Monday, February 18, 2019

Surgical Breast Cancer Treatments from the Best Laparoscopic Cancer Surgeon

Breast cancer is the most common form of cancer in India, having overtaken cervical cancer. In cities like Mumbai, Delhi, Bengaluru, Kolkata, Chennai, Bhopal, Ahmedabad, breast cancer accounts for 25%-35% of all female cancers.

Breast cancer is also more common in the younger population. Almost 50% of all cases are in the age group of 25-40.  The numbers are staggering and the most disturbing fact is that Indian Council for Medical Research published a report in 2016 which stated that the total number of new cancer cases is expected to be about 15 lakhs. This figure will likely to increase to 18 lakhs in 2020. So, it is of paramount importance to be aware of diagnosis, treatment and surgical options for breast cancer.

https://www.oncologistindia.com/what-do-we-treat/cancer-in-women/breast-cancer

Surgical removal of the tumor is the primary treatment for invasive breast cancers. Quite often, radiation therapy will follow to help prevent a local recurrence of the breast cancer depending on the tumor type. There are different types of surgery used to treat breast cancer.

1. Lumpectomy


Lumpectomy is the removal of lump or sweeling, this procedure doesn't require wide mapping, it is done for benign (non cancerous swelling). It involves removing the cancerous breast tissue while leaving as much healthy tissue as possible in place. When a non-malignant tumor such as a fibroadenoma of the breast is removed, it is often called an excisional breast biopsy. Lumpectomy is not suitable for every breast cancer patient, and when it is performed, the amount of tissue removed can vary greatly depending on the extent of the cancer.

The main advantage of lumpectomy is that it can conserve much of the manifestation and sensation of the breast. It is a less invasive surgery and the recovery time is shorter.

After the completion of a lumpectomy, a pathologist will evaluate the tumor margins using the sample of healthy tissue that was removed along with the tumor.  The lumpectomy is considered to be a success if no cancer cells (clear margins) are identified. Nevertheless, if the margins contain malignant cells, further surgery may be required.

2. Breast conservative surgery


It involves removal of cancerous lump with marging and removal of Lymph Nodes. It is less radical surgery, early recover from surgery. Patient undergoing breast conservative surgery require adjuvant radiation therapy irrespective of the pathology, findings.

3. Mastectomy


Mastectomy is a surgical procedure which involves the removal of entire breast. Mastectomy is recommended for benign tumors involving whole of the breast. Ex: Phylloides tumor. Other indicators are as prophalaois in high risk patient to prevent breast cancer. (Ex: Angelina Jolie underwent B/L prophylactic mastectomy to prevent cancer). Mastectomy is also recommended to prevent cancer from occurring in women who have a high risk for breast cancer.

There are several types of mastectomy procedures:

 

Simple or Total Mastectomy:


The entire breast, including the nipple, is removed with the exception of the lymph nodes and muscle tissues.

Double Mastectomy:


A double mastectomy refers to the removal of both breasts due to a high risk of the cancer spreading (metastasize).

Modified Radical Mastectomy:


This is a kind of the total mastectomy that involves the removal of entire breast including the lymph nodes under the arm.

Radical Mastectomy:


This is a variation of the total mastectomy that removes the entire breast, including the lymph nodes under the arm, and the pectoral muscles under the breast. This may be advised only when breast cancer has spread to the chest muscles.

Skin sparing mastectomy: 


This mastectomy approach preserves as much of a patient’s skin as possible. The breast tissue, nipple and areola are removed while the skin on top the breast is left untouched. This type of mastectomy is recommended for those who plan to have immediate breast reconstructive surgery.

Nipple Spearing Mastectomy: 


Sometimes called as total skin-sparing mastectomy, the nipple, areola and skin on top the breast is left intact, while all of the breast tissue, including the ducts to the nipple and areola are removed. Breast reconstructive surgery is done right after the mastectomy.

Cancer cells might have spread into the lymph nodes nearer to the breast and to detect if the breast cancer has spread to axillary (underarm) lymph nodes, one or more of these lymph nodes will be removed and examined.  Lymph nodes may be removed either as part of the surgery to remove the breast cancer or as a separate procedure.

Sentinel Node Biopsy


The surgical procedure to check whether the cancer has spread from primary tumor into lymphatic system is sentinel node biopsy. It is used in finding breast cancer and melanoma. The first few lymph nodes which tumor drains are sentinel nodes.

https://www.oncologistindia.com/department-of-excellence/surgical-oncology

 

Oncoplastic Surgery for Breast


This surgery begins at the time of breast conservation surgery, or weeks or months to years afterwards (delayed). This is a smooth surgical process, this can be done in one operative setting.

Breast Reconstruction


Those who have been diagnosed with breast cancer are required to go through certain surgeries. The main surgeries for treating breast cancer are mastectomy and lumpectomy. Breast reconstruction surgery is a surgery for rebuilding breasts after mastectomy or lumpectomy. It can be done simultaneously after your breast cancer surgery or at a later time.

There are many different reconstruction techniques available and they can be done months or years after breast cancer surgeries. This is the surgery in which the plastic surgeon reconstructs the breast shape using artificial implants, these implants can be flap of tissue from your body. After the reconstruction surgery proper care has to be taken for recovery. Having reconstruction surgery at the time of mastectomy gives better cosmetic results. However, if one is not sure about having the surgery, it can be done later also. Those who are interested in having a reconstruction, it is better to consult their breast surgeon early on. You may also ask your surgeon for referral to a plastic surgeon so that you can discuss your reconstruction options in advance.

Types


1. Silicon implants for breast augmentation
2. Pedicaled flaps -Latissimus, TRAM flap
3. Free flap transfer
4. Reduction mammoplasty

 

Surgical Oncology in India


Dr. Shiva Kumar Uppala, one of the best laparoscopic cancer surgeon in Bangalore, specializes in minimal access surgical techniques and has performed more than 500 surgeries till now. He received extensive training and has done his residency in surgical oncology from esteemed institutions.


Contact us


Visit @ oncologistindia.com
Mail us: oncologistindiadrshiva@gmail.com
Book appointment: www.oncologistindia.com/book-appointment

Thursday, December 20, 2018

Understanding the Types of Thyroid Cancers

Thyroid Cancer is not a type of cancer that typically makes headlines. But it's vital to learn the facts about thyroid cancer because more and more people are being diagnosed with the disease nowadays.  

Nobody ever gives much thought to their thyroid, but the small butterfly-shaped gland in the neck beneath Adam’s apple has a huge influence on your entire body. 

The prevalence of thyroid cancers is rapidly increasing in India especially among the younger population (age group < 40). Reports suggest that cancer of thyroid gland forms the commonest type (60 percent) occurring in the endocrine system. Thyroid cancer also accounts for one percent of all body cancers. This can affect an individual of any age group, although it affects women predominantly in a ratio of 3:1, men are not altogether spared.
thyroid cancer treatment in bangalore

Types of Thyroid cancer  
There are four types of thyroid cancer:

  • Papillary carcinoma (PTC): This is the most common type of thyroid cancer, accounting for approximately 70- 80 percent of cases. In fact, this is the 8th most common cancer among women overall as well as the most common cancer in women younger than 25. Papillary carcinomas are slow growing, differentiated cancers that develop from follicular cells which can develop in one or both lobes of the thyroid gland and may spread to nearby lymph nodes in the neck. Although the most common etiologic factors for papillary thyroid cancer include radiation exposure and a family history of thyroid cancer, it is important to note that the majority of patients have no risk factors at all. Luckily, papillary carcinoma is also the thyroid cancer with the best prognosis and most patients can be cured if treated appropriately and early enough.
  • Follicular Thyroid Carcinoma (FTC): FTC is the second most common type of malignancy arising from follicular cells, and accounts for approximately one out of 10 cases. This is found more frequently in countries with an insufficient dietary intake of iodine, however, tends to occur less common now days than in the past.  When compared with papillary thyroid carcinoma (PTC), FTC does not spread into lymph nodes of the neck but they are more likely than papillary cancers to spread to other organs, like the lungs or the bones. In general, it is associated with a good prognosis while it is rather more aggressive than papillary cancer.  Follicular carcinoma is further classified into three categories based on the scale of invasion: widely, moderately and minimally invasive FTC.  Minimally invasive FTC is generally a more sluggish, slow-growing disease. Widely invasive FTC is more aggressive and exhibits a poorer prognosis than moderately and minimally invasive FTC.
  • Hurthle cell carcinoma (HCC): Also known as oxyphil cell carcinoma, this is a subtype of follicular carcinoma and accounts for approximately 3 -5 percent of all thyroid cancers. Hurthle cells in thyroid are cells that have undergone oncocytic change (cellular change as a result of accumulation of altered mitochondria. distinguished by a profuse eosinophilic granular cytoplasm) and they can also spread to neck lymph nodes.
  • Medullary thyroid carcinoma (MTC): They are a rare form of thyroid cancer and develop from parafollicular cells or C cells in the thyroid gland; however, they are more aggressive and less differentiated than papillary or follicular cancers. Approximately 3-4 percent of all thyroid cancers will be of the medullary subtype. Compared with the more differentiated thyroid cancers, these cancers are more likely to spread to lymph nodes and other organs. They usually originate in the upper central lobe of the thyroid. 
  • Anaplastic carcinoma (ATC): This is the least common type of thyroid cancer and also the most undifferentiated type of thyroid cancer, meaning that it looks the least like normal cells of the thyroid gland. Consequently, it is a very aggressive form of cancer that quickly spreads to other parts of the neck and body. It occurs in approximately 1-2 percent of thyroid cancer cases and are more common in older people (with an average age of about 60).

Thyroid cancer- Unknown facts:


  1. Thyroid cancer is becoming more common - Over the last decade, the frequency has increased three to five-fold worldwide. Experts suggest that at least some of that spike is due to increased screening along with improved imaging techniques.
  2.  Thyroid cancer may not present symptoms – You may be aware of classical thyroid symptoms. Sometimes thyroid cancer may be asymptomatic or completely without symptoms. This means, there is a possibility it has developed even if you do not present symptoms of thyroid cancer.  
  3. 2 in 3 cases are in people younger than 55-
  4. Though cancer, in general, is rare among the younger population, most thyroid cancer patients are in the age group of 30-50, and about 2% of thyroid cancers occur in teens and children. Thyroid cancer tops the chart for cancer in women of age group 15-30 and the second most common cancer (behind breast cancer) for women of age (30-39)
  5. Thyroid cancer doesn’t alter the functions of thyroid gland (most of the times) - Unlike hyper- and hypothyroidism, thyroid cancer does not cause symptoms such as heart palpitation, weight changes and thinning hair. Most of the time thyroid cancer doesn’t affect how well your thyroid does its job and there are exceptions, but it continues to function normally
  6. If you are a thyroid cancer patient, you are at risk of developing other cancers - Unfortunately, most of thyroid cancer patients are not aware that they have an increased risk of developing secondary forms of cancer. While thyroid cancer has a high rate of survivability, it is really significant for thyroid cancer survivors to remain cautious during and after treatment.

Risk factors for thyroid cancer

Risk factors for thyroid cancer include:

  • Having a family history of thyroid cancer
  • Those who have a bowel condition known as familial adenomatous polyposis
  • Having a history of breast cancer
  • Acromegaly – a hormonal disorder where the pituitary gland produces too much growth hormone(GH)
  • Radiation exposure
  • People with  Carney complex or Cowden disease
  • Age is also a risk factor. Thyroid cancer is most likely to occur for older people (age group < 40).
  • Lifestyle factors such as low iodine diet
  • Thyroid cancer is more prevalent among Asian people 
thyroid cancer treatment in bangalore

Dr. Shiva Kumar Uppala, one of the best cancer doctors in India who has performed more than 500 surgeries till now, is an experienced surgical oncologist with specialization in minimal access surgical techniques. He received extensive training and has done his residency in surgical oncology from esteemed institutions.  Considered as the best for thyroid cancer treatment in India, contact his services for the best oncology treatments in Bangalore.
Visit @ oncologistindia.com
Mail us: oncologistindiadrshiva@gmail.com
Book appointment: oncologistindia.com/book-appointment