Back Pain During Pregnancy

Low back pain is one of the most common reason to see a gynecologist in Delhi during pregnancy. Most pregnant women have some degree of back pain. Women who had previous back pain or are overweight have an increased risk of back pain during pregnancy. Below are possible causes, as well as ways to prevent and relieve back pain.

The road to greater well-being

There are several causes of back pain during pregnancy. These are due to the changes that occur in your body.

Pressure on the back muscles:

As your baby grows, your uterus expands and becomes heavier. This increases the weight on the back muscles. You can find yourself leaning back or arching your lower back. Pressure can cause back pain or stiffness.

Weakness in stomach muscles:

Your growing baby also puts pressure on the stomach muscles. This can cause them to stretch and weaken. Your stomach and your back muscles are connected. The back muscles have to work harder to compensate for the belly.

Position:

Pregnancy can change your center of gravity. The way you move, sit and stand can cause pain in your back and other parts of your body. A compressed nerve due to poor posture can also cause pain.

Pregnancy hormones:

Many hormones change for different reasons when you are pregnant. When your pregnancy progresses, hormones increase to relax the muscles and ligaments of the pelvis. This prepares your body for childbirth. If your muscles and ligaments become too loose, they can cause back pain.

Stress:

Anxiety and accumulated tension can tighten or stiffen the back muscles.

To help prevent back pain, consider how you feel, stop and move, and how you sleep.

• Sit in a way that supports your back. Choose a lumbar support chair or place a pillow behind your lower back. Try to lift your feet to increase blood flow and avoid slouching.
• Sit down and stand straight. Try to keep your back aligned with your bottom and legs, instead of arching your lower back. Do not sit or stand in the same position for a long time. It could pinch a nerve. Do not lock your knees. If you have to stand for long periods, try resting one foot at a time on a box or stool.
• Wear low-heeled shoes that are comfortable and support your entire body. It may be useful to use anatomical insoles. Avoid shoes with heels that can make you lose your balance.
• Sleep on a mattress that is not too soft and offers support. When you are pregnant, it is better to sleep on your side. Place pillows under your stomach and between your legs for added support. Try to avoid sleeping on your back. This can put pressure on your uterus and cut off the blood flow to your baby.
• Do not twist or make sudden movements that can tighten the back or stomach muscles.
• Don't lift things leaning forward. Instead, keep your back straight and stand up with your legs instead of your back. Be careful not to lift or carry too much weight at a time.
• Exercise a lot This will help strengthen the muscles of the back and stomach, and improve posture. Talk to the best gynecologist in Delhi about what type of exercise is safe. Walking and swimming often do well. If you were very active before pregnancy, you can continue doing the same level of activity. Certain movements and stretches, such as Kegel exercises, also prepare you for childbirth.
• Wear maternity pants. Wide elastic waistband provides additional support.

If you have back pain, these tips can help relieve pain and stiffness.

• Apply heat or a cold compress on your back. Avoid putting extreme temperatures in your stomach.
• Take acetaminophen.
• Look for ways to relieve stress. Learn breathing exercises or take a prenatal yoga class.
• Get a prenatal massage from a certified therapist.
• Ask your gynecologist in South Delhi about alternative medicine. This could include acupuncture or a chiropractic adjustment, or also osteopathic manipulation. It moves your muscles and joints by stretching them and exerting gentle pressure.

Aspects to consider

The best gynecologist in South Delhi does not recommend some imaging studies when low back pain has been present for less than six weeks. The exception is if there is a serious risk, such as a neurological problem. Research shows that images taken before 6 weeks do not improve results. Health care costs increase. Some imaging diagnoses may not be safe during pregnancy. Talk to your gynecologist in Lajpat Nagar about the benefits and risks of all medication options.

When to consult the gynecologist in Delhi

Contact your gynecologist in East of Kailash if:

• Your pain gets worse or does not go away after two weeks. Back pain could be a sign of premature delivery.
• Loses sensation in the back, legs, pelvis or genital area.
• You have a fever, burning sensation when urinating or vaginal bleeding. You may have a urinary tract infection (UTI) or a kidney infection.
• You have an injury or trauma that causes back pain.

Questions to ask your gynecologist in Defence Colony

• How do I know if my back pain is intense or not?
• What type of exercise is safe during pregnancy?
• Is it safe to receive a massage during pregnancy?
• Will my back pain go away after giving birth?

High Risk Pregnancy: Causes, Care and Treatment

One of the main concerns of women who want to have a baby is to have a High-Risk Pregnancy.

It is a type of pregnancy that, either due to pre-existing maternal disease or produced by the pregnancy itself, requires a more exhaustive control of it.

Next, we want to help you know how to detect a high-risk pregnancy and, also, that you know the complications arising from this situation. Keep in mind that, in these cases, thorough gestation control is essential to prevent problems from increasing.

What is a High Risk Pregnancy and how is it detected?

When we talk about a high-risk pregnancy, we are referring to the fact that, due to the pregnancy itself, the woman or the baby may have some type of health complication. We have to emphasize that this is a very specific problem, since it only affects 10% of women in a state of pregnancy, however, it is important to know its existence and diagnosis.

During a high-risk pregnancy, some gynaecological, medical and obstetric situations usually occur that may endanger the health of those involved. This does not mean that, because of having this pregnancy, something bad is going to happen but that, simply, precautionary measures must be taken.

The Diagnosis of a High Risk Pregnancy

But how is a high risk pregnancy detected? There are different ways to detect the existence of this type of condition:

·        Prior detection: it is possible that, due to the gynaecological history of the future mother, there are more chances that she can develop a high-risk pregnancy. Normally, the doctor is in charge of testing to detect the woman's health condition (by blood tests, urine tests, etc.). The pre-pregnancy pathology determines that it is considered high risk

·        During pregnancy: another way to detect that a pregnancy is being at high risk is during the 9 months of gestation. Here some health problems may occur that cause gynecologist in Delhi to identify you as a pregnancy of this type (gestational diabetes, preeclampsia, multiple pregnancy)

Symptoms of High-Risk Pregnancies

If you want to be able to detect if the pregnancy you are having may have some type of risk for you or your baby, it is important that you know some of the symptoms of this condition. In general, the signs that may indicate that you are at risk are:

·        Vaginal bleeding

·        Constant and very severe headaches

·        Emergence of contractions

·        Loss of amniotic fluid before 37 weeks.

·        Blurry vision

·        Twin or triple pregnancies are considered high-risk pregnancies.

·        Chronic hypertension, pregestational diabetes, kidney, haematological or cardiac diseases prior to pregnancy also constitute a high-risk pregnancy.

However, it should always be the best gynaecologist in Delhi who diagnoses this condition. Therefore, it will be vital that, before any abnormal symptoms, go to the doctor for an exam.

Complications of a High Risk Pregnancy

It is essential that you detect in time if you suffer from a high-risk pregnancy because, otherwise, you could endanger your health and that of your baby. By consulting the gynecologist in South Delhi and following the guidelines that you set, you can better control the evolution of pregnancy and minimize the risks to the fullest.

And it is that high-risk pregnancy can cause some serious complications such as those indicated below:

·        Having a baby with a weight much lower than healthy and safe

·        Premature delivery

·        Haemorrhages

·        Malformations in the baby

·        In extreme cases, the death of the mother or the baby

For all these reasons, it is vitally important that, during pregnancy, you undergo a regular gynaecological check that checks your baby's evolution and health status.

High Risk Pregnancy Treatment in Delhi

As we have seen in the previous section, there are several causes of high-risk pregnancy. Consequently, high risk pregnancy treatment in Delhi should always focus on the origin of the risk situation.

For example, in cases of maternal hypothyroidism it is necessary to keep a regular check. It can be done through analytics that collect thyroid hormone levels.

On the other hand, if the mother is diabetic or suffers from gestational diabetes, it is important to take care of food and control blood glucose.

The same happens in cases of hypertension, where blood pressure will be monitored regularly to prevent the foetus from having repercussions.

In addition to these specific measures, there are a number of guidelines that are common in any high-risk pregnancy. The most prominent are the following:

·        Go to each and every review with your medical team.

·        Rest and avoid situations of stress or emotional overload.

·        In the case of a family history of any disease, notify the doctor immediately.

·        Do not take medication other than the usual one without consulting the specialist: not all drugs are accepted during pregnancy. Some produce malformations and other alterations on the foetus.

·        Avoid eating raw meat and fish. Sausages are also included in this group.

·        Do not smoke or drink alcoholic beverages.

·        Avoid eating sweets and ensure a good supply of liquids.

How to prevent a High Risk Pregnancy?

Some preventive measures include:

·   Plan your pregnancy:  If you are considering having a baby, we recommend consulting with a specialist. The best gynecologist in South Delhi will indicate all the necessary care you should have. If you have a medical condition, you can receive the appropriate and timely treatment so that you can have a healthy and risk-free pregnancy.

·     Go to all your medical appointments:  Going to all your medical appointments will help you keep better control of your baby's health. In addition, you will know if a problem is developing or if you need special care.

·   Eat a healthy diet:  It is essential to have a healthy diet during pregnancy. You will need larger amounts of calcium, iron, folic acid, among other essential nutrients. You can supplement your diet with vitamin supplements. Consult your doctor if you need to eat a special diet.

·    Stop bad habits:  Avoid smoking, drinking alcohol, using drugs, self-medicating among other bad habits. Which only harm your health and that of your baby.

·      Gain weight properly: Obtaining the ideal weight will help you contribute to the proper development of your baby. In addition, it will be much easier to carry the extra weight. We recommend you check with your doctor so you can know the exact weight you need.

If you find yourself going through a high-risk pregnancy, you will most likely feel scared and anxious. Unfortunately, anxiety can affect your health and that of your baby. Consult with your doctor about the appropriate forms and techniques of relaxation that you can apply. For example, imagining positive things or good experiences will help you lower anxiety levels. Another excellent option is to listen to music or read interesting books to help you clear your mind.

Gynecological Problems That Challenge Emotional Well-Being

The female genitals are changing throughout life, especially during pregnancy, childbirth, and menopause. These changes usually lead to gynecological problems that also affect the emotional well-being of women. Next, we review the main disorders and how to prevent them in order to enjoy positive sexual health.

The vaginal atrophy, dryness, vaginal laxity, urinary incontinence, the decrease in pelvic organs (uterus and vagina) or constant itching in the genital area are some of the gynecological problems most commonly affecting a large number of women of all ages.

Many of the women who suffer from these genital disorders feel embarrassed to talk about them and even feel misunderstood. This brings with it pictures of emotional instability, depression or loss of self-esteem and even breakups.

According to Dr. Sadhana Kala, gynecologist in Delhi, women are getting more aware of these problems.

Partly because women go more to consultation and also because there are more gynecological women, she points out, "which helps women open up to tell about problems they didn't feel supported before."

Until now, gynecologists used to focus on issues more related to pregnancy control and childbirth. However, “we did not realize that the genitals are changing throughout life. Until recently we did not know.”

“More than half of the women who go to the clinic to perform their gynecological examination after childbirth, do not count that they have frequent urine losses or vaginal dryness, which causes pain in their sexual relations or lack of pleasure or sexual desire”.

When do the changes arrive?

Gynecological problems and discomforts in sexual intercourse can come with pregnancy, childbirth, continuous activities that produce abdominal overexertion (such as running, doing abdominal crunches, steps, etc.), age or menopause.

Commonly, genital disorders tend to appear in the fourth decade of life. That is when oestradiol levels begin to drop in women. The alteration of this female hormone causes symptoms such as dryness or lack of lubrication in sexual intercourse. The change in metabolism also plays an important role at this stage.

Like almost all parts of the body, the woman's genitals will change throughout her life, however, "this is information that is practically not explained to them." The pregnancy and childbirth "are key moments in the life of a woman suffer pelvic floor were some very important changes."

Also, the type of delivery influences. "If it has been instrumented or not, depending on the weight of the baby, the hours of expulsion, etc ... All these influences that we see more or less damage to the pelvic floor."

“Many women assume that their sex life will not be the same after delivery. They believe that it is the price they have to pay for being mothers and that, they bear it many times with great frustration.”

Therefore, a gynecologist in South Delhi warns of the mistake that not long ago was committed by "trying to reassure them, simply telling them that their condition would improve and that it is only a matter of time."

How to prevent gynecological problems

The following table summarizes the five preventive strategies to avoid genital disorders and maintain optimal sexual health:

Having healthy sexuality and not avoiding relationships

Sexual intercourse is essential to keep the genitals healthy and feel good. "Maintaining sex contributes to genital health," she says.

Many patients who spend long periods of sexual inactivity encounter tremendous discomfort when they try to resume their sexual intercourse.

Genital hydration

Vaginal dryness causes pain and the inability to have sex. Depending on the severity, there are different solutions:

• Early pelvic floor rehabilitation exercises
• Genital laser (to tighten and rejuvenate vaginal tissue)
• Creams with oestradiol (to improve tissue quality of both the vulva and the vagina)
• Genital hyaluronic acid infiltrations

Perform pelvic floor exercises

The purpose is to prevent tissue laxity, bladder, uterus or rectum descent, hypermobility of the urethra, among other problems related to the loss of urine.

"It is very important to emphasize that these exercises should be guided by a specialist physiotherapist" and thus, avoid possible complications in cases of patients with certain pathologies.

Periodically go to the gynecologist

The best gynecologist in Delhi should be visited at least once a year or at any symptom or alarm signal. "Any doubt should always be consulted without fear of a specialist," she says.

Be alert to the changes in our body

Paying attention to any symptoms or changes observed in the body is essential. The moments of most alterations in a woman's life will be during pregnancy, postpartum and menopause.

The speed with which they begin to take care of the genital organs will stop the onset of gynecological problems. "For example, during the first three months of postpartum, thanks to the hormonal alteration, the body is very receptive to respond to treatment and completely recover abdominal and pelvic muscles, visceral descents or hyperreactive behaviors."

Polycystic Ovary Syndrome

Dr. Sadhana Kala, the best gynecologist in Delhi, specialized in the diagnosis and treatment of Polycystic Ovarian Syndrome (PCOS). It is estimated that this problem affects between 8-13% of the female population of reproductive age and can have a significant impact on fertility and quality of life. In addition, in the long term, it can favor the onset of metabolic disorders and cardiovascular health problems.

For this reason, it is important to treat this disease from a multidisciplinary point of view, which includes lifestyle control measures and medical monitoring from various specialties: gynecology, endocrinology, nutrition, and reproductive medicine. In some cases, psychological support may also be indicated, as it may affect physical appearance, sexual intercourse, and fertility.

At Moolchand Hospital, we have specialists in all these areas that work in coordination. This fact allows us to address this disease from an interdisciplinary point of view, and adapt the treatment to each case and to the lifestyle and needs of each patient, as recommended by the gynecologist in Delhi.

What does it consist of

PCOS is a dysfunction of the ovaries that can cause hormonal and metabolic alterations, as well as irregularities in the menstrual cycle. In addition, it can occur in a very diverse way: acne, high body mass index (BMI), a tendency to obesity, anovulation, excess body hair, etc. Although its cause is not known exactly, it is believed that there is a genetic predisposition and there are several factors that can aggravate it, such as a sedentary lifestyle or improper diet.

Dr. Sadhana Kala, a gynecologist in South Delhi, explains how this problem can be kept under control.

In which cases, a medical visit is recommended

PCOS has very varied symptoms, and not all are present or occur jointly in patients suffering from it. Here, the best gynecologist in South Delhi indicates some of the most frequent. If you have at least two of them, you should request a visit:

• Irregular cycles or absence of rules for long periods.
• Excess hair in areas where women usually have little hair.
• Acne and oily skin.
• Hair loss.
• Difficulty losing weight or tendency to obesity.
• Difficulty getting pregnant
• The ovulation test always negative.
• Ovaries of polycystic appearance, that is, they have a very high number of follicles.

What treatments are there?

The way in which this syndrome is presented is very different in each woman, so we cannot generalize the treatment. The first thing to do is to confirm the diagnosis.

To do this, in addition to a first visit to know the family history and medical history, it is necessary to perform several tests, such as a blood test and a gynecological ultrasound, which will determine if the patient has a higher level of male androgen hormones -androgens- than normal and polycystic ovaries.

The first option is the implementation of dietary control measures and lifestyle. With this, it is possible to prevent weight gain and reduce the risk of metabolic disorders and cardiovascular problems, in addition to improving menstrual regularity, ovulation and the probability of pregnancy.

In some cases, pharmacological treatment may be indicated, by taking contraceptives, which keep the ovaries at rest, which contributes to reducing excess body hair and acne.

If you want to get pregnant but do not ovulate regularly, a hormonal stimulation treatment to induce ovulation may be indicated, and if you have an added fertility problem, the start-up of an assisted reproduction treatment would be studied.

Can you be a mother with Polycystic Ovarian Syndrome?

The quick answer is yes, you can be a mother with polycystic ovarian syndrome, but you have to take into account the nuances that we explain in this post. Although pregnancy is possible, it is necessary to diagnose polycystic ovarian syndrome (also known by its acronym SOP or as Stein-Leventhal syndrome) and make adequate treatment from best gynecologist in Delhi for each woman to get pregnant.

What is polycystic ovarian syndrome and how is it diagnosed?

The polycystic ovarian syndrome is an endocrine disorder that affects female fertility because of the irregularity of the rule and anovulation (failure to release any eggs in the menstrual cycle). Since there is an alteration in ovulation, it is more likely to encounter difficulties at the time of seeking pregnancy.

This syndrome is behind 30% of cases of infertility of female origin and it is estimated that 1 in 10 women suffer from it. In short, this reproductive pathology is the most common in women of childbearing age.

Polycystic ovarian syndrome and pregnancy

Women who suffer from this pathology have a greater difficulty in becoming pregnant, so it is advisable to go to an infertility specialist in Delhi to receive advice to receive the necessary guidelines to achieve pregnancy. In addition, it should be borne in mind that the process can be lengthy, so it is convenient to go to the infertility doctor in Delhi as early as possible to assess the particular case.

Although in some cases it is possible to restore fertility by modifying the patient's lifestyle and / or with some drugs that regulate hormonal alterations, in cases where fertility cannot be restored, it will be necessary to resort to assisted reproduction techniques as in vitro fertilization or artificial insemination to achieve pregnancy, suggests gynecologist in Delhi.

What are the symptoms of polycystic ovarian syndrome?

The most common symptoms that manifest in women suffering from PCOS are:

• Irregular menstruation (less than 9 annual rules) or absence of menstruation.
• Hirsutism: excess hair
• Alopecia or hair loss
• Acne
• Hormonal alterations
• Insulin resistance
• Obesity

How to treat polycystic ovarian syndrome?

Although the origin of this pathology is unknown, it is important to diagnose and treat it correctly. For this, the gynecologist in Lajpat Nagar must perform tests such as anamnesis, transvaginal ultrasound, hormonal analysis.

Once PCOS is diagnosed, it is important to have adequate infertility treatment in Delhi to prevent associated diseases, and it is essential to follow a healthy lifestyle with a balanced diet and regular physical activity.

The success rates with the correct advice and assisted reproduction treatments are very high, the best gynecologist in Lajpat Nagar has extensive experience in cases of this type.

If you have polycystic ovarian syndrome or suspect it and are planning to become a mother, go to a specialized gynecologist in Delhi to answer your questions and have the appropriate guidance for your case.

Best Gynecologist in Kailash Colony Delhi

Dr. (Prof.) Sadhana Kala Obstetrics & Gynecologist in East of Kailash, Delhi, is a highly renowned, integrated and the leading Woman Care doctor in Delhi. Our Centre is well equipped with all the facilities that make you feel warm and at home. We strive to maintain the highest standard of consultancy and cater Advise with the most concurrent and innovative knowledge regarding all subjects within the era of Dr. (Prof.) Sadhana Kala Care. Best Gynecologist in Kailash Colony Delhi delivers a number of services, each woman requires through her life; ranging from her puberty till her midlife. The specialty of Gynecology, Obstetrics, Infertility, and Sexual Health has been our main area of specialization over many years.

Dr. (Prof.) Sadhana Kala is a leading provider of comprehensive Obstetrics & Gynecology Services. Our whole cadre collaborates to cater women and expectant mothers the highest standard of multidisciplinary and high-quality care. Our cadre works closely with other specialty areas and solutions should the want arise. We use the updated information and innovative technology to diagnosis and cure patients and are proud to be a part of over many labor and deliveries every year.

Dr. (Prof.) Sadhana Kala caters the full standard of obstetrical services, and also serves superior gynecological care for women, from adolescence through the post-menopausal years. Our years of going through in the multi-cultural community of Best Gynecologist in Delhi give us the knowledge to cater solutions according to a broad range of cultural values and personal preferences. We endeavor to realize your requirements and will provide you the specialized care you expect.

Ameliorating the clinical effectiveness and efficiency is the key to achieve our target of absolute patient satisfaction. Dr. (Prof.) Sadhana Kala makes a positive contribution by regularly organizing training and educational activities relating to health and medicine. The future is unsealed and everyone fears that the work of a lifetime could be in jeopardy. The possibility of losing what took a lifetime to form can only break one’s confidence. During these times, thoughts inevitably turn to what is more valuable in one’s life.

BREAST CANCER

SYNOPSIS

Breast cancer (BC) is the biggest killer-cancer of women in the world, and in India. In the next fifteen years, BC will kill over twelve lakh women in India. But it doesn’t have to. A few life style changes can reduce the incidence of BC; and early detection can increase the survival rate.

BC was a disease of old age. No longer. Twenty-five years ago, 69% of BC patients in India were age 50 and above. But now only 52% are 50 and above; 48% are less than 50; and a few are in the teens.

Every woman is at risk of BC. It cannot be prevented. The risk increases with age, heredity and genetic predisposition; and the risk reduces with healthy weight, regular exercise and healthy diet.

Early detection is the key to survival. Early detection can be by self-examination of breasts, or by screening by imaging devices such as X-ray, Ultra sound, and MRI. However, confirmation is only possible by biopsy.

Depending on the stage at which the cancer is detected, the treatment can be surgery, radiation, chemotherapy and other adjuvant therapies.

If detected early, BC is treatable. If detected late, it is fatal. Five-year survival rate for Stage 1 BC is 100%; for stage 4 is 22%.

So exercise and eat healthy and you would have done your bit to reduce your cancer risk. And do regular cancer screening and you would increase the probability of early detection and of successful treatment.

INTRODUCTION

Breast cancer (BC) will kill about 80,000 women in India in 2020. For every two women with BC, one will die. Many of these deaths are preventable simply by early detection. But detection is often late and thus fatal. Lack of awareness is the major reason for late detection.

Breast cancer is the most common cancer in women in India, 27% of all cancers, closely followed by cervical cancer at 22%. Incidence of and death due to BC is more than that due to cervical cancer. BC is rising at a rapid rate. By 2030, the number of BC cases will rise to about 200,000 a year and deaths to about 100,000 a year. India has the worst survival rate from BC, and the highest number of women dying from BC, in the world. Even if we start a cancer awareness program today, 20-30 years will pass before its effect becomes discernible.

BC was a disease of old age. Twenty-five years ago, 69% of BC patients were above the age of 50. Now 48% are below the age 50; and 20% of them below the age of 40.

Breast cancer cannot be prevented. But BC incidence can be reduced by a few simple lifestyle changes; and the survival rate can be improved by early detection.

WHAT IS CANCER ?

Our body is composed of many different types of cells. These cells grow and divide in a controlled manner to produce more cells as required by the body. Also, the older cells and the damaged cells die.

However, sometimes, the genetic material of one cell gets damaged or changed [mutation] and the cell becomes immortal: that is, it will not die. When this ancestor cell divides, its descendant cells are also immortal. This gives rise to a limitless number of immortal descendant cells. The number of cells is far in excess of what the body needs. The extra cells then form a mass that is called a tumour.

These immortal cells are called cancer cells. The cancer cells are: immortal; capable of limitless division, and thus of limitless growth in the number of cells; and capable of spreading [Metises] to other parts of the body through blood and lymph system.

There are more than 100 types of cancers. Not all cancers form tumours: cancers of the blood and the bone-marrow [leukaemia], for example, do not form tumours.

Most cancers are named for the body part in which they begin: colon cancer, prostate cancer, ovarian cancer, breast cancer and so on.

WHAT IS BREAST CANCER ?

Breast consists of lobules (milk producing glands), ducts (tiny tubes that carry the milk from lobules to the nipple) and blood and lymphatic vessels.
Breast cancer is a malignant tumour that starts in the cells of the breast. It begins in the ducts; sometimes in the lobules; and rarely, in other cells of the breast.

It then spreads through the breast lymph vessels to lymph nodes under the arms and thence to other parts of the body.

WHO IS AT RISK OF BREAST CANCER ?

Every woman is at risk of breast cancer. In India, one in 28 women will get breast cancer. Certain factors increase the risk of BC.

•  AGE. Cancer is a disease of old age: most cancers begin to strike at age 60 and above. But now cancer is also striking, though only rarely as yet, the teenagers. Risk of breast cancer, for example, is about 0.25% for a 30-year old woman but increases to about 11% in a seventy-year old. In different countries, breast cancer risk in a 70-year old is 54% to 154% higher than in a 30-year old. Thus, as longevity has increased, so has the cancer incidence.
• HEREDITARY. If first degree relatives [mother/father/brother/sister] had cancer, the risk of cancer is increased.
• GENETICS. A person can be genetically predisposed to get cancer. A woman who has a family history of breast cancer is statistically more likely to get breast cancer. However, only a small percentage, less than 0.3% of population, is genetically disposed to get cancer. And less than 3-10% of all cancers are because of genetic predisposition. In women with BRCA 1 and BRCA 2, the probability of getting breast and ovarian cancer is more than 75%. Mutations in a few other genes [PTEN, CDH 1, TP 53 etc.] also increase the risk though not as much.
• OBESITY. In obese postmenopausal women breast cancer risk is twice as much as in the non-obese women.
•  DIET. Diet contributes to up-to 80% of cancers of colon, prostate and breast; and also contributes to cancers of pancreas, lung, stomach and esophagus. Alcohol, red meat, sugar increase the risk of cancer.
• SMOKING, night work, no children or child born after age 30, recent use of oral contraceptives (reverts to normal on stopping), HRT, and Chemicals in environment – increase the cancer risk.
•  MENOPAUSE. Late menopause increases the risk.

REDUCING THE RISK

Healthy weight, physical activity – brisk walking, cycling, swimming – 45-60 minutes five or more days a week, Breast feeding, no red meat, less sugar and less alcohol lowers the risk.

Controversy about whether diet rich in whole grains, fruits, vegetables and legumes and low in total fat (butter, oil), more vitamins, Marine Omega 3 fatty acids (found in seafood (e.g. fish oils) and in walnut, seeds, flaxseed oil etc.), and antiperspirants and bras reduce the risk. Abortion and Breast Implants have no effect.

Selective Estrogen Receptor Modulators such as tamofoxien reduce BC risk but increase the risk of thromboembolism and endometrial cancer.
So eat well and exercise and you would have done your bit to reduce your cancer risk.

EARLY DETECTION

Since cancer-prevention is not possible, the saying, “prevention is the cure” is amended to “early detection is the cure.”

Only about 10% of cancer deaths are because of primary tumour. Most of the deaths are because of metastasis – spreading of the cancer to other parts of the body. Once metastasis happens, it is very difficult to treat. Early detection of cancer is therefore of utmost importance.

Several ways of early detection:

1. SELF-EXAMINATION OF BREASTS
More than 80% cancers are detected by women doing self-examination of breasts. The examination should be done every month, 5-7 days after menorrhoea. Do the examination as shown in the three pictures. Look for the following:

• Lumps in breast (less than 20% are cancer) or in lymph nodes in armpits.
• Thickening of breasts
• One breast becoming larger than other
• A nipple changing position or shape or becoming inverted
• Discharge from nipple
• Constant pain in part of breast or armpit
• Swelling beneath the armpit or around the collarbone

In case of palpated anomaly, consult your gynecologist.

The limitations of self-examination are:

• Only 20% women do self-examination of breasts.
• The tumour/changes are large by the time they are felt and this delay in detection can adversely affect the treatment outcome.

2. IMAGING TECHNIQUES
Early detection of cancer is required and is possible by using Imaging Techniques. Six Imaging Techniques are available:

• X-ray (Mammography)
• Ultra sound (Sonography)
• MRI
• Computer Assisted Detection (CAD)
• CT-scan
• PET

A visual inspection by endoscopy can also be done.

• MAMMOGRAPHY.
X-rays examination. Small neoplasmatic tissue formations can be seen.
• SONOGRAPHY
Sonography is done in addition to Mammography to rule out possible cysts and to estimate the size of the tumour. However, tumours smaller than 5 mm cannot be detected.
• MRI
MRI is used to find out if the breast has been affected by more than one tumour.
• COMPUTER ASSISTED DETECTION (CAD)
CAD is used to point out possibly diseased regions. It is used mainly as a second opinion to the report of the doctor.

LIMITATIONS OF IMAGING

• Imaging techniques magnify the tumour much as the magnifying glass magnifies the letters in a book. Normal letter size, called font, is 12. If the font size is halved, that is made 6, you may still be able to identify the letter. But if the font is reduced still further, say to 3 or 4, you will not be able to identify the letter even with the magnifying glass. In a similar way, the imaging techniques cannot identify tumours that are small.
• The QUALITY of cancer is more important than the QUANTITY. A small tumour can be more dangerous than a large tumour. Imaging can tell the quantity of the tumour, that is, its size, but cannot tell the quality of the tumour.

• Most of the time, Imaging cannot even tell whether a tumour is cancerous or not.

CONFIRMING CANCER

The only absolute way to confirm cancer is by biopsy: a small tissue from the tumour is taken and microscopically examined to check for cancer.

TYPES OF BIOPSY

• Punching Biopsy. Done in a locally-sedated state.
• Needle Biopsy. Done with a syringe and a special needle. As painful as venepuncture.
• Advanced Breast Biopsy Instrumentation (ABBI). Done with X-ray to ensure localisation of target. Only a few doctors are experienced in this technique.

Microscopic examination of biopsy is sufficient; but in a few rare cases specialized lab tests are required.

CANCER TREATMENT

Even small localised tumours have the potential of metastasis and therefore need to be treated. The treatment is surgery, medications (hormonal therapy and chemotherapy), radiation and immunotherapy.

Surgery offers the single largest benefit. Used along with chemotherapy and radiation, the local relapse rate is reduced and the overall survival rate may increase.

SURGERY
• Mastectomy: remove whole breast.
• 2Quadrantectomy: remove quarter breast.
• 3Lumpectomy: remove small part of breast.
• Breast Reconstruction Surgery or breast prostheses: to simulate breast.

Neo-adjuvant, that is prior to surgery, and Adjuvant that is after and in addition to surgery, medication is used as part of treatment. For example, Neo-adjuvant use of aspirin may reduce the mortality from Breast Cancer.

Adjuvant Therapies are:

Radiation (negative effect on normal cells) to kill cancer cells in tumour bed and regional lymph nodes that may have escaped surgery. It reduces the risk by 50 – 66 % (i.e., 1/2 to 2/3 reduction of risk). It is confined to region being treated. But only solid tumour can be treated.

Therapies using drugs/agents etc.

• Chemotherapy (negative effect on normal cells). Uses drugs, usually two or more drugs in combination, to destroy cancer cells.
• Targeted Therapy that became available in 1990s that uses drugs that inhibit enzymes.
• Monoclonal Antibody Therapy in which the agent is an antibody
• Immunotherapy that uses patient’s immune systems to fight cancer using drugs.
• Hormone Blocking Therapy. Uses Estrogen Receptors (ER +) Tamoxifen and Progesterone Receptors (PR +) Anastrozole that block the receptors.

Experimental Cancer Treatment
1. Gene Therapy
2. Ultrasound Energy.

Alternative Medicine.

Patients with good prognosis are offered less invasive treatment – e.g. lumpectomy + radiation + hormone.
Patients with poor prognosis are offered more aggressive treatment – extensive mastectomy + radiation + chemotherapy + adjuvant medication.

TREATMENT SUCCESS RATE

If the cancer is detected early, that is at Stage 1, prognosis is excellent and usually chemotherapy is not required.

If detected in Stage 2 & 3 prognosis is progressively poorer with a greater risk of recurrence. Surgery, chemotherapy, and radiation are required.

If detected in Stage 4, that is metastatic cancer (spread to distant sites), prognosis is poor. Surgery, radiation, chemotherapy, and targeted therapies are used. But the 10-year survival rate is 5% without treatment and 10 % with optimal treatment.

In India, more than 60% of the BC’s are diagnosed at stage III or IV. Hence the low survival rate.

For Consultation with Best Gynecologist in Delhi  contact us : +91-9999886583, +91-9999889464

PSYCHOLOGICAL AND EMOTIONAL ASPECTS

Cancer patients need psychological and emotional support. Besides the family, such support can be provided by support groups who are trained and experienced in providing such support. ‘Cancer Sahyog’ is one such support group in India.

CONCLUSION

Cancer is a 3200 year old disease. It is endogenous, a part of life-process. So it can neither be eradicated, nor prevented, nor cured.

As yet.

Over the past 2000 years, the survival rate for many cancers has improved dramatically: life expectancy increased by 20-30 years. But for a few other cancers – metastatic pancreas cancer, metastatic breast cancer, in-operable gallbladder cancer – improvement has been marginal: life extended by just a few months.

Late detection of cancer is fatal. The causes for late detection are many but lack of awareness is the principal cause. Other main causes are: patient being shy, social stigma and doctors’ ignorance because of which the treatment is delayed. An awareness program with Best Gynecologist in Delhi will address all these issues.

Present state of our knowledge makes us believe that cancer prevention or cure is not possible because cancer is a product of the processes essential to the life process.

Will some radical discovery in the future make cancer prevention and cure possible? We don’t know. But we can always hope.

Because as Richard Clauser, Director, National Cancer Institute, USA, says about the future of cancer cure, “There are far more good historians than there are prophets.”

REFERENCES

1. India still has a low breast cancer survival rate of 66%: study: For every 2 women newly diagnosed with breast cancer, one woman dies of it in India https://www.livemint.com/Science/UaNco9nvoxQtxjneDS4LoO/India-still-has-a-low-breast-cancer-survival-rate-of-66-st.html
2. Epidemiology of breast cancer in Indian women: Breast cancer epidemiology: https://www.researchgate.net/publication/313545712_Epidemiology_of_breast_cancer_in_Indian_women_Breast_cancer_epidemiology
3. Epidemiology of breast cancer in Indian women
https://www.ncbi.nlm.nih.gov/pubmed/28181405
4. BREAST CANCER INDIA
Correct information is .. half the war won already
http://www.breastcancerindia.net/statistics/trends.html
5. Breast Cancer Survival Rates
https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/breast-cancer-survival-rates.html
6. The Top 5 Cancers Affecting Women Top 5 Cancers Affecting Women
https://www.everydayhealth.com/womens-health/cancers-affecting-women-today.aspx https://www.everydayhealth.com/womens-health/cancers-affecting-women-today.aspx https://www.everydayhealth.com/womens-health/cancers-affecting-women-today.aspx
7. The Emperor of All Maladies: A Biography of Cancer – a book by Siddhartha Mukherjee, a physician and oncologist. Available at Amazon and at Flipcart