A Simple Guide to Acoustic neuroma

A Simple Guide to Acoustic neuroma
---------------------------------------------------

What are Acoustic neuroma ?
------------------------------------------------

Acoustic neuroma is a neurofibroma of the eight nerve.


Who are at risk of Acoustic neuroma?
-------------------------------------

1.Both sexes are equally affected.

2.Acoustic neuroma occurs more in the 50- 60 age group.

3.It forms 5-10% of the intracranial tumors in adults.


What are the different types of Acoustic neuroma?
--------------------------------------------------------

1.Neurofibroma I -
a. Unilateral acoustic neuroma usually
Bilateral acoustic neuromas are not common.

b. occurs in adult life,

c. the tumor involve the 8th nerve,

d. can involve any other cranial nerve or the spinal root.

e.Incidence is usually 90-95%

2.Neurofibroma II -
a. bilateral acoustic neuromas are common

b. occurs before the age of 21.

c. affects the entire nerve

d. autosomal dominant inheritance.

e. Incidence is about 5 to 10%.


What are the Causes of Acoustic neuroma?
------------------------------------------------------

Acoustic neuroma in the adult begins in the Schwann's cells of the vestibular portion of the 8th nerve inside the internal auditory canal.

The tumor grows slowly and can extend into the posterior fossa to occupy the space between the cerebellum and the pons.

Because of its location, it can also compress the 5th, 7th, and less often, the 9th and 10th cranial nerves.

If it grows larger, it may also compress the pons and lateral medulla of the brain, causing blockage of the cerebrospinal fluid and increased intracranial pressure.


What are the symptoms and signs of Acoustic neuroma?
-------------------------------------------------------

Symptoms:
--------------
1.unilateral hearing loss

2.tinnitus with unilateral high-pitched ringing sound

3.loss of sense of balance

4.vertigo

5.nausea and vomiting

6.altered gait

7.pressure in the ear

8.rarely headache and altered consciousness.

Signs:
-------------

1.unilateral facial weakness.

2.sensory impairment of the nerve

3.impairment of glandular secretions

4.loss of taste

5.loss of sensation in one side of the face and mouth

6.rarely altered gag or swallowing reflexes.


How are diagnosis of Acoustic neuroma made?
------------------------------------------------------------

1.Contrast-enhanced CT will detect almost all acoustic neuromas that are greater than 2.0 cm in diameter

2.MRI with gadolinium enhancement may show even smaller tumors

3.Audiology and vestibular tests are done to check for Nerve versus conduction hearing loss.


What is the Treatment of Acoustic neuroma?
-------------------------------------------

Treatment of acoustic neuroma is usually by surgery and radiotherapy.

Conservative treatment
--------------------------

In some cases because the neuroma grow so slowly, the tumor is monitored by annual MRI to see its growth.

This method is common among patients over 70 years old.

In rare cases, acoustical neuroma have been known to disappear spontaneously.

Acoustic neuroma may result in gradual hearing loss and tinnitus.


Surgery
-----------------

Surgical removal of acoustic neuroma usually involve microsurgery to remove the tumor.

The superior and inferior vestibular nerves are removed at surgery.

This effectively restores balance in the patient.

Radiation treatment
-----------------------

Radiotherapy using gamma knife radiosurgery or fractionated stereotactic radiotherapy does not remove the tumor but is able to slow or stop its growth.


What is the Prognosis of Acoustic neuroma?
-------------------------------------------

Prognosis is good in all early diagnosis and small tumors.

Large tumors may give rise to residual neurolgical damage even afer removal.

A Simple Guide to Thyroid Nodules

A Simple Guide to Thyroid Nodules
-----------------------------------

What are Thyroid Nodules ?
------------------------------------------------

Thyroid nodules are abnormal swellings in the thyroid gland which occurs when the thyroid tissues starts to proliferate in one part of the thyroid gland.


Who are at risk of thyroid nodule?
-------------------------------------

1.Thyroid nodules are more common in females than in male.

2.However the thyroid nodule in males are more prone to malignancy than in females

3.Thyroid nodules occurs more in the 30- 60 age group.


What are the different types of Thyroid Nodules?
--------------------------------------------------------------

1.solid - solid thyroid nodules which may or not feel hard

2.cystic - the nodules is filled with fluid.

3.benign - non malignant

4.malignant - cancerous


What are the symptoms and signs of Thyroid Nodules?
-------------------------------------------------------

In mild cases there is usually no obvious symptoms.

In moderate or severe cases of thyroid nodules:

Symptoms:
--------------

1.Obvious swelling in the thyroid gland

2.Neck swelling -suuggest presence of spread to the lymph node

3.Hoarseness of voice may occur if there is pressure on the vocal cord or recurrent nerve to vocal cord

4.Dyspnea or breathlessness if there is pressure on the trachea

5.Dysphagia or difficuly in swallowing due to pressure on the oesophagus


Signs:
-------------

1.Thyroid nodules are felt only if they are more than 1.5 to 2cm in diameter.

2.Cystic nodules may feel hard while solid nodules may be soft to firm.

3. The vocal cords should always be examined to exclude lesions in the vocal cords causing hoarseness.

4.Malignant thyroid nodules present similarly to benign nodules but can spread to other parts of the body.


How are diagnosis of Thyroid Nodules made?
------------------------------------------------------------

1.blood test for thyroxine and TSH levels

2.fine needle aspiration biopsy is a simple way to determine if a nodule is benign or malignant.

The biopsied material is then sent to the lab for tests to look for any malignant cells.

3.ultrasound scans are done to differentiate between solid and cystic nodules,

4.thyroid scans which help to show if a nodule is producing excessive thyroid hormone(hot) or not.

5.CT Scan or MRI are not routine to thyroid nodules investigation except where there is suspected compression of teachea.


What is the Treatment of Thyroid Nodules?
-------------------------------------------

Benign lumps can be monitored by doctors at regular intervals.

If there are symptoms of compressing a neighbouring organ or the nodule is cancerous, surgery is required.

Patients who has symptoms of hyperthyroidism are advised to go for radioactive iodine treatment or surgery.


What is the Prognosis of Thyroid Nodules?
-------------------------------------------

Prognosis is good in all benign cases.

Malignant thyroid nodules will depend on any spread to other organs.

A Simple Guide to Cancer

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

This is a summary of all the articles that I have done on the different types of Cancer.

There is a common thread which runs through all the articles such as the risk factors, causes and treatments.

What is Cancer?

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

A normal cell can be compared to a "hero" because it saves the body by repairing any damage or injury to the tissues of the body.

A person's body is made up of many types of cells which normally grow, divide and die. Sometimes, the cells mutate (change to abnormal cells) and begin to grow and divide more quickly than normal cells.

Rather than dying, these abnormal cells clump together to form tumors.

If these tumors are cancerous (also called "malignant"), the cancer cells can invade and kill your body's own healthy tissues becoming a "villian" in the process.

By contrast, noncancerous tumors (also called "benign") do not spread to other parts of the body.

What are the dangers of Cancer?
--------------------------------------

Normal healthy cells grow and multiply in an orderly, controlled manner.

Cancer cells on the other hand multiply uncontrollably.

They do not function normally and instead form a growth or tumour which can enter the blood and spread to nearby tissues and organs as well as to other parts of the body.

Cancer kills by:

Destroying important organs
Disturbing normal body functions
Blocking important blood vessels or air passages.

Cancer is really a group of diseases. There are many types of cancer which can arise from the different types of cells in the body.

What are the most common cancers?
--------------------------------------------

MOST COMMON TYPES OF CANCER IN THE WORLD ARE:
Lung
Colon & rectum(large intestine)
Breast
Ovary
Stomach
Cervix(neck of the womb)
Liver
Prostate
Nasopharynx(back of the nose)
Lymphomas

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

1. Genetic -family history,chromosonal abnormality

2. Viruses & Bacteria -hepatitis B, Epstein Barr, HIV : Helicobacter pyrori

3. Smoking - chemicals from cigarette smoke

4. Alcohol - liver cirrhosis

5. Chemicals -pesticides, asbestos,preservatives,chemotherapy, aflatoxins

6. Radiation -from sun rays, x-rays, radiotherapy,nuclear plants

7. Obesity - fat can cause breast, ovarian cancer

8. Age - mutations increase with age

How can you prevent yourself from cancer?
---------------------------------------------------

Cancer can be prevented.

Cancer is not contagious like the flu or chickenpox.

About one-third of all cancers can be prevented from occurring:
1. A healthy lifestyle
------------------------
get some exercise, a well balanced diet and avoid stress.

2. Smoking
-------------
avoid cigarettes and cigarette smoke.

Cigarette smoke contains about 40 different cancer-causing substances.

Almost all of those who develop lung cancer are smokers.
Smoking also causes cancers of the mouth, throat, larynx , oesophagus, stomach, pancreas, kidney and bladder.

Breathing in other people's smoke can increase your risk of developing lung cancer, so ask any smokers not to smoke in your presence.

What you can do
Don't smoke.
If you do, then stop.
Ask your family and friends to support your efforts to quit.
Get rid of all your cigarettes and lighters.
Enrol in a programme that helps smokers to quit.
Spend less time with friends who smoke.
Spend more time with non-smoking friends in smoke-free places.
There are chewing gum and skin patches with nicotine to help you to stop smoking.

3.Food and chemicals
--------------------------
avoid any cancer causing chemicals such as asbestos or nitrosamines from preserved food.
The chemicals used to preserve foods like ham, bacon, luncheon meat may form cancer-causing substances when they are digested.

These substances have also been found in salted or preserved foods (such as salted fish or pickled vegetables) and may lead to cancer of the stomach and nasopharynx.
Eat them less often.

Peanuts, seeds and grains that are not stored properly often become mouldy.
Some of these moulds produce toxins(aflatoxins) that can cause liver cancer.

What you can do:
1.Have some fresh fruits and vegetables at every meal. Fruits and vegetables contain vitamins and fibre which help to reduce the risk of developing colorectal and stomach cancer.
Choose dark-green leafy vegetables and orange-yellow fruits as these contain greater amounts of vitamins and minerals.

2.Take more fibre by eating wholemeal bread or wholegrain cereals such as brown rice.

3.Eat less salted, pickled, preserved and processed foods.
Store nuts in air-tight containers to prevent them from going mouldy.

4.Obesity
-----------
People who are overweight are more likely to develop cancers of the colon, rectum, breast and prostate.

What you can do
Exercise regularly .
To maintain a healthy weight, take up a regular exercise or sport.
Aim to stay in the healthy weight range.
Exercise for at least 20 minutes three times a week.
Play a game or sport that you enjoy and can do with your friends or family.

Eat less foods high in fat or sugar.
Trim away fat from meat and skin from poultry before cooking.
Change to foods low in fat like skimmed milk, reduced fat cheese or low-fat yoghurt.
Use low-fat cooking methods like stewing, baking, steaming or boiling instead of deep frying.
Choose healthier snacks like fresh fruit or wholemeal crackers.

5.Radiation
--------------
radiation from sun, x-rays, nuclear plants can cause damage to the skin,bones and other organs of the body resulting in cancer.


What you can do
Avoid sunburn and prevent overexposure to the sun.
The ultraviolet rays from the sun damage the skin.
Sunburn may lead to skin cancer.
Avoid overexposure to the sun, especially if you are fair-skinned.
Stay in the shade whenever possible.
Wear a hat or a cap.
Use a sunscreen or sunblock with a sun protection factor of at least 15 on any exposed areas of skin.


6. Workplace chemicals
----------------------------
exposure to cancer-causing substances at work can lead to cancer of lungs, liver, kidneys, skin. Always follow the safety regulations as they are meant to protect you.

What you can do
Hide behind protective shields or stay in the "safe" area.
Remember to wear protective equipment (like gloves, masks or goggles).
Be careful when you handle the equipment or the chemicals.
Learn about safety drills and what to do in case of emergencies.

6.Alcohol
-----------
People who frequently drink large amounts of alcohol are likely to develop liver cancer.
They are also at risk of developing cancer of the mouth, throat and oesophagus .

What you can do
Limit yourself to not more than two standard drinks a day.
One standard drink is roughly equal to:
One can of beer(285 mls)
One glass of wine (120 mls)
One measure of spirits(30 mls)

Alternate your drinks with non-alcoholic ones.
Drink them slowly so they last longer.

How to screen for Cancer:
-------------------------------
Mneumonics for Warning Signs of Cancer
-------------------------------------------------

Be on the alert for: CANCERS

1.Changes in bowel or bladder

2.A lump in breast or elsewhere

3.Nagging cough, hoarseness,

4.Changes in the size, shape or colour of a mole on the skin

5.Extraordinary bleeding from the nose or any other part of the body, and blood in the stools.

6.Reccuring Indigestion

7.Sore or an ulcer anywhere on the body, including the mouth, which does not heal properly.


Look out for these early warning signs and let your doctor know.

What you can do
Inform your doctor about it right away.
He can examine you and do some tests to find out if your problem is serious.

Regular breast self examination (BSE) helps to detect breast cancer at a stage when it can still be treated and even cured.
Learn how to do BSE properly and then do it every month.
See your doctor for a breast examination once every two years.
Women over 40 should see their doctor once a year.
Mammograms are special X-rays of the breasts to look for lumps.
They are usually recommended for women over 50.

Regular Pap Smears at least once in 2 years should be done for women who are sexually active. A Pap smear is a simple, quick and painless test that detects cervical cancer at an early stage when it has a good chance of cure.

Women infected with certain sexually transmitted diseases have a higher chance of getting cervical cancer.

Speak to your doctor about your personal and family medical history of cancer.
Certain medical conditions may increase your risk of developing some cancers.
Examples are people who are carriers of the Hepatitis B virus are more likely to develop liver cancer.
Some cancers (like breast and colorectal cancers) tend to run in families.
If your parents, brothers or sisters have had cancer, discuss it with your doctor.
If you have any risks of cancer, the doctor can tell you what steps you can take to reduce your risk of developing cancer.
He may recommend some screening tests to help determine your risk for developing the same cancer.

In fact, about one-third of all cancers can be cured if they are detected and treated early enough.
Recognising the early warning signs and going for regular check-ups can save your life if cancer strikes.

What are the Treatment of Cancers ?
-------------------------------------------

Basic treatments for cancer are traditionally surgery, radiotherapy and chemotherapy.

However with the advancement of medical treatment, there are more choices of treatments.

Surgery - is still the mainstay of cancer treatment in the early stages and other stages except for leukemia, nasopharyngeal and some rare cancer.

Radiotherapy-standard, intensity modulated radiotherapy, stereotactic radiotherapy, interventional radiotherapy.

Radiotherapy is used particularly in nasopharyngeal cancer, brain cancer and in conjuction with surgery. It can be curative as well as palliative( help to relieve pain)

Chemotherapy - standard,molecular targetted therapy is fast becoming the choice for many cancers because of newer drugs with lesser effects and more effective than before.

Hormonotherapy - espcially for breast,ovary,uterine,prostate, testicular cancer

Immunotherapy - immune systems are boosted with vaccines against certain viruses such as HPV(Human Papilloma Virus)

Stem cells - can help in replacing killed cancer cells with normal cells usually used in conjunction with chemotherapy

Bone marrow transplant - similar to stem cells therapy

Organ transplant especially in liver cancer

Other ways of treatments:

Healthy life style will help to strengthen the patient during the cancer treatment

Well balanced Diet will also help to improve the healing process

Meditation and avoidance of stress reduce the reduced immunity of patients and pyschological effect of cancer treatment

Finally:

Cancer can be cured.

Many people are afraid of cancer because they think it is incurable.

In fact, about one-third of all cancers can be cured if they are detected and treated early enough.

Modern medicine has also improved the survival rates of most cancers.