What are the risk factors for endometrial cancer?

A risk factor is anything that changes your chance of getting a disease such as cancer. Different cancers have different risk factors. For example, unprotected exposure to strong sunlight is a risk factor for skin cancer. Smoking is a risk factor for many cancers.

There are different kinds of risk factors. Some, such as your age or race, can't be changed. Others are related to personal choices such as smoking, exercising, body weight, drinking, or diet. Some factors influence risk more than others. 

Although certain factors increase a woman's risk for developing endometrial cancer, they do not always cause the disease. Many women with one or more risk factors never develop endometrial cancer. Some women with endometrial cancer do not have any known risk factors. Even if a woman with endometrial cancer has one or more risk factors, there is no way to know which, if any, of these factors was responsible for her cancer.

Hormone factors

A woman's hormone balance plays a part in the development of most endometrial cancers. Many of the risk factors for endometrial cancer affect estrogen levels. Before menopause, the ovaries are the main source of the 2 main types of female hormones -- estrogen and progesterone. The balance between these hormones changes during a woman's menstrual cycle each month. This produces a woman's monthly periods and keeps the endometrium healthy. A shift in the balance of these two hormones toward more estrogen increases a woman's risk for developing endometrial cancer. 

After menopause, the ovaries stop making these hormones, but a small amount of estrogen is still made naturally in fat tissue. This estrogen has a bigger impact after menopause than it does before menopause. Female hormones are also available to take (as a medicine) in birth control pills to prevent pregnancy and as hormone therapy to treat symptoms of menopause.

Estrogen therapy

Treating the symptoms of menopause with estrogen is known as estrogen therapy or menopausal hormone therapy. Estrogen is available in many different forms such as pills, skin patches, creams, shots, and vaginal rings to treat the symptoms of menopause. Estrogen treatment can reduce hot flashes, improve vaginal dryness, and help prevent the weakening of the bones (osteoporosis) that can occur with menopause. Doctors have found, however, that using estrogen alone (without progesterone) can lead to endometrial cancer in women who still have a uterus. Progesterone-like drugs must be given along with estrogen to reduce the increased risk of endometrial cancer. This approach is called combination hormone therapy.

Giving progesterone along with estrogen does not cause endometrial cancer, but it does still have risks. Studies have shown that this combination increases a woman's chance of developing breast cancer and also increases the risk of serious blood clots.

Birth control pills

Using birth control pills (oral contraceptives) lowers the risk of endometrial cancer. The risk is lowest in women who take the pill for a long time, and this protection continues for at least ten years after a woman stops taking this form of birth control. However, it is important to look at all of the risks and benefits when choosing a contraceptive method; endometrial cancer risk is only one factor to be considered. It's a good idea to discuss the pros and cons of different types of birth control with your doctor.

Total number of menstrual cycles

Having more menstrual cycles during a woman's lifetime raises her risk of endometrial cancer. Starting menstrual periods (menarche) before age 12 and/or going through menopause later in life raises the risk. Starting periods early is less a risk factor for women with early menopause. Likewise, late menopause may not lead to a higher risk in women whose periods began later in their teens.

Obesity

Most of a woman's estrogen is produced by her ovaries, but fat tissue can change some other hormones into estrogens. Having more fat tissue can increase a woman's estrogen levels, which increases her endometrial cancer risk. In comparison with women who maintain a healthy weight, endometrial cancer is twice as common in overweight women, and more than three times as common in obese women.

Ovarian tumors

A certain type of ovarian tumor, the granulosa-theca cell tumor, often makes estrogen. Estrogen release by one of these tumors is not controlled the way hormone release from the ovaries is, which can sometimes lead to high estrogen levels. The resulting hormone imbalance can stimulate the endometrium and even lead to endometrial cancer. In fact, sometimes vaginal bleeding from endometrial cancer is the first symptom of one of these tumors.

Polycystic ovarian syndrome

Women with a condition called polycystic ovarian syndrome (PCOS) have abnormal hormone levels, such as higher androgen (male hormones) and estrogen levels and lower levels of progesterone. The increase in estrogen relative to progesterone can increase a woman's chance of getting endometrial cancer.

 

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Advanced MR imaging helps in interpretation of Brain Tumours

Advanced MR imaging techniques such as perfusion and functional imaging have been a great help in improving the diagnosis and staging of brain tumours. Unlike conventional MR techniques, advanced MR techniques can be used to obtain information not only on the morphological, but also on the functional characteristics of tumours.

One of the most common types of brain tumour is glioblastoma, which is highly malignant and has a high cell reproduction rate due to the fact that it is nourished by a large network of blood vessels. there are two types of glioblastoma: primary glioblastomas, which tend to form and make their presence known quickly by growing aggressively, and secondary glioblastomas, which are also aggressive but show slower growth and only represent 10% of all diagnoses.

Due to a lack of effective of therapies, the prognosis in cases of glioblastoma remains poor, and so there is an urgent need to find new therapeutic approaches.

One of the reasons why the treatment of glioblastoma is such a challenge is that it consists of various cell types, which may react differently to various forms of treatment. As a result, the treatment, in most cases, combines several methods.

“Overall there is no effective treatment for high-grade glioblastoma. The current therapeutic approaches are surgical resection of the tumour bulk if possible, depending on the location of the tumour, followed by radiation and chemotherapy. One of the main difficulties is that it can be difficult to exactly measure the tumour‘s extent, since malignant tumour cells often infiltrate the brain parenchyma beyond the tumour’s contrast-enhanced portion, which makes it difficult to completely surgically resect the initial tumour .

Radiation and chemotherapy are used to slow the growth of tumours that cannot be removed surgically. Chemotherapy may also be used in young children to delay the need for radiation.

Despite achievements in the field of advanced imaging techniques it still remains difficult to predict and monitor brain tumour response in individual patients, especially when it comes to the use of anti-angiogenic therapies, during which uncommon patterns of tumour response and progression can be seen.

Pseudoprogression for example usually occurs early while treating a brain tumour with radiation and Temodar, which makes the tumour appear to progress due to its increased size and contrast enhancement. This is a common reaction to the treatment, but the lesion will decrease in size and concentration on its own if the initial treatment is continued without any change.

Pseudo-response on the other hand occurs during anti-angiogenic therapy, for example the use of Avastin, which causes significant reduction in contrast enhancement due to changes in vascularity, but should not be mistaken for a real reduction in the extent of the lesion.

“Both can be best detected with advanced MR imaging especially diffusion-weighted imaging, which looks at the random motion of water molecules and perfusion imaging, which studies the cerebral blood volume and cerebral blood flow in the brain, including the tumour. Though MR spectroscopy is less helpful.”

Confusion and incorrect interpretation can, in part, be avoided by having good clinical information about the original tumour type; tumour extent, as seen through MR imaging after contrast administration; current course of chemotherapy treatment; radiation dose; and the time between radiation treatment and imaging findings. It is also helpful to use perfusion and diffusion imaging as part of the MR imaging protocol. The use of PET imaging might also be valuable, as well as a combination of information gained from both modalities.

Despite the fact that the long-term prognosis remains poor, there have been recent studies which have shown an increase in the overall survival rate for glioblastoma patients treated with Avastin .

Especially in recurrent glioblastoma, the treatment options have mainly been limited to high-dose chemotherapy. The administration of Avastin alone or in combination with CPT-11 has shown a significant improvement in response rates, progression-free survival times and overall survival.

A more recent study has shown that Avastin alone was nearly as effective as it was in combination with chemotherapy, but with much milder side effects. When dealing with patients suffering from terminal glioblastoma a stand-alone Avastin therapy may lead to an improvement in quality of life, without the common toxic side effects of chemotherapy.

When asked about whether we need advanced imaging techniques in daily practice, Yes, I strongly advocate the use of advanced MR imaging in the work-up and follow-up of a patient with brain tumour. It is helpful for the radiologist or neuroradiologist to give the correct interpretation and it is helpful for the clinician in the treatment of the patient.

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What You Need to Know About Liver Cancer and Hepatitis B

Worldwide, chronic infection with hepatitis causes 80% of all primary liver cancers and more than 500,000 people die each year from this lethal cancer. Currently, primary liver cancer has a 5-year survival rate of only 10%.

Additionally, there are effective therapies to control and manage chronic hepatitis B infections to help prevent the progression to liver cancer as well.

What is primary liver cancer?

There are two types of cancers found in the liver: (1) Primary liver cancer which originates from the liver (also known as hepatocellular carcinoma or HCC), and (2) Secondary liver cancer which originates in other parts of the body and spreads to the liver. Worldwide, primary liver cancer is the 3rd leading cause of cancer deaths and the primary cause of cancer deaths among men

What is the link between hepatitis B and liver cancer?

The most common risk factor for liver cancer is chronic infection with the hepatitis B virus (HBV). Individuals chronically infected with HBV are 100 times more likely to develop liver cancer than uninfected people because the virus directly and repeatedly attacks the liver, which over time can lead to progressive liver damage and liver cancer.

Alarmingly, with chronic HBV infections on the rise in the United States, there is a growing incidence of primary liver cancer and it has become one of the three fastest growing cancers in the country. While the overall incidence of cancer has stabilized, and in many cases decreased, primary liver cancer is an increasing public health threat and has a five-year survival rate of less than 10% (making it the 2nd deadliest cancer in the U.S.).

What are the risk factors for liver cancer?

The risk for developing liver cancer among those who are chronically infected with HBV increases as a person gets older or if they have been diagnosed with cirrhosis. Although liver cancer most often occurs in the presence of cirrhosis, this is not always the case. Primary liver cancer can occur even in the absence of cirrhosis, which is why regular liver cancer screening is so important.

Additional factors that increase the risk of liver cancer include a family history of liver cancer, persistence of high HBV DNA levels, co-infection with HIV or HCV, and lifestyle choices such as excessive alcohol use and smoking. Studies have also shown that obesity and diabetes may be important risk factors for liver cancer. Liver cancer is more common among men than women regardless of race or ethnicity.

What are the symptoms of liver cancer?

Liver cancer is a silent killer because the majority of patients appear to be perfectly healthy and have no early signs or symptoms. Both small and large tumors may be undetected due to the shielded location of the liver underneath the ribs which does not register pain.

Pain is uncommon until the tumor is quite large. Later stages of liver cancer, when the tumor is very large or when it impairs the functions of the liver, can produce more obvious symptoms such as abdominal pain, weight loss, lack of appetite, weakness and fatigue, and finally the development of jaundice (yellowing eyes and skin) and abdominal swelling. People who experience any of these symptoms should see their doctor immediately for further evaluation.

Who should be screened for liver cancer?

Since liver cancer develops quietly, usually without symptoms, patients with chronic HBV should be screened for liver cancer as part of their routine medical management. For those with chronic hepatitis B, primary liver cancer can develop with or without cirrhosis, so regular screening is essential. Early detection of liver cancer results in more treatment options, which substantially improves the chances of survival after initial diagnosis.

What is liver cancer screening?

Liver cancer screening can be done as part of your regular doctor’s visit and generally consists of a simple blood test for alpha-fetoprotein (AFP) levels every 6 months and an ultrasound of the liver once or twice a year. Either test alone can miss the diagnosis. Some doctors prefer MRI or CT scans to ultrasounds. Once a patient develops cirrhosis, or has a family history of liver cancer, more frequent screening is generally recommended.

Liver Cancer Treatment Options Available at Best Cancer Hospitals in India

The treatment options are dictated by the stage of Liver Cancer and the overall condition of the patient. The treatment to be given depends mainly on the size, number, and site of tumors in the liver. Before planning the appropriate treatment the functioning of the Liver is checked as also the spread of the cancer within and outside the liver is to be tested. The Various treatment options available are as follows:

• Surgery : Surgery is the removal of the tumor and surrounding tissue during an operation. It is likely to be the most successful disease-directed treatment, particularly for patients with small tumors (smaller than 5 cm). A surgical oncologist is a doctor who specializes in treating cancer using surgery.
• Hepatectomy : When a portion of the liver is removed, the surgery is called a Hepatectomy. A Hepatectomy can be done only if the cancer is in one part of the liver, and the liver is working well. The remaining section of liver takes over the functions of the entire liver and may regrow to its normal size within a few weeks
• Liver Transplantation :Liver transplant may be the best option for some people with small liver cancers. At this time, liver transplants are reserved for those with small tumors (either 1 tumor smaller than 5 cm across or 2 to 3 tumors no larger than 3 cm) that have not invaded nearby blood vessels. In most cases, transplant is used for tumors that cannot be totally removed, either because of the location of the tumors or because the liver is too diseased for the patient to withstand removing part of it.
• Chemoembolization:This is a type of chemotherapy treatment in which drugs are injected into the hepatic artery and then the flow of blood through the artery is blocked for a short time so the chemotherapy stays in the tumor longer. Blocking the blood supply to the tumor also kills cancer cells
• Radiation Therapy :Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. A radiation therapy regimen (schedule) usually consists of a specific number of treatments given over a set period of time. External-beam radiation therapy is radiation given from a machine outside the body. External-beam radiation therapy is not often used for HCC.
• Targeted Therapy :Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to normal cells. Recent studies show that not all tumors have the same targets. To find the most effective treatment, your doctor may run tests to identify the genes, proteins, and other factors in your tumor.
  
  
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Simple Blood Test Leads to Early Detection of Lung Cancer

A simple blood test that can be used to diagnose whether people have cancer or not.

Early results have shown the new test gives a high degree of accuracy in diagnosing cancer and pre-cancerous conditions from the blood of patients with melanoma, colon cancer and lung cancer.
The test will enable doctors to rule out cancer in patients presenting with certain symptoms, saving time and preventing costly and unnecessary invasive procedures, researchers said.

We found that people with cancer have DNA which is more easily damaged by ultraviolet light than other people, so the test shows the sensitivity to damage of all  . White blood cells are part of the body's natural defence system. They go under stress when they are fighting cancer or other diseases.

The Lymphocyte Genome Sensitivity (LGS) test looks at white blood cells and measures the damage caused to their DNA when subjected to different intensities of ultraviolet light (UVA), which is known to damage DNA.

The results of the empirical study show a clear distinction between the damage to the white blood cells from patients with cancer, with pre-cancerous conditions and from healthy patients.
The study looked at blood samples taken from 208 individuals. The samples were coded, anonymised, randomised and then exposed to UVA light through five different depths of agar.

The UVA damage was observed in the form of pieces of DNA being pulled in an electric field towards the positive end of the field, causing a comet-like tail.
In the new blood test, the longer the tail the more DNA damage, and the measurements correlated to those patients who were ultimately diagnosed with cancer (58), those with pre-cancerous conditions (56) and those who were healthy (94).

If the LGS proves to be a useful cancer diagnostic test, it would be a highly valuable addition to the more traditional investigative procedures for detecting cancer .

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Types of Surgery for Breast Cancer in India : Breast Conserving Surgery

Most women with breast cancer have some type of surgery. Surgery is often needed to remove a breast tumor. Options for this include breast-conserving surgery and mastectomy. The breast can be reconstructed at the same time as surgery or later on. Surgery is also used to check the lymph nodes under the arm for cancer spread. Options for this include a sentinel lymph node biopsy and an axillary (armpit) lymph node dissection.

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 in India : Advantages of Next Generation Technology Over Conventional Neurosurgery to Remove Brain Tumor

MRI Guided 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. MRI Guided Brain Tumor Surgery is an advanced imaging treatment technique developed to enable neurosurgeons with intra-operative MRI to aid in the removal of complex and difficult-to-access brain tumors during surgery.  The technique involves use of a powerful computer system that precisely helps neurosurgeon locate a lesion, plan each step of the procedure on computer screen and find out the ideal access to the tumor before performing the operation. The technique is particularly helpful in treating a tumor that has difficult accessibility such as it is located deep inside the brain. During the procedure, the instrument movement is tracked very precisely by the computer providing surgeon with total control inside the brain with the help of real-time imaging. The technique also helps the surgeon to check if the tumor has been removed. 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 Conventional Neurosurgery to remove Brain Tumor MRI Guided Brain Tumor Surgery in a Brain Suite, Next Generation Technology Conventional neurosurgical procedure like conventional craniotomy relies on surgeon's visualization of the tumour. The surgeon has to spend time and significant effort to find the 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. In some types of tumours, surgeons may not completely visualize the tumour and there is a risk that surgeon can resect normal brain tissue along with the tumor, which can result in neurologic deficit, paralysis, loss of speech, blindness etc. 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. Normal brain tissue can be damaged unnecessarily. This can result in neurologic deficit and prolonged stay in the hospital MRI guided Brain Tumor Surgery allows a more complete tumor removal with much less risk to surrounding brain tissue. A surgeon performs a subtotal removal of the tumor . The consequence is only partial tumor resection that will result in a faster recurrence of the tumor and neurological symptoms. "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 technolog