6.Blurred or double vision

7.Difficulty in breathing or speaking

8.Persistant Sore throat

9.Paralysis of one side of the face

10.Headaches

How can Nasopharyngeal Cancer be detected?
-----------------------------------------------------

Examination of the upper part of the nose for swelling or lumps.
An endoscope is inserted into the nose. The ENT specialist may extract tissue(biopsy) which can be sent for testing, to confirm if there is a cancerous growth.

If a tumour is found, magnetic resonance imaging (MRI) can be used to assess its size.

Patients may also be tested for the presence of the Epstein-Barr virus in their systems. This is used to indicate the likelihood of contracting NPC.

How can NPC be prevented?
--------------------------------

No one can be fully protected from NPC.
However, you can modify your lifestyle practices to reduce your chances of contracting NPC.
Avoid preserved foods at an early age.
Eat fresh fruit and vegetables. Studies ave found that citrus fruits (rich in Vitamin C) and orange-coloured vegetables (eg, carrots and sweet potatoes), tomatoes, and dark green vegetables (all rich in carotenoids) also help lower the chances of contracting NPC.
Don't smoke. Smoking increases the risk of NPC by two to four times. Those who smoke, can still lower their risk by cutting down on the number of cigarettes smoked a day. Better still, quit smoking.

How can Nasopharyngeal Cancer be treated?
----------------------------------------------------

Radiotherapy.
This is the most common treatment. This involves the use of radiation to attack cancer cells, stopping them from growing or multiplying.

Chemotherapy.
This involves the use of anti-cancer medication to treat the cancer.
For both methods, the patient may experience side-effects such as tiredness and nausea.

Surgery
Surgery is seldom used because of the danger of cutting tissues too close to the brain.

Early treatment is recommended as it increases the patient's chances of survival.
Delayed action could result in the cancer spreading to other parts of the body, making it more difficult to treat.

Saturday, September 22, 2007

A Simple Guide to Lung Cancer


A Simple Guide to Lung Cancer
---------------------------


What is Lung Cancer?
--------------------------


Lung Cancer is the uncontrolled growth of abnormal cells in one or both lungs.
The cells lining air passages grow and divide until an abnormal mass or tumour is formed. The cells then grow and spread to the rest of the body.

What are the types of Lung Cancer?
------------------------------------------


There are 2 main types of Lung Cancer:
1. small cell lung cancer (SCLC) has the most aggressive clinical course of any type of pulmonary tumor, with poor survival rate from diagnosis of only 2 to 4 months.

2. non-small cell lung cancer:
a.Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells that look like fish scales.
b.Large cell carcinoma: Cancer that may begin in several types of large cells.
c.Adenocarcinoma: Cancer that begins in the cells that line the alveoli and make substances such as mucus.
d.Other less common types of non-small cell lung cancer are: pleomorphic, carcinoid tumor, salivary gland carcinoma, and unclassified carcinoma.

These types are diagnosed based on how the cells look under a microscope.

The Non-small cell Lung cancer may take up to 10-30 years to develop. Thus it is often seen in middle aged and elderly persons.
Once developed Lung cancers tend to spread quickly because the lungs are richly supplied by blood and lymph vessels.
In the travel through the lymph vessels, it can cause enlarged lymph nodes.
If it enter the blood , the cancer cells can spread to the liver, bone, brain or other parts of the body.

What are the causes of Lung Cancer?
-------------------------------------------


1.Cigarette smoking is the main cause of lung cancer.

2. Cigar and pipe smoking is also a source of lung cancer though less than those who smoke cigarettes.

3. Passive smoking in a family where one member smokes has been to increase the risk of lung cancer by 35%

4. Industrial hazards such as chemicals and smoke emitted at work[place also increase the risk of lung cancer. Examples are asbestos, coal gas,chromates,uranium.

5.Being treated with radiation therapy to the breast or chest.

What are the symptoms of Lung Cancer?
------------------------------------------------


1.Persistent cough which does not improve
2. shortness of breath and wheezing dut to the pressure of the tumour on the airway
3.Production of blood stained sputum
4. chest pain especially together with a chronic cough
5.Sudden unexplained loss of weight
6. Loss of appetite
7. General weakness and tiredness
8.Recurrent chest infections and fever
9. hoarseness of voice

How do you diagnose Lung Cancer?
-----------------------------------------


1. History & Medical examination especially history of smoking and exposure to chemicals
2. Chest X-ray to check for lung shadows
3. Sputum cytology- sometimes the cancer cells may be detected in the sputum
4. Bronchoscopy- a bronchoscope is passed into bronchi to study the airway while the patient is under general anesthesia.
Suspicious growth can be taken for biopsy(examination under microscope for cancer cells)
5.CT Scan & MRI produce 3D mages of the lung
6.Ultrasound or another imaging procedure is used to locate the abnormal tissue or fluid in the lung.
7.Thoracoscopy: A surgical procedure to look at the organs inside the chest to check for abnormal areas. An incision is made between two ribs, and a thoracoscope is inserted into the chest. Tissue samples and lymph nodes may be removed for biopsy. This procedure may be used to remove parts of the esophagus or lung. If certain tissues, organs, or lymph nodes can’t be reached, a thoracotomy may be done. In this procedure, a larger incision is made between the ribs and the chest is opened.

What is the Treatment of Lung Cancer?
----------------------------------------------

As usual the treatment consists of Surgery, Radiotherapy and chemotherapy.The choice of treatment depends on the size, extent of cancer , the type of lung cancer and the general health of the patient.

Surgery:
Part or whole of the lung can be removed in the treatment of lung cancer.
After surgery the patient may required assisted ventilation for a short period.
Physical activity may be limited for a while.
If the remaining lung is in good condition, the patient may be able to live a normal life.

Chemotherapy:
Certain type of lung cancer( small cell) are sensitive to chemotherapy. It is used in combination with surgery and radiotherapy.

Radiotherapy:

Radiation may be used in conjunction with surgery or to relieve pressure symptoms or pain caused by the lung cancer.

What is the prognosis of Lung Cancer?
---------------------------------------------


The prognosis (chance of recovery) depend on the following:

The stage of the cancer (the size of the tumor and whether it is in the lung only or has spread to other places in the body).
The type of lung cancer.
Whether there are symptoms such as coughing or trouble breathing.
The patient’s general health.

For most patients with non-small cell lung cancer, current treatments do not cure the cancer.

Small cell lung cancer has a greater tendency to be widely disseminated by the time of diagnosis but is much more responsive to chemotherapy and radiation therapy.
Because patients with small cell lung cancer tend to develop distant metastases, localized forms of treatment, such as surgical resection or radiation therapy, rarely produce long-term survival. With use ofchemotherapy regimens in the treatment program, however, survival is much prolonged.


Added 4th October 2008
---------------------------------

Lung Cancer
------------------

1. Lung cancer is still the biggest cancer killer in the world.

2. Every 30 seconds someone dies of lung cancer

3. About 40% of smokers who continues smoking from their early teens risk early death from lung cancer

4. 1 in 10 people with lung cancer lives for more than 5 years after diagnosis

5. Women smokers are twice as likely to get lung cancer than male smokers.

Friday, September 21, 2007

A Simple Guide to Deep Vein Thrombosis


A Simple Guide to Deep Vein Thrombosis
--------------

What is Deep Vein Thrombosis?

---------------

Deep vein thrombosis (DVT) is a blood clot (thrombus) in a deep vein leading to the heart, usually in the legs.The blood clot may either block the vein completely or partially.
It is more common in the elderly and the obese.
Women are more prone to it.

What is the danger of Deep Vein Thrombosis?
-------------------------------------------------

Blood Clots can form in superficial veins (called superficial thrombophlebitis or phlebitis) and in deep veins due to poor blood flow or stasis.
Blood clots in superficial veins rarely cause serious problems.
Blood clots in deep veins (deep vein thrombosis) require immediate medical care.
These clots are dangerous because they can break loose and then travel through the bloodstream to the lungs, causing a pulmonary embolism(Blockage of a pulmonary artery resulting in damge to the lung supplied by it).
A pulmonary embolism is often life-threatening.
Blood clots most often develop in the calf and thigh veins, and less often in the arm veins or pelvic veins.

What causes Deep Vein Thrombosis?
-------------------------------------------

3 major factors
play a part in the development of DVT.

1.Venous stasis i.e. the pooling of blood in the veins. This may be the result of immobility, old age or heart failure.

2.Damage of the vein due to trauma or local pressure. Surgery or an injury can damage your blood vessels and cause a clot to form.

3.Increased coagulability (tendency of blood to clot) of the blood which is sometimes seen in clotting disorders, pregnancy, the use of oral contraceptives, dehydration or in some cancers.

Sitting for long periods without exercising your leg muscles is a main factor. Passengers in first class seats in a plane have been known to develop DVT.
Similarly, DVT has been seen in students sitting for many hours preparing for exams.
Blood clots can form in veins when you are inactive.

For example, clots can form if you are paralyzed or bedridden or must sit while on a long flight or car trip. Some people have blood that clots too easily, a problem that may run in families.

What are the symptoms of Deep Vein Thrombosis?
-----------------------------------------------------------

Symptoms of DVT include :

1.Pain and tenderness of the affected limb which may become worse especially when standing

2.Swelling of the affected limb

3.Redness and warmth of the area surrounding the blood clot.

If a blood clot is small, it may not cause symptoms.
These symptoms may not be present immediately the clot is formed.
Sometimes it may take up to 2 weeks before the symptoms became apparent.
In some cases, pulmonary embolism is the first sign that you have DVT.

How is Deep Vein Thrombosis diagnosed?
------------------------------------------------

1.If there is any suspicion that you have DVT, you probably will have an ultrasound test within 24 hours to measure the blood flow through your veins and help find any clots that might be blocking the flow. Unless done within 24 hours, an ultrasound may or may not be able to detect the blood clot .However it is useful in measuring the blood flow through your vein.

2.A venogram is the most accurate of all the tests. However because it requires a doctor to administer it and is invasive unlike an ultrasound, it is only done if ultrasound results are unclear. A venogram is an X-ray test that takes pictures of the blood flow through the veins.

3.Other tests like a MRI will also be able to show the blood clot and the flow of the blood in the vein. Like the ultrasound , it must be done early in order to detect any blood clot.

How is Deep Vein Thrombosis treated?
---------------------------------------------

Treatment must start right away to reduce the chance that the blood clot will grow or that a piece of the clot might break loose and flow to your lungs.

Treatment for DVT usually involves taking blood thinners (anticoagulants) such as heparin and warfarin.
Heparin is given through a vein (intravenously, or IV) or as an injection.
Warfarin is given as a pill.
Treatment usually involves taking blood thinners for at least 3 months to prevent existing clots from growing.

Anti-coagulants - these are agents which prevent further clot formation and thins the blood. Examples are Heparin injection, warfarin, Plavix, Ticlid, Aspirin
Thrombolytic agents - these are agents which dissolve clots that have already formed. Examples are streptokinase, tPA.

After this first course of blood thinners, your doctor may want you to keep taking a lower dose of warfarin to prevent deep vein clots from happening again. He may need to adjust the dose of your medicine or change the medicine to a lighter blood thinner like Aspirin.
You may need to have blood tests often to see how well the blood thinners are working.

It is also recommended that you
prop up or elevate your leg when possible,
use a heating pad,
take walks, and
wear tight-fitting stockings.
These measures may help reduce the pain and swelling that can happen with DVT.

Rarely a vena cava filter may be inserted into a vein to help prevent blood clots from traveling to the lungs. This device is usually only used if a person is at high risk for pulmonary embolism and is not able to take blood thinners.
It may also be used if you have DVT that comes back again or you had a pulmonary embolism while taking blood thinners.

What is the Complication of Deep Vein Thrombosis?
--------------------------------------------------------------

Deep vein thrombosis in itself is not that serious. The danger occurs when the blood clot or a part of it breaks off and travels to the lungs where it can block an artery. This complication is called pulmonary embolism. It is a life-threatening situation and often ends in fatalities. Emergency medical attention is imperative.
Dislodged clots can travel to other areas and cause stroke or damage to organs depending on where they get lodged.
DVT can also cause long-lasting problems.
DVT may damage the vein and cause the leg to ache, swell, and change color.
It can also cause leg sores.

How can Deep Vein Thrombosis be prevented?
------------------------------------------------------

There are things you can do to prevent deep vein thrombosis.
Many doctors recommend that you
1.wear compression stockings during a journey longer than 8 hours.
2. avoid sitting in a cramped position for too long
3.Wriggle your toes and move your ankles and knees
4.Massage muscles of the lower limbs
5.Don't cross your legs or sit on the edge of your seat
6.Get up and walk along the aisle at least once an hour
7.Wear loose clothing
8.Avoid stockings or socks with tight bands
9.Drink plenty of water
10.Avoid alcohol & caffeine
11.Don't smoke
12.Wear special support stockings designed for travelling

On long flights, walk up and down the aisle hourly, flex and point your feet every 20 minutes while sitting, drink plenty of water, and avoid alcohol and beverages with caffeine.

Thursday, September 20, 2007

A Simple Guide to Rubella


A Simple Guide to Rubella
------------------------------


What is Rubella?
---------------------


Rubella is a infectious viral disease characterised by fever, generalised rash and swollen glands behind the ears and in the neck.
It can be spread through the air or by contact.
It can also be transmitted to a foetus by a mother with an active infection.
The disease is usually mild and may even go unnoticed. It is also called German Measles.

What are the Symptoms of Rubella?
------------------------------------------


Most children have few symptoms.
Adults may experience a prodrome (warning symptom) of a fever, headache, malaise, runny nose, and inflamed eyes, that lasts from 1 to 5 days before the rash appears.

A person can transmit the disease from 1 week before the onset of the rash until 1 week after the rash disappears.

The child with rubella may not look or act sick, but symptoms may include:
1. low-grade fever

2.swollen glands behind the ears and at the back and sides of the neck.

3.Loss of appetite, irritability, loss of interest in personal care.

4.Rash (maculopapiular) which appears on the face and torso and spreads to the arms and legs, lasting 3 to 5 days.

5.Rarely joint pain and arthritis (more common in adult women).

Lifelong immunity to the disease follows infection.

What is the danger of Rubella?
-------------------------------------


The disease is potentially dangerous because it is able to produce defects in a developing foetus if the mother is infected during early pregnancy.
About 10 to 15% of women in their childbearing years are susceptible to infection.

Congenital rubella syndrome occurs in 25% or more of infants born to women who acquired rubella during the first trimester of pregnancy.
Defects may occur in an infected foetus and include deafness, cataracts, microcephaly, mental retardation, congenital heart defects, and other defects.
A miscarriage or stillbirth may occur.
Defects are rare if the infection occurs after the 20th week of pregnancy.
Risk factors include lack of immunisation and exposure to an active case of rubella.

What is the Treatment of Rubella?
----------------------------------------


The infected child should stay at home while sick or up to a week after the rash disappears.
There is no cure for Rubella.
Treatment of a child with rubella is usually symptomatic .

Keep your child quiet, especially if she has a fever.
Children should be kept at home while any rash is visible and for a week thereafter.
Avoid scratching the rash.
Apply Calamine lotion or give the child some antihistamine to stop the itch.
Cool sponging will help relieve fever and discomfort from a rash.
An acetaminophen-based pain reliever may also help.

If you are pregnant and are exposed to rubella, you should contact your doctor immediately.
The risk of birth defects is higher the earlier the exposure occurred in your pregnancy.
In some cases, your doctor may advise you to consider a therapeutic termination of your pregnancy.

How do you Prevent Rubella?
-----------------------------------


Two doses of the MMR vaccine are recommended for children.
The MMR (measles, mumps, and rubella vaccine) is now given at 15 months, with a booster at the age of 12.

If your child has rubella, notify any at-risk individuals who have had contact with your child during the illness and up to 10 days before symptoms appeared, so they can seek appropriate care.

Pregnancy Concerns
If you are pregnant, and uncertain of your immunity to rubella, and suspect you have been exposed, contact your doctor immediately. There is a risk the virus can be passed to your unborn child.

If any household member is pregnant and there is any question of her not being immune, your doctor will recommend delaying immunisation of your children to prevent exposing the mother-to-be to the live, though weakened, virus in the vaccine.

At least three months before trying to become pregnant, a woman should have a blood test to see if the rubella antibodies are present.
If antibodies are not present, she should be immunised or reimmunised.

Wednesday, September 19, 2007

A Simple Guide to Cervical Cancer


A Simple Guide to Cervical Cancer
--------------------------------------

What is Cervical Cancer?

------------------------------

Cervical cancer is a common cancer in women which affects the cervix (the neck of the womb).

What are the types of Cervical Cancer?
----------------------------

There are 2 main types:

1. Squamous cell carcinoma

2. Adenocarcinoma

Squamous cell carcinorma is more common in the younger woman whereas the adenocarcinoma is more common in the older woman.

Who is at risk of Cervical Cancer?
---------------------------------------------

All women aged between 25 and 69 who had:
1. Sex intercourse at early age
2.Multiple sexual partners
3.Sexually transmitted infections (STI) e.g. genital herpes and human papillomavirus infection (HPV)
4.Any medical condition or treatment which affects the immune system eg. auti-immune disease
5.Smoking

What are the symptoms of cervical cancer?
---------- -----------------------------------------------

The following are symptoms of cervical cancer:

1.Vaginal bleeding after sexual intercourse
2.Irregular bleeding in between periods or after menopause
3.Foul-smelling vaginal discharge
4.Non-specific pain in the pelvic area or lower back
5.Tiredness or loss of weight

The initial stages of cervical cancer are usually symptomless, so women may not know it.
Regular Pap smear screening detects abnormal changes in the cervical cells and prevents cancer.

How is Cervical Cancer Screening done?
-------------------------------------------------------

To check if you may have cervical cancer, go for a Pap smear test.
This is simple, quick, safe and is usually painless procedure.
If you have had sex before or are sexually active, you should go for a Pap smear once every 2 years.
Pap smears are available at all hospitals, most private clinics and the local Cancer Society.

If the Pap smear is positive, a colposcopy (examination of the inner lining of the womb) followed by cone biopsy of any suspicious area may be done.

What is the treatment of Cervical Cancer?
--------------------------------------------------------

In the pre-cancerous stage and Early Cancer Stage(carcinoma-in-situ) of the cervix, removal of all the abnormal tissues can be done by a cone biopsy.

Repeated Pap smears must be done to confirm that there is no recurrence of the cancer.

In all cases of established cancer of the cervix(stage II - IV), surgery is done with removal of the womb followed by radiotherapy( external or internal) and if necessary chemotherapy.

Reviews of the woman's condition is done regularly.
Sexual intercourse should be avoided temporarily after treatment.
Normal physical and social activities may be resumed in 2-3 month after treatment.

How do you prevent Cervical Cancer?
-------------------------------------------

A Pap smear screening test is the best prevention against Cervical Cancer.
A newly developed vaccine for HPV has been shown to be able to reduce the incidence of cervical cancer.
Avoid multiple sexual partners.
Use condoms for protection against sexually transmitted idsease especially HPV.
As usual keep a healthy lifestyle and have a well balanced diet


So take steps now to protect yourself against cancer.
Encourage your loved ones to go for screening if they have not done so.
Bear in mind that a pro-active approach with regular clinical screening is to prevent common cancers like breast and cervical cancers from affecting your lives.


Added 4th October 2008
---------------------------------

Cervical Cancer
---------------------

The most common HPV types causing 70% of all cervical cancers are the HPV 16,18, 31 and 45.

Both new vaccines against HPV Cervarix and Gardasil are equally effective in producing high antibodies against HPV 16 and 18 and preventing these infections over a 5 year period.

However prevention of the HPV 16 and 18 does not mean the cervical cancer can be abolished totally.

Tuesday, September 18, 2007

A Simple Guide to Hypertension


A Simple Guide to Hypertension
--------------------------------------

What is Hypertension?
-----------------------------

Hypertension, or high blood pressure, refers to a condition in which the blood is pumped around the body above normal pressure.

It is a silent disorder and the only way to detect it is to have your blood pressure checked.

When is it High Blood Pressure?
-------------------------------------

Blood pressure is not fixed. It varies with time of day or night, physical activity and emotional factors. Therefore, blood pressure has to be taken under resting condition and on more than one occasion.
A blood pressure reading of 120/80 is read as 120 over 80 millimetres of mercury.
The top number is your systolic pressure. This is the pressure in your arteries when your heart pumps.
The bottom number is your diastolic blood pressure. This is the pressure measured in your arteries when your heart relaxes between pumps.

Blood pressure may vary from 90/60 in a young healthy person to 130/80.
Normal blood pressure is below 130/80.
Blood pressure between 130/80 and 139/89 is called "pre-hypertension".
Blood pressure of 140/90 or above is considered high.
Hypertension is present when your blood pressure is persistently at or above 140/90( at least 3 consecutive readings).


What are the Causes of Hypertension?
---------------------------------------------

In 95% of cases, there is no definite known cause and it is known as essential hypertension. Older people and men are more likely to develop high blood pressure.

It also tends to run in families. Although, you may inherit the tendency to get high blood pressure, other lifestyle choices (eating an unhealthy diet, smoking, not exercising) will often determine if you eventually get the disease.

The other 5% of high blood pressure cases are due to kidney disease, glandular (hormone/endocrine) problems or a side effect of some medications and are called secondary hypertension.

Listed below are some causes of secondary hypertension:
Adrenal gland tumours
Cushing's syndrome
Kidney disorders
Kidney failure
Use of medications, drugs, or other chemicals
Pregnancy or the use of oral contraceptives
Diabetes mellitus
Obesity

What are the Symptoms of Hypertension?
-------------------------------------------------

Hypertension often causes no noticeable symptom but can cause damage of various organs in the body if the blood pressure remains persistently high. It is thus often called the silent killer. Over years it can lead to damage to the heart and blood vessels, making it more likely that the individual will develop a stroke or heart attack.

Occasionally, especially when the blood pressure is extremely high, the individual may experience:

Headaches,
Dizziness,
Alterations in vision.
Confusion
Nausea
Vomiting
Anxiety
Excessive perspiration
Redness of the face or other areas
Muscle tremors
Angina-like pain: crushing central chest pain

How is Hypertension Assessed?
-------------------------------------

Assessment of hypertension is important in determining the known causes of Hypertension (5%) and in the treatment of the condition:

1. Medical history
2. Physical examination
3. Evidence of complications
4. Blood and urine tests
5. Chest x-ray
6. ECG (electrocardiogram)

What are the Complications of Hypertension?
------------------------------------------------------

Hypertension is an important risk factor for coronary heart disease and cerebrovascular disease e.g. strokes.

Poorly controlled hypertension ultimately can cause damage to blood vessels in the eye, thickening of the heart muscle and heart attacks, hardening of the arteries (arteriosclerosis), kidney failure, and strokes.

An elevation of the systolic and/or diastolic blood pressure increases the risk of developing
1. Heart (cardiac) disease,
2. Kidney (renal) disease,
3. Hardening of the arteries (atherosclerosis),
4. Eye damage, and
5. stroke (brain damage).

These complications of hypertension are often referred to as end-organ damage because damage to these organs is the end result of chronic (long duration) high blood pressure.

For that reason, the diagnosis of high blood pressure is important so efforts can be made to normalize blood pressure and prevent complications.

It was previously thought that rises in diastolic blood pressure were a more important risk factor than systolic elevations, but it is now known that in people 50 years or older systolic hypertension represents a greater risk.

Prevention, early detection and adequate treatment of hypertension are necessary to prevent complications of hypertension.

What is the Treatment of Hypertension?
-----------------------------------------------
The aim of treatment is to reduce the risk of complications.

This is done in 2 ways:
Control of high blood pressure
Management of the risk factors eg obesity, diabetes, raised blood cholesterol

Every hypertensive patient or person at risk of developing high blood pressure should adopt a healthy lifestyle.
This means eating wisely:
A diet with reduced salt,
Low fat and high fibre.

Keep your weight in the healthy range,

Exercise regularly,

Not smoke or drink and

Manage your stress better.

Occasionally, marginally raised blood pressure goes back to within the normal range when the patient loses weight, exercises more and cuts down salt intake.

If these measures are not successful, then drug treatment is necessary.
Once medication is started, it important to continue treatment as well as continue with healthy lifestyle practices.
The goal of treatment is to reduce blood pressure to a level where there is decreased risk of complications. Your doctor will try to prescribe a single drug with minimal side effects to control your hypertension. But if a single drug does not work, he will prescribe two or more drugs.

Some of the common drugs used are:
1. Diuretics, which increase urination, to reduce salt and water retention and lower blood volume. They may be used alone or in combination with other drugs.
2. Beta-blockers, which slow the heart rate and cause the heart to beat less forcefully. 3.Calcium channel blockers which relax the blood vessels by slowing the entry of calcium into cells.

4. Angiotensin-converting enzyme (ACE) inhibitors which block the production of angiotensin II (which causes arteries to constrict and stimulate the release of a hormone which causes salt retention).

5. Angiotensin II receptor blockers (ARB) which relax blood vessels by blocking the action of angiotensin II.

Which drug is suitable for you depends on the effectiveness of the drug on your blood pressure and also on the side effects. If the the side effects are severe, it is advisable to change the medications until you have a suitable drug.

Treatment for most people is life-long.

Do not stop or reduce the dosage of your medications without consulting your doctor.

For effective blood pressure control, you should visit your doctor regularly to monitor your blood pressure. You can also monitor your own blood pressure at home with an electronic blood pressure monitor.

How do you prevent the risk of Hypertension?
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You can adopt these lifestyle measures to reduce your risk of high blood pressure.
Lifestyle changes are also important for those who already have high blood pressure.

1.Lose weight, if overweight. Excess weight adds to strain on the heart. In some cases, weight loss may be the only treatment needed.

2.Adopt a healthy diet. Dietary adjustments may be beneficial, especially a decrease of sodium in your diet. Sodium intake may have little effect in persons without hypertension but may have a profound effect in those with hypertension. Salt, MSG, and baking soda all contain sodium. Make sure you eat a diet rich in vegetables and fruit and low in fat.

3.Stay active. Do at least 30 minutes of moderate intensity exercises five or more days a week. You can break up the 30 minutes of exercise a day into 10 minute bouts. As your fitness level improves, do vigorous intensity exercise for 20 minutes a day at least 3 times a week for example, jogging or swimming continuous laps. Remember to consult your doctor before you embark on any exercise plan.

4.Stop smoking. If you are a smoker, stop smoking. Smoking greatly adds to the risk of suffering a heart attack or stroke.

5.Limit alcohol intake. Keep your alcohol intake to less than 1 or 2 standard drinks a day.

6.Learn to relax and avoid stress. Meditation, yoga, tai-chi are some ways in which you can learn to relax and lead a less stressful life.


REMEMBER that long term effective control of high blood pressure is crucial in reducing the risks of serious complications of HYPERTENSION !



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