Tests used to screen for Colorectal Cancer

The tests used to screen for colorectal cancer are described below:

Colonoscopy. This test allows the doctor to look inside the entire rectum and colon while a patient is sedated. A flexible, lighted tube called a colonoscope is inserted into the rectum and the entire colon to look for polyps or cancer. During this procedure, a doctor can remove polyps or other tissue for examination (see biopsy in theDiagnosis section). This is the only screening test that allows the removal of polyps, which can also prevent colorectal cancer.

Computed tomography (CT or CAT) colonography. CT colonography, sometimes called virtual colonoscopy, is a screening method being studied in some centers. It requires interpretation by a skilled radiologist, a doctor who specializes in obtaining and interpreting medical images, to be used to the best advantage. However, it may be an alternative for people who cannot have a standard colonoscopy due to the risk of anesthesia, which is medication to block the awareness of pain, or if a person has a blockage in the colon that prevents a full examination.

Sigmoidoscopy. A sigmoidoscope is a flexible, lighted tube, and it is inserted into the rectum and lower colon to check for polyps, cancer, and other abnormalities. During this procedure, a doctor can remove polyps or other tissue for later examination. The doctor cannot check the upper part of the colon, the ascending and transverse colon, with this test. If polyps or cancer is found using this test, a colonoscopy to view the entire colon is recommended.

Fecal occult blood test (FOBT). This is a test used to find blood in the feces, or stool, which can be a sign of polyps or cancer. A positive FOBT test, meaning that blood is found in the feces, can be from causes other than a colon polyp or cancer, including bleeding in the stomach or upper GI tract and even ingestion of rare meat or other foods. There are two types of tests: guaiac and immunochemical. Polyps and cancers do not bleed continually, so the FOBT must be done on several stool samples each year and should be repeated yearly. Even then, the reduction in deaths from colorectal cancer is fairly small at around 30% if done yearly and 18% if done every other year.

Double contrast barium enema (DCBE). For patients who cannot have a colonoscopy, an enema containing barium is given, which helps the outline of the colon and rectum stand out on x-rays. A series of x-rays is then taken of the colon and rectum. In general practice, most doctors would recommend other screening tests because a barium enema is less likely to detect precancerous polyps than a colonoscopy, sigmoidoscopy, or CT colonography.

Stool DNA tests. This test analyzes the DNA from a person’s stool sample to look for cancer. It uses changes in the DNA that occur in polyps and cancers to determine whether a colonoscopy should be done.

Screening Recommendations

Different organizations have made different recommendations for colorectal cancer screening. Two sets of recommendations are described below. Talk with your doctor about the best test and time between tests based on your health history and personal cancer risk.

The following tests detect both polyps and cancer:

• Flexible sigmoidoscopy, every five years
• Colonoscopy, every 10 years
• DCBE, every five years
• CT colonography, every five years

These tests primarily detect cancer:

• Guaiac-based FOBT, every year
• Fecal immunochemical test, every year
• Stool DNA test, as often as your doctor recommends
  
  
  
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Uterine Cancer Symptoms & Treatment : Best Cancer Hospitals in India

Endometrial Cancer (Uterine Cancer)

The most common cancer of a reproductive system of a woman is known as uterine cancer. This cancer starts in cell layers that form the lining of the uterus. This cancer can be detected in its early stage as it causes abnormal vaginal bleeding. The surgical removal of the uterus can cure uterine cancer.

Types of Uterine Cancer :- 

Sarcoma: Sarcoma cancer grows in the supporting tissues of the uterine glands or in the myometrium. This cancer accounts for 2-4% of uterine cancers.

Adenocarcinoma: This cancer is considered as the main type of uterine cancer that grows from the cells in the uterus lining. Endometrial cancer is the other name of this cancer.

The Symptoms of Uterine Cancer include :

• Unusual Vaginal Bleeding or Discharge
• Trouble Urinating
• Pelvic Pain
• Pain during sexual intercourse
• Discomfort or pain in the lower abdomen

Diagnosis of Endometrial Cancer (Uterine Cancer)

A pelvic exam is performed by the doctors checking the vagina, uterus, ovaries, bladder, and rectum for Endometrial Cancer (Uterine Cancer). An instrument called a speculum is used to widen the vagina so the doctor can see the upper portion of the vagina and the cervix.

The Pap Smear test is often performed during a pelvic exam Endometrial Cancer (Uterine Cancer). The doctor uses a wooden scraper (spatula) or small brush to collect a sample of cells from the cervix and upper vagina. The cells are then sent to a medical laboratory to be checked for abnormal changes. Because uterine cancer begins inside the uterus, it may not show up on a Pap test, which examines cells from the cervix.

A biopsy may be needed for a definitive diagnosis where the doctor removes a sample of tissue from the uterine lining. In some cases, a woman may require a dilation and curettage (D&C), which is usually a day care procedure. During a D&C, the opening of the cervix is widened and the doctor scrapes tissue from the lining of the uterus. A pathologist examines the tissue to check for cancer cells, hyperplasia, or other conditions.

Common Endometrial Cancer (Uterine Cancer) Symptoms

•   Abnormal bleeding- heavy bleeding between periods, or heavy bleeding  during irregular periods
•    Pain during intercourse, pelvic pain or pain in the legs or back
•    Difficulty urinating or pain during urination
•    Enlarged uterus , Vaginal discharge and or unexplained weight loss

Surgical Treatment of Endometrial Cancer (Uterine Cancer)

Surgery is the best option when Endometrial Cancer (Uterine Cancer) is diagnosed in its very early stages. At this time, the location and the stage of cancer make removal easy. Sometimes patients are treated with a combination of surgery and radiation therapy. Laparoscopy Assisted Vaginal Hysterectomy - involves the minimally invasive or open surgery to remove the uterus. If required teh surgeon may decide to remove both ovaries and the fallopian tubes if there is a risk of Endometrial cancer spread to the ovaries. 

In most cases, uterine cancer is an Adenocarcinoma that metastasizes late, usually from the endometrium to the cervix, ovaries, fallopian tubes, and other peritoneal structures. It may spread to distant organs, such as the lungs and the brain, through the blood or the lymphatic system. In such cases advanced tratement post Hystrectomy like Chemotherapy and Radiation are advised



Chemotherapy 

Involves modern cancer drugs that are administered intravenously or orally to kill cancer cells and to reduce the chances of the tumour returning elsewhere in the body.


Radiation therapy 

India's leading Cancer hospitals now have some of the world's moset advanced radiation equipment like Linac, Novelis, Gamma Knife and Cyberknife for treating Colon rectal Cancers. High technology radiation is used to kill cancer cells without affecting the healthy tissues. Radiation may be used to reduce the tumor prior to surgery or to obviate the symptoms of colorectal cancer such as pain, bleeding, or blockage.

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Pros and Cons of HIFU Prostate Cancer Treatment in India

HIFU prostate cancer treatment is one of the most rapidly growing treatment methods around the world.

Prostate cancer is one of the most common forms of cancer in men. In the early stages, medication might be used to treat the condition. However, if the cancer tumor spreads, then surgery might be needed.

People dread going for surgery as there are notorious side effects like impotence and urinary incontinence associated with prostate cancer surgeries. But with the introduction of HIFU, things have changed.

HIFU stands for High Intensity Focused Ultrasound. The advantage of using HIFU prostate cancer treatment is that it is very precise and does not come with side effects like with traditional surgery procedures. In this treatment method, high intensity ultrasound waves are used to destroy the cancer cells.

Pros and Cons of HIFU Prostate Cancer Treatment:

Ultrasound waves are focused on the diseased location. The temperature at that location rises up to 90 degree celcius in just a few seconds time. This rapid heating causes the cancer cells to be burned up and destroyed. The success rate of HIFU prostate cancer treatment is similar to other surgeries, but. That is the reason for the suddenly rising popularity of this treatment method.

The patient will not require very long hospital stay. In most cases, he can walk out the same day the operation is performed. In HIFU prostate cancer treatment, the patient is given local anesthetic and then a probe is inserted through his anus. The whole process takes anywhere from 2 to 4 hours. At the end of this, the patient can walk out of the hospital without the enlarged prostate.

However, there are certain downsides to HIFU prostate cancer treatment. First of all, it is very costly. So everybody cannot afford it. Secondly, only those patients can be treated whose cancer has not spread outside of the prostate gland. Another drawback is that this treatment is relatively new and there is not much statistical data yet on its long term success. Although the results published so far have been very promising, there might be some side effects which have not come to light as yet.

For this reason, HIFU prostate cancer treatment is not yet approved in United States by the FDA. It is however approved in various other countries like China, Japan, Mexico, European nations etc. It may take another few years before FDA finally agrees to allow this treatment in USA.

Quite often, patients successfully treated with HIFU might not have required any surgery at all. They might have been perfect candidates for ‘watchful waiting’, in which doctors wait and carefully monitor the growth of prostate cancer before beginning treatment.

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Planning Treatment for Breast Cancer - Surgery for Breast Cancer

Surgery for breast cancer

Surgery usually involves removing part, or sometimes all, of the breast (mastectomy). The type of operation you have usually depends on the size and position of the cancer. Your surgeon will recommend surgery that keeps as much of the breast tissue and the shape of the breast as possible. This is called breast-conserving surgery. However, in some situations removing all of the breast (mastectomy) is advised. Your doctor and breast care nurse will talk you through your options.

Your surgery may also involve having the lymph nodes in your armpit removed or you may have tests to check the nodes. Sometimes women are given treatment with hormonal therapy or chemotherapy to shrink the cancer before they have surgery.

In early breast cancer, studies show that removing the lump followed by radiotherapy is as effective as a mastectomy. Some women may be asked to choose for themselves which operation to have

Types of surgery for breast cancer include:

·         Wide local excision (lumpectomy)

·         Mastectomy

Wide local excision (lumpectomy)

This is when the cancer and an area of surrounding tissue is removed. It’s called a wide local excision or lumpectomy. This operation removes the affected breast tissue and for most women the appearance of their breast after a lumpectomy is good.

If the lump is very small, a fine wire (guide wire) is used to mark the area to be removed so that the surgeon can find it more easily. The doctor or radiologist will inject some local anaesthetic into the area to numb it before inserting the wire, using x-ray or ultrasound to guide them. 

Occasionally, an operation called a quadrantectomy is done. This removes a larger area of breast tissue. The effect on the appearance of the breast will be more noticeable than after a lumpectomy. The treated breast will be smaller than your other breast and there may be a noticeable dent in it. Women can have surgery to reduce the size of the other breast (mammoplasty) so that both breasts are the same size. 

After these operations you’ll need to have radiotherapy to the remaining breast tissue to destroy any cancer cells that may have been left behind.  

Some women may need to have all of the breast removed (mastectomy). A mastectomy is usually advised if:

·         the lump is large in proportion to the rest of the breast

·         there are areas of cancer in different parts of the breast (multi-focal)

·         there’s widespread DCIS in the breast

·         you’ve previously had radiotherapy to the chest, for example, to treat Hodgkin lymphoma.

Mastectomy

Types of Mastectomy

A mastectomy removes all of the breast tissue. At the same time, you may have a test to check the lymph nodes in your armpit, or have some (or all) of the nodes removed.

A radicalmastectomy is where all the breast tissue, the muscles behind the breast and the lymph nodes in the armpit are removed. It’s only done if the cancer is found in the muscle under the breast. But this type of mastectomy is rarely needed as chemotherapy or hormonal therapy can usually be given before surgery to shrink the cancer. This means a mastectomy that removes only the breast tissue can then be done. 

Breastreconstruction

If you’re having a mastectomy, you’ll usually be offered breast reconstruction at the same time. This is when a new breast shape is formed. Breast reconstruction is very specialised surgery. Surgeons who do this type of operation may be plastic surgeons or oncoplastic surgeons, who are trained in both breast cancer surgery and reconstruction surgery.

Different techniques are used – for example, muscle from the back or the tummy area, or a silicone implant can be used. Some women may decide not to have it done immediately – it can be done months or even years after a mastectomy.

Medworld India offers comprehensive care for patients with Breast Cancer, including advanced diagnosis, best treatment options . A team of Surgical Oncologists, Radiation Oncologists, Medical Oncologists, Urologists, Rehabilitation team and other medical specialties work together to treat each Breast Cancer patient We consider each patient's type and extent of Breast Cancer to recommend the most appropriate treatment plan. They also carefully consider and select the treatment option that will allow the patient to maintain quality of life with good survival rate.

Why should you choose to get Indian hospitals offer the Best Cancer Treatment in India at affordable prices. MedWorld india associated Best Cancer Treatment Hospitals in India have the latest technology and infrastructure to offer the Most Advanced Cancer Treatment at low cost.;

At MedWorld India Affiliated Best Cancer Hospitals are to deliver highest quality and advanced oncology care in a supportive and compassionate environment to all our patients, and to advance the treatment and prevention of cancers through innovative research.

MedWorld India Affiliated Best Cancer Hospitals in India offer:

·         World class results for Cancer Treatment

·         World Class equipment for investigations, radiotherapy and surgery

·         Cancer specialists with great qualifications and experience

·         India has many super specialists ( specialization in one particular area: Breast Cancers, Stomach Cancers, Prostate Cancers, etc)

·         Low cost of cancer treatment

·         India offers the perfect combination of expertise and economical costs

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MRI Guided Brain Tumor Surgery - Most Advanced Brain Tumor Surgery in India

A brain tumor is a group (mass) of abnormal cells that start in the brain. Primary brain tumors can arise from the brain cells, the membranes around the brain, nerves, or glands.

Tumors can directly destroy brain cells. They can also damage cells by producing inflammation, placing pressure on other parts of the brain, and increasing pressure within the skull. The cause of primary brain tumors is unknown. There are many possible risk factors that could play a role.

Advanced imaging technique now developed to enable Neurosurgeons with intra-operative MRI to aid in the removal of complex and hard-to-access brain tumors during surgery. This new technique relies on a powerful computer system, which assists the surgeon in precisely localizing a lesion, in planning each step of the procedure on the computer screen, and in calculating the ideal access to the tumour before the operation.

This is particularly useful in reaching a tumour located deep inside the brain, areas traditionally considered to be difficult to reach. During the procedure, the computer tracks instrument movement with an extremely high precision, providing the surgeon with total control inside the brain at all times using "real-time" imaging. The surgeon can also check if the tumor has been removed as planned. This improves the outlook for the patient.

“BRAIN SUITE” in India – Amongst very few such facilities worldwide

It is the most advanced Neuro-Surgical Operating Room with high field MR. This system permits the neurosurgeon to have an MRI study on the patient during surgery, and if tumor has remained which was hidden to the human eye, can be detected by special MRI sequences, and can be targeted using neuro navigation (which works on the same principle as the GPS system).

The Brain Suite has two main parts. There is a high-intensity MRI scanner integrated with an image-guided surgical system. The MRI scanner has a wide-bore opening allowing a patient to lie on his or her side. Previously, tumors that could only be accessed from the side of the skull were not easy to scan. This special MRI system lets doctors repeat scans during the operation to get more accurate information on the location, shape and size of the tumor. This minimizes problems associated with brain tumors shifting during excision.

Advantages of Next Generation Technology over Conventional Neurosurgery to Remove Brain Tumor:-

• The surgeon is guided during the surgery by live Advanced New Generation computer assisted MRI and thus knows exactly where tumor ends and normal brain begins.
• Enhanced ability of Neurosurgeon to excise the complete tumor. Less risk of post operative complications. Functional image guidance with MRI allows for accurate, non-invasive preoperative assessment and planning for brain tumor surgery.
• MRI guided Brain Tumor Surgery allows a more complete tumor removal with much less risk to surrounding brain tissue.
• "Inoperable" tumors (inoperable by conventional surgical techniques) can be resected with MRI Guided Brain Tumor Surgery. Frequently, these are deep seated-relatively benign tumors in children and young adults or elderly patients. Many of these tumors can be cured with this most advanced technology.
  
  
  

Leukemia symptoms vary, depending on the type of leukemia. Common leukemia signs and symptoms include

Leukemia is cancer that starts in the tissue that forms blood. To understand cancer, it helps to know how normal blood cells form. Most blood cells develop from cells in the bone marrow called stem cells. Bone marrow is the soft material in the center of most bones. Stem cells mature into different kinds of blood cells. Each kind has a special job

Leukemia symptoms vary, depending on the type of leukemia. Common leukemia signs and symptoms include:

• Fever or chills
• Persistent fatigue, weakness
• Frequent or severe infections
• Losing weight without trying
• Swollen lymph nodes, enlarged liver or spleen
• Easy bleeding or bruising
• Recurrent nosebleeds
• Tiny red spots in your skin (petechiae)
• Excessive sweating, especially at night
• Bone pain or tenderness

Bone marrow

Bone marrow is a spongy material that is found inside the bones, and it produces all of the blood cells. It also produces vital cells called stem cells that can create other specialised cells that carry out essential functions. These specialised cells are of three types:

* Red blood cells which carry oxygen around the body

* White blood cells which help fight infection

* Platelets which help stop bleeding

Acute leukaemia prevents the affected bone marrow from producing stem cells that mature into adult blood cells. Instead it releases numerous immature blood cells called blast cells. The immature white blood cells begin to rapidly disrupt the normal balance of cells in the blood, limiting the presence of red blood cells or platelet cells in the body. This can lead to tiredness and other

symptoms of anaemia, and also increase risk of excessive bleeding. The patient also becomes more vulnerable to infection as the white blood cells are not properly formed and thus ineffective in

fighting bacteria and viruses.

Types of acute leukaemia

There are two main types of white blood cells classified according to the type of white blood cells that are affected by cancer:

Lymphocytes which are mostly used to fight viral infections

Myeloid cells which fight bacterial infections defend the body against parasites and prevent the spread of tissue damage

The two main types of acute leukaemia are:

Acute lymphoblastic leukaemia, which is cancer of the lymphocytes

Acute myeloid leukaemia, which is cancer of the myeloid cells

Acute myeloid leukaemia

It is more common in older people, especially when over 50 years of age, and more common in males than females, though it is not clear why. The causes of acute leukaemia are uncertain, but known risk factors include:

Exposure to high levels of radiation

Exposure to benzene, a chemical that is used in manufacturing and is also found in cigarettes

The lack of healthy blood cells in the blood supply causes most of the symptoms of acute leukaemia, which usually begin slowly before rapidly escalating in severity as the number of blast cells in the blood increases.

Acute lymphoblastic leukaemia

ALL is the most common type of cancer found in children, though it is uncommon on an overall basis. Approximately one in every 2,000 children will develop ALL. The majority of cases develop in the age group of two to five year olds, and 85 per cent develop in children below the age of 15.

Treatment

Treatment for AML involves two stages:

Induction: The aim of the initial stage of treatment is to kill the leukaemia cells in the bone marrow, restore the blood to proper working order and resolve any symptoms that may be present.

Consolidation: This stage aims to kill any remaining leukaemia cells that may be present in the central nervous system.

Treatment for ALL involves three stages:

Induction

Consolidation

Maintenance, which involves taking regular doses of chemotherapy tablets to prevent the leukaemia returning. This seems to be the most effective stage.

Other treatments

The other treatments that are used in some circumstances are:

• Radiotherapy
• Stem cell transplant
• Targeted therapies

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Major factors that may increase your risk of Colon Cancer

Causes and risk factors of colon and rectal cancer

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.

Testsand 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.