Goel Clinic

Namaskar,

I am Dr. Arun Kumar Goel. Aaj main aap se rectal cancer ya carcinoma rectum ke baare mein baat karne wala hoon. To rectum jo badi aant ka niche ka hissa hota hai use kaha jata hai aur isme hone vale jo cancer hai usme jo mareejo mein symptoms hote hai unme sabse common symptom hai latreen ki jo habit hoti hai usme koi change ya change in bowel habits bolte hai, kafi marijo ko constipation hota hai, kabs hoti hai, kuch marijo ko aisa lagta hai ki pet saaf nahi hua aur isilye unhe bar bar stools jana padta hai jisko hum log kehte hai spurious diarrhoea. To ye iske alawa kuch marijo mein latreen mein blood bhi aa sakta hai, to ye jo common symptoms hai lekin important baat ye hai ki ye symptoms jyadatar log ignore kar dete hai ya aisa socha jata hai ke patient ko kuch common bimaiyan hai jaise piles ya bawaseer jise kehte hai ya kayi bar discharge hota hai to vo bhagandar ya fistula se bhi suspect kiya jata hai aur is vajah se iski jo diagnosis hai late ho jati hai.

To aise koi bhi symptoms khastor se agar vo 50 ke umar ke bad ho rahe hai toh unko ignore nahi karna chahiye, turant surgeon ko ya cancer specialist ko dikha ke jaanch karani chahiye. Isme jo jaanch hoti hai woh latreen ke raste mein ek pehle surgeon jaanch karte hai ungli ke dwara uske alawa fir doorbeen se jaanch ki jati hai aur iska confirmation jo hai cancer ka woh ek tukda ya biopsy lekar kiya jata hai. 1 bar jab cancer ka confirmation ho jata hai to staging ke liye test kiye jate hai jisme CT scan hai, MRI hai, PET-CT scan hai vo kiye jate hai aur dekha jata hai ki bimari shareer mein kahi door faili hai ya sirf rectum ke andar hi hai. Zadatar cases mein jab rectum mein agar stage 2 ya stage 3 ka cancer hota hai to patients ko pehle hum log radiotherapy aur chemotherapy dekar ke jise bolte hai hum log neoadjuvant treatment, neoadjuvant chemo-radio therapy vo dete hai; ye ilaaj kareeb 5-6 hafte ka hota hai. Isse bimari kafi shrink kar jati hai aur jo patient ko benefit long term survival mein bohot milta hai. Yeh treatment khatam hone ke baad roughly 6-8 hafte ka ek interval dete hai jisme iska response pura aur develop hota hai sath hi iske jo side effects hote hai radiation ke, usse bhi patient recover kar jata hai. Uske baad main surgery ki jati hai. Rectal Cancer ki surgery mein jo logon ke mann mein ghabrahat ya darr hota hai vo hota hai ki latreen ka rasta jo hai niche se band hoke aur pet mein ek permanent colosny bana di jayegi.

Lekin aaj ke din zadatar mareej hum kahenge ki 80-90% patients mein iski zarurat nahi hoti hai, chemoradiotherapy karke jab tumor shrink ho jata hai to zadatar cases mein hum neeche ka rasta bacha pate hai. Kuch cases mein hame ek temporary stoma ya ileostomy pet mein banana padta hai vo lekin vo kuch mahine ke bad band kar diya jata hai. Ye operation ek traditional ya open surgery ki tarah to hamesha se hota hi hai lekin aaj kal iske liye minimally invasive approach bhi aa gayi hai jisme hum log laproscopy ke dwara bhi ye surgery kar sakte hai. Usme patient ke pet mein kafi chota cut aata hai aur uski recovery kafi fast ho jati hai. To ye operation karne ke bad patient ko kuch cases mein additional chemotherapy bhi dena padta hai. Overall yahi hai ki agar hum time se is bimari ko pakad sakte hai aur proper ilaaj karte hai to zadatar mareej permanently theek ho jate hai aur usme normal latreen ka rasta bacha bhi rehta hai. To mera yahi message hai ke bimari se darein nahi, iski agar koi bhi symptoms ho to turant jaanch karayein aur proper ilaaj karayein.

Thank you!

Namaskar,

I am Dr. Arun Kumar Goel. Aaj mein aap ko hereditary breast cancer ke bare mein bataunga. Ye sabse common cancer hai. Agar patient ki family mein ovarian and breast cancer hai to first degree cancer unmein bhi ho sakta hai. Kuch cases aise bhi hain ki jiski family mein cancer nahi hai but fir bhi unhein cancer ho sakta hai. Hum blood test se diagnose karte hain. Hum chemotherapy and radiotherapy ke through aap ko treatment dete hain.

Jiske heredity mein cancer hota hai uski family ke members ko cancer hone ka bhi risk hota hai. Agar patient ko cancer ho gya hai to, patient ka ovarian cancer mein hum ovary remove kar dete hain jisse patient ko breast cancer ka risk reduce ho jata hai. Hum patient ko ye option bhi dete hain ki vo breast ka operation hi kara lein. Agar patient kehta hai to hum breast reconstruct kar dete hain. Hum heredity test kar ke family ke uss person mein ye bhi dekhte hain ki unmein abnormal gene hai ya nhi. Isliye aap ko isse darne ki jarurat nahi hai, kyunki iska acha treatment aaj ki date mein available hai.

Thank You!

Namaskar, I am Dr. Arun Kumar Goel, Max Superspeciality Hospital, Delhi se.

Aaj main aapko gallbladder cancer ke baare mein bataunga. Ye cancer north india mein bahut common hai. Iska bahut important cause hai gallstones or pitt ke thaili ki pathri. Iske symptoms hain stomachache, loss of appetite, weight loss, jaundice hain.

Pitt ke thali ka diagnoses karana important hai. Agar ye diagnose timely ho jaye to hum ise immediately operation kar ke hata bhi sakte hain. Stones nikaalne ke baad bhi report me aata hai ki aapko gallbladder mein cancer hai. Isliye humein iska operation karna padta hai. Operation karne se cure me kaafi ache chances ban jaate hain. Isliye iska timely treatment bahut important hai. Ye surgery kaafi safe hai. Agar operation ke baad bhi cancer ke symptoms hain to hum chemotherapy and radiotherapy se ise treat kar skte hain. Timely detect kar ke iska ache se treatment kia ja sakta hai. Cure ka success rate bahut high hai. Gallbladder se daren na or iska samna karen. Dhanywad.

Namaskar! Mai Dr. Arun Kumar Goel, Max Superspeciality Hospital Vaishali mei cancer surgery vibhag mei senior consultant hun.

Aaj mai aapko kuch cancer ke baare mein samanya jaankari dena chahta hun , taaki aap samajh sakein ki iss bimari ke kaaran kya hain? Iss se bacha kaise ja sakta hai? Iske diagnosis kaise hoti hai? Aur, iska ilaaj kaise hota hai?

Sabse mukhya ye hai ki jankari mai jo samajhta hun, vo is bimari se jo darr hai logon ke man me, us s apko bacha sakti hai. Pehli chiz to ye ki cancer, sharir ke jo cells the hain ya koshikayein, unki ek bimari hai. Normally, jab ye koshikayin multiply krti hain ya nyi koshikayein bnati hain to vo ek controlled tarike se hota hai. Lekin cancer me koshikayon ka uncontrolled tarike se banna hota hai, jrurat se jyada koshikayein banti rehti hain. Isme body ka jo control hai vo khtm ho jata hai. Or ye cells jahan se shurat hoti hai vhan se failti hain or sharir ke dusre hison me chali jati hain, ultimately sharir ko khokla krti hain or mariz ki jaan le leti hain.

Ye bimari pehle kaafi lailaj samjhi jati thi. Par pichle 30-40 saalon me jitni taraki hui hai, uske bad aaj jo bimari me success hai safalta hai ilaj ki, vo bhut achi hai. Agar hum log early stage me bimari ko pakad lein, to 80-90% insano me ye bimari jadd se khatam ho jati hai. Sabse pehle mai apko iske kaaran btana chahunga. Ek pramuh kaaran hai tobacco. Har trha se tobacco ka istemaal khatarnak hai. Aur cancer ho skta hai muh ka, galle ka, fefadon ka, urinary bladder ka. Labhag 1/3 cancer duniya me tobacco ki vjha se hai. To tobacco ka istemal bhut khtarnak chiz hai. Iske alwa jo or risk factors hain vo hai virus infection.

Jaise liver mein hepatitis-B, C infection hai. Fir uterus me human papillomavirus infection hai. Inme se kuch ke liye jaise liver ke liye vaccine available hai or cervical cancer k liye HPV vaccine available hai. To ye vaccination krne k liye in cancer se kafi bachav ho skta hai. Iske alwa kuch cancers hain jo badhti hui umar ke sath hote hain. Isliye aapko inke symptoms ko janna or inka ilaj krana important hai. Radiation exposures bhi cancer ka ek kaaran hota hai. Jarurat se jyada radiation exposures hai jaise unnecessary x-ray karana hai, vo avoid krna chaiye. Kuch radiation hamare background me hota hai jisko aap avoid nhi kar skte hain. To main chiz apko ye smjhna hai ki cancer ko early kaise detect kren.

To cancer ka ek symptom specific nhi hai. Sharir ke jis bhag me cancer hai, us se related symptoms hain, jo cancerous or non-cancerous sab bimariyon mei ho skta hai. Ek advice ye hota hai ki koi bhi symptom agar 2-3 hafte tak hai, uska kaaran nhi pta lag rha hai to uski janch krayein. Or agar cancer ka shakh hai to related testing hoti hai jisme x-rays ho skte hain. Or kayi bar needle test se biopsy ki jati hai. Or agar early stage mei bimari pakad me aa gyi to uska ilaj turant or achi jgha pe krana chaiye. Cancer ke ilaj mei operation, radiotherapy, chemotherapy. Ye 3 therapy ke through ilaj hote hain. Alag alag marizon me konsa ila hoga ye caner ke specialist decide krte hain. Kafi marizon mei ek se jyada trha ka ilaj kia jata hai.

To jo bhi ilaj ho vo pura ilaj krna chaiye. Iss se bimari jadd se khatam ho jati hai. Aurr uska vapis aane ka risk bhi khatam ho jata hai. To mai yahi kehna chahunga ki sabse pehle is bimari se dariye nhi. Agar koi bhi symptom 2-3 mahine mei thik nhi ho rahein hain to cancer ke bare mei soche, uski janch krayein or agar cancer nikalta hai to uska pura ilaj krayein. To aisa krne se aap bimari se jaad se mukti paa skte hain. Agar cancer ke bare mei apke mann mei koi shakh hai, koi janch krana chahte hain, opinion lena chahte hain to aap mujhe Max Superspeciality Hospital Vaishali mei contact kar sakte hain. Iske alawa aap mujhe Lybrate ke through bhi contact kar sakte hain. Online consultations bhi possible hain. Aur agar koi bhi shakh ya daar ho, to hesitate na karein.

Namaskar,

Mai Dr. Arun Kumar Goel, Max Super Speciality Hospital, Vaishali, Ghaziabad mein Cancer Surgery department ka head hoon, aur breast oncology unit ka director bhi hoon.

Mere main area of interest me breast cancer ka management ek pramukh area hai, breast cancer mahilaon ka sabse common cancer hai jo major cities hai metropolitan Delhi- NCR, Bombay aur aisi cities mein. Aur iska jo incidence hai woh badhta ja raha hai jiske kai karan hai, isme breast cancer ke ilaj mein pichle 30-40 saalon mein bahut tarakki hui hai aur aaj ke din hum dekhte hain ki breast cancer ke marijoo ka survival rate hai woh 90% se upar hai, lekin itna achha survival achieve karne ke liye hame jo hai uski diagnosis bahut jaldi karni padti hai. Toh yeh ek bahut sabse important baat hai, jo sabse common symptom hai breast cancer ka woh hai breast mein ek lump ya ganth ka hona.

Ab breast ki ganthe kuch cancerous hoti hai kuch non-cancerous hoti hai, lekin jab bhi koi ganth ho toh yeh possibility zaroor sochna chahiye ki kahi cancer to nahi hai aur turant ek cancer specialist ya breast surgeon se opinion lena chahiye. Cancer ki diagnosis banane ke liye usme kuch janche hoti hai jisme mammography ya ultrasound hota hai, fine needle aspiration cytology ya biopsy hoti hai aur kabhi kabhi breast ka MRI bhi kiya jata hai. Toh agar cancer confirm hota hai toh phir uske baad kuch staging test karte hain yeh dekhne ke liye ki bimari sharir mein kahin faili toh nahi hai, jyadatar cases me bimari localised hoti hai aur uska ilaj jo hai sabse pehle operation ya surgery ke dwara kiya jata hai jo meri main feild hai. Jyadatar logo ko breast cancer surgery mein jo pareshani hoti hai ki pehle ilaj hota tha usme purye breast ko remove kiya jata tha jise hum log mastectomy kehte thye, lekin agar mareez early stage mein aata hai ganth bahut badi nahi hai to pura breast nikalna zaroori nahi hai, hum log breast conservation surgery ke dwara breast ko bchaa sakte hain.

Isme aage aur kafi advances huye hai aur aaj kal hum log jo approach follow karte hain jis bolte hain oncoplastic breast conservation surgery, jisme jo cosmetic results pehle se bhi bheter hai. Agar kuch marijoo mein pura breast nikalna zaroori bhi hota hai toh reconstruction bhi kiya ja sakta hai. Aur ek nai approach jo surgery mein aaj kal hum log use kar rahe hai jise kehte hain Sentinel lymph Node Biopsy, yeh armpit ki jo ganthe hoti hain nodes unke management ke liye ek latest approach hai aur iss approach ka istemal karne se jo hathon mein sujan aane ka risk hai Lymphedema wo kafi kam ho jati hai. Toh surgery basically jo ho jati hai uske baad kuch marijoo mein additional treatment ki zaroorat ho sakti hai jaise chemotherapy hai, radiotherapy hai, ya kuch dawaiya hai jo hormonal intervention karti hain. Toh surgery ke baad kafi marijoo mein jo pehela ilaj hoga woh chemotherapy hota hai, jo 4 se 8 cycle tak diya ja sakta hai. Radiotherapy jin marijoo mein hoti hai woh bhi again aaj kal karib 3 hafte mein puri ho jati hai jo ki pehle usme 6 se 7 hafte lagte thye, aur nahi radiation technology ke through jo side effects hai radiation ke wo kafi kam ho gaye hain. Isi prakar hormonal therapy jo hai woh yeh radiation or chemo khatam hone ke baad di jati hai jis mein sirf ek tablet hoti hai jo marijoo ko ghar pe regular istemal karna padta hai aur wo 5 se 10 saal tak use ki ja sakti hai.

Ek aur important cheez yeh hai ki jo bhi cancer ke marij hote hain unko ek regular follow up pe chalna padta hai, toh ilaj pura hone ke baad har 3 mahine baad unhe apne surgeon ke pass follow up ke liye jana chahiye, jisme examination jo hai woh ek bahut important part hai. Phir uske baad kuch testing ho sakti hai jaise chhati ka x-ray hai, ultrasound hai, mammography hai, aur agar koi aur takleef hoti hai tu Bol Scan, MRI, CT ya Pet Scan bhi kiya ja sakta hai. Iske alawa breast cancer ke marijoo mein jo ek aur cheez hoti hai hum log ek jo usko promote karte hain woh hai support group ka concept, jisme breast cancer ke survival aapas mein milte hain, ek doosre se cheeze discuss karte hain aur support bhi provide kar sakte hain aur isse unki jo future life hai wo kafi better rehti hai. Toh mein yahi kahunga ke cancer se aapko waise bhi nahi darna chahiye aur breast cancer ke jo aaj ke din success rate hai wo bahut hi acchi hai toh bina darre janch karaye aur apna ilaj pura kare.

Dhanyavad, Thank you.