Breast lumps are innocuous things that have a hidden potential to land one in a whole lot of trouble. Breast cancer as such is a condition that can be detected and diagnosed early if we are aware of it. I firmly believe anyone who need not go through it should not. All we need is a high degree of alertness and awareness to follow up on suspicions.
How do we know there is a problem?
The commonest way an early cancer can present is in the form of an innocent lump in the breast. This is easy enough to detect by oneself by regular self-examination. Do not examine daily, then you cannot make out any new change. It would be mre sensible to examine once a month instead. Self examination is ideally performed 3 to 5 days after your period as the breast is least painful or lumpy then.
One of the better ways to examine is: Lie down on the bed. To examine the right breast, tuck your right arm under your head and with the flat of the fingers of your left hand, press down in small circular motions on the right breast and check for any lumps. In a standing or sitting position, check the armpit for lumps (some breast tissue extends into the armpit). To examine the left breast, lie down, tuck in the left arm under your head and examine the left breast with the flat of the fingers of your right hand. Again, do not forget to feel the armpit as well. Stand in front of a mirror and examine both breasts with your arms by your side and also with your arms held up straight. Look for changes in shape, contour, texture of skin- any dimpling or indentations that resemble an orange peel and changes in the nipple.
Self examination is very useful indicator, but it cannot substitute being examined by a doctor or a routine mammogram. So you must not depend on this alone.
Who is at risk?
It is rare to find cancer of the breast in women below 20 years. Those above 20 years must routinely self-examine. Women in whose family other women have had breast cancer are at a greater risk. They must have routine examinations by a doctor and routine mammograms.
As far as diet is concerned, high intake of alcohol is linked to an increased incidence of breast cancer. Body weight? Women who are obese have a greater incidence.
Here is something interesting: Breast cancer is more common in women who have not had children. Breast feeding and child-birth at an earlier age have a protective effect. Hormone Replacement Therapy's role in breast cancer is controversial. Usually those on HRT get more benefit from it which will outweigh any risk.
Men are not exempted: Less than 0.5% of those with breast cancer are men.
If you do have a breast lump, who do you go to?
Breast lumps are dealt by surgeons, not gynecologists. So go to a surgeon.
If you are below 40, an ultrasonogram will be of more use than a mammogram. Above 40 years, a mammogram will give better results.
If the lump is confirmed, get a biopsy done. Do not delay. Every day you save will make a difference.
Biopsy:
This is the clincher. There are two types of biopsy:
1. Fine Needle Aspiration Cytology (FNAC)- In this, the surgeon will put in a needle in different parts of the lump and withdraw some aspirate. Cells from this aspirate will be tested for cancerous or as we call it, 'malignant' changes. THIS CAN ONLY BE DEPENDED ON FOR A POSITIVE RESULT. A negative FNAC does not rule out cancer. Its simple logic. If cancer cells are present in an area the needle missed, obviously the result will be negative! But if there is cancer and the cells are picked up by the needle, then we know there is a problem and can plan further.
2. Excision biopsy: Small lumps can ususally be taken out as a day procedure under local anesthesia. Taken with adequate clearance (which is, a margin of normal tissue around the lump) in case this shows cancer cells, further surgery may not even be needed.
All patients who are discovered to have cancer cells must undergo the full list of investigations to check if the cells have spread anywhere else in the body (this sneaky disease starts to spread early at the microscopic level). Further treatment such as chemotherapy and radio therapy are planned depending on the results of such investigations.
I suppose this is about all I need to write here. Do remember, like the old addage says, 'Prevention is better than cure'. Early catch can also be as good as cure. So don't delay on the biopsy if you have a lump. Don't hesitate to get a second opinion.
Two conditions that cause a lot of confusion with breast cancer are 'fibroadenoma' of the breast which is single or multiple small lumps that are mobile and smooth and 'fibroadenosis' in which the whole breast is painful and lumpy. Fibroadenoma can be biopsied to rule out cancer. Fibroadenosis can be ruled out by a doctor's examination though an ultrasonogram or a mammogram may sometimes be necessary.
Monday, February 25, 2008
Monday, February 4, 2008
Blood Pressure? Who, me?
I sure hope its not you! Even if it is, be armed with knowledge and attack it right back!
Blood Pressure is more of a 'trait' than disease. It risies with age and is closely related to Stroke and Cardiovascular disease among a host of other things (it can also affect the eye and the kidney).
Blood Pressure is measured as two readings and expressed in a form that looks like a fraction (but it is NOT a fraction!). For eg. 150/90mm of Hg. This simply means that when the heart is pumping out the maximum blood pressure reached in the blood vessels is 150mm of Hg - we call this the Systolic Blood Pressure; when the heart is relaxed and getting filled with venous blood, the blood pressure that continues to hold up the blood vessels is 90mm of Hg - we call this the Diastolic Blood Pressure.
There are many definitions for ideal blood pressure, but an average reading of 120/80mm of Hg is taken as normal. Between Systolic and Diastolic blood pressures, Systolic is more fluctuant (varies more easily with stress, emotions, position, time of day, etc). So a Diastolic blood pressure reading will give a better guide to control, though controlling the systolic blood pressure is no less important.
A Diastolic blood pressure of 90mm of Hg or lesser is known to increase health benefits.
The WHO classifies 130-139mm of Hg Systolic pressure and 85-89mm of Hg Diastolic pressure as 'high' normal blood pressure.
Blood Pressure tends to run in families but there are many external factors that influence it, which fall well within our control. Some of these factors are diet, smoking, blood cholesterol, alcohol intake and stress. Other factors like age, gender (men are more prone than women but no, it is not proved that women are a cause!), diabetes, ethnic origin are beyond our control.
Diet, smoking, alcohol intake are eminently under our powers to modify and control as is blood cholesterol though to a lesser extent.
A diet rich in salt makes you more prone to developing high blood pressure, especially if someone in your family (I mean a blood relative like parent, brother, sister, uncle, aunt, grand-parent or cousin) is already known to have blood pressure. So keep your hands off the yummy Indian pickle, the dry fish, dry-chillies and other things that come enticingly soaked and dried in curd! Some studies have shown a diet high in potassium can have a protective effect. So grab that banana, and any other fresh fruit you can lay your hands on!
Smoking is slow poison. Like all poisons, best avoided. This requires an entire discussion by itself, coz this is the commonest thing we pay for to buy disease!! All I can say now is stopping smoking can begin to clear out some of the bad effects (depending on how long and how much the smoking has been for. Most effects are reversible in a span of 10 years, though all are not) and going on drugs without stopping will give much less benefit.
Alcohol is a double-take. Too much and it does you in (liver, heart, brain all the way to heaven) but take it in small amounts (what is small amounts?) and it can actually help lower blood pressure! If you do wish to try it out, make sure you are able to stop with small amounts!
Blood Cholesterol is something you can modify though you may not be able to control. This also unfortunately runs in families. There are two types of blood cholesterol: The good HDL (this acts like a big scavenger that removes the smaller bad ones from the blood vessels) and the bad Triglycerides and LDL. The ratio between these types is more important than the actual Total Cholesterol.
Good cholesterol or HDL is abundant in olive oil, certain types of fish and nuts. Upto 4 or 5 helpings of fresh fruits and salads a day also contributes to keep the cholesterol ratio good.
Bad cholesterol starts getting deposited in blood vessels from the age of 2. So start early on a good diet. Ghee, butter are delicious but brim over with bad cholesterol. So keep off them.
Exercise also has many beneficial effects. If you have the time and motivation, go ahead!
How do you know if you have Blood Pressure?
The best way is to have regular health checks. Other than that, here are some symptoms you could watch out for:
Any nagging headache, chest pain (due to prolonged undiagnosed bloodpressure against which the heart struggles to pump out), breathlessnes (since heart finds it difficult to pump against so much resistance, some backlog might soak the lungs), palpitations, bleeding from the nose. Disturbance in vision, fits and transient loss in consciousness can indicate to an impending stroke!
Sometimes, blood pressure can also be secondary to other disease like disease of the kidney, some hormonal problems, disease in blood vessels, pregnancy and certain drugs.
Did you know there is a defined form of blood pressure called 'White-coat' hypertension? It is blood pressure increase in people only in clinical visits!!
If you do have blood pressure, do all the things we have discussed to avoid it and get treated! Whatever anyone might say, once you get blood pressure, it is sadly your friend for life. It is under control on medication, then it is under control because of the medication, so don't try to stop it on your own. Even if it does come under control on diet and exercise, check it out at regular intervals so that it will not quietly sneak up on you without your knowing it!
Blood Pressure is more of a 'trait' than disease. It risies with age and is closely related to Stroke and Cardiovascular disease among a host of other things (it can also affect the eye and the kidney).
Blood Pressure is measured as two readings and expressed in a form that looks like a fraction (but it is NOT a fraction!). For eg. 150/90mm of Hg. This simply means that when the heart is pumping out the maximum blood pressure reached in the blood vessels is 150mm of Hg - we call this the Systolic Blood Pressure; when the heart is relaxed and getting filled with venous blood, the blood pressure that continues to hold up the blood vessels is 90mm of Hg - we call this the Diastolic Blood Pressure.
There are many definitions for ideal blood pressure, but an average reading of 120/80mm of Hg is taken as normal. Between Systolic and Diastolic blood pressures, Systolic is more fluctuant (varies more easily with stress, emotions, position, time of day, etc). So a Diastolic blood pressure reading will give a better guide to control, though controlling the systolic blood pressure is no less important.
A Diastolic blood pressure of 90mm of Hg or lesser is known to increase health benefits.
The WHO classifies 130-139mm of Hg Systolic pressure and 85-89mm of Hg Diastolic pressure as 'high' normal blood pressure.
Blood Pressure tends to run in families but there are many external factors that influence it, which fall well within our control. Some of these factors are diet, smoking, blood cholesterol, alcohol intake and stress. Other factors like age, gender (men are more prone than women but no, it is not proved that women are a cause!), diabetes, ethnic origin are beyond our control.
Diet, smoking, alcohol intake are eminently under our powers to modify and control as is blood cholesterol though to a lesser extent.
A diet rich in salt makes you more prone to developing high blood pressure, especially if someone in your family (I mean a blood relative like parent, brother, sister, uncle, aunt, grand-parent or cousin) is already known to have blood pressure. So keep your hands off the yummy Indian pickle, the dry fish, dry-chillies and other things that come enticingly soaked and dried in curd! Some studies have shown a diet high in potassium can have a protective effect. So grab that banana, and any other fresh fruit you can lay your hands on!
Smoking is slow poison. Like all poisons, best avoided. This requires an entire discussion by itself, coz this is the commonest thing we pay for to buy disease!! All I can say now is stopping smoking can begin to clear out some of the bad effects (depending on how long and how much the smoking has been for. Most effects are reversible in a span of 10 years, though all are not) and going on drugs without stopping will give much less benefit.
Alcohol is a double-take. Too much and it does you in (liver, heart, brain all the way to heaven) but take it in small amounts (what is small amounts?) and it can actually help lower blood pressure! If you do wish to try it out, make sure you are able to stop with small amounts!
Blood Cholesterol is something you can modify though you may not be able to control. This also unfortunately runs in families. There are two types of blood cholesterol: The good HDL (this acts like a big scavenger that removes the smaller bad ones from the blood vessels) and the bad Triglycerides and LDL. The ratio between these types is more important than the actual Total Cholesterol.
Good cholesterol or HDL is abundant in olive oil, certain types of fish and nuts. Upto 4 or 5 helpings of fresh fruits and salads a day also contributes to keep the cholesterol ratio good.
Bad cholesterol starts getting deposited in blood vessels from the age of 2. So start early on a good diet. Ghee, butter are delicious but brim over with bad cholesterol. So keep off them.
Exercise also has many beneficial effects. If you have the time and motivation, go ahead!
How do you know if you have Blood Pressure?
The best way is to have regular health checks. Other than that, here are some symptoms you could watch out for:
Any nagging headache, chest pain (due to prolonged undiagnosed bloodpressure against which the heart struggles to pump out), breathlessnes (since heart finds it difficult to pump against so much resistance, some backlog might soak the lungs), palpitations, bleeding from the nose. Disturbance in vision, fits and transient loss in consciousness can indicate to an impending stroke!
Sometimes, blood pressure can also be secondary to other disease like disease of the kidney, some hormonal problems, disease in blood vessels, pregnancy and certain drugs.
Did you know there is a defined form of blood pressure called 'White-coat' hypertension? It is blood pressure increase in people only in clinical visits!!
If you do have blood pressure, do all the things we have discussed to avoid it and get treated! Whatever anyone might say, once you get blood pressure, it is sadly your friend for life. It is under control on medication, then it is under control because of the medication, so don't try to stop it on your own. Even if it does come under control on diet and exercise, check it out at regular intervals so that it will not quietly sneak up on you without your knowing it!
Quirky Snippets!
Well here is some food for thought:
1. Who was the very first Anesthetist?
Ans: God
2. Who was the very first Surgeon?
Ans: God
Reference? Bible, Genesis Chapter 2: 21,22
I find this very interesting.
"So the Lord caused the man to fall into a deep sleep;" - Exactly what anesthetists do: Put patients into 'deep sleep' before painful surgery.
"and while he was sleeping, he took one of the man's ribs and closed up the place with flesh" - Exactly what surgeons do: After the patient is in 'deep sleep', open, tinker around doing what they have to, then 'close the place with flesh'.
Here comes the best part still: After 'taking one of the man's ribs', what did he do? "Then the Lord God made a woman from the rib he had taken out of the man"!
Guess what the rib is known to contain? Stem Cells!!
So did God use Stem Cells from Adam, do a bit of genetic modification, replace the 'Y' chromosome with 'X' and let it grow? Adam does say Eve is 'bone of my bones and flesh of my flesh'.
To me, Science is the attempt to unravel the mysteries hidden in Creation. This is one mystery everybody is trying to crack!
A final one to munch on: "God formed the man from the dust of the ground and breathed into his nostrils the breath of life": What is 'dust' of the earth? Silica, Carbon- two of the most stable elements in nature. Contained in fossils and diamonds among other things!
1. Who was the very first Anesthetist?
Ans: God
2. Who was the very first Surgeon?
Ans: God
Reference? Bible, Genesis Chapter 2: 21,22
I find this very interesting.
"So the Lord caused the man to fall into a deep sleep;" - Exactly what anesthetists do: Put patients into 'deep sleep' before painful surgery.
"and while he was sleeping, he took one of the man's ribs and closed up the place with flesh" - Exactly what surgeons do: After the patient is in 'deep sleep', open, tinker around doing what they have to, then 'close the place with flesh'.
Here comes the best part still: After 'taking one of the man's ribs', what did he do? "Then the Lord God made a woman from the rib he had taken out of the man"!
Guess what the rib is known to contain? Stem Cells!!
So did God use Stem Cells from Adam, do a bit of genetic modification, replace the 'Y' chromosome with 'X' and let it grow? Adam does say Eve is 'bone of my bones and flesh of my flesh'.
To me, Science is the attempt to unravel the mysteries hidden in Creation. This is one mystery everybody is trying to crack!
A final one to munch on: "God formed the man from the dust of the ground and breathed into his nostrils the breath of life": What is 'dust' of the earth? Silica, Carbon- two of the most stable elements in nature. Contained in fossils and diamonds among other things!
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