Surgery: Archives

Cancer November 10, 2020

Types Of Cancer Surgery And New Approaches

Cancer is the most common term for a large group of diseases that affect any part of the body. Few other terms that are used to describe this disease are malignant tumors and neoplasm. In simple words, cancer can be explained as the quick creation of abnormal cells that grow outside their usual borders, and crowd other parts of the body. This phenomenon makes the body inefficient in the way it functions and if not treated appropriately can lead to death. Today, as per the World Health Organization, cancer is the second leading cause of death and is responsible for an estimated 9.6 million deaths globally. There are more than 100 types of cancer and some of the most common cancers are Lung cancer, breast cancer, colorectal, prostate, skin cancer and stomach cancer. WHO also states that around one-third of deaths from cancer occur due to 5 leading behavioral and dietary risks: high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco intake, and excessive alcohol consumption. Tobacco use is the most critical risk factor for cancer and is responsible for approximately 22% of cancer deaths worldwide. But, cancer can be treated very well for many people. More people than ever before lead full lives post-cancer treatment after the new age advancements in the medical space. However, for that, the doctor needs to know correctly what stage the cancer is in and how far it has spread from where it originated. Knowing the type and stage of cancer can help the doctor determine the best treatment options available. Let’s now dive deeper and understand cancer surgeries and its different kinds.

Cancer surgery is a surgical operative procedure carried out to remove the tumor and its surrounding tissue. It is the oldest provision to treat cancer, but it is effective even today to treat multiple types of cancer. Many different types of surgeries exist today, that aid in treating cancer patients alone or in tandem with other treatment options such as radiation and chemotherapy. Some common cancers like breast cancer, cervical cancer, oral cancer, and colorectal cancer have high cure rates when detected at an early stage and if treated with best practices.

Following are the various types of cancer surgeries:

A) Curative Surgery: It extracts the entire cancerous tumor from the body. This surgery type is preferred as a primary mode of treatment in cases where the tumor is restricted to a specific area in the body. Unlike diagnostic surgeries that may get rid of a small portion of tissue to confirm the existence and the stage of the disease, curative surgeries take a much more fundamental surgical approach, typically ensuing in partial or total removal of the organ of origin.

B) Preventive Surgery: It is used for the removal of tissue that is devoid of cancer cells, but tends to develop into a malignant tumor (Pre-cancerous growth) such as intestinal polyps.

C) Diagnostic Surgery: It aids to decide if cells are cancerous or not. It is used to extract a tissue sample for testing in a lab, which confirms the diagnosis of cancer and identifies the cancer type along with the determination of the stage of cancer. There are multiple ways to detect or confirm the existence of a cancer cell. The microscopic examination of biopsy samples is the ultimate way for a positive diagnosis of cancer.

D) Staging Surgery: Staging is the process of finding out the location of the cancer cell and how much of it is there in a person’s body through a laparoscopic procedure. It depends on how the doctor defines the stage of cancer.

E) Debulking Surgery: The main goal is to remove as much cancerous tissue in a patient’s abdomen as possible. Some tumors may be completely removed while others are just reduced in size.

F) Palliative Surgery: It is used in treating cancer at progressive stages Palliative surgery aims at supplying the greatest benefit to the patient using the least invasive intervention.

G) Supportive Surgery: It resembles palliative surgery and aids other treatments of cancer to work with more effectiveness.

H) Restorative Surgery: It is used to restore the patient’s normal look or function after a curative surgery affecting the patient’s appearance such as surgery for oral cancer. There are other novel specialized cancer surgery types, which can help treat cancers.

These newer approaches are:

A) Cryosurgery which uses extremely low temperatures to kill cancer cells. The surgery most often involves the use of liquid nitrogen, although carbon dioxide and argon may also be used.

B) Laser Surgery uses light energy beams to destroy very small cancers. It can also be used to activate drugs to kill cancer cells. This surgery is preferred to treat cancers of difficult to reach areas such as the rectum, cervix, etc.

C) Electrosurgery: As the name suggests, this approach uses electrical current to kill cancer cells, preferably in cancers of the skin and oral mucosa. The two other types of electrosurgery most commonly used are high-frequency electrosurgery and electrocautery.

D) Microscopically controlled surgery or Moh’s Surgery is used in cases where the cancer is present in delicate body parts like the eye. It involves the careful removal of cancerous tissue layer by layer until the extracted layers stop showing evidence of cancer cells.

To round off, a correct cancer diagnosis is the first and the most important step for adequate and effective treatment because every cancer type requires a specific treatment regimen that encompasses one or more modalities. Cancer mortality can be reduced if cases are detected and screened early. The primary goal of all kind of surgeries is generally to cure cancer or to significantly prolong life. Improving the patient’s quality of life is also an important goal as well and this can be achieved by supportive or palliative care and psychosocial support.

Cancer November 10, 2020

All You Need To Know About Types Of Cancer Treatment

Treatment of cancer involves the use of either surgical removal or the use of radiation, medicines, and multiple other modalities for curing cancer. Currently, multiple types of cancer treatment are available. The selection of a treatment regimen for cancer depends on each patient’s medical condition, his/her cancer type, involving organs or the extent of cancer spread. A cancer patient may be prescribed either a single treatment option or a combination of multiple treatment options.

The goal of cancer treatment

Achieving a total or maximum possible cure for your cancer is the ultimate goal of cancer treatment, which may allow a cancer patient to lead a normal life. A complete cure and normal lifespan might not be possible in every patient post-treatment, but it may enable the treating doctors to reduce the size of the patient’s cancer tumor or delay the growth of cancer so that the patient may lead a symptom-free life for the maximum possible period after treatment.

Forms of cancer treatment

Treatment in cancer may be in two chief forms

Primary Treatment

The goal of a primary form of treatment is to entirely remove cancer from your body or kill all the existing cells of cancer in your body. Any treatment type in cancer can work as a primary mode of cancer treatment, but surgery is the most frequently recommended primary mode of treatment in most patients. Your doctor may also recommend radiation or drug therapy as primary treatment if you are particularly sensitive to these treatment regimens.

Adjuvant Treatment

Adjuvant treatment’s goal is to kill any existing cancer cells, which are surviving post-primary treatment. Adjuvant treatment in cancer reduces the chance of cancer recurrence. Same as primary treatment, any cancer treatment can work as adjuvant treatment. However, most frequent adjuvant therapies include drug or chemotherapy, radiation and hormonal therapy.

Neoadjuvant Treatment

This treatment type is similar to the adjuvant type but its goal is different from the adjuvant treatment. Neoadjuvant treatment is used to make the primary treatment easier or raise its effectiveness and is used before primary treatments.

Palliative Treatment

It is used in treating cancer at progressive stages. It does not treat cancer but eases the discomfort or associated adverse effects of cancer treatment.

Types of Cancer Treatment

Multiple treatments are currently available for treating cancer. However, selecting a particular treatment type for each patient depends on the individual patient’s cancer type and stage, his/her overall health and also his/her preferred treatment type. You and your doctor together can decide which treatment is best suited for you based on the merits and demerits of each treatment.

Options to treat cancer include:

Surgery

The goal of cancer surgery is the removal of the entire or maximum possible cancerous tumor from the patient’s body.

Chemotherapy

It involves the usage of drugs to kill cancer cells in the patient’s body.

Radiation Therapy

This method utilizes uses high-intensity beams of light energy for killing cancer cells. The radiation source may be placed outside your body or may even be inserted in the patient’s body.

Bone Marrow Transplant

Bone marrow is the material present inside the bones of each human that produces blood cells. A bone marrow transplant can utilize the patient’s cells of bone marrow or from a healthy donor, mostly a family member. This method enables the doctor to use a higher chemotherapy dose to kill cancer cells or replaces the cancerous bone marrow.

Immunotherapy

This therapy boosts the immune system of the patient’s body to fight and kill the cancer cells by enabling it to recognize the cancer cells present in the body.

Hormonal Therapy

It is used to treat some hormone-related cancers such as breast cancer. This therapy involves the removal of these hormones or blocking their effects in the body, stopping the growth of cancer cells.

Targeted Drug Therapy

This therapy concentrates on particular defects within cancer cells that enable the survival of the cancer cells.

Cryotherapy

It uses extremely low temperature to kill cancer cells. During cryoablation, a thin, wandlike needle (cryoprobe) is inserted through your skin and directly into the cancerous tumor. Gas is pumped into the cryoprobe to freeze the tissue. Then the tissue is allowed to thaw. The freezing and thawing process is repeated several times during the same treatment session to kill the cancer cells.

Radiofrequency Ablation

This treatment involves the use of electrical energy to raise the temperature of cancer cells, leading to their death.

While there are multiple treatment options available to treat cancer, it is advisable to consult a surgeon to prescribe the best treatment for your case as the line of treatment will always depend on the types and severity of the disease.

Hernia September 25, 2020

Hernia Mesh: All your queries answered!

Hernias do not heal on their own. Though they can remain asymptomatic for a long time and cause no trouble, they also have high possibilities of getting worse with time. Usually surgical repair is recommended for treating hernias but your doctor may prescribe OTC (Over-the-Counter) antacid medicines at times to reduce the risk of your hernia or may ask you to wear a supporting truss. The hernia has a high rate of recurrence, and surgeons often use surgical mesh to strengthen the repair and reduce the rate of recurrence. The use of surgical mesh may also improve patient outcomes through decreased operative time and minimized recovery time. Now let’s understand more about Hernia mesh.

What is hernia mesh?

A hernia mesh is a surgical device used to provide added backing to damaged or impaired tissue due to hernia till it gets healed. It is placed through the area around the hernia, attaching it with stitches, staples or glue. Mesh’s pores let tissue to grow into the device.

How a hernia mesh works?

A hernia surgical mesh functions as an elastic scaffold for hernia repair. It reinforces walls of muscles and prevents organs from protruding through them.

Types of Hernia mesh

Most of contemporarily existing hernia mesh devices are composed of synthetic materials or tissues of animals. Surgical mesh manufactured from synthetic materials is available in knitted or non-knitted variants. The synthetic hernia meshes are made of absorbable, non-absorbable or a combination of these materials. Animal-derived meshes are made of processed and disinfected intestine or skin of pigs or cows, which are absorbable, suited for application as an implanted device.

Is Hernia mesh safe?

Hernia repair using mesh is currently one of the most regularly accomplished surgeries in general surgery. The use of mesh is recognized to reduce recurrence rates of hernia. As per evidence, non-mesh repair of hernias are associated with a higher recurrence rate at 1 year when compared to mesh repair.

Currently, chronic pain following hernia surgery is the most concerning post-operative complication with recurrence rates decreasing than ever before by using surgical hernia mesh.

Hence, the focus in hernia surgery is now shifted in defining, assessing and identifying risk factors relating to chronic pain. Chronic pain hernia surgery is a vital problem for a considerable number of patients. Some identified risk factors for post-operative pain include younger age, female gender, hernia recurrence, operative complications, and elevated pain levels in the immediate post-operative period. However, recent evidence confirms the safety and effectiveness of mesh utilization in hernia surgery. The recent evidence demonstrates that hernia repair with mesh is not linked to an intolerable level of severe chronic pain. Complication rates are low for hernia repair surgery and in majority of cases, not related to the mesh itself. It is shown that pain scores normally improve post 1 year of hernia repair.

How long does Hernia mesh last?

Non-absorbable mesh stay in the body forever and is termed as an everlasting implant. It is used to provide long-lasting support to the repaired hernia. On the contrary, absorbable mesh gets degraded eventually, losing its strength over time depending on its composition. It is not meant to provide lasting support to the repair site. As the absorbable mesh material degrades, new tissue growth is meant to give power to the repair.

If you are unsure about the specific which mesh to go with, mesh manufacturer and brand used in your surgery and have questions about your hernia repair, contact your surgeon or the facility where your surgery was performed to obtain the information from your medical record.

Knee Replacement September 25, 2020

Arthritis: Available Treatment options to cure Chronic Knee Pain

The Knee and its Structure

The knee is human body’s largest joint and its healthy maintenance is required to perform most of everyday activities, easily. The knee is made up of the lower end of the thighbone which is called the femur, the upper end of the shinbone which is called the tibia, and the kneecap which is called the patella. The ends of these three bones where they meet are covered with a smooth substance that protects the bones and enables them to move easily (articular cartilage). The C-shaped wedges located between the femur and tibia are menisci. These act as “shock absorbers” that cushion the joint. Large ligaments hold the femur and tibia together to provide stability, the long thigh muscles provide strength to the knee. Large ligaments hold the femur and tibia together and provide stability whereas, the long thigh muscles provide strength to the knee. All remaining surfaces of the knee are covered by a thin lining called the synovial membrane. This membrane releases a fluid that lubricates the cartilage, reducing friction to nearly zero in a healthy knee. Normally, all of these components work in harmony. But disease or injury can disrupt this harmony which results in pain, muscle weakness, and reduced function.

What is Arthritis and different types of arthritis?

The most common disease responsible for disrupting the harmony and causing chronic knee pain and disability is arthritis. Swelling and tenderness in any of the joints of our body, including the knees is referred as arthritis.

Although there are many types of arthritis, mostly knee pain is caused by just three types: osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis.

Osteoarthritis is an age-related type of arthritis. It occurs in people 50 years of age and older but may occur in younger people, too. In this type of arthritis, the cartilage that cushions the bones of the knee softens and wears away. The bones then rub against one another, causing knee pain and stiffness.
Rheumatoid arthritis is a disease in which the synovial membrane that surrounds the joint becomes inflamed and thickened. This chronic inflammation can damage the cartilage and eventually cause cartilage loss, pain, and stiffness. Rheumatoid arthritis is the most common form of a group of disorders termed “inflammatory arthritis.”

Post-traumatic arthritis is a type of arthritis that can follow a serious knee injury. Fractures of the bones surrounding the knee or tears of the knee ligaments may damage the articular cartilage over time, leading to knee pain and limiting knee function.

Treatment of Arthritis

Treatment of arthritis concentrates on providing relief from symptoms and improving function of the joint/knee. You may need to try multiple treatments or combine several treatments from the following to help you in getting relief from your arthritis.

Lose some weight (in case of overweight or obese patients)

Exercise: Muscle strengthening around the knees through exercise restores stability of the knee joint and reduces pain. Stretching of muscles through exercise aids in maintaining the mobility and flexibility of the knee joint

Pain-killers: These include over-the-counter paracetamol, naproxen, diclofenac, etc. However, these should not be continued for more than 10 days without your doctor’s consultation.
Corticosteroid or hyaluronic acid injections directly in the knee: Corticosteroids act as powerful anti-inflammatory agents whereas hyaluronic acid is a kind of lubricant in the knee.
Alternative therapies such as topical counter-irritant creams containing capsaicin, acupuncture therapy or supplementation with glucosamine and others can sometimes help to improve arthritis symptoms.
Physical or Occupational Therapy can also aid in teaching you ways of performing routine activity through exercises or alternate ways of performing routine work.

Using braces: Devices such as braces can either transfer the weight from the sides of the knee affected by arthritis or even support the entire knee.
Surgery: When every treatment from the above options fail to provide relief from arthritis of the knee, your doctor can recommend surgical options such as arthroscopy (removing the debris in the joint through a tiny telescope and other small equipments), osteotomy (altering the alignment of the knee by changing the knee’s shape) or total knee replacement (where the natural worn out knee joint is replaced by an artificial knee joint made of metals or plastic).

Usually, the treatment of arthritis is dependent on the specific type of arthritis present. But, sometimes the patients may need to try several different treatments, or combination of treatments before they determine what works best for them. However, in most cases, an exact diagnosis increases the chances for successful treatment of arthritis. After undergoing treatment, the doctor may recommend some physical therapy to help the patient regain strength in the knee and to restore range of motion making it possible to perform daily activities more effortlessly.

Heart Attack September 24, 2020

Cardiovascular Disease (CVD): Facts, Causes & Treatment

Cardiovascular diseases (CVDs) also called Heart diseases are a group of disorders of the heart and blood vessels. The numerous problems causing most of the CVD is atherosclerosis (blockages in coronary arteries), a process mainly governed by lifestyle factors. As per World Health Organization, It is estimated that 17.7 million people died from CVDs in 2015, representing 31% of all deaths taking place worldwide; more people die every year from CVDs than from any other cause. Cardiovascular diseases are showing an increase among the Indian population. CVDs form a significant share of 24% from the 53% of all the deaths attributed to non-communicable diseases (NCDs) in India, as per the nation-wise statistical estimate of the WHO on NCDs.

In older men, nearly all heart attacks are caused by atherosclerotic blockages in coronary arteries. Classical coronary artery disease (CAD) is also dominant amongst young adults. Around 60% of these younger adults are affected by CAD in a single coronary vessel, whereas the older adult patients are more prone to get affected by CVD in multiple arteries. The rate of coronary heart disease in young Indian men is almost twice as high as that in their western counterparts and there is evidence that Cardiovascular diseases (CVD) affect Indians at least 10 years earlier as compared to their counterparts in Europe. CVD stays the number-one danger to the health of women. There is a strong gender difference in CV-related death, with more affected women dying each year as compared to the affected men. The lifetime risk of a woman dying from heart disease is eight times more than that of breast cancer. Also, People with diabetes, particularly type 2 diabetes, may have the following conditions like Hypertension, cholesterol, poor sugar levels etc. that contribute to their risk for developing cardiovascular disease.

Listen to Dr. Nimit Shah as he takes the time to explain the various causes of heart attacks in the country and the different treatments available for the same.

Listen to Dr. Nimit Shah, Interventional Cardiologist in the UK, Dr. Nimit Shah talks about the various risks and benefits of angioplasty, the different kinds of angioplasty procedures, and the different kinds of drug stents available in the country for the same.

Read more about Meril’s state of the art Drug Eluting Stent Evermine50 here: https://bit.ly/331QdkF