|
|
|
|
| HEALTH & FITNESS |
|
|
|
Who can have lung cancer? Tips to reduce weight Curing non-palpable breast cancer Health Notes
|
|
Who can have lung cancer? Lung cancer is among the five main types of cancer causing about 1.3 million deaths every year globally. According to the WHO, it leads to about 75,000 deaths per year in India. How does one get lung cancer? Lung cancer is most commonly associated with smoking. However, certain people may have a genetic predisposition to cancer. Even if you do not smoke, you may be exposed to smoke through your smoking colleague/spouse (passive smoking) or your environment. Several workplace substances have also been associated with an increased risk for lung cancer, including arsenic, asbestos, beryllium, silica, radon, etc. What are the signs and symptoms of lung cancer? Most patients with lung cancer will have one or more of the following symptoms:
n
Persistent cough and coughing up of blood
n
Wheezing and shortness of breath
n
Discomfort during breathing
n
Chest pain
n
Pneumonia symptoms such as fever and mucus-producing cough
n
Discomfort during swallowing
n
Hoarseness
n
Weight loss and poor appetite Surgical options For patients with early stage lung cancer, surgical removal of the tumour and the lung tissue surrounding the tumour is the standard care. If the tumour is too large for surgery at diagnosis, many lung cancer patients may receive radiation or chemotherapy in an attempt to shrink the tumour before surgery is performed. The type of surgery performed depends upon the location and size of the lung tumour. The decision for surgery is made by the cardio-vascular and thoracic surgeon taking several factors into consideration. These include over-all medical condition and lung function; the size of the tumour; the location of the tumour; whether there is any sign of spread to lymph nodes; and the type of the tumour. Frequently asked
questions about surgery Q: How much of the lung is removed during surgery? There are three lobes of the right lung and two lobes of the left lung. Lobectomy involves removing the tumour along with the lobe of the lung from which the tumour arises. In some cases, lobectomy may not be sufficient to remove the entire tumour. In this case, removal of the entire lung may be recommended. This operation is called pneumonectomy. Q: Is it possible to breathe normally after a part of your lung is removed? Patients with healthy lungs will be able to breathe normally after the removal of a lobe, or even an entire lung. Pulmonary function tests are used to determine how much lung can be removed without limiting your ability to breathe. Q: What can be expected during and following surgery? Patients are generally out of bed and walking the first day after the operation. A yoga therapist and physiotherapist instructs patients in deep breathing and coughing exercises, which are important to help prevent infection in the lungs. Q: Is there pain following surgery? The operation itself is done under full general anaesthesia. An epidural catheter is used successfully for pain control post-operation. Q: Will I need follow-up care? Yes, follow-up care is essential for the patients who have undergone lung cancer surgery. Q: Are there things the patient can do to increase his chances of living a “normal” life after lung surgery? Yes, these include totally quitting smoking, eating well, and exercising (walking for 30 minutes to an hour per day). Chest physiotherapy and yoga exercises are mandatory. Q: What does the rehabilitation consist of? Formal pulmonary rehabilitation consists of professionally monitored sessions, occurring three-four days per week for 1-2 hours per day. A new technique being used with great success at Christian Medical College & Hospital in Ludhiana has been the use of yoga therapy by a trained full-time yoga therapist. This technique has been presented to international experts in various international conferences and, in fact, won the first prize for the best paper at the 1st International Yoga Conference in Jan 2011. An innovative new technique has been devised in Punjab to reduce the complications of surgery and make the operation safer. This was presented and discussed with an elite group of international experts and has been much appreciated by them. Prevention of lung cancer Total abstinence from tobacco is the surest way of preventing lung cancer. The writer is Head of Cardio Vascular & Thoracic Surgery at Christian Medical College & Hospital, Ludhiana, and was earlier with the Escorts Heart Institute , New Delhi and the St Vincents Hospital in Sydney. E-mail: drhsbedicmc@gmail.com |
|
Tips to reduce weight Obesity is generally defined as a condition where individual weight is 20 per cent or more over ideal weight for one’s age and sex. Complications due to childhood obesity can be the risk of heart disease, diabetes, breathing problems, depression, etc. In the absence of any hormonal imbalance, the aim should be to reduce the intake of calories and increase the level of physical activity. Obesity is a major factor for knee-related problems. One pound of weight puts six times more stress on the knee. If one is five pounds overweight, that puts extra 30 pounds weight on the knees. It is just like having Maruti tiers on a truck. A workout is 25 per cent perspiration and 75 per cent determination, meaning thereby that it is one part physical exertion and three parts self-discipline which can help in reducing weight. Avoid all weight loss programmes or diets promising fast or quick weight loss of two pounds per week. It is advisable to alter eating habits and physical activity habits on a long-term basis to keep excess weight off for a long time. Losing weight makes it sure that you are taking fewer calories than your body is expending. The safest and ideal way to lose weight is to lose no more than one pound per week. Very rapid weight loss can cause water or muscle loss rather than fat. Decreasing the intake of 250 calories and burning 250 calories through aerobic activity gives a total of 500 calories per day that means losing one pound of weight per week approximately. Warming up is a pre-requisite for weight reduction. It improves flexibility and suppleness of the muscles reducing the chances of injury. Weight-bearing exercises are beneficial for the obese as these strengthen the muscles and increase bone density DIET DIET-related habits rather than the hereditary factor are responsible for obesity in most cases. Diet control is an integral part of losing weight but it can’t burn fat that is already stored in the body. Exercise is the most effective way of shedding stored fat. Taking three meals a day shows the tendency to being overweight rather than taking five small means as it is the total caloric intake rather than the frequency of meals that influence weight. Food is fuel and if your body is taking less fuel then it goes into a “starvation mode”, leading to headache, fatigue, loss of energy, loss of sleep, etc, which are potentially dangerous for health. People who totally depend on diet restriction for weight reduction become too tired to exercise because the body starts burning muscle mass in addition to fat. Aerobic exercises do not help in losing weight. Fat reduction occurs when respiration and heart rate are elevated for an extended period of time — 20 to 40 minutes. Walking, if undertaken correctly, is one of the best forms of aerobic activity which can be practised by anyone and everyone all year round, requiring no infrastructure or tools except a good pair of walking shoes. Brisk walking is also a form of aerobic activity as then the body has oxygen which is required to burn fat. Walking at a modest pace (3.5 kilometres per hour) for half an hour can burn off 150 to 200 calories equaling a bottle of cola-based drinks or one big cup of noodles Swimming not only helps in fat reduction but also incorporates all aspects of fitness like speed, stamina, strength and flexibility. It is often seen that obese people over-exercise in order to quickly shed off weight. After a few days of over-training they leave the exercise due to some injury, muscles soreness, fatigue, depression, etc. Ideally, one should not do more than one-hour exercise per day. Resting for a day in a week helps reduce fatigue, muscle soreness, etc. Strenuous activity/high intensity exercise suppresses the immune system. Therefore, it should be avoided during high fever, viral infection, etc. It is advisable to start aerobic exercises at a comfortable pace, which should be gradually increased. Stop exercising in case of dizziness, discomfort in chest, arm, breathlessness, etc. The writer is a former doctor/physiotherapist, Indian cricket team E-mail
— chadhar587@gmail.com |
|
Curing non-palpable breast cancer Breast cancer [BC] is either palpable when the woman presents with a breast complaint or a mass is palpable at physical breast examination by a healthcare provider. Cancer detected on screening mammography is non-palpable and usually asymptomatic. The incidence of incidental non-palpable breast cancer is progressively increasing. Nearly 20% to 35% of breast cancer cases are treated when non-palpable at oncology centeres. In a study from Netherlands, with a well-established screening programme, of all the suspicious non-palpable breast lesions, 10%-55% turned out to be malignant. Screening programmes play an important role in detecting BC early. Screen-detected cancers are smaller than the palpable cancers, are less likely to be advanced and not having spread to lymph nodes. In women with a palpable lump, the size of the tumour is significantly larger than cancer detected by mammography. Most of the non-palpable tumours are detected by mammogram. Mammography is the most effective modality used for breast cancer screening and detection. On mammogram one sees microcalcification, abnormal opacity or abnormal density, or a combination of these. Nearly 10% of non-palpable cancers are detected on ultrasound examination. The size of the mass detected on imaging study may vary from 6mm to 10mm and appear somewhat irregular in shape. Non-palpable cancer can be effectively detected in the US and the diagnosis can be confirmed by US-guided biopsy. Widespread use of screening programmes and diagnostic breast imaging [CT, MRI] identify these non-palpable breast cancers that eventually require surgical excision for definitive diagnosis and treatment. PET scan may detect a cancer as small as 4mm which has been missed on mammography, ultrasound and MRI. A histopathological examination is required to establish the correct diagnosis of cancer. Image-guided fine needle aspiration cytology [FNAC], core needle biopsy, the advanced breast biopsy instrumentation system[ABBI] and vacuum-assisted core biopsy[VACB] represent alternatives to surgical biopsy for correct identification of cancer.Percutaneous image-guided biopsy is faster, less invasive and less deforming than surgical biopsy for diagnosing non-palpable lesions. Non-palpable tumours are difficult to discern at surgery. A localised procedure is thus required to enable intraoperative identification and surgical resection. Various procedures are in practice for localisation of non-palpable lesions. The hook wire localisation [HWL] has been the gold standard for intraoperative localisation. The radiologist inserts a fine guide wire to the site of the lesion and the surgeon excises the lesion with the help of the guide wire to locate the site of biopsy. Specimen mammography is subsequently done to confirm the presence of the lesion. The problems with wire localization are discomfort, wire displacement, or even dislodgement. Positive margin rates after wire localisation are high leading to re-operation or an increased risk of local recurrence. Radio-guided occult lesion localisation [ROLL] : This enables radio-guided surgery to identify the occult lesion and perform immediate breast resection with good and safe margin of normal tissue. A radioactive isotope is injected into or around the tumour under radiological guidance. A hand-held gamma probe is used to locate the breast lesion and guide the excision. A specimen mammogram or ultrasound is done to ensure that the breast lesion has been excised with adequate margin. The advantages of this procedure are that there is no patient discomfort and the localisation process is easier. Clinically, occult [non-palpable] cancers which are not palpable and discovered only with mammography, ultrasound or MRI show a high survival rate. A 98.6% five-year overall survival is reported. Women with palpable tumours have a large tumour and of a more advanced stage at presentation. They also have worse cancer-specific survival than those with mammographically detected cancers. Most of the non-palpable breast cancers are early cancers. The writer, a former Professor and Head, Department of General Surgery, PGI, Chandigarh, is at presented associated with Fortis Hospital, Mohali
|
|
Health Notes London: It is believed that starting a family will lead parents to healthier eating habits, as they try to set a good example for their children. But in one of the first longitudinal studies to examine the effect of having children on parents’ eating habits, researchers have found that parenthood does not lead to healthier diets. “We found that parenthood does not have unfavorable effects on the parents’ diets but neither does it lead to significant improvements compared to non-parents, as health practitioners would hope,” lead investigator Helena H. Laroche, University of Iowa and the Iowa City VA Medical Center. “In fact, parents lag behind their childless counterparts in decreasing their intake of saturated fat, and their overall diet remains poor,” she stated. — ANI 2 drugs better than 1 to treat type-2 diabetes in youth
Washington: Researchers have found that a combination of two diabetes drugs, metformin and rosiglitazone, is more effective in treating youth with recent-onset type-2 diabetes than metformin alone. But adding an intensive lifestyle intervention to metformin provided no more benefit than metformin therapy alone. They also found that metformin therapy alone was not an effective treatment for many of these youth. In fact, metformin had a much higher failure rate in study participants than has been reported in studies of adults treated with metformin alone. The Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study is the first major comparative effectiveness trial for the treatment of type-2 diabetes in young people. — ANI WHO calls for early treatment to stop HIV from spreading
London: Any HIV infected person should be given immediate treatment to reduce the risk of transmission of the virus to his/her partner, suggests the World Health Organization. The recommendation is part of a global crackdown on the spread of HIV. Last year, a clinical trial found that giving antiretroviral drugs to an infected partner earlier reduces the risk of transmission by 96 per cent. The new strategy is part of a drive to stop HIV spreading, even if it means treating people whose immune systems are not yet depleted to the levels that usually require therapy. “This is the first time people would get treatment not necessarily for their own benefit, but to protect their partners,” New Scientist quoted Bernhard Schwartlander, director of evidence, innovation and policy at UNAIDS in Geneva, Switzerland, as saying. — ANI
|
Lung cancer is among the five main types of cancer causing about 1.3 million deaths every year globally. According to the WHO, it leads to about 75,000 deaths per year in India.
