HB TC DC Test

Cancer like most other diseases has the best rates of recovery with early detection and intervention. As there are no regular health screenings for blood cancer, only the awareness about the early warning signs can save your life. November is designated as the Lung Cancer Awareness Month, to ensure every individual is equipped to fight against lung cancer right from the start. Here are 4 vital facts you must know to win your fight against blood cancer.
Lung cancer is also known as pulmonary carcinoma or cancer of the lung. It occurs when DNA mutations develop in the cells/ tissues of the lungs leading up to uncontrolled growth in the tissues of the lung. By far, it is known to be the most common cancer in Asia.

1. Type: lung cancers can present as one of the following types: 

1. Non-Small Cell Lung Cancer (NSCLC): Most common type of lung cancer and constitutes nearly 85% of all lung cancers. The sub-types of NSCLC are as follows:
   • Large cell carcinoma
   • Squamous cell carcinoma (SqCC) (Epidermoid)
   • Adenocarcinoma – accounts for majority of the NSCLC.
2. Small Cell Lung Cancer (SCLC): It is also known as oat meal cancer and tends to spread (metastasize) quickly. This constitutes about 15% of the lung cancers.
3. Mesothelioma: It is a rare cancer that develops in the mesothelial cells of the pleural or peritoneal surfaces. It usually arises in the pleural membrane lining the lungs, known as pleural mesothelioma. One that arises from the peritoneum is called the peritoneal mesothelioma and the one that arises from the pericardium is known as pericardial mesothelioma. Lastly, it can also arise from the tunica vaginalis known as testicular mesothelioma. People working with or prior exposure to asbestos are mostly at risk of developing mesothelioma. The latency period between time of exposure and development of mesothelioma can be somewhere between 20 to 40 years. Maximum of the patients who develop mesothelioma are men.

2. Gender: It affects the male populace predominantly. It is more common in men than in women and in those of lower economic status. However, the incidence of lung cancer, in women too, is on the rise of late.

3. Etiology: Cigarette/ Tobacco smoking remains the most important cause of lung cancer accounting for 85 – 90% of the cases. Incidence/ risk is proportionate to the number of cigarettes smoked irrespective of the age. Also, environmental toxins including smoke from burning black tar, exhaust gases from automobiles etc. too contribute actively to various lung diseases including cancer. People working in asbestos manufacturing factories who are exposed to asbestos dust are also likely to get lung cancer. Tuberculosis too is an additive risk factor. Again, people who have received ionizing radiation especially to treat Hodgkin Lymphoma or other malignancies also run the risk of developing lung cancer. Above-mentioned causes apart, genetic factors may also play a role.

4. Features: Lung cancer clinically presents in the following ways mainly. Signs & symptoms of malignant mesothelioma are as enumerated below

• Difficult/ labored breathing (Dyspnea)
• Chest pain
• Palpable chest wall mass
• Discordant chest wall expansion
• Weight loss (Cachexia)
• Loss of appetite (Anorexia)
• Night sweats

Signs & symptoms of non-small cell lung cancer (NSCLC) are as enumerated below. Majority of patients are symptomatic at diagnosis

• Chronic cough
• Difficult/ labored breathing (Dyspnea)
• Chest pain
• Blood stained sputum (Hemoptysis)
• Hoarseness
• Weight loss (Cachexia)
• Loss of appetite (Anorexia)
• Weakness
• Bone pain
• Pleural or pericardial effusion
• Superior vena cava syndrome
• Brachial plexopathy
• Neurologic pain
• Hypercalcemia of malignancy

Signs & symptoms of small cell lung cancer (SCLC) are as enumerated below

Symptoms as per the points 8 – 18 depicted above for NSCLC are applicable for SCLC as well. Additionally, patients suffering from SCLC may have:

• Fever associated with chest infections like bronchitis/ pneumonia that refuse to go away or keep coming back
• Horner syndrome
• Paraneoplastic syndromes including encephalitis/ sub-acute sensory neuropathy, hyponatremia, acromegaly, cancer associated retinopathy, ectopic corticotropic syndrome etc all.

5. Screening: is generally recommended for asymptomatic/ symptomatic populations as surveillance for high-risk individuals – who are either current or former smokers (quit smoking within the last 15 years) have at least a 30 pack-year smoking history and those who do not have any prior history of lung cancer. The goal of screening, as usual, is to be able to detect & diagnose lung cancer at an early stage which is potentially curable. It is mostly radiologic with a low dose helical computed tomography (CT) scan being more effective in detecting early-stage lung cancer than a chest radiograph can.

6. Diagnosis: Abnormal blood test results may be indicative of malignancy, but a follow-up imaging/ biopsy is always the gold standard for an accurate diagnosis. Following are the diagnostics employed mainly:

1. Blood: Hb may be low, TLC, ESR and polymorphs increased. Adenocarcinomas are likely to express thyroid transcription factor 1 (TTF-1) or carcinoembryonic antigen (CEA). On the other hand, mesotheliomas are likely to express Wilms Tumor -1 (WT-1) protein and Calretinin.
2. Imaging: Thoracoscopy, Bronchoscopy, X-Ray, CT Scan etc all. Positron Emission Tomography (PET) / CT scan and Magnetic Resonance Imaging (MRI) scan help detect metastasis if any.
3. Biopsy: It clinches the histologic diagnosis and the nature of the disease.

7. Treatment: Conventional treatment includes surgery, chemotherapy and radiotherapy as contextually appropriate. Simultaneously, an adjunctive or integrative naturopathic treatment with suitable complementary & alternative medicines (CAM) too can help improve clinical outcomes and facilitate recovery as would be feasible contextually.

8. Prognosis: Preventive measures, earlier diagnosis and right early treatment are key for effective therapeutic management & better prognosis. Like most other cancers, the chances of cure for early-stage lung cancer are more. The cure/ recovery chances are influenced by the grade, stage of cancer, recurrence and the patient’s general health & vitality etc all. The primary determinant of prognosis in NSCLC is the stage at which the cancer is diagnosed. For non-metastatic cancers, however, it is the nodal status that determines the stage and hence the prognosis.

9. Prevention: Rightly said, prevention is always a better choice. Cigarette smoking is to be avoided by all means as it is the single major cause of lung cancer. Even exposure to cigarette smoke (passive or secondhand) is also an established cause of lung cancer and is known to increase the risk of lung cancer in non-smokers as well. Preventing exposure to secondhand smoke can be helpful in decreasing the incidence and mortality of primary lung cancers. Above-mentioned apart, other important risk factors such as exposure to ionizing radiation, environmental carcinogens like smoke from burning black tar, exhaust gases from automobiles, outdoor air pollution, and occupational exposure to asbestos, arsenic, beryllium, nickel, cadmium, chromium etc all too are known to increase the risk for lung cancer and mortality thereof. In fact, cigarette smoking is known to potentiate the effect and hence the lung cancer risk of many of the above-mentioned carcinogens, multi-fold, in smokers. Thus, either eliminating or reducing the exposure to the above-mentioned carcinogens can lead to a decrease in the risk of lung cancer and incidences thereof. Furthermore, randomized clinical trials indicate that high-intensity smokers (only) who take supplementation of beta-carotene have an increased risk/ incidence of lung cancer. Vitamin E supplementation, on the other hand, does not affect the risk of lung cancer as indicated by the trials. 

In case you have a concern or query you can always consult an expert & get answers to your questions!

Disorders of intimate arousal include several aspects of arousal - physical such as genital lubrication, congestion and sensation, subjective such as interest, distress or interpersonal relationship difficulty. Problems of arousal vary among women and can be classified in the following ways:

1. Primary: The woman has never experienced sufficient arousal, even when she has had sufficient desire and sexual stimulation.
2. Secondary: The woman has been sufficiently aroused in the past, but currently experiences decreased arousal.
3. Non-situational: The problem occurs in all sexual situations.
4. Situational: The problem occurs only in some sexual situations.

Common factors for this problem include decrease of estrogens and androgens; diabetes; thyroid and prolactin abnormality, vaginal and urinary tract infections; surgery, radiation, and medication, smoking, alcoholism; chronic diseases and psychological factors such as depression and anxiety. Other factors are negative sexual attitudes, low self-esteem triggered by body image like small breast size, overweight and sexual and childhood abuse. Lack of communication can also affect sexual arousal like if a woman cannot tell her partner how she prefers to be stimulated.

1. Partner’s sexual dysfunction is also a major cause, it includes erectile dysfunction or premature ejaculation.
2. Women with sexual arousal disorder are assessed by medical and detail sexual history and clinical examination, including vaginal and breast examinations. Also talking about distress, attitude to sex, and communication with partner etc.
3. Testosterone, estrogens, Prolactin, TSH, Sugar, Hb, TC, DC any other test depending on physical examination.
4. Treatment depends on the cause of the disorder, related to physical, psychological, and interpersonal factors. If abnormalities are found in blood tests they are treated by medicines.
5. Estrogen therapy in the form of local creams or oral tablets or skin patch is used to improve vaginal lubrication and decrease vaginal dryness. Non medicated lubricants can also be used.
6. Drugs like Sildenafil, Tadalafil etc increase genital blood flow. DHEA is claimed to improve sexual interest and genital sensation.

Hyperactive arousal Disorders

Some women experience persistent genital arousal called restless genital syndrome. There is increased genital blood flow in non-sexual situations causing distress. It may be related to depression and anxiety there may be physical causes like vascular, neurologic, pharmacologic, and hormonal. Its treatment involves relaxation exercises, topical anesthetics, avoiding use of medications or herbal and nutritional products. Medical treatment includes antidepressants. If you wish to discuss about any specific problem, you can consult a Sexologist.

Gastric (stomach) cancer occurs when malignant cells form in the lining of the stomach. By far, it is known to be the second most common cause of cancer-related deaths not only in Asia but also worldwide. Though it can affect both male and female populace, it is seen more commonly in men and in people aged 50 years or older.

1. Type: Gastric cancers can present as one of the following types - 

   1. Adenocarcinoma: Begins in the glandular cells lining the inside of the stomach. This forms a majority of the stomach cancers.
   2. Lymphoma: Begins in immune system cells present in the walls of the stomach. Occurrence of lymphoma, in the stomach, is rare.
   3. Carcinoid Tumor: Begins in hormone producing cells of the stomach.  Occurrence of carcinoid cancer, in the stomach, is rare.
   4. Gastrointestinal Stromal Tumor (GIST): begins in nervous system cells of the stomach. Occurrence of GIST, in the stomach, is rare.

2. Gender: It affects both male and female populace.

3. Etiology: The factors that are associated with increased risk of gastric cancer include the following mostly –

   • ‘Helicobacter Pylori’ bacterial infection in the stomach is a common cause of gastric cancer of both the intestinal (expanding) & diffuse (infiltrative) type. Furthermore, studies indicate that high salt intake is synergistic with H. Pylori infection in the manner that it is likely to increase the risk of gastric cancer that is induced by H. Pylori bacteria.
   • Smoking, consuming alcohol, red meat, salty/ smoked/ processed foods, low intake of fruits and vegetables, diets rich in nitroso compounds, eating foods contaminated with aflatoxin fungus etc all.
   • Atrophic gastritis characterized by chronic stomach inflammation is known to increase the risk multi-fold. Chronic gastric inflammation can lead to atrophy of the gastric mucosa, metaplasia, dysplasia and finally carcinoma.
   • History of pernicious anaemia, gastric ulcers, adenomatous gastric polyp etc all.
   • Family history of gastric cancer. Several familial syndromes that have been associated with a pre-disposition to gastric cancer include familial adenomatous polyposis, Lynch syndrome, Peutz-Jeghers syndrome and e-cadherin mutation (diffuse type)
   • Blood group A, Obesity etc all are known to be associated with diffuse or cardia gastric cancer.
   • Low socioeconomic status - persistent lifestyle issues/ irregularities including high stress coupled with an improper diet/ dietary pattern.
   • Epidemiological evidence is indicative of a risk or pre-disposition to gastric/ stomach cancer for people suffering from diabetes mellitus (DM).
   • Very high dose ionizing radiation exposure is an uncommon risk for gastric cancer.

4. Features: There are often no early stage symptoms. Early stage symptoms, if any, are non-specific and are likely to be ignored, thus delaying the diagnosis most often. Hence, gastric/ stomach cancer is often detected at an advanced stage where the disease is either locally advanced or metastatic. The various presentations (of signs & symptoms), by stage (early or advanced), of gastric cancer are as enumerated below:

   1. Early Stage – can present with one or more of the following non-specific symptoms/ signs -

      • Dyspepsia (Indigestion),
      • Stomach/ Epigastric discomfort,
      • Bloated feeling after eating,
      • Mild Nausea/ Vomiting,
      • Blood in Vomit (Haematemesis),
      • Heartburn,
      • weight loss (Cachexia)
      • Anaemia,
      • Occult blood in stool/ Melaena,
   2. Advanced Stage – presents with one or more of the following symptoms/ signs -
      • GI Bleeding with black tarry stools (Melaena),
      • Persistent Nausea/ Vomiting,
      • Blood in Vomit (Haematemesis),
      • Early Satiety,
      • Anaemia,
      • Loss of Appetite (Anorexia),
      • Weight loss (Cachexia),
      • Persistent pain in the abdomen,
      • Fluid build-up in the peritoneal cavity (Ascites),
      • Edema of the lower extremities,
      • Liver Enlargement (Hepatomegaly)/ Jaundice,
      • Difficulty swallowing food (Dysphagia)
5. Screening: Is generally recommended for asymptomatic populations in high incidence areas or as surveillance for high risk individuals. The goal of screening, as usual, is to be able to detect & diagnose gastric cancer at an early stage which is potentially curable. It is mostly endoscopic/ radiologic.

6. Diagnosis: Following are the diagnostics employed in gastic cancer -​

   • Physical Examination: May be remarkable for palpable abdominal mass, weight loss (cachexia), abdominal distension, ascites, hepatomegaly, lower extremities edema and lymphadenopathy for gastric cancers in the advanced stage. For early gastric cancers, however, physical examination is largely uninformative.
   • Blood: Hb- may be low, ESR – raised, tumor markers CEA & CA-19-9 could be raised sometimes in adenocarcinoma but are not frequently elevated. Abnormal blood test results may be indicative of malignancy, but a follow-up gastroscopy/ biopsy is always the gold standard for accurate diagnosis.
   • Stool: Occult blood may be +ve
   • Barium Meal X-Ray: Could show a filling defect at the site of the carcinoma/ cancer growth.
   • Gastroscopy/ Biopsy: Clinches the diagnosis.
   • Endoscopic Ultrasound: Maximizes tumor staging as it helps determine the depth of invasion of the tumor.
   • CT Scan: Of chest, abdomen & pelvis helps detect metastatic disease, if any, and also helps stage the disease (TNM) appropriately.
   • Bone Scan: Helps detect osseous metastasis (bone mets), if any.
7. Treatment: Conventional treatment includes surgery, chemotherapy and radiotherapy as contextually appropriate. Surgery (i.e. gastrectomy either sub-total or total), with an adjuvant chemotherapy and/ or radiotherapy as contextually relevant, is the only treatment that is known to cure the disease in light of the prognostic indicators as briefly enumerated in the section below. Chemptherapy and/ or radiation alone cannot be curative. Mostly, it can improve symptoms, and may prolong survival. Simultaneously, an adjunctive or integrative naturopathic treatment with suitable complementary & alternative medicines (CAM) too can help improve clinical outcomes and facilitate recovery as feasible contextually.

8. Prognosis: For gastric cancer is variable. Preventive measures, earlier diagnosis and right early treatment is key for an effective therapeutic management & better prognosis. Like most other cancers, the chances of cure for an early stage gastric cancer are more. The cure/ recovery chances are influenced by the grade, stage of cancer, recurrence and the patient’s general health & vitality etc all. Distal tumors are known to be cured more often than the proximal ones. Again, intestinal-type gastric cancers are known to have a better treatment outlook in comparison to the diffuse-type gastric cancers.

9. Prevention: Rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an adherence to a relative Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising, de-stressing and relaxation is highly recommended for reducing the risks of many cancers including gastric cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. The consumption of alcohol, if any, has to be strictly in moderation, and is best avoided in a high risk scenario. Smoking is to be avoided too. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly. Not only it is important to eat healthy, but also it is equally important to eat properly. Insufficient chewing, eating until full, eating meals within a short time etc all are best avoided so as to ease off digestive burden on the stomach/ other organs in the GI tract. Last but not the least, consumption of clean and filtered water, natural probiotics like freshly prepared yogurt/ butter milk, maintenance of cleanliness & hygiene including oral hygiene etc. all can help guard against H. Pylori infections. Breastfeeding is known to be protective against H. Pylori infections too.

Colorectal cancer is otherwise known as cancer of the colon or the rectum. This can affect both men and women with age being a major risk factor. Majority of such cancers are seen to occur after age of 50 years.

1. Type: Colorectal cancers can present as one of the following types: 

   1. Adenocarcinomas are the most common type of colorectal cancers. These cancers begin in the cells making mucous and other fluids. Certain colorectal cancers begin as adenomatous polyps (adenomas) that turn cancerous over a period of time. This is precisely why the adenomas are regarded as pre-cancerous or pre-malignant.

   2. Gastrointestinal (GI) carcinoid tumors, GI stromal tumors, primary colorectal lymphoma, leiomyosarcoma, melanoma & squamous cell carcinoma are certain other colorectal cancers

      • Carcinoid tumors: start in specialized cells that produce hormones, in the intestine.

      • GI Stromal tumors: start in the interstitial cells of Cajal (ICC), in the wall of the colon.

      • Lymphomas: start typically in the lymph nodes but they may also start in colon or rectum.

      • Sarcomas: can start in the muscle and the connective tissue in the walls of the colon and rectum.

2. Gender: It affects both male and female populace.

3. Etiology: Mostly, the factors that are associated with increased risk of colorectal cancer include the following –

   1. Age exceeding 50 years.

   2. Racial & ethnic background such as African Americans, in the USA, are known to have the highest incidence of colorectal cancer, and mortality rates.

   3. Low fibre and high fat diet. Excessive consumption of red meat (e.g. goat meat, beef, pork, lamb, or liver), processed meats, butter, refined grains, sweets, sugary drinks etc all can increase the risk of colorectal cancer.

   4. Personal history of inflammatory bowel diseases (IBD) (e.g. ulcerative colitis), Crohn’s disease, adenomatous colorectal polyps, colorectal cancer etc all.

   5. Family history of colorectal cancer or adenomatous polyps etc all.

   6. Inherited syndromes such as familial adenomatous polyposis (FAP) and Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC).

   7. Sedentary lifestyle/ associated Obesity.

   8. Type 2 diabetes.

   9. Tobacco and alcohol abuse.

4. Features or symptoms can vary from person to person depending on the size and location of the tumour. Following are the signs & symptoms mainly -

   1. Changes in bowel habits, diarrhea or constipation or an alternating diarrhea and constipation.

   2. Occult/ blood in the stool, and 

   3. Problems related to blood loss (e.g. anemia, weakness, fatigue, intolerance to exercise, shortness of breath, increased heart rate, chest pain etc all),

   4. Abdominal discomfort (frequent gas/ flatulence, bloating, fullness, cramps, and pain), vomiting etc.

   5. Unexplained weight loss,

   6. Pain with bowel movement,

   7. Feeling that bowel does not empty completely,

   8. Stools are narrower than usual.

5. Diagnosis: Following are the diagnostics employed. Abnormal blood test results may be indicative of malignancy, but a follow-up imaging/ biopsy is always the gold standard for accurate diagnosis.
   1. Blood: fecal occult blood test, Carcinoembryonic Antigen (CEA) assay values are raised, Hb/ RBC counts may be low.
   2. Imaging: Colonoscopy, Endorectal Scan/ CT Scan followed by Biopsy clinches the diagnosis and the nature of the disease.
   3. Apart from the above-mentioned barium enema X-Ray, USG, Chest X-ray, PET CT scan etc all help detect metastasis, if any. An increase in level of the serum tumor marker ‘CEA’ is indicative of metastatic spread/ proliferation that can be ascertained through a PET CT scan.
6. Treatment: Conventional treatment includes surgery, radiation and chemotherapy as contextually appropriate. Simultaneously, an adjunctive/ integrative naturopathic treatment with suitable complementary & alternative medicines (CAM)/ therapies too can help improve clinical outcomes and facilitate recovery as feasible contextually.

7. Prognosis: Preventive measures, earlier diagnosis and right early treatment is key for better prognosis and efficient/ effective therapeutic management. Usually, the chances of cure for an early stage cancer are more. Above-mentioned apart, recovery chances are influenced by the grade, stage of cancer, recurrence and the patient’s general health & vitality etc all too.

8. Prevention: Rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an adherence to a Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising (for at least 30 minutes daily), de-stressing and relaxation is highly recommended for prevention or reducing the risks of colorectal cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. It is advisable to limit milk/ dairy, preferably of low fat content, to 1 to 2 servings max daily. Although alcohol is optional and is not for everyone, the consumption of the same, if any, has to be strictly in moderation, and is best avoided. Smoking is to be avoided as well. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly or are best avoided too. Apart from the generic preventive measures as mentioned above, certain pre-malignant conditions, of which adenomas are the most common, can be successfully treated with complementary and alternative medicines too.

Thalassemia is a type of disease, resulting in the abnormal production of haemoglobin in the blood. Haemoglobin stimulates oxygen circulation all over the body. Therefore, a dip in the haemoglobin count can lead to anaemia, a disease inducing weakness as well as fatigue. Acute anaemia can take a toll on the organs and ultimately cause death.

Severe thalassemia in children yields symptoms, such as dark urine, abdominal swelling, slow growth, jaundice, a pale appearance and deformed skull bones. Diarrhoea, frequent fevers and eating disorders are also common.

Treatment:

1. Blood transfusions: Regular blood transfusion is the only treatment needed for beta-thalassemia aiming to keep sufficient Hb level to avoid long-term complications, though bone marrow transplant is a radical cure for the disease.
2. Iron chelation therapy: The haemoglobin in the red blood cells is rich in iron-protein that gets deposited in the blood with regular blood transfusion. This condition is known as iron overload as it damages the heart, liver and various parts of the body. Iron chelation therapy is used to prevent this damage as it helps to remove the excess iron from the body.  Deferoxamine and Deferasirox are two such medicines used for this therapy.
3. Folic acid supplements: Folic acid being a B vitamin produces healthy red blood cells and is therefore recommended as a substitute for the above procedures.
4. Transplant of blood and marrow stem cell: A blood and a marrow (a substance within the cavities of bones where blood cells are produced) transplant replaces the faulty stem cells with healthy ones contributed by a donor.