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| HEALTH & FITNESS |
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Cancer treatment: Delay is dangerous
Drug addiction: observe your child’s behaviour
Challenge of pain management
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Cancer treatment: Delay is dangerous It is estimated that a million new patients of cancer are added in our country every year. Combine it with the surviving patients and the number becomes mind-boggling. Remarkable progress has been done in all aspects of cancer management, right from diagnosis to management, but, unfortunately, the majority of the patients still reach a doctor at a very late stage. It is surprising to see well-educated and well-placed persons presenting themselves at a very late stage, even in a city like Chandigarh. Who is responsible for this delay: the patient and his relations or the doctor who could not do the correct diagnosis when confronted with the problem? I think both are to blame, with the patient’s share being on a higher scale. The World Health Organisation (WHO) has identified a few symptoms and signs called Warning Signals, and these have been grouped into the following seven: 1. Change in bowel or bladder habit 2. A sore that does not heal 3. Unusual bleeding or discharge 4. Swelling in any part of the body 5. Indigestion or difficulty in swallowing 6. Obvious change in wart or mole 7. Nagging cough or hoarseness of voice The above-mentioned complaints do not per se prove the diagnosis of cancer as they occur quite commonly in non-cancerous conditions too. These are only warning signals when the patient must undergo a clinical examination to rule out the possible occurrence of cancer. In case a patient has taken medical treatment for two weeks and the problem persists, then the possibility of cancer arises. The main causes of delay in reaching the correct diagnosis being:
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Patients or their relations \ attendants do not take notice of the warning signals, considering these to be a trivial matter, and keep on neglecting the obvious problems. They do not take the patient to a doctor.
l It has been often seen that the patient is taken to a homoeopath or a naturopath or even to a quack. They are given treatment, which has no effect and, therefore, the precious time is further lost.
l Even the practitioners of modern medicine (allopathy), both general duty and specialist doctors, make the mistake in not suspecting the presence of cancer in the patient and, therefore, do not proceed with investigations to reach the exact diagnosis.
l It should be remembered that even investigations can mislead, even FNAC or biopsy can give false negative results if not properly carried out and reported by a competent pathologist. Following the diagnosis, time is further lost as the patient first tries to get treatment by consulting those associated with the alternative systems of medicine. The patient reaches a cancer specialist only when definite deterioration has taken place. The stage of the disease at the onset of commencement of treatment has a direct relationship with the ultimate prognosis. Therefore, delayed diagnosis and treatment are definitely harmful for the patient. It has been well established that for the successful treatment of the majority of cancer cases, a combination of surgery, chemotherapy, radiotherapy, hormone therapy, immunotherapy and other modes of cure is needed. The sequence and selection of the mode of therapy depend on many factors and have to be decided by the consultant in charge of the individual case. The bottom line in the management of cancer is awareness, early diagnosis and proper treatment by an experienced, competent doctor at a good medical centre. The writer is former Senior Professor and Head, Department of Surgery, PGI, Chandigarh. He has also authored a book,
CANCER
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Drug addiction: observe your child’s behaviour The child never got an opportunity to imbibe good habits. He became over-ambitious without deserving anything. He was admitted to an elite school. When he befriended Nicky and added pleasurable drugs to his menu, the parents did not notice. Now he has joined the international club of 200 million people, who are consuming illegal drugs. For those trapped by addiction, treatment is a wayout, but not easy at all. Drug addiction shortens a person's life and ruins the family. It causes many health and social problems. Most of the drug addicts say after taking the drug their mind becomes cool. Some say it is a thrilling experience. Some take it for ecstatic feeling. Ricky feels that taking to drugs has enhanced his status. Now his only objective in life is drug abuse, by hook or crook. Health problems Health problems arising due to drug/alcohol addiction depend on the type of drug that is being abused and the duration of abuse. Here we will take examples of alcohol, heroin and amphetamine: Alcohol abuse can result in psychological dependence, liver disease, chronic pancreatitis, gastritis, heart problems, high BP and neurological complications. Alcohol abuse is linked to the cancer of the esophagus, pharynx, mouth, liver, breast, etc. Heroin can cause depressed respiration, clouded mental functioning, death due to overdose, nausea and vomiting and spontaneous abortion in pregnant woman. Intravenous use can cause infectious diseases (e.g. HIV/AIDS and hepatitis B and C), collapsed veins, bacterial infections, arthritis and other rheumatological problems. Long-term heavy use of amphetamines may lead to malnutrition, skin disorders, ulcers and diseases resulting from vitamin deficiencies. It may contribute to a lack of sleep and weight loss. Intravenous users are at greater risk. Symptoms Loneliness, inappropriate attachments to objects, lack of response when called, inappropriate laughing and giggling, avoiding eye contacts, difficulty in socialising, no understanding of fear and dangers, echoing words and phrases, extreme restlessness, telling lies, not respecting elders, etc. Drug addiction can lead to the following conditions: Unhappiness and depression, indulgence in criminal and nefarious activities, serious health problems, severe mental disturbance, fake marriages, divorce and separation, bad social behavior, lack of understanding of responsibilities, distorted and shady personality, and anxiety. What can be done? 1.Leading a simple life of dedication to the family and profession 2. Improvement in the laws that would help in decreasing drug pedaling. 3. Better implementation of the law by enforcement agencies. 4. An active judiciary that would quickly dispose of drug offence-related cases and aggressively punish the guilty. 5. Better rehabilitation programmes for the addicts. 6. Increase public awareness regarding the hazards of drug/alcohol addiction by using mass media. 7. Public figures and icons should aggressively participate in anti- drug campaigns. 8. Social, psychological and economic support to the family of the addicts. The writer is a Chandigarh-based eye specialist and author of medical books.
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Challenge of pain management The key to better treatment of pain lies in increased professional and public understanding of it and pain management and research. People having pain miss work. One in six employed people living with chronic pain say it has adversely affected their career. To many chronic pain patients, it may seem that not much progress has been made thus far in this field. However, a closer look at the situation shows that more attention is being paid to the issue. In the United States, the National Pain Awareness Campaign (NPAC) has been started in collaboration with the National Pain Foundation (NPF) and the American Academy of Pain Medicine (AAPM). September 2009 has been declared as the pain awareness month. India lags far behind with pain nearly missing in our medical training programmes. There is an acute shortage of pain services and pain clinics in hospital set-ups. We still do not have figures of population suffering from chronic pain. Campaigns have now been started to increase public awareness that the medical speciality of pain medicine exists and to help connect pain sufferers with certified pain medicine specialists so that the patient’s access to reliable cure is improved. Finding a pain care provider who can address your specific needs is not always easy. Remember, the best tool you have is your own knowledge. Pain can be acute or chronic. Chronic pain is any pain lasting longer than six months or that occurs beyond the usual course of a disease, or beyond reasonable time for an injury to heal. Chronic pain can be caused by diseases, syndromes, injuries, or surgeries. One of the hardest parts of dealing with chronic pain is that no one else can feel our pain. Since pain is a feeling generated within our own bodies and interpreted by our own brain, no one can know exactly what we feel. Unrelieved pain is associated with severe impairment of physical, psychological and social well- being. Unemployment, reduced physical activity and sleep disruption associated with chronic pain may lead to a downward spiral of physical inactivity, altered sleep-wake cycles, decreased socialisation and, off course, “doctor shopping”. Depression and medication overuse may occur, along with family dysfunction and poor work performance. Conservative approaches to the treatment of chronic pain include medication, physical therapies and functional restoration programmes, as well as psychological behavioural interventions. Once we get beyond these approaches, we begin to talk about trying to identify the pain generator, that is, what anatomical structure is causing the pain. We try to provide interventions which take away the pain from the pain generator. Interventional pain management is anything that goes beyond the traditional conservative approaches to pain management with the goal to relieve, reduce or manage pain and improve the patient’s quality of life through minimally invasive techniques. Services are provided by the interventional pain physician to help patients return to their everyday activities quickly and without reliance on medication. In India, pain management has now started expanding from the use of simple analgesics to surgical interventions to blind injections to novel minimally invasive fluoroscopy guided interventions. The writer is an interventional pain physician at Ivy Pain Management
Centre, Mohali.
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Health Notes Researchers at the University of Nottingham surveyed 1,300 people, and found that customers generally believe that products branded “smooth”, “silver” or “gold” were healthier and easier to give up. They said that when people were shown plain packs, the false beliefs disappeared. Under the European Union rules, it is banned to claim that some cigarettes are safer than others.
— ANI Oral contraceptive pills don’t affect fertility
Wellington: Taking oral contraceptive pills does not affect a woman’s ability to conceive after she stops it, reveals a study. The study led by German researchers showed that neither the length of time the pill was taken nor the type of hormones used had an affect on pregnancy rates. In the European Active Surveillance Study on Oral Contraceptives, the researchers followed 60,000 European women for five years. Among them, 2064 admitted that they stopped using the pill because they wanted to become pregnant. The findings revealed that 21 per cent became pregnant one cycle after stopping contraceptive use. After three cycles, the rate of pregnancy had increased to 45.7 per cent, and at one year (13 cycles) 79.4 per cent were pregnant.
— ANI Molecular signature and cancer patients
London: American scientists say that a molecular signature that helps account for the aggressive behaviour of a variety of cancers-such as pancreatic, breast and melanoma — may also help identify patients who are likely to respond to a particular anti-cancer drug. Researchers at the Moores Cancer Center at the University of California-San Diego (UCSD) say that their findings may lead to a personalised approach to treatment for a variety of solid tumours that are currently resistant to therapies. In a study, they have found that a receptor sitting on the surface of certain aggressive tumour cells can activate a key enzyme, src-kinase, which helps tumour cells to become more aggressive in the body.
— ANI |
Cancer today has become one of the commonest killer diseases. Earlier, cancer was not commonly seen in India and other developing and under-developed countries, but it is no more true. With an increase in longevity, greater awareness of the disease and better diagnostic facilities, cancer has become a common ailment in India. 
Ricky was born with a silver spoon in his mouth, to a doctor-couple. The parents loved the only child a lot but substituted gifts and cash for affection, being short of time in busy practice. They believed in exhibiting richness to the child, just for status. They would allow the child whatever he demanded without going into the merit of being good or bad. 
London: