Low Cost Colon Cancer Treatment and Surgery in India

Diagnostic tests for colorectal cancer are usually done when:

• The symptoms of colorectal cancer are present

• The doctor suspects colorectal cancer after talking with a person about their health and completing a physical examination

• Screening tests suggest a problem with the colon or rectum

Many of the same tests used to initially diagnose cancer are also used to determine the stage (how far the cancer has progressed). Your doctor may also order other tests to check your general health and to help plan your treatment. Tests may include the following.

Medical history and physical examination The medical history is a record of present symptoms, risk factors and all the medical events and problems a person has had in the past. The medical history of a person's family may also help the doctor to diagnose colorectal cancer. In taking a medical history, the doctor will ask questions about: a personal history of polyps in the colon or rectum inflammatory bowel disease colorectal cancer a family history of colorectal cancer familial adenomatous polyposis hereditary non-polyposis colorectal carcinoma (also known as Lynch syndrome) signs and symptoms Tumour marker tests Tumour markers are substances – usually proteins – in the blood that may indicate the presence of colorectal cancer. Tumour marker tests are used to check a person's response to cancer treatment, but they can also be used to diagnose colorectal cance Colonoscopy A colonoscopy is a procedure that lets the doctor look at the lining of the colon using a flexible tube with a light and lens on the end (an endoscope). A colonoscopy is preferred over a flexible sigmoidoscopy because the entire colon can be checked for polyps or abnormal areas. A colonoscopy is done in a hospital on an outpatient basis. The doctor gently inserts the colonoscope (a type of endoscope) through the anus and slowly moves it into the rectum and colon. The colon is inflated with air to stretch out the lining so the doctor can look at the entire surface. This can be uncomfortable, so drugs are given to help the person relax during the procedure. Biopsy During a biopsy, tissues or cells are removed from the body so they can be tested in a laboratory. The pathology report from the laboratory will confirm whether or not cancer cells are present in the sample and may also identify the type of cancer. A biopsy is the only definite way to diagnose colorectal cancer. Biopsies of polyps or abnormal areas are taken during a sigmoidoscopy or colonoscopy. A biopsy sample will allow the doctor to find out the type of colorectal cancer and the grade. Biopsy results may also show how far the cancer has grown through the wall of the colon or rectum. Computed tomography (CT) scan A CT scan uses special x-ray equipment to make 3-dimensional and cross-sectional images of organs, tissues, bones and blood vessels inside the body. A computer turns the images into detailed pictures. It is used to: check if the cancer has spread to other organs in the abdomen or pelvis (small areas of spread [microscopic spread] may not be detected by CT scan) check if the cancer has spread to the lymph nodes in the abdomen check how far the tumour has grown into the wall of the colon or, especially, the rectum CT-guided needle biopsy CT scans may also be used to help guide a needle to perform a biopsy (CT-guided needle biopsy) to check for cancer cells in a tumour in the colon or a suspected area of metastasis (cancer spread outside of the colon or rectum). Virtual colonoscopy Virtual colonoscopy uses a CT scan to create images of the colon without having to insert an endoscope through the rectum. A virtual colonoscopy is less invasive and more comfortable than a regular colonoscopy. Studies are continuing to examine the effectiveness of this test.  Ultrasound Ultrasound uses high-frequency sound waves to make images of structures in the body. Endorectal ultrasound (EUS or ERUS) uses a special instrument (transducer) that is inserted into the rectum. It is used to see: how far a tumour has grown into the rectal wall if the tumour has spread to nearby organs or lymph nodes Abdominal ultrasound may be done to see if the cancer has spread to other organs in the abdomen, such as the liver. Pelvic ultrasound may be done if doctors suspect that the cancer has spread to the urinary tract. An ultrasound may also be used during abdominal surgery. The surgeon can place the transducer directly on the liver to check for metastases. Positron emission tomography (PET) scan A PET scan uses radioactive materials (radiopharmaceuticals) to detect changes in the metabolic activity of body tissues. A computer analyzes the radioactive patterns and makes 3-dimensional colour images of the area being scanned. PET scans are not routinely used to diagnose colorectal cancer. They are more commonly used to help stage and check for recurrent disease if a person's CEA level starts to rise following treatment. PET scans are not readily available at all centres. For more information visit:          http://www.medworldindia.com                           https://www.facebook.com/medworld.india Please scan and email your medical reports  to us at care@medworldindia.com and we shall get you a Free Medical Opinion from India’s Best Doctors. Call Us : +91-9811058159 Mail Us : care@medworldindia.com

Bone Marrow Transplant at World Best Hospitals in India

A large number of foreign patients now come to India for Live Related Organ Transplant Surgery like Kidney Transplants, Liver Transplants and Bone Marrow Transplants. Organ Transplantation is a very complex surgical specialty and requires very high degree of Clinical skills and Medical Technology and Infrastructure. India has now become the most preferred destination for organ transplant procedures. These include Liver, Kidney and Bone marrow transplant surgeries. .Not only the cost is low; the success rate of organ transplant in India is at par with the world's best success rate for organ transplant.
Since Organ Transplantation is a very complex surgical specialty and requires very high degree of Clinical skills and Medical Technology, and Indian surgeons and healthcare has proven its competence, there has been a great surge in the number of medical tourists coming to India for various organ transplants. The Infrastructure and technology used at these best organ transplant hospitals in India is the most sophisticated technology available in the world, which results in better patient recovery, higher success rate, low cost and convenience to the patient.

Bone Marrow Transplant
Stem cells produce red blood cells, white blood cells, and platelets. In some cases, stem cells in your bone marrow may not be functioning well or need to be destroyed to help treat a disease. If this happens, you will need new stem cells.
During this procedure, healthy stem cells are taken from a donor's:·         Bone marrow (bone marrow transplant or BMT)
·         Blood (peripheral blood stem cell or PBSC)


The stem cells will be injected into your vein. The new cells travel through the bloodstream to your bone cavities. It may take about a month for the donor stem cells in the bone marrow to begin to function fully. If the transplant is successful, new bone marrow cells will produce healthy red blood cells, white blood cells, and platelets.

Stem cell transplantation may be done using:·         Stem cells that were taken from your own bone marrow or blood and stored
·         Stem cells from a donor

How Bone Marrow Transplant would be donePrior to procedure the donor will be carefully tested to check for diseases. Both you and the donor will be tested to ensure that your tissues are compatible. In order for the transplant to be successful, certain markers, called HLS types, on the blood cells and bone marrow cells must match.

As the recipient, you will be given medicines to suppress your immune system. This is to prevent your body from rejecting the donor stem cells. In the weeks prior to the transplant, you may have to have:
·Chemotherapy
·Radiation therapy



This process is called "conditioning." It will rid the body of diseased cells and clear the bone marrow cavities for the new bone marrow.

If the stem cells will be from the donor's bone marrow (BMT), the doctor will clean an area of the donor's hip. A hollow needle and     syringe will be used to remove the bone marrow.The doctor will make several small punctures. This is to harvest enough bone marrow for the transplant (1-2 quarts). Lastly, the wounds will be covered with bandages.
If the stem cells will be from the donor's blood (PBSC), the doctor will stick a needle in the donor's large vein or veins in the arms. A machine will receive blood from the vein. This machine will spin the blood so that the stem cells are concentrated. The rest of the blood will be given back to the donor. The doctor will cover the puncture wounds with bandages. This procedure may require more than one blood donation. The donor may also be required to take pills that cause more stem cells from the bone marrow to go into the blood.
The donated stem cells will be filtered. Next, the doctor will administer the cells through a small, flexible tube, called a catheter, into one of your large veins.
Immediately after procedure the donor will recover quickly. You, the recipient, will be placed in isolation. This is to avoid infection until the new stem cells in the bone marrow begin to produce infection-fighting cells.

Recovery
The new bone marrow normally takes almost a year in order to function normally. During this period the patient is to be monitored closely to identify any infections or complications that may develop. The recovery process continues for several months or longer after discharging from the hospital, during which time the patient cannot return to work or many previously enjoyed activities.

MedWorld India Affiliated Hospitals in India the Leading Destination for Organ Transplant Surgery
·         Indian doctors are known all over the world for their skill and knowledge and have the experience of studying and working at the best hospitals in the world.

·         India's leading liver transplant centre conducts perhaps the world's highest number of liver transplants (16 to 18 every month)
·         The hospital has a special centre for liver diseases amongst children and liver transplants for children . Highly skilled surgical teams with vast experience and excellent track record of doing largest numbers of Live related donor kidney and liver transplants with survival rates comparable to world's best centers.
·         Most advanced Technology Infrastructure - Blood Bank with 24 hour apharesis facility, advanced laboratory and microbiology (infection control) support, advanced cardiology, DSA and interventionalradiology, portable and colour ultra-sonology, Liver Fibro-scan, 64 slice CT scanner, 3 T MRI, PET-CT and nephrology (including 24 hour dialysis and CVVHD) facilities. Organ Transplant Hospitals in India are now equipped with the latest and high end technology


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Advantages of Robotic Prostate Surgery over the Conventional Prostate Cancer Surgery

A boon for Prostate Cancer patients - Advanced Robotic Prostate Surgery is now preferred choice for Prostate Cancer patients due to following Unmatched advantages

• Minimal Bleeding
• Much quicker recovery
• Reduced hospital stay
• Lesser pain killer requirements
• Lower blood transfusion rates
• Improved preservation of physical appearance
• Three (3) D vision enables surgeon to perform Prostate excision with Cancer
• Control without risk of Post Surgery Continence (control over urinary and
• fecal discharge) and causing Impotency

What is Da Vinci master slave Robotic System?

Da Vinci master slave robotic system is used to completely eradicate cancer with minimal side effects for treating Prostate Cancer. Through this system a minimally invasive robot assisted radical prostatectomy technique has been developed in which doctors evolved a unique sequence of surgical steps.

The Da Vinci is a sophisticated master-slave robot that incorporates 3-D high definition visualization, scaling of movement, and wristed instrumentation. The operations with the Da Vinci System are performed with no direct mechanical connection between the surgeon and the patient. The surgeon is working a few feet away from the operating table, while seated at a computer console with a three-dimensional view of the operating field.

 How it is  performed ?

Robotic Prostatectomy, also known as Robotic surgery for prostate cancer or da Vinci Prostatectomy is a minimally invasive surgery that is now the preferred approach for removal of the prostate in those diagnosed with organ-confined prostate cancer. The da Vinci Prostatectomy may be the most effective, least invasive prostate surgery performed today. Though any diagnosis of cancer can be traumatic, the good news is that if your doctor recommends prostate surgery, the cancer was probably caught early. And, with da Vinci Prostatectomy, the likelihood of a complete recovery from prostate cancer without long-term side effects is, for most patients, better than it has ever been.

The operation is performed using the daVinci Surgical system and 3-D endoscopic and wristed instruments inserted through 5-6 small incisions across the mid-abdomen

Unbeatable Advantages of Robotic Prostate Surgery over the Conventional Prostate Cancer Surgery
1) Usually in conventional approach, surgeons make decisions using tactile and visual cues to identify a phenomenon, which is actually microscopic which is likely to damage nerves or to leave cancer behind. In the Advanced Robotic Technique (ART) surgeons uses a sophisticated mastr slave robot that incorporates 3-D high definition vision, scaling of movement and wristed instrumentation that gives him the ability to perform Prostate excision with minimal risk of leaving the cancer behind and also minimal bleeding and post operative risk of incontinence and impotence.

2) Neither clinical nor imaging tests are sensitive enough to capture a tumour at T3 stage where it has become locally advanced and a risk for spreading to other body parts. Sometimes it is difficult for surgeons to find a precise plane between the cancer and urinary sphincter or the nerves and err on the side of cancer safety leading to incontinence or Impotence Da vinci robot system minimizes side effects thereby greater control for the patient over urinary discharge i.e. continence and return to normal sexual function after the surgery.

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Latest and Advanced Treatment options for Brain Tumor in India

There are many different types of brain tumors. They are usually categorized by the type of cell where the tumor begins, or they are also categorized by the area of the brain where they occur. 

The most common types of brain tumors include the following:

• Gliomas. The most common type of primary brain tumor is a glioma. Gliomas begin from glial cells, which are the supportive tissue of the brain. There are several types of gliomas, categorized by where they are found, and the type of cells that originated the tumor. The following are the different types of gliomas:
  
  
• Astrocytomas. Astrocytomas are glial cell tumors that are derived from connective tissue cells called astrocytes. These cells can be found anywhere in the brain or spinal cord. Astrocytomas are the most common type of childhood brain tumor, and the most common type of primary brain tumor in adults. Astrocytomas are generally subdivided into high-grade, medium-grade, or low-grade tumors. High-grade astrocytomas (glioblastomas) are the most malignant of all brain tumors. Astrocytomas are further classified for presenting signs, symptoms, treatment, and prognosis, based on the location of the tumor. The most common location of these tumors in children is in the cerebellum, where they are called cerebellar astrocytomas. These people usually have symptoms of increased intracranial pressure, headache, and vomiting. There can also be problems with walking and coordination, as well as double vision. In adults, astrocytomas are more common in the cerebral hemispheres (cerebrum), where they commonly cause increased intracranial pressure (ICP), seizures, or changes in behavior.
  
  
• Brain stem gliomas. Brain stem gliomas are tumors found in the brain stem. Most brain stem tumors cannot be surgically removed because of the remote location and delicate and complex function this area controls. Brain stem gliomas occur almost exclusively in children; the group most often affected is the school-age child. The child usually does not have increased intracranial pressure (ICP), but may have problems with double vision, movement of the face or one side of the body, or difficulty with walking and coordination.
  
  
• Ependymomas. Ependymomas are also glial cell tumors. They usually develop in the lining of the ventricles or in the spinal cord. The most common place they are found in children is near the cerebellum. The tumor often blocks the flow of the CSF (cerebral spinal fluid, which bathes the brain and spinal cord), causing increased intracranial pressure. This type of tumor mostly occurs in children younger than 10 years of age. Ependymomas can be slow growing, compared to other brain tumors, but may recur after treatment is completed. Recurrence of ependymomas results in a more invasive tumor with more resistance to treatment. Two percent of brain tumors are ependymomas.
  
  
• Optic nerve gliomas. Optic nerve gliomas are found in or around the nerves that send messages from the eyes to the brain. They are frequently found in children who have neurofibromatosis, a condition a child is born with that makes him or her more likely to develop tumors in the brain. People usually experience loss of vision, as well as hormone problems, since these tumors are usually located at the base of the brain where hormonal control is located. These are typically difficult to treat due to the surrounding sensitive brain structures.
  
  
• Oligodendrogliomas. This type of tumor also arises from the supporting cells of the brain. They are found commonly in the cerebral hemispheres (cerebrum). Seizures are a very common symptom of these tumors, as well as headache, weakness, or changes in behavior or sleepiness. These tumors have a better prognosis than most other gliomas, but they can become more malignant with time. About two percent of brain tumors are oligodendrogliomas.
  
  
• Metastatic tumors. In adults, metastatic brain tumors are the most common type of brain tumors. These are tumors that begin to grow in another part of the body, then spread to the brain through the bloodstream. When the tumors spread to the brain, they commonly go to the part of the brain called the cerebral hemispheres, or to the cerebellum. Often, a patient may have multiple metastatic tumors in
  several different areas of the brain. Lung, breast, and colon cancers frequently travel to the brain, as do certain skin cancers. Metastatic brain tumors may be quite aggressive and may return even after surgery, radiation therapy, and chemotherapy.
  
  
• Meningiomas. Meningiomas are usually benign tumors that come from the meninges, the outer coverings of the brain just under the skull. This type of tumor accounts for about one third of brain tumors in adults. They are slow growing and may exist for years before being detected. Meningiomas are most common in older patients, with the highest rate in people in their 70s and 80s. They are commonly found in the cerebral hemispheres just under the skull. They usually are separate from the brain and can sometimes be removed entirely during surgery. They can, however, recur after surgery and certain types can be malignant.
  
  
• Schwannomas. Schwannomas are usually benign tumors, similar to meningiomas. They arise from the supporting cells of the nerves leaving the brain, and are most common on the nerves that control hearing and balance. When schwannomas involve these nerves, they are called vestibular schwannomas or acoustic neuromas. Commonly, they present with loss of hearing, and occasionally loss of balance, or problems with weakness on one side of the face. Surgery can be difficult because of the area of the brain in which they occur, and the vital structures around the tumor. Occasionally, radiation (or a combination of surgery and radiation) is used to treat these tumors.
  
  
• Pituitary tumors. The pituitary gland is a gland located at the base of the brain. It produces hormones that control many other glands in the body. These glands include the thyroid gland, the adrenal glands, the ovaries and testes, as well as milk production by pregnant women, and fluid balance by the kidney. Tumors that occur in or around the area of the pituitary gland can affect the functioning of the gland, or overproduce hormones that are sent to the other glands. This can lead to problems with thyroid functioning, impotence, milk production from the breasts, irregular menstrual periods, or problems regulating the fluid balance in the body. In addition, due to the closeness of the pituitary to the nerves to the eyes, patients may have decreased vision.

Tumors in the pituitary are frequently benign, and total removal makes the tumors less likely to recur. Since the pituitary is at the base of the skull, approaches for removal of a pituitary tumor may involve entry through the nose or the upper gum. Certain types of tumors may be treated with medication, which, in some cases, can shrink the tumor or stop the growth of the tumor.

• Primitive neuroectodermal tumors (PNETs). PNETs are much more common in children than in adults. They can occur anywhere in the brain, although the most common place is in the back of the brain near the cerebellum. When they occur here, they are called medulloblastomas.      The symptoms depend on their location in the brain, but typically the patient experiences increased intracranial pressure. These tumors are fast growing and often malignant, with occasional spreading throughout the brain or spinal cord.
  
  
• Primary CNS lymphoma. Lymphocytes are carried in lymph fluid in and out of the brain. A CNS tumor occurs when these cells turn malignant. A weakened immune system may increase the risk of this tumor.
  
  
• Medulloblastomas. Medulloblastomas are one type of PNET that are found near the midline of the cerebellum. This tumor is rapidly growing and often blocks drainage of the CSF (cerebral spinal fluid, which bathes the brain and spinal cord), causing symptoms associated with increased ICP. Medulloblastoma cells can spread (metastasize) to other areas of the central nervous system, especially around the spinal cord. A combination of surgery, radiation, and chemotherapy is usually necessary to control these tumors.
  
  
• Craniopharyngiomas. Craniopharyngiomas are benign tumors that occur at the base of the brain near the nerves from the eyes to the brain, and the pituitary gland. These tumors are more common in children and comprise only about 1% of all brain tumors diagnosed in the U.S. Symptoms include headaches, as well as problems with vision. Hormonal imbalances are common, which may lead to poor growth in children. Symptoms of increased intracranial pressure may also be seen. Although these tumors are benign, they are hard to remove due to the sensitive brain structures that surround them.
  
  
• Pineal region tumors. Many different tumors can arise near the pineal gland, a gland that helps control sleep and wake cycles. Gliomas are common in this region, as are pineal blastomas (a type of PNET). In addition, germ cell tumors, another form of malignant tumor, can be found in this area. Benign pineal gland cysts are also seen in this location, which makes the diagnosis difficult between what is malignant and what is benign. Biopsy or removal of the tumor is frequently necessary to tell the different types of tumors apart. People with tumors in this region frequently experience headaches or symptoms of increased intracranial pressure. Treatment depends on the tumor type and size.
  
  
  Latest and Advanced Treatment options for
  
  Brain Tumor in India
  
  
  Brain Tumor is no more a scary health condition as modern technology and advanced surgical modalities now offer near perfect clinical outcomes and the patients can soon return to normal life after surgery.
  
  
  • Brain Suite - Intra-operative MR Navigation Microsurgery
  • Trans-Nasal Endoscopic Removal of brain Tumor through the nose
  • Stereotactic Radiosurgery - Gamma Knife & Novalis TX
  • Tumor Embolization using Neuro Interventional Radiology
  • CyberKnife Radiosurgery

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Alternative Treatments for Prostate Cancer - HIFU

HIFU treatment uses high frequency ultrasound energy to heat and destroy cancer cells in your prostate gland. When high frequency sound waves are concentrated on body tissues, those tissues heat up and die. To use this as a cancer treatment, the specialist targets the area containing the cancer.

HIFU is a great advancement over other prostate cancer treatment options as this technique involves heating only the tumours with a highly focused ultrasound, will mean men can be treated without an overnight stay in hospital and avoiding the distressing side effects associated with current therapies.

If you have an enlarged prostate and your urologist (a doctor who specialises in identifying and treating conditions that affect the urinary system) recommends you for HIFU, you may be offered another type of treatment beforehand to shrink the gland. For example, you may be given hormone therapy, or a procedure called transurethral resection of the prostate.

What are the Alternatives to HIFU ?

The type of treatment you have for prostate cancer depends on whether the cancer has spread, and if so, how much. If you’re invited to take part in a clinical trial for HIFU, your surgeon will make sure you’re aware of the other treatment options that are available.

Alternative treatments for prostate cancer include the following : - 

Watchful waiting – This involves monitoring the cancer, but not treating it unless it grows.

Surgery – Your prostate may be removed using either open or keyhole surgery.

Radiotherapy – This is where radiation is used to destroy cancer cells.

Brachytherapy – This involves having small, radioactive seeds put into your prostate. There is also high-dose rate brachytherapy, in which radiation is put into your prostate for a few minutes at a time.

Cryotherapy – Liquid gas is used to freeze and kill the cancer cells (but is only offered as part of a clinical trial).

Chemotherapy, which uses medicines to destroy cancer cells, and hormone therapy can be used to treat more advanced forms of prostate cancer.

Preparing for HIFU

Your surgeon will explain how to prepare for the procedure.

HIFU is usually done as a day-case procedure under general anaesthesia. This means you will be asleep during the procedure. If you’re having a general anaesthetic, you will be asked to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand. However, it’s important to follow your surgeon’s advice.

Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.

What Happens During HIFU?

HIFU takes up to three hours, but this depends on the size of your prostate and how much of it is being treated. Your surgeon will pass a lubricated probe into your rectum. The probe gives out a beam of ultrasound, which your surgeon will focus so that it heats and destroys the area of prostate tissue where there is cancer. The probe will have a cooling balloon around it to protect nearby areas from the high temperature

Recovering from HIFU

If you’ve been prescribed antibiotics, it’s important to complete the full course. If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen.

World's Most Advanced Medical Treatment in India - Get free Expert Medical Opinion and Treatment Estimate Cost

MedWorld India offer free, no obligation assistance to international patients to find world class medical treatment in India. A large number of people from all over the world are now traveling to India for top class medical treatment like Heart Surgery, Cancer Care, Spinal fusion surgery in India, sleeve gastrectomy surgery in India, and other major surgeries. 

India offers an unmatched cost and quality advantages because it has world class hospitals and globally trained and experienced surgeons across every specialty. Whether you are considering cervical disk replacement surgery, brain tumor surgery in India, heart valve replacement surgery, or prostate cancer treatment in India, we offer support and services to facilitate the care you require. We can help you find the best heart hospital in India, IVF hospital in India, or best cancer hospital in India.

The First step is to email your Medical Reports to us for an opinion from leading doctors in India. We will send you an expert medical opinion and estimate for the cost of your treatment from at least three leading hospitals in India. Once you decide, we help you schedule appointments, apply for a medical Visa and make the arrangements for your stay.

MedWorld India has a team of dedicated doctors who personally attend to all your queries. We are the only facilitators that appoint a personal doctor to the patient from the time of enquiry till the time the patient fully recovers. Your personal doctor will stay in constant contact with you, your local doctor and your medical team in India throughout your stay, and will relay information back to your loved ones. 

From initial registration of interest, to returning the patient back to his or her home country after the procedure and recuperation, MedWorld India will ensure the whole process is as smooth and stress-free as possible for its patients. We believe that timely, affordable and quality medical treatment is every human beings right. We are dedicated to this cause and strive to deliver the benefit and pleasure of medical care to people across the globe.

Our mission at MedWorld India is simple. We want to help you to safely and successfully receive your medical procedure(s) at a world-class healthcare facility for a fraction of the cost elsewhere.

Advantages of MedWorld India

 Top Quality Healthcare services at Low cost

 Save up to 60-80% on medical costs

 Highly Qualified Physicians/Surgeons and Hospital support staff

 Get free Opinion - No charge for consultation

 Guide you to select the Best Hospital and Doctor for your procedure.

 Make all your arrangements for travel

Causes and Risk Factors of Colon and Rectal Cancer

Causes and risk factors 

Age : – About 90 percent of people diagnosed with colon cancer are older than 50. Colon cancer can occur in younger people, but it occurs much less frequently.

A personal history of colorectal cancer or polyps : – If you’ve already had colon cancer or adenomatous polyps, you have a greater risk of colon cancer in the future.

Inflammatory intestinal conditions : – Long-standing inflammatory diseases of the colon, such as ulcerative colitis and Crohn’s disease, can increase your risk of colon cancer.

Inherited disorders that affect the colon : – Genetic syndromes passed through generations of your family can increase your risk of colon cancer. These syndromes cause only about 5 percent of all colon cancers. One genetic syndrome called familial adenomatous polyposis (FAP) is a rare disorder that causes you to develop thousands of polyps in the lining of your colon and rectum.

When to seek medical advice

If you notice any symptoms of colon cancer, such as blood in your stool or a persistent change in bowel habits, see your doctor as soon as possible. Keep in mind that colorectal cancer can occur in younger as well as older people. If you’re at high risk, don’t wait until symptoms appear. See your doctor for regular screenings.

Talk to your doctor about when you should begin screening for colon cancer. Guidelines generally recommend colon cancer screenings begin at age 50. Your doctor may recommend more frequent or earlier screening if you have other risk factors, such as a family history of the disease.

Tests and diagnosis

Screening

Most colon cancers develop from adenomatous polyps. Screening can detect polyps before they become cancerous. Screening may also detect colon cancer in its early stages when there is a good chance for cure.

You may be embarrassed by the screening procedures, worried about discomfort or afraid of the results. Discuss your screening options and your concerns with your doctor. Most procedures are only moderately uncomfortable, and working with a doctor you like and trust can help ease your embarrassment…

Diagnosis 

If your doctor suspects you may have colon cancer based on your signs and symptoms, he or she may recommend colonoscopy to look for colon cancer. Colonoscopy allows your doctor to look for polyps or unusual areas in your colon. Your doctor can also remove a sample of tissue from your colon to look for cancer cells. In some cases, barium enema or flexible sigmoidoscopy may be used to diagnose colon cancer.

Treatments 

The type of treatment your doctor recommends will depend largely on the stage of your cancer. The three primary treatment options are: surgery, chemotherapy and radiation.

• Surgery :Surgery is the mainstay of treatment and involves in block removal of diseased segment with adequate margins, surrounding tissue and lymph nodes. The names given to such resections are right hemicolectomy, transverse colectomy, left hemicolectomy, sigmoid colectomy, and subtotal colectomy
• Polypectomy : If the cancer is found in a polyp (a small piece of bulging tissue), the polyp is often removed during a colonoscopy.
• Local excision : If the cancer is found on the inside surface of the rectum and has not spread into the wall of the rectum, the cancer and a small amount of surrounding healthy tissue is removed.
• Resection : If the cancer has spread into the wall of the rectum, the section of the rectum with cancer and nearby healthy tissue is removed. Sometimes the tissue between the rectum and the abdominal wall is also removed. The lymph nodes near the rectum are removed and checked under a microscope for signs of cancer.
• Pelvic exenteration : If the cancer has spread to other organs near the rectum, the lower colon, rectum, and bladder are removed.

Surgery is the Primary Treatment for Breast Cancer - Best Cancer Hospital in India

Breast Surgery

Surgery is used to:

• potentially cure the cancer by completely removing the tumour

• determine if the cancer has spread to the lymph nodes

• treat a local recurrence of breast cancer

• the size and location of the breast tumour

• the size of the breast itself

• how many areas of cancer there are in the same breast (multifocal disease)

• whether the cancer has spread to the lymph nodes, and the number of lymph nodes involved

• the woman’s overall health

• factors like the woman’s choice of surgery or her ability to travel for treatment

• prior treatments for breast cancer

• breast-conserving surgery (BCS)
  This type of surgery may also be called lumpectomy.

• mastectomy

• sentinel lymph node biopsy

• axillary lymph node dissection

• Compared to the size of the breast, the tumour is small enough that the surgeon can safely remove all the cancer and a margin of healthy tissue around it.
  In some very select situations, chemotherapy is given before surgery to shrink a large breast tumour enough to allow BCS to be done instead of a mastectomy.

• The woman wants to keep as much of her breast as possible.

• If no cancer cells are found in the edges of the removed tissue, it is reported as clear or negative margins.

• If cancer cells are found, it is reported as positive margins.
  
  With positive margins, another operation will need to be done. It will either be another BCS to remove more breast tissue from the same surgical site or a mastectomy. This second operation is needed because cancer left behind after BCS can lead to a recurrence.

• The woman prefers to have a mastectomy.

• The area of cancer is large compared to the size of the breast.

• The tumour has a shape or is in a location that would leave little breast tissue or a deformed breast if BCS was done.

• The cancer is in more than one area of the breast.

• BCS has been done and the tissue removed has cancer cells (positive margins).

• The woman has inflammatory breast cancer.

• The woman has already had radiation therapy to the breast.

• The woman cannot or does not want to have radiation therapy after BCS because:

• A disability or condition (such as arthritis) prevents her from lying flat or stretching out the arm during radiation treatment.

• She has a connective tissue disease called systemic lupus erythematosus (the immune system attacks the body’s own tissue and organs) or scleroderma (thickening and hardening of the skin). These diseases make radiation treatment unsuitable because there is an increased chance of side effects.

• Some women may find it too difficult to go for daily radiation treatments that are needed after BCS or do not want to have to deal with the possible side effects from radiation therapy.

• A pregnant woman may be advised to have a mastectomy because they cannot have radiation therapy to treat breast cancer during pregnancy.

• The breast cancer is very early stage (non-invasive, in situ, stage 0) and has not spread to the surrounding lymph nodes.

• The woman has a high risk of developing breast cancer and wishes to reduce her risk by removing her breasts (prophylactic mastectomy).

The type of surgery done depends mainly on:

The types of surgery for breast cancer are:

The surgeon will discuss possible surgical options and the risks and benefits of each type of procedure. In most cases, a woman will be given the choice between breast-conserving surgery and mastectomy.

Breast-conserving surgery

Breast-conserving surgery (BCS) is an operation that removes the tumour and some of the healthy tissue around it. This type of surgery allows a woman to keep, or conserve, as much of her breast as possible. Often the breast is a little different after BCS, but the changes are often not very noticeable. After surgery, the breast is smaller, slightly different in shape and slightly firmer. In most cases, BCS will be followed by radiation therapy.

BCS is considered an option if:

Procedure for breast-conserving surgery

BCS is most frequently done using general anaesthetic. A cut (incision) is made over or near the breast tumour and the lump or abnormality is removed, along with a margin of healthy tissue.

The skin is closed with stitches (sutures) or special staples and a bandage or dressing covers the wound. Stitches or staples are removed once the incision has healed. Some stitches dissolve on their own.

The removed breast tissue is sent to a laboratory. A pathologist (a doctor who specializes in the causes and nature of disease) examines the edges of the tissue sample for cancer cells.

Mastectomy

A mastectomy is an operation that removes the entire breast. Reconstructive surgery may be done at the same time as a mastectomy or later as a separate surgery.

Mastectomy may be recommended as a treatment option in some cases if:

Types of mastectomy

The 3 different types of mastectomy are:

Total mastectomy

A total mastectomy (simple mastectomy) removes the entire breast, the nipple and the lining over the chest muscles (pectoral fascia). The lymph nodes, nerves and muscle in the chest are left in place.

A total mastectomy may be done if:

If breast reconstruction is being considered at the same time as the surgery to remove the cancer, a skin-sparing mastectomy may be an option for some women. A skin-sparing mastectomy is like a total mastectomy except that it preserves the skin overlying the breast. This allows for breast reconstruction to take place with minimal visible scarring.

Modified radical mastectomy

A modified radical mastectomy removes the entire breast, the nipple, most or all of the lymph nodes in the armpit and the lining over the chest muscles (pectoral fascia). Nerves and muscles are usually left in place.

Radical mastectomy

A radical mastectomy removes the entire breast, the nipple, all of the lymph nodes in the armpit and the muscles in the chest. This type of mastectomy is seldom done anymore. It may be done if a woman has a recurrence of breast cancer in the chest muscles.

Procedure for mastectomy

Mastectomy is done under general anesthetic. One or more drains (plastic or rubber tubes) may be put into the area where the breast was or under the arm to remove blood and lymph fluid that collects during healing. The skin is closed with stitches (sutures) or special staples and a bandage or dressing covers the wound (incision).

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