Ductal Carcinoma in Situ (DCIS) & Mastectomy

In India Breast Cancer is the top occurring cancer amongst females with a mortality rate of 12.7 per 1,00,000. A non-invasive form of breast cancer, Ductal carcinoma in situ (DCIS) is a common form of cancer in India. Ductal means ducts as its starts in the milk ducts and carcinoma means cancer that starts in the skin or any other tissues covering the internal organs and in situ means in its original place. The reason this cancer is known as non- invasive cancer is that is has not spread beyond the milk duct to the neighboring tissues.

DCIS is a grade 0 cancer and is not a life threatening cancer but having it in first place does increase the risk of developing an invasive breast cancer later on compared to people who haven’t had it before. The possibility of recurrence is usually 5 or 10 years post the first appearance with a 30% likelihood.

Ductal carcinoma in situ (DCIS)

The possibility of recurrence in women undergoing the breast conserving surgery is around 25% to 30% . To lower the risk of recurrence by 15% you need to include radiation therapy in the treatment plan. Also, if DCIS comes back after treatment it could either be non-invasive or invasive too, chances are 50% for each.

Here’s a look through the symptoms, causes, diagnosis and treatment of the condition.

DICS – Symptoms
Generally there are no visible symptoms of DCIS. Only a few people might have a lump in the breast or some nipple discharge. Diagnosis is only possible for most of the cases through mammography.

DICS – Diagnosis
Breast Examination – A physical examination of breasts is carried out if a lump is present though such lump is rarely noticeable.

Mammography – A mammography can easily detect DCIS. Even when a physical examination fails, mammography can be used to detect DCIS.

Biopsy – Biopsy is only carried out when a mammogram does not give a clear result. There are two kinds of non-invasive biopsies which involve a bit of surgery.

  •  Core needle biopsy – A large needle is inserted for a big sample of tissue from the suspicious area.
  •  Fine needle biopsy – A sample of cells are obtained by inserting a small hollow needle in the breast and then examining it under the microscope.

Though more invasive biopsies are rarely need for DCIS, if the above are not able to give conclusive results then biopsies like incisional and excisional biopsy’s are to be done.

Treatment – Once the diagnosis confirms DCIS, surgery is done to remove the cancer as well as the border of the healthy tissues surrounding the cancer, known as the clear margins. This means doing the procedure of lumpectomy or sometimes mastectomy.

Be Aware of the Silent Killer Called Ovarian Cancer

Many women aren’t aware that ovarian cancer is also known as the Silent Killer because generally no visible symptoms indicate the presence of this cancer and the symptoms surface only during the final stages. This cancer has known to affect as many as over 20K women across the world every year and due to the lack of visible symptoms indicating the cancer, it makes this cancer even scarier.

The causes of this cancer are not clear as yet but family history is one of the risk factors and the women having a family member or relative with ovarian cancer or breast cancer are definitely at a higher risk of the same. Age can also be termed as one of the risk factors because most women get it after 60 -63 years. Also, the women who have had one or more pregnancies before the age of 26 are at a lower risk. The risk is lower if the number of pregnancies is higher. Even using contraceptives frequently tends to lower the risk of ovarian cancer. As per doctors there is this contraceptive hormone called DMPA or Depo pro-vera CI that if injected of more than 3 years, reduces the risk of ovarian cancer even further. Women who make use of infertility treatment drugs over a period of one year are also known to have a high risk of getting ovarian cancer. Other risk factors include obesity, hormone therapy and gynecologic surgery as in surgery of reproductive organs and getting endometriosis at the age of 30 years.

Ovarian Cancer

The doctor on examination will ask for some tests that include blood test, a CT scan or MRI as well as Laparoscopy, biopsy, abdominal fluid aspiration test or colonoscopy for that matter.

As per the American Cancer society ovarian cancer has four stages
Stage 1 – This is the preliminary stage of ovarian cancer where only the ovary or the ovaries are affected.
Stage 2 – This is the secondary stage where the cancer is out of the ovaries and spread around the areas like fallopian tubes, uterus, rectum or the bladder.
Stage 3 – This is a later stage of cancer where the cancer affects the lymph nodes, abdominal lining or even the back of the abdomen.
Stage 4 – The last stage of cancer where the cancer has spread to other parts of the body outside the peritoneal cavity viz. abdomen or pelvis upto the liver, fluid around the lungs or the spleen.

The initial symptoms of ovarian cancer are easy to miss because they are very much similar to premenstrual syndrome. So, you have to be alert and if you find any of the below mentioned symptoms that persist for a long time then good idea is to go for checkup.

Recurring Abdominal Pain
If you have been experiencing stomach ache for a long time even if you don’t have your monthly cycles then its time you get it tested.

Appetite loss and Nausea
When ovarian cancer starts spreading around, it affects the bowel system and causes nausea. If you feel you have been experiencing and loss in your appetite or feeling full sooner than ever, check it out.

Bloating and Constipation
When a tumor is growing inside you even when you do not eat much you feel fuller and bloated. It can also affect your bowel movement leading to regular constipation issues.

Irregular monthly cycles
A tumor in the ovary will cause your monthly period to become irregular or sorts. So, if you haven’t been experiencing any irregularity in your monthly periods earlier but only lately for a while, good idea to meet up with your doctor.

Frequent urination
If you have been making frequent trips to the bathroom for peeing then this could be the sign. Do not ignore and visit your doctor.

The treatment is based on the diagnosis of the stage of the cancer and includes procedures like surgery, chemotherapy, radiation therapy, targeted therapy as well as hormonal therapy. One or more treatments in combination are usually used depending upon the stage of the cancer.

Surgery types
The extent of surgery is also based on the stage and includes removal of ovaries, fallopian tubes, uterus as well the affected surrounding tissues. Then there is de-bulking surgery and lymph node dissections also which is done to reduce the cancerous tissues if the cancer is spread beyond the pelvic region and removal of lymph nodes near the aorta respectively.

Therapy types
Chemotherapy is generally done post-surgery to kill the remaining cancer cells. A medication known as cytotoxic medication poisonous drugs to the cells in-order to prevent growth and division. This is a recurring process based on the cancer growth. Targeted Chemotherapy is another treatment that involves target specific function or pathways of cancer cells. Another therapy that is used as a part to treatment is Hormone therapy. It is done to cut the supply of estrogen from the cancer cells in order to slow their growth. Radiation therapy is also used for treatment of cancer and is generally used in advanced form of cancer.

As the stage increases the survival rate decreases. While for Stage I there is a 90% chance of survival, for stage IV, the chance is 17%.

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*Sourced from the Internet

Compulsive Doing Syndrome – Do you Have It?

Do you feel that you are very busy and occupied most of the times. Do you answer in a negative when someone asks you to meet up, hangout or for any other meet? Is the answer to most questions about availability as ‘Sorry, Busy’. Then, you have a compulsive doing syndrome. The symptoms of this syndrome include –

Compulsive Doing Syndrome

  • No time for family affairs
  • Not time to eat
  • Your to do list goes on increasing
  • Sleepless nights for a long time
  • You might seem busy and hardworking but nothing out of the box

Now, for the reason. This syndrome is because we are brought up believing that being busy means being worthy. This is the most common causes of Compulsive doing syndrome too.

Another reason is that we tend to overburden ourselves until there is no time left for anything to fit in. Many times it can be a sign of running away from problems, situations and issues. So, if you feel that you are busy all the time, know it once and for all that it is apparently a lifestyle issue and needs to be worked up.

Being over occupied without any time to spare apparently show that your time management skills are not good enough. Besides, it also points to clarity or work and focus issues. If you are focused on your work you can finish off your work faster and ample time left for other priorities.

Exercising Breathing for 5 minutes every day helps you calm down, distress and relax. Doing it will certainly help you manage yourself better. Have time allocated for activities that help you feel well mentally, physically and spiritually. Could be a jog, or exercise or music or some extra-curricular activity.

Try to get away from gadgets be it your phone, laptop or television and concentrate on eating while having your meals. Give your family the attention they deserve and not non-living objects over them. Sparing some time out for meditation is definitely a food idea for mental health and overall wellness.

Well, compulsive doing syndrome can be worked up if you are willing to understand that being busy is very much about time management, concentration and clarity.

Do You Legs Pain All Night? Know Why

Many of us experience leg pain at night. But, ever thought about the reasons behind it. Many of us should have and many should have not. So, if you are also amongst the ones who do experience leg pain at night on a regular basis and have been ignoring it or just bearing it through, here are a few reasons that could be the reason, perhaps.

Do You Legs Pain All Night

1. Deficiency of vital nutrients
Many of us never know if our diet is a balanced one of not. With a hectic life schedule and not time for to spare towards caring for health besides a diet that is more of junk and less of nutrient rich food, deficiency of vital nutrients like calcium, potassium and magnesium as well as Vitamin D can lead to leg pain.

2. Dehydration
Nocturnal leg pain is also known to be caused due to dehydration. Due to the electrolyte imbalance in blood, it can lead to nocturnal cramps. So keep yourself hydrated throughout the day and even if you tend to wake up at night stay hydrated.

3. Standing long hours
Standing for long hours can lead to leg pain at night. The reason is that standing for along time tends to accumulate the blood and water in your lower body causing fluid imbalance and cramping.

Health Conditions
If you are suffering from other health conditions that you are not aware of then, you could be having leg pain due to the same.

As you age your bones become weak and nocturnal leg pain is pretty common then. It is after 50 years that you may start experiencing this condition because you start losing neurons and get frequent cramps due to it.

Well, health is wealth and ignoring it can lead to an irreversible or life threatening damage to the body. So, if you are experiencing the symptoms get yourself checked and do the needful. Why compromise on quality of life.

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Leptospirosis – The Rat Fever that’s Killing People in Kerala Post Floods

Kerala floods have caused a havoc in kerala washing out villages and towns and post the floods the fear of epidemics is hovering already. Nipah the deadly virus had taken as may has over two dozen lives some months back and now it’s another fever called the rat fever of leptospirosis that has been causing deaths in Gods own country.

Last month a total number of deaths registered in Kozhikode has risen to 17 due to leptospirosis of which 6 have been confirmed and rest are suspected to be due to rat fever. To avoid further spread and even as an immediate measure, 85 bed isolation ward is setup in Kozhikode general hospital as well as government hospitals in Koyilandy, Vadakara and Feroke. Meanwhile low lying Alappuzha and three north-central districts reported a total of nine casualties due to rat fever.


The rat fever attacked as many as over 559 people across the state last month already of which 229 were confirmed cases of Leptospirosis.

Here’s a look into the condition, its causes, symptoms, treatment and preventive measures.

Leptospirosis is a condition caused due to a rare bacterial infection caused by a bacteria called Leptospira interrogans and spreads through the urine of animals like rodents, dogs as well as farm stock. These animals never show any symptoms but act as carriers while the organism resides in their kidneys. Although it is not a life threatening disease like Nipah most of the times, there is a possibility of severe leptospirosis which can lead to a fever that returns. When the fever returns, the condition is called Weil’s disease and requires hospitalization because it can have serious symptoms like chest pain, legs and swollen arms.

You can easily contract the bacteria if you are anywhere near to the place where the carrier animal has peed as the germs can invade the body through the scratches, dry areas and open wounds besides genitals, nose or mouth. Human to human infection can only spread to intercourse or breastfeeding.

So, if you are even around animals a lot then you are at high risk of it. Hence, people like veterinarians, underground or sewer workers, farmers, military persons and veterinarians are at high risk of contracting the bacteria. People who are into adventure activities like rafting, camping or swimming.

The symptoms may include fever that can spike up to 104 degrees besides Muscle ache, Headache, Vomiting, Jaundice, Skin Rash and even jaundice.

The doctor will recommend a blood test and check for antibodies in the blood. Your body will produce antibodies to fight this bacteria but if you have had this condition before, it can give a false positive report. Hence, another test needs to be done for confirmation purpose after one week. The doctor could also advise you to go for a DNA test to be more precise, but it can get expensive to go for this test.

Treatment and Prevention
The treatment course runs across a period of one week where the doctor could prescribe ibuprofen tab for fever and muscle pain besides antibiotics like doxycycline and penicillin. A more serious condition like meningitis, lung issues and kidney failure might require you to get admitted immediately.

As they say prevention is always better, to avoid getting into this mess called Leptospirosis, stay away from domestic animals, live-stock and wild rats.


How Rural India is a Bearing the Brunt of Non Communicable Diseases

A doctor practicing in the rural area was taken by surprise to find numerous cases of non communicable diseases amongst men and women in and around rural areas. While a 55 year old male suffered from from a heart attack, a 53 year old female was suffering from depression and anxiety. Other cases included that of chronic back pain and more, that too from a tribal village that is situated in one of the most backward districts of the state.

The question that doctors are pondering on is how are rural and tribal areas populace experiencing the health issues that are commonly associated with lifestyle of urban people. The fact is that the pattern of India’s health structure is making a paradigm shift and this has been so over the past 15 years. The fact came to light when the Government of India released its report on the death causing diseases. Further more, the figures of the report of 2010-13 showed enormous growth revealing 47% of the deaths were due to NCD’s and 30% due to Communicable Diseases. This significant rise of 7% undoubtedly indicated taking a keen interest in the healthcare issues of rural population and Non communicable diseases more so.

Well, even though as per statistics the life expectancy of people in urban as well as rural India remains the same more or less, the health issues related to aging seems to crop up in rural areas as well and not just the cities. Having said that, there are challenging dealing with rural NCDs compared to that of cities. Here’s a look through a few –

  • Unavailability for diagnosis and treatment in rural areas.
  • It can be expensive and economic issues like poverty amongst families
  • Unavailability of advanced professionals needed for treatment of NCD’s
  • Data Collection issues around Rural NCD’s hampers working on the problem further in a systematic way.
  • In India compared to developed countries NCD is common among the younger generation
  • Awareness is one of the main reasons NCD’s in rural region is not gaining the kind of attention it needs to get.

Well, NCD in rural India is no myth today as can be seen from the figures and hence the policy makers and government need to focus on devising and implementing solutions to deal with this growing healthcare issue of rural India.