Categories
Medreads

Pancreatic Cancer

Pancreatic Cancers

Pancreatic cancers are often aggressive cancers and the treatment depends on the extent of spread of the cancer and overall health of the patient. Your doctor will advice you the exact treatment plan after a thorough evaluation and adequate investigations which may include a CT scan, MRCP and even an endoscopic evaluation.

The main stay in the treatment of pancreatic cancer is surgery. Though the surgeries take long hours and involve complex procedures, with advances in anaesthesia, medical and intensive care, and better equipment; these surgeries have now become safe and involve a very low mortality rate. The surgery required depends on the location of the tumor.

 

 

Lesions located in the head of the pancreas are treated by a surgery called the Whipple’s Surgery or Pancreatoduodenectomy. It involves removal of the pancreatic head together with the duodenum, part of the bile duct and the gall bladder. The continuity is then restored by anastomosing the remnant pancreas, the bile duct and finally the stomach to the jejunum.

Lesions located in the body and tail of pancreas are treated by a surgery called as distal pancreatectomy. It involves removal of the body and tail of the pancreas and may involve removal of the spleen as well.

Dr. Sanket Mehta not only performs these surgeries routinely, he also performs distal pancreatic surgery by the laparoscopic approach. His study on laparoscopic distal pancreatic surgery and its advantages has been published in Surgical Endoscopy, the highest rated endoscopy journal.

 

Categories
Medreads

Liver Cancer

Liver Cancers

Liver cancer (hepatocellular carcinoma) is a cancer arising from the liver. It is also known as primary liver cancer or hepatoma. The liver is made up of different cell types (for example, bile ducts, blood vessels, and fat-storing cells). However, liver cells (hepatocytes) make up 80% of the liver tissue. Thus, the majority of primary liver cancers (over 90%-95%) arises from liver cells and is called hepatocellular cancer or carcinoma. 

When patients or physicians speak of liver cancer, however, they are often referring to cancer that has spread to the liver, having originated in other organs (such as the colon, stomach, pancreas, breast, and lung). More specifically, this type of liver cancer is called metastatic liver disease (cancer) or secondary liver cancer. 

This is a much more common problem around the world than primary liver cancer and frequently leads to confusion, because the term liver cancer actually can refer to either metastatic liver cancer or hepatocellular cancer.
What are the Symptoms of Liver Cancer
Most of the time liver cancer in the early stages does not cause symptoms. If symptoms are present, they may include: unexplained weight loss on-going lack of appetite fullness after a small meal a swollen liver or a mass that can be felt in the area of the liver ongoing stomach pain extending to the back and shoulder a swollen abdomen yellow-green color to the skin and eyes (jaundice) increased symptoms of illness in those who have chronic hepatitis or cirrhosis.
Categories
Medreads

Gall Bladder Cancer

Gall Bladder Cancer

The gall bladder is a small pouch that stores and concentrates bile. Bile is a fluid that helps us to digest food. Its main function is to break down fats in food. Bile is made by the liver and stored in the gall bladder. The gall bladder is connected to the small intestine and the liver by the bile ducts.

Cause and Risk Factors

Most of the time liver cancer in the early stages does not cause symptoms. If symptoms are present, they may include:

  • Gall stones and inflammation: Gall bladder cancer is more likely to occur in people who have a history of gallstones or in people who have inflammation of the gall bladder (cholecystitis). However, most people who have gallstones or an inflamed gall bladder won’t develop gall bladder cancers.
  • Polyps: These are non-cancerous (benign) tumours of the gall bladder that increase the risk of developing gall bladder cancer.
  • Abnormal bile ducts: Gall bladder cancer is slightly more common in people who are born with (congenital) abnormalities of the bile ducts.
  • Porcelain gall bladder: People who have a condition called porcelain gall bladder, in which calcium forms in the wall of the gall bladder, also have a slightly increased risk of this type of cancer.
  • Smoking: Some evidence suggests that people who smoke cigarettes are more likely to develop gall bladder cancer.
  • Family history: People who have a close relative (parent, brother or sister) with gall bladder cancer have a slightly higher risk of developing this type of cancer.
  • Obesity: Being overweight increases your risk of developing gall bladder cancer.Early gall bladder cancer often causes no symptoms and is usually discovered unexpectedly when someone has surgery to remove gallstones. About 1 in 5 gall bladder cancers are found in this way.

Most tumours are only discovered at an advanced stage. They can cause a variety of symptoms, including sickness, high temperatures, weight loss and pain in the tummy (abdomen).

If the cancer blocks the bile duct, it may stop the flow of bile from the gall bladder into the small bowel. This causes bile to flow back into the blood and body tissues, and leads to the skin and whites of the eyes becoming yellow (known as jaundice).

The urine also becomes a dark yellow colour and stools (bowel motions) are pale. The skin may become itchy.

These symptoms may be caused by other problems, such as gallstones or infection of the gall bladder, but it’s important to get them checked by your doctor.

Categories
Medreads

Oesophageal Cancer

Oesophageal Cancer

Cancer of the oesophagus is a disease in which malignant cells arise from the tissues of the oesophagus (tube leading to stomach). These eventually grow and obstruct the oesophagus, and spread to other parts of the body, such as the liver. There are two main types of oesophageal cancer: adenocarcinoma and squamous cell carcinoma. Most adenocarcinomas are now thought to arise in Barrett’s mucosa (see Barrett’s Oesophagus). The most common sign of cancer of the oesophagus is difficulty in swallowing (dysphagia). Pain in the chest may be felt when swallowing or at other times. Loss of appetite and weight loss will occur. As the oesophagus becomes obstructed, food which has not passed down the oesophagus may spill over into the lungs (aspiration), causing pneumonia.

Medical Treatment

The decision regarding treatment is complex. There are several options:

  • Surgery to remove the cancer, with intent to cure
  •  Surgery to remove the cancer, to provide palliation (relief)
  • Radiotherapy and chemotherapy (alone or combined with surgery)
  •  Photodynamic therapy (for very early cancers in selected patients)
  • Laser therapy (mainly palliative if the cancer is large)
  •  Stenting (insertion of a tube to prevent the cancer obstructing the oesophagus)

The choice of treatment depends on many factors including the size of the cancer and extent of spread, age and fitness of the patient, and the patient’s wishes. The chance of recovery (prognosis) depends on the stage of the cancer (whether it is in the oesophagus or if it has spread outside to other tissues) and the patient’s general state of health.

Categories
Medreads

Stomach Cancer

Stomach Cancer

Stomach cancer usually begins in cells in the inner layer of the stomach. Over time, the cancer may invade more deeply into the stomach wall. A stomach tumor can grow through the stomach’s outer layer into nearby organs, such as the liver, pancreas, esophagus, or intestine. Stomach cancer cells can spread by breaking away from the original tumor. They enter blood vessels or lymph vessels, which branch into all the tissues of the body. The cancer cells may be found in lymph nodes near the stomach. The cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues. The spread of cancer is called metastasi.

When you’re told that you have stomach cancer, it’s natural to wonder what may have caused the disease. But no one knows the exact causes of stomach cancer. Doctors seldom know why one person develops stomach cancer and another doesn’t. Doctors do know that people with certain risk factors are more likely than others to develop stomach cancer. A risk factor is something that may increase the chance of getting a disease.

Medical Treatment

Studies have found the following risk factors for stomach cancer:

Helicobacter pylori infection: H. pylori is a bacterium that commonly infects the inner lining (the mucosa) of the stomach. Infection with H. pylori can cause stomach inflammation and peptic ulcers. It also increases the risk of stomach cancer, but only a small number of infected people develop stomach cancer.

Long-term inflammation of the stomach:People who have conditions associated with long-term stomach inflammation (such as the blood disease pernicious anemia) are at increased risk of stomach cancer. Also, people who have had part of their stomach removed may have long-term stomach inflammation and increased risk of stomach cancer many years after their surgery.

Smoking:Smokers are more likely than nonsmokers to develop stomach cancer. Heavy smokers are most at risk.

Family history: Close relatives (parents, brothers, sisters, or children) of a person with a history of stomach cancer are somewhat more likely to develop the disease themselves. If many close relatives have a history of stomach cancer, the risk is even greater.

Poor diet, lack of physical activity, or obesity:Studies suggest that people who eat a diet high in foods that are smoked, salted, or pickled have an increased risk for stomach cancer. On the other hand, people who eat a diet high in fresh fruits and vegetables may have a lower risk of this disease. A lack of physical activity may increase the risk of stomach cancer. Also, people who are obese may have an increased risk of cancer developing in the upper part of the stomach. Most people who have known risk factors do not develop stomach cancer. For example, many people have an H. pylori infection but never develop cancer. On the other hand, people who do develop the disease sometimes have no known risk factors.

Categories
Medreads

Breast Cancer

Breast Cancer

The causes of breast cancer are unknown. But certain things called risk factors can affect a woman’s chances of getting breast cancer. Having risk factors doesn’t necessarily mean you will get breast cancer. Some women get it while others (with the same risk factors) don’t.Even though the exact causes of breast cancer aren’t fully known, it’s likely to be caused by a combination of different risk factors rather than just one.

Age:The risk of breast cancer increases with age. It’s rare in women under 35, and 8 out of 10 breast cancers (80%) occur in women aged 50 or over.

Previous cancer and other breast conditions:Women who’ve had breast cancer or other breast conditions in the past may be at a higher risk of developing breast cancer. This includes women who have previously had: breast cancer, including ductal carcinoma in situ (DCIS) lobular carcinoma in situ (LCIS) an over-production of slightly abnormal cells called atypical ductal hyperplasia radiotherapy to the chest to treat Hodgkin lymphoma at a young age dense breast tissue (when the breast is mostly made up of glandular and connective tissue with very little fatty tissue).

SmHormonal factors:Exposure to the hormones oestrogen and progesterone for long, uninterrupted periods can affect your breast cancer risk. Factors that increase this risk include: taking combined hormone replacement therapy (HRT) containing oestrogen and progesterone over several years (if you’re over 50) not having children or having them later in life not having breastfed or breastfeeding for less than a year starting your periods early (under 12) or having a late menopause (after 50) taking the contraceptive pill (but the risk reduces if you stop taking it).

Lifestyle factors: Close relatives (parents, brothers, sisters, or children) of a person with a history of stomach cancer are somewhat more likely to develop the disease themselves. If many close relatives have a history of stomach cancer, the risk is even greater.

Alcohol: Drinking more than two units of alcohol a day over many years can damage your liver. This increases your breast cancer risk because the liver helps to control oestrogen levels.

Your weight: After the menopause, body fat is the main source of oestrogen. So if you’re overweight, the level of oestrogen in your body may be high, increasing your breast cancer risk.

Smoking:Smoking heavily over many years, especially if you started smoking at a young age, increases your risk.

 

 

Categories
Medreads

Neuroendocrine Tumors

Neuroendocrine Tumors

About the endocrine system and endocrine tumors:
The endocrine system consists of cells that make hormones. Hormones are chemical substances that are formed in the body and carried in the bloodstream to have a specific regulatory effect on the activity of other organs or cells in the body. A tumor begins when normal cells begin to change and grow uncontrollably, forming a mass. A tumor can be benign or malignant. A benign tumor is not cancerous and usually can be removed without it causing much harm. A malignant tumor is cancerous and can be harmful if not found early and treated. It can spread to and damage the body’s healthy tissues and organs.
An endocrine tumor is a growth that affects the parts of the body that secrete hormones. Because an endocrine tumor arises from cells that produce hormones, the tumor itself can produce hormones and cause serious illness.
About neuroendocrine tumors:
A neuroendocrine tumor begins in the hormone-producing cells of the body’s neuroendocrine system, which is made up of cells that are a cross between traditional endocrine cells (or hormone-producing cells) and nerve cells. Neuroendocrine cells are found throughout the body in organs, such as the lungs and gastrointestinal tract (such as the stomach and intestines), and perform specific functions, such as regulating the air and blood flow through the lungs and controlling the speed at which food is moved through the gastrointestinal tract.
Categories
Publications

Human papillomavirus infection: Is it associated with epithelial ovarian cancer?

Categories
Publications

Pattern of recurrence after interval cytoreductive surgery and HIPEC following neoadjuvant chemotherapy in primary advanced stage IIIC/IVA epithelial ovarian cancer

Categories
Publications

Distribution of residual disease in the peritoneum following neoadjuvant chemotherapy in advanced epithelial ovarian cancer and its potential therapeutic implications