Detecting breast cancer through mammogram is so far considered as a safe test to detect breast cancer. Mammography is a low-dose x-ray imaging of breasts to find out breast cancer.  Mammograms enable the doctor to have a closer look for breast lumps and changes in breast tissue and show small lumps if any that may not be found during a routine clinical breast check-up.  Mammography is so far considered the best screening tool to detect breast cancer.  But this may change if the research to detect breast cancer through blood test becomes a reality.

A team of scientists in McGill University in Canada are one step closer to developing a blood test that accurately detects breast cancer at very early stages.  This may be a breakthrough and this new development they say could make mammography screening obsolete.  The team has also mentioned that they have made improvements to the existing technology while discovering a biomarker “signature” for a common subtype of breast cancer – which is estrogen receptor-positive. The findings are from sampling the blood of a group of healthy people and breast cancer patients.  And the samples were measured for the concentration of 32 proteins in the blood samples. Using the latest in microarray technology the team found that out of the 32 proteins, six could be used to establish a signature for the hormone receptor-positive cancer.

David Juncker, leading the study, said, “Mammography is slow and expensive, and it’s is uncomfortable.  So, here the idea is you could do a test in a droplet of blood, and it could be more accurate than a mammograph.”  “From this small study we cannot really make the claim, but the hope is that this could become more accurate,” Juncker said. Mammography does not work well for women with dense breasts and thus many young and African American women are actually not well served by the screening.”  So this test could be complementary and more sensitive,” Juncker said.

Detecting breast cancer through blood test becomes a reality; it may become the best and easily affordable test to detect breast cancer and tests to detect breast cancer may not be uncomfortable to the persons undergoing the test which is so in mammography to detect breast cancer.

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Green vegetables vital for breast cancer patients

Women diagnosed with breast cancer are more likely to survive if they eat up their greens, a study suggests. A Chinese study has found a link between higher consumption of cruciferous vegetables such as greens, cabbage and broccoli, and reduced breast cancer death rates.

Researchers followed the progress of almost 5,000 women for around five years after they were diagnosed with breast cancer, Daily Mail reported. They found that the more cruciferous vegetables women ate during the first three years after diagnosis, the less likely they were to die.

As consumption increased, the chances of dying from breast cancer fell
by between 22 percent and 62 percent and from all causes by between 27
percent and 62 percent.

During the study period, 587 women died, 496 from breast cancer, the Mail said. The researchers pointed out that cruciferous vegetable consumption habits differed between China and the West.

“Commonly consumed cruciferous vegetables in China include turnips, Chinese cabbage/bok choy and greens, while broccoli and brussels sprouts are the more commonly consumed cruciferous vegetables in the US and other Western countries,” said study leader Sara Nechuta, from Vanderbilt University in Nashville, US.

Chinese women who ate cabbage, broccoli and leafy greens saw improved survival rates after breast cancer than women who did not eat these cruciferous vegetables, said a US study presented on Tuesday.

The findings came from data on 4,886 Chinese breast cancer survivors age 20-75 who were diagnosed with stage one to stage four breast cancer from 2002 to 2006 and who were part of the Shanghai Breast Cancer Survival study.

Women who ate more cruciferous vegetables over the 36 months following their diagnosis saw their risk of dying from any cause decrease by 27 percent to 62 percent compared to women who reporting eating little or none of these veggies.

The risk of dying of breast cancer decreased by 22 to 62 percent for the cruciferous veggie eaters, and their chance of experiencing a recurrence of breast cancer dropped by 21 to 35 percent.

Sarah Nechuta, a postdoctoral research fellow at Vanderbilt University in Nashville, Tennessee, said the findings suggest breast cancer survivors “may consider increasing intake of cruciferous vegetables, such as greens, cabbage, cauliflower and broccoli, as part of a healthy diet.” Nechuta, who presented the study at the American Association for Cancer Research meeting in Chicago, pointed out that diets among Chinese and Western women tend to vary.

“Commonly consumed cruciferous vegetables in China include turnips, Chinese cabbage/bok choy and greens, while broccoli and brussels sprouts are the more commonly consumed cruciferous vegetables in the United States and other Western countries,” she said.

“Second, the amount of intake among Chinese women is much higher than that of US women.”

Nechuta said future research could focus on the role of the bioactive compounds in cruciferous vegetables — namely isothiocyanates and indoles — and how varying doses may have an effect on cancer.

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Cancer Is Curable : Two-thirds of the cancers diagnosed these days are curable. The preservation of organ and function is possible, and is the standard of care now, Is cancer curable?

This is a common question asked. Yes, cancer is curable! These days more than two-third of cancers are curable if treated adequately. The rest one-third are not curable because of late diagnosis and advanced stage of disease. So, we need to be worried about late diagnosis of cancer and not cancer per se. Most of the cancers are almost curable if they are diagnosed in the early stage. Patients can not only get cured of cancer, but also get away with minimal treatment and less morbid procedures. It is very important that we should go for regular screening tests at regular intervals to diagnose cancer early.

Quality of life apart from quantity of life

As more and more cancers are getting cured, we need to look at the quality of life too. Curing cancer at any cost is not accepted casually in recent times. More than ever before, a premium is being placed on return to a productive and useful lifestyle after cancer treatment. The concept of organ and function preservation has been in the forefront of modern cancer care. The preservation of organ and function is now the standard of care in numerous malignancies including breast, larynx, rectum, anal canal, bladder, sarcomas of limb and many more, wherever possible. To be generally adopted, organ conservation approaches must have a likelihood of eradicating the tumour, have a low risk of recurrence and not compromise on organ form and function.

Let’s consider a few examples where organ preservation strategies have really made a difference in the patient’s quality of life:

* Throat cancers (larynx and pharynx): Traditionally, the treatment of laryngeal cancers involved total laryngectomy (removal of voice box) and radiotherapy either used alone or in combination. This radical surgery amounts to loss of speech, compromise in respiration and swallowing functions. The significant technological advancements in radiation delivery, availability of effective chemotherapy drugs, and voice rehabilitation have shifted the focus to ‘organ preservation’. The co-administration of chemotherapy and radiotherapy in properly selected patients has provided reasonable tumour control rates, organ preservation and maintenance of quality of life of the patients.

* Breast cancer: Mastectomy i.e. complete removal of breast and adjacent tissues has been the traditional standard surgery for patients diagnosed with breast cancer. This procedure not only leads to restriction of movements of the arm, but has a profound impact on the patient’s psyche. The loss of breast has a significant bearing on quality of life of breast cancer patients. With better understanding of tumour behaviour and technological advancements, mastectomy has been replaced by breast conservation surgery, where only the tumour bearing area and a rim of adjacent normal tissue is removed with acceptable cosmesis. This technique has shown equivalent tumour control rates and is now a widely accepted modality in the treatment of breast cancer.

* Bladder cancer: Cystectomy i.e. removal of the urinary bladder with an artificial passage of urine through the abdominal wall is the standard treatment for muscle-invading bladder cancers. The advancements in radiation planning and delivery techniques, availability of effective and less toxic chemotherapy drugs, have led to the development of bladder preserving approaches in carefully selected patients.

* Rectal cancer: Strong considerations are given to the functional outcomes while deciding the treatment protocol for rectal cancers. The restoration of bowel functions and anal continence are the issues on which importance is placed.  In recent times, the use of pre-operative chemo-radiation protocols have led to the down staging of tumour, improved resectability and preservation of anal sphincter, and this has had a significant impact on a patient’s quality of life.

*Anal cancer: The traditional approach in the management of anal cancers involved loss of anal sphincter and permanent bag on abdominal wall for passage of stools. In the last three decades, chemo radiation has become the standard of care with preservation of anal sphincter and obviating the need of permanent stoma.

* Soft tissue/bone sarcoma of limbs: The traditional approach of amputation in these cancers dealt a significant blow to the patient’s quality of life. With the advancement and refinement of surgical techniques, rehabilitation services and effective chemotherapy drugs, limb preservation protocols are commonly practised. Multi-disciplinary collaborative approaches with knowledge and respect for the benefits and shortcomings of individual treatment modalities have led to the development of organ and function preservation protocols. Further efforts are being made in the endeavour to improve quality of life of cancer patients and provide acceptable cure rates.

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Cancer Treatment in India , Best Cancer Hospitals in India , Top Cancer Doctors in India

A recent study revealed that more than of all cancer is preventable. The only thing needed is to proper knowledge of information to the society to act upon. A team of researchers from the Washington University School of Medicine, St. Louis, have marked the obstructions in front of making a huge impression in the cancer burden in the US and as well as across the world.

“We actually have an enormous amount of data about the causes and preventability of cancer,” said epidemiologist Graham A. Colditz, at the Washington School of Medicine, the journal Science Transnational Medicine reported.

As per Colditz and his co-authors, the major factors causing cancer includes lifestyle of people, from consumption of tobacco to diet and exercise, said a Washington university statement.

According to a data revealed by researchers it is observed that the specific cause of one third of total cancer cases in US is smoking. However, 20 percent is accounts due to excess body weight and obesity.

But if we leave the aspect of individual habits, the structure of the society which includes medical research funding to building design and food subsidies also influences the burden of cancer to a great extent and be changed in order to reduce it.

The major obstacle faced by them in the implementation of cancer prevention programme broadly is: Skepticism that cancer can be prevented. 75 percent cases of lung cancer in US can be prevented only by eradicating cigarette smoking.

Benefits of prevention may be underestimated in a short-term focus of cancer research as they take several years to complete, and research funding often spans five years or less.

Implementing strategies such as vaccination against cancer-causing viruses, such as the human papilloma virus that causes cervical cancer, were quite effective in the early stage of young people before they start sex.

Moreover, the cancer based treatments are mainly confined to single organ while behavioural changes can reduce cancer and death rates from many other chronic diseases too.

The health experts should take the moral responsibility to make the people aware of the risk factors even though they are unaware of the biological mechanism by which they cause cancer.

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colorectal cancer,colorectal cancer India,colorectal cancer Treatment

Though colorectal cancers are common in developed countries, the incidence is low in India, and intriguingly, the incidence is twice the rate in the rural group as compared to the urban population. Colorectal cancers rank third in frequency in men and second in women. They are the fourth leading cause of cancer mortality.

Etiology

The basis of colorectal cancer is the genetic change in the epithelial cells of mucosa. This is brought about by certain mutagens present in diets rich in red meat, especially those cooked by barbeque or grilled methods, and also diets rich in fat content.

Genetic risk factors

Some colorectal cancers occur on account of an inherent genetic defect, giving rise to two basic categories:

* Familial polyposis syndromes
* Hereditary non polyposis cancer

Signs and symptoms

* Bleeding per rectum

* Altered bowel habits (i.e., frequent constipation)

* Anaemia

* Abdominal pain and distension

* Vomiting

* Weight loss and fatigue

Evaluation

Through clinical examination and history, an oncologist pinpoints the diagnosis aided by:

* Fecal occult blood test

*Colonoscopy and biopsy

* CT scan, PET-CT scan (used to stage the disease)

Management

Localized colorectal cancers are managed by upfront surgery followed by chemo radiation if required. However, advanced cancers may require chemo-radiation to downstage the disease followed by surgery.

Surgical procedures typically individualized by site of colorectal cancers are:

* Hemicolectomy

* Proctocolectomy, where the diseased portion of the bowel along with its lymphatic drainage is removed and intestinal continuity restored by anastomosing the cut ends by sutures or staplers.

Rectal cancer

The Colo rectal Cancer surgical procedures for the rectum are far more intricate and for long have been dreaded because of the predominance of ablative procedures like abdominoperineal resections, which are associated with a permanent colostomy (i.e. a stoma on the surface on the abdomen through which all fecal contents are evacuated).

Sphincter saving procedures

These are designed to restore intestinal continuity after resection of the diseased segment so that the natural pathway is restored and patients do not need a colostomy. The procedures are:

* Anterior resection

* Low anterior resection of rectum (upto 5cm from anal verge)

* Ultra low anterior resection (upto 2cm from anal verge)

Using these procedures, 90 per cent of rectal cancers can be treated and a colostomy is avoided. These procedures are facilitated by the use of staplers in some cases. Depending on the pathology report of the resected tumour, the exact stage and extent of the disease is known, and additional treatment in the form of radiotherapy and chemotherapy according to the stage is initiated.

Prognosis

As a thumb rule, all node negative cancers carry a greater than 60 per cent five year survival rate on an overall basis. In the early stages of the disease, more than 90 per cent cure rate can be achieved. Node positive cancers have less than 40 per cent five year survival rate. Even though the cure rates are good, colorectal cancers are the fourth leading cause of mortality. Therefore primary prevention is even more important than early diagnosis.

The following factors help to prevent colorectal cancer:

* High fibre diet (WHO recommendation – at least 25gm/day)

* Low fat diet

* Avoidance of red meat, barbequed/ grilled meat.

* Low alcohol intake

* Avoidance of tobacco

* Lifestyle changes – Increased aerobic exercises like running and jogging reduce obesity and the risk of colorectal cancers

Secondary screening

It involves identification of high-risk populations:

* Age group of below 45 years

* Inherited colorectal cancer families

* Inflammatory bowel diseases (Ulcerative colitis, Crohn’s disease)

Screening of the groups for colorectal cancer needs to be carried out so that the disease can be detected at an early stage, and hence the cure rates can also be improved. Individuals above 45 years of age are recommended to undergo:

* Fecal occult blood testing yearly

* Colonoscopy once in three years

* Ultrasound abdomen once in three years

The incidence of colorectal cancer can be significantly reduced by dietary and lifestyle changes. Screening leading to early detection of cancer will lead to higher cure rates and reduce mortality.

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Leukemia Cancer in India, Acute lymphoblastic leukemia, Chronic lymphocytic leukemia, Acute myelogenous leukemia, Chronic myelogenous leukemia

Cancer occurs when there is uncontrolled abnormal cell growth and development. It disturbs the normal life span of cells wherein they are formed, mature, carry out their intended function, die, and are replaced by new cells which are constantly regenerated in the body to maintain normal cellular function. Cancer represents the disturbance of this process.

Leukaemia is cancer of the white blood cells. The symptoms of leukaemia include:
* Breathlessness
* Having repeated infections over a short space of time
* Pale skin
* Tiredness

In acute leukaemia, the condition progresses at a rapid and aggressive pace, and treatment needs to be administered immediately.

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.

Outlook

The outlook for people with AML depends on the sub-type of AML, with some subtypes being more challenging to treat than others. The cure rate thus varies, and some sub-types have a 75 per cent cure rate, while others have a 20 per cent cure rate. The outlook also favours younger people as compared to older people. The treatment usually includes a combination of chemotherapy and radiation, or a bone marrow transplant in some cases.

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.

Outlook

The outlook for children with ALL is optimistic, as almost all of them will achieve a remission from their symptoms. 85 per cent of children will be completely cured, whereas only 40 per cent of adults will be completely cured.

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

New directions

The treatment of hematologic malignancies is rapidly changing, and primary therapy for leukaemia has advanced steadily over the past years. Biologic advances have led to a better understanding of drug resistance and the emergence of various targeted therapies, which have revolutionised the way in which leukaemia’s are treated. Some of these offer patients more treatment options with less toxicity.

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Removal of the tumor-like growths known as adenomatous polyps was
associated with a 50% reduction in expected colon cancer deaths in the
largest and longest follow-up of polyp patients ever conducted.

Published in the New England Journal of Medicine, the study confirms
what has long been suspected, says researcher Ann G. Zauber, PhD, a
biostatistician at Memorial Sloan-Kettering Cancer Center in New York
City.

“You would expect to reduce deaths from colorectal cancer when you
remove the adenomas that cause them, but we really haven’t had the
data to prove it until now,” she says, adding that the findings
support current colorectal cancer screening recommendations.

The study included slightly more than 2,600 patients with precancerous
colon polyps removed during colonoscopy screenings.

The patients were followed for an average of about 16 years after
having the procedure, with the longest follow-up being 23 years.

Four out of five patients also had additional surveillance and
colonoscopy procedures, as recommended.

Often, a follow-up colonoscopy is recommended three to five years
after polyps are removed. The time interval recommended for a repeat
colonoscopy varies and is based on several factors, such as the number
and type of polyps found.

In the study population, detection and removal of the polyps was
associated with a 53% reduction in death from colon cancer compared to
expected deaths in the general population of similar age and gender.

Durado Brooks, MD, MPH, director of the American Cancer Society’s
prostate and colorectal cancer division, says the findings are in line
with smaller studies suggesting that polyp removal and surveillance
can cut colorectal deaths in half.

“This research provides solid data to confirm this,” he tells WebMD.
“But it is not all good news. Even though the death rate was reduced
by half, people in this group still died of colorectal cancer.”

Twelve of the patients died of the cancer an average of about a decade
(the range was six to 22 years) after having polyps removed during
colonoscopy. Five of these fatal cancers were diagnosed during
follow-up surveillance.

“Colonoscopy is an extraordinary tool, but it is not infallible,”
Brooks says. “Once a polyp is found, people need to be rechecked on a
regular basis.”

Any Screening Better Than None

Memorial Sloan-Kettering gastroenterologist and researcher Sidney J.
Winawer, MD, says his research team is conducting trials comparing
colonoscopy outcomes with other colorectal cancer screening methods,
including stool blood testing.

Screening methods that search for evidence of blood in the stool must
be done every year.

“When I’m asked which test is best, the answer I always give is that
the best test is the one that gets done,” he tells WebMD.

The ACS recommends colorectal cancer screening beginning at age 50 for
both men and women with an average risk for developing colorectal
cancer. People with a family history of the disease or other risk
factors should begin screenings earlier.

Winawer says at a time when the value of many cancer screening tests
is being questioned, the new findings are reassuring.

“The most common outcome of screening colonoscopy is the
identification and removal of polyps, and if we remove polyps we
prevent cancer and save lives,” he says.

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When researchers followed dietary details, lifestyle information and medical history of 67,470 women aged 34-59 from the start of the study in 1980 till 2006; they found that compared with women who drank less than 1 cup of coffee a day, those who drank 4 or more cups had a 25% lower risk of endometrial cancer. Participants who drank 2 or more
cups of decaffeinated coffee per day had a 22% lower risk of endometrial cancer.

Lead author, Youjin Je said, “For healthy non-pregnant women, drinking four cups of coffee a day has no known negative effects. But, a substantial amount of sugar, cream or milk added to coffee can negate the potential benefits.”

The study has been published online recently in Cancer Epidemiology, Biomarkers & Prevention.

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