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Brain Cancer

Animation of an MRI brain scan, starting at th...
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Alternative Names:Glioma, Meningioma

Definition:
Brain cancer is a disease of the brain in which cancer cells (malignant) arise in the brain tissue. Cancer cells grow to form a mass of cancer tissue (tumor) that interferes with brain functions such as muscle control, sensation, memory, and other normal body functions.

 click & see the pictures

There are more than 100 different types of brain tumour, depending on which cells within the brain are involved. The most common (about 50 per cent of brain cancers) is called a glioma, and it is formed not from the nerve cells of the brain but from the glial cells, which support those nerves. The most aggressive form of glioma is known as a glioblastoma multiforme – these tumours form branches like a tree reaching out through the brain and may be impossible to completely remove.

Other tumours include:
*Meningiomas – account for about a quarter of brain cancers and are formed from cells in the membranes, or meninges, that cover the brain

*Pituitary adenomas – tumours of the hormone-producing pituitary gland

*Acoustic neuromas – typically slow-growing tumours of the hearing nerve often found in older people

*Craniopharyngioma and ependymomas – often found in younger people

The treatment and outlook for these different brain tumours varies hugely. Some, such as meningiomas and pituitary tumours, are usually (but not always) benign, which means they don’t spread through the brain or elsewhere in the body. However, they can still cause problems as they expand within the skull, compressing vital parts of the brain. Other types of brain cancer are malignant, spreading through the tissues and returning after treatment.

Brain tumours are also graded in terms of how aggressive, abnormal or fast-growing the cells are. Exactly where the tumour forms is also critical, as some areas of the brain are much easier to operate on than others, where important structures are packed closely together.

Causes:
The cause of brain cancer  remains a mystery, but some risk factors are known. These include:

*Age – different tumours tend to occur at different ages. About 300 children are diagnosed with brain tumours every year, and these are often a type called primitive neuroectodermal tumours (PNETs), which form from very basic cells left behind by the developing embryo. PNETs usually develop at the back of the brain in the cerebellum

*Genetics – as many as five per cent of brain tumours occur as part of an inherited condition, such as neurofibromatosis

*Exposure to ionising radiation – such as radiotherapy treatment at a young age

*Altered immunity – a weakened immunity has been linked to a type of tumour called a lymphoma, while autoimmune disease and allergy seem to slightly reduce the risk of brain tumours

*Environmental pollutants – many people worry that chemicals in the environment (such as from rubber, petrol and many manufacturing industries) can increase the risk of brain cancers, but research has so far failed to prove a link with any degree of certainty. Neither is there clear and irrefutable evidence for risk from mobile phones, electricity power lines or viral infections, although research is ongoing.

Symptoms:
The symptoms and signs of a brain tumour fall into two categories.

Those caused by damage or disruption of particular nerves or areas of the brain. Symptoms will depend on the location of the tumour and may include:

*Weakness or tremor of certain parts of the body

*Difficulty writing, drawing or walking

*Changes in vision or other senses

*Changes in mood, behaviour or mental abilities

Those caused by increased pressure within the skull – these are general to many types of tumour and may include:

*Headache (typically occurring on waking or getting up)

*Irritability

*Nausea and vomiting

*Seizures

*Drowsiness

*Coma

*Changes in your ability to talk, hear or see

*Problems with balance or walking

*Problems with thinking or memory

*Muscle jerking or twitching

*Numbness or tingling in arms or legs

Diagnosis:
The initial test is an interview that includes a medical history and physical examination of the person by a health-care provider.If he or she  suspects a brain tumour, you should be referred to a specialist within two weeks. Tests are likely to include blood tests and the most frequently used test to detect brain cancer is a CT scan (computerized tomography). This test resembles a series of X-rays and is not painful, although sometimes a dye needs to be injected into a vein for better images of some internal brain structures.

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Another test that is gaining popularity because of its high sensitivity for detecting anatomic changes in the brain is MRI (magnetic resonance imaging). This test also resembles a series of X-rays and shows the brain structures in detail better than CT. MRI is not as widely available as CT scanning. If the tests show evidence (tumors or abnormalities in the brain tissue) of brain cancer, then other doctors such as neurosurgeons and neurologists that specialize in treating brain ailments will be consulted to help determine what should be done to treat the patient. Occasionally, a tissue sample (biopsy) may be obtained by surgery or insertion of a needle to help determine the diagnosis. Other tests (white blood cell counts, electrolytes, or examination of cerebrospinal fluid to detect abnormal cells or increased intracranial pressure) may be ordered by the health-care practitioner to help determine the patient’s state of health or to detect other health problems.

Treatment:
The type of treatment offered and the likely response depends on the type, grade and location of the tumour. Unlike many other organs, it’s very difficult to remove parts of the brain without causing massive disruption to the control of body functions, so a cancer near a vital part of the brain may be particularly difficult to remove.

The main treatments for brain tumours include:

*Surgery – to remove all or part of the tumour, or to reduce pressure within the skull

*Radiotherapy – some brain cancers are sensitive to radiotherapy. Newer treatments (stereotactic radiotherapy and radiosurgery) carefully target maximum doses to small areas of the tumour, avoiding healthy brain tissue.

*Chemotherapy – these treatments are limited by the fact that many drugs cannot pass from the bloodstream into brain tissue because of the ‘blood-brain barrier’, but may be useful when tumours are difficult to operate on, or have advanced or returned.

*Biological’ therapies – for example, drugs that block the chemicals that stimulate growth of tumour cells

*Steroids – can help to reduce swelling of the brain and decrease pressure in the skull
Often a combination of treatments will be recommended.

While, as a general rule, brain tumours are difficult to treat and tend to have a limited response, it can be very misleading to give overall survival figures because some brain cancers are easily removed with little long term damage, while others are rapidly progressive and respond poorly to any treatment.

While only about 14 per cent of people diagnosed with a brain tumour are still alive more than five years later, this sombre statistic could be unnecessarily worrying for a person with a small benign brain tumour. What a person diagnosed with brain cancer needs to know will be the outlook for their individual situation, which only their own doctor can tell them.

Treatments do continue to improve – for example, survival rates for young children have doubled over the past few decades, and many new developments are being tested.

Other treatments may include hyperthermia (heat treatments), immunotherapy (immune cells directed to kill certain cancer cell types), or steroids to reduce inflammation and brain swelling. These may be added on to other treatment plans.

Clinical trials (treatment plans designed by scientists to try new chemicals or treatment methods on patients) can be another way for patients to obtain treatment specifically for their cancer cell type. Clinical trials are part of the research efforts to produce better treatments for all disease types. The best treatment for brain cancer is designed by the team of cancer specialists in conjunction with the wishes of the patient.

Prognosis:
Survival of treated brain cancer varies with the cancer type, location, and overall age and general health of the patient. In general, most treatment plans seldom result in a cure. Reports of survival greater that five years (which is considered to be long-term survival), vary from less than 10% to a high of 32%, no matter what treatment plan is used.

So, why use any treatment plan? Without treatment, brain cancers are usually aggressive and result in death within a short time span. Treatment plans can prolong survival and can improve the patient’s quality of life for some time. Again, the patient and caregivers should discuss the prognosis when deciding on treatment plans.

Living with Brain Cancer:
Discuss your concerns openly with your doctors and family members. It is common for brain cancer patients to be concerned about how they can continue to lead their lives as normally as possible; it is also common for them to become anxious, depressed, and angry. Most people cope better when they discuss their concerns and feelings. Although some patients can do this with friends and relatives, others find solace in support groups (people who have brain cancer and are willing to discuss their experiences with other patients) composed of people who have experienced similar situations and feelings. The patient’s treatment team of doctors should be able to connect patients with support groups. In addition, information about local support groups is available from the American Cancer Society at http://www.cancer.org/docroot/home/index.asp.

Prevention:
Although there is no way to prevent brain cancers, early diagnosis and treatment of tumors that tend to metastasize to the brain may reduce the risk of metastatic brain tumors. The following factors have been suggested as possible risk factors for primary brain tumors: radiation to the head, HIV infection, and environmental toxins. However, no one knows the exact causes that initiate brain cancer, especially primary brain cancer, so specific preventive measures are not known. Although Web sites and popular press articles suggest that macrobiotic diets, not using cell phones, and other methods will help prevent brain cancer, there is no reliable data to support these claims.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.medicinenet.com/brain_cancer/page5.htm
http://www.nlm.nih.gov/medlineplus/braincancer.html
http://commons.wikimedia.org/wiki/File:MRI_head_side.jpg

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Morning Sickness, All Day Long

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Pregnancy sometimes causes nausea and vomiting. It is dismissed as normal morning sickness. In some cultures, vomiting is actually taken as proof of pregnancy.
…..CLICK & SEE
Morning sickness, however, is not necessarily confined to the morning, though 80 per cent of pregnant women fall in this category. It can occur at any time of the day or night. The remaining 20 per cent of the women may show other signs of pregnancy such as eating ravenously.

Vomiting usually starts around the sixth week — around two weeks after the period is missed. It settles around the twelfth week, and then disappears around the fifth month. Any strong smell can precipitate waves of nausea — be it garbage or spices being fried in the kitchen.

Baffled scientists put forward many theories to explain this strange phenomenon. It was touted as an unconscious rejection of the pregnancy. Women were unsympathetically told to “control themselves”. Some blamed it on the hormonal changes during the period, which causes relaxation of the smooth muscles of the oesophagus and gall bladder and slows digestion.

Scientists have now discovered that the nausea is due to sensitivity to a hormone called HCG (human chorionic gonadotrophin). The vomiting coincides with peak levels of this hormone (six to 12 weeks).

The sensitivity varies and is genetically determined. Women who vomit during pregnancy often have mothers and sisters who had the same problem. It also tends to recur in each succeeding pregnancy, though, if the tolerance levels to HCG build up, the vomiting in the second pregnancy can be less than that in the first.

Excessive vomiting causes 1 per cent of the women who vomit to become morbidly ill. They lose 5 per cent or more of their pre-pregnancy weight. The violent retching can cause tears in the esophagus, resulting in blood in the vomit. The inability to retain any food in the stomach can result in dehydration severe enough to affect the kidneys. Blood may begin to clot in the veins. The brain may be affected as a result of electrolyte imbalance or dehydration. Loss of vitamins, particularly thiamine, may cause delirium.

This severe vomiting is also known as hyperemesis gravidarum (in Latin, gravid means pregnant, and hyper is excessive). It is more likely in younger women who are underweight before the pregnancy, pre-diabetic (abnormal GTT values) or have migraine headaches.

Persistent hyperemesis can be a danger signal. It can occur if the levels of HCG are higher than normal. This occurs when it is a twin pregnancy or if the baby has a chromosomal abnormality like trisomy 18 or 21. Or, it may not be a pregnancy at all but a tumour called hydatidiform mole that mimics pregnancy. An ultrasound examination at this stage will pick up all the above abnormalities.

Well meaning advice to tackle morning sickness with bed rest is counterproductive. The reclining position may further aggravate reflux from the stomach. Moreover, inactivity may lead to loss of muscle mass. This may make it difficult to withstand the rigours of labour and childbirth.

• To tackle morning sickness, consider the following.

• A good diet with adequate vitamins, particularly folic acid.

• Exposure to fresh air. Try going for a walk outdoor for half an hour in the morning and evening.

• Eat several small meals instead of three regular ones.

• Avoid anything that triggers the vomiting even if it touted as being “good for the baby”.

Ginger helps as lozenges, ginger tea or lime juice. Supplements are available but since the other additives in the capsules are not known, it is probably better and safer to use the natural product.

Peppermint can be sucked as lozenges or peppermint oil used as inhalations.

Try acupressure. The pressure point to reduce nausea is located in the middle of the inner wrist, three finger-breadths away from the crease and between the two tendons. Locate and press firmly, one wrist at a time for three minutes.

Despite this, if uncontrollable vomiting occurs, with aversion to food, loss of weight, dark coloured urine, loss of consciousness, headache, confusion or fainting, it is better to seek medical help. Hyperemesis can be fatal.

An initial evaluation will rule out a correctable cause like a urinary tract infection, acid dyspepsia, chromosomal abnormalities or a hydatidiform mole. Intravenous fluids (IV) can be given to restore hydration, electrolytes, vitamins and nutrients.

If anti-nausea medications are used, the danger to the baby has to be weighed against the risk to the mother. Strict medical supervision and documentation of the dose and duration of treatment are required.

Source : The Telegraph ( Kolkata, India)

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New Methods for Curbing Nausea of Chemotherapy

Ginger, a home remedy for helping an upset stomach, and a cocktail of anti-nausea drugs both reduced vomiting and sickness in cancer patients.

Chemotherapy could soon become less grueling.

Simply adding about half a teaspoon of ginger to food in the days before, during and after chemotherapy can reduce the often-debilitating side effects of nausea and vomiting, a large, randomized clinical trial has found. And a newer type of anti-nausea drug, when added to standard medications, can help prevent such side effects as well.

The ginger results will be presented this month at the American Society of Clinical Oncology annual meeting; the drug study was published this week in the Lancet Oncology journal.

The findings are significant, cancer experts say, because about 70% of chemotherapy patients experience nausea and vomiting — often severe — during treatment.

“Chemotherapy has come to be the thing cancer patients fear the most,” said Dr. Steven Grunberg, a professor of medicine at the University of Vermont and lead author of the study in the Lancet Oncology. “We’ve made a huge amount of progress, but we haven’t completely solved the problem.”

In the ginger study, 644 patients, most of them female, from 23 oncology practices nationwide received two standard anti-emetic medications at the time of chemotherapy. They also were given a capsule containing either 0.5 gram, 1 gram or 1.5 grams of ginger, or a placebo capsule. The patients took the capsules containing the placebo or ginger for three days before chemotherapy and three days after the treatment.

All of the patients receiving ginger experienced less nausea for four days after chemotherapy, said lead study author Julie L. Ryan of the University of Rochester Medical Center. Doses of 0.5 gram and 1 gram were most effective, reducing nausea by 40% compared with the patients on the placebo.

The study is the largest to examine the effect of ginger, already widely used as a home remedy for an upset stomach. One gram of ground ginger is equivalent to about 1/2 teaspoon. Ryan cautioned that some foods labeled as ginger, such as ginger ale or ginger cookies, may contain only ginger flavoring.

Researchers don’t know why ginger seems to help, Ryan said. But, she added: “There is other research showing it has a potent anti-inflammatory effect in the gut.”

In the study led by Grunberg, 810 patients were given two standard anti-nausea drugs, dexamethasone and ondansetron, that work by blocking a neural pathway in the brain that controls nausea. This two-drug regimen is most effective in preventing nausea and vomiting in the first 24 hours after chemotherapy.

One-third of the patients also received a one-day dose of the new drug, casopitant mesylate, while one-third received a three-day dose and one-third received a placebo.

Adding casopitant mesylate, the authors found, helped control symptoms in the so-called delayed phase of nausea that occurs beyond the first day after chemotherapy. Of patients receiving the standard two-drug regimen, 66% experienced no nausea or vomiting in the five days after chemotherapy, compared with 86% of patients taking a single dose of casopitant mesylate.

Casopitant mesylate probably adds extra relief from nausea because it acts on different nerve systems than the standard drugs, Grunberg said. Dexamethasone and ondansetron are in a class of drugs known as serotonin receptor antagonists; casopitant mesylate blocks the so-called NK1 pathway in the brain.

“NK1 antagonists work better for that later period,” Grunberg said. “This study reinforces the value of this family of anti-nausea agents.”

It also appears that the three-drug combination can be given on the day of chemotherapy without the need for additional doses, he said.

“That is a huge convenience for the patient, if we can give them all the drugs they will need for this period on the day they come to the clinic for chemotherapy,” Grunberg said. “Our whole goal is maintain the highest quality of life during chemotherapy.”

Sources: Los Angeles Times

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Acute Cholecystitis

Alternative Names: Cholecystitis – acute

Definition: Acute cholecystitis is a sudden inflammation of the gallbladder that causes severe abdominal pain.

click & see the pictures

You may Click  See also: Chronic cholecystitis

Causes :-
In 90% of cases, acute cholecystitis is caused by gallstones in the gallbladder. Severe illness, alcohol abuse and, rarely, tumors of the gallbladder may also cause cholecystitis.

Acute cholecystitis causes bile to become trapped in the gallbladder. The build up of bile causes irritation and pressure in the gallbladder. This can lead to bacterial infection and perforation of the organ.

Gallstones occur more frequently in women than men. Gallstones become more common with age in both sexes. Native Americans have a higher rate of gallstones.

Symptoms :-

The main symptom is abdominal pain that is located on the upper right side or upper middle of the abdomen. The pain may:

*Be sharp, cramping, or dull
*Come and go
*Spread to the back or below the right shoulder blade
*Be worse after eating fatty or greasy foods
*Occur within minutes of a meal
*Shortness of breath due to pain when inhaling

Other symptoms that may occur include:–
*Abdominal fullness
*Clay-colored stools
*Excess gas
*Fever
*Heartburn
*Indigestion
*Nausea and vomiting
*Yellowing of skin and whites of the eyes (jaundice)
*Stiff abdomen muscles, specially on the right side
*Chills

Diagnosis:
Because the symptoms of acute cholecystitis can resembles symptoms of other illness, it is sometimes difficult to diagnose. If doctor suspects Cholecystitis after a carefull physical examination, he or she may perform some of the following tests:-

Blood Test:-
*Amylase and lipase
*Bilirubin
*Complete blood count ( CBC) — may show a higher-than-normal white blood cell count
*Liver function tests

Imaging tests that can show gallstones or inflammation include:
*Abdominal ultrasound
*Abdominal CT scan
*Abdominal x-ray
*Oral cholecystogram
*Gallbladder radionuclide scan
.

Treatment:-
Seek immediate medical attention for severe abdominal pain.

In the emergency room, patients with acute cholecystitis are given fluids through a vein and antibiotics to fight infection.

Although cholecystitis may clear up on its own, surgery to remove the gallbladder (cholecystectomy) is usually needed when inflammation continues or recurs. Surgery is usually done as soon as possible, however some patients will not need surgery right away.

Nonsurgical treatment includes pain medicines, antibiotics to fight infection, and a low-fat diet (when food can be tolerated).

Emergency surgery may be necessary if gangrene (tissue death), perforation, pancreatitis, or inflammation of the common bile duct occurs.

Occasionally, in very ill patients, a tube may be placed through the skin to drain the gallbladder until the patient gets better and can have surgery.

For Alternative Medication  you may click to see:->
*Cholecystitis as related to Herbal Medicine :
*An alternative approach to acute cholecystitis :
*Acute cholecystitis – Traditional Chinese Medicine, Nature therapy :

Prognosis:-Patients who have surgery to remove the gallbladder are usually do very well.

Possible Complications:-
*Empyema (pus in the gallbladder)
*Gangrene (tissue death) of the gallbladder
*Injury to the bile ducts draining the liver (a rare complication of cholecystectomy)
*Pancreatitis
*Peritonitis (inflammation of the lining of the abdomen)

When to Contact a Medical Professional:

*Call your health care provider if severe abdominal pain persists.
*Call for an appointment with your health care provider if symptoms of cholecystitis recur after an acute episode.

Prevention :
Removal of the gallbladder and gallstones will prevent further attacks. Follow a low-fat diet if you are prone to gallstone attacks.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.nlm.nih.gov/medlineplus/ency/article/000264.htm

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Acute Bilateral Obstructive Uropathy

Urinary system
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Alternative Names: Urethral obstruction; Acute urethral obstruction; Obstructive uropathy – bilateral – acute

Definition:Acute bilateral obstructive uropathy is a sudden blockage of the flow of urine from both kidneys. The kidneys continue to produce urine in the normal manner, but because urine does not drain properly, the kidneys start to swell. You may click to See also:

*Cronic unilateral obstructive uropathy

*Acute unilateral obstructive uropathy

CLICK & SEE

Causes: In men, acute bilateral obstructive uropathy is most often a result of an enlarged prostate. Other causes in men include: *Bladder cancer *Kidney stones *Prostate cancer Acute bilateral obstructive uropathy is much less common in women, but may be due to: *Bladder cystocele *Cervical cancer *Injury from surgery involving the reproductive organs *Pregnancy Other causes in men and women include: *Blood clots *Neurogenic bladder *Other rare retroperitoneal processes *Papillary necrosis *Posterior urethral valves in infant boys Acute bilateral obstructive uropathy occurs in about 5 out of 10,000 people. You may click to enlarge the pictures and see:-> *Female Bladder Catheterization..…..>. *Male Bladder catheterization…..……> *Female Urinary Tract…………………………..> *Male Urinary Tract………………………………>

 

Symptoms: *Abnormal urine flow — dribbling at the end of urination *Blood in the urine *Burning or stinging with urination *Decrease in the force of the urinary stream, stream small and weak *Decreased urine output (may be less than 10 mL per day) *Feeling of incomplete emptying of the bladder *Fever *Frequent strong urge to urinate *Recent increase in blood pressure *Leakage of urine (incontinence) *Nausea and vomiting *Need to urinate at night *Sudden flank pain or pain on both sides *Urinary hesitancy *Urine, abnormal color

 

.Diagnosis: Physical Exams : The doctor will perform a physical exam. The exam may show: *Large and full bladder *Swollen or tender kidneys *Enlarged prostate (men) *There may be signs of chronic kidney failure, high blood pressure, and infection. Fever is common with an infection. Tests that may be done include: *Arterial blood gas and blood chemistries *Basic metabolic panel — will reveal kidney function and electrolyte balance *Blood BUN *Creatinine clearance *Complete blood count *Potassium test *Serum creatinine test *Urinalysis and a urine culture (clean catch) *Ultrasound of the bladder *Uroflowmetry The following tests may show hydronephrosis (swelling of kidneys): *IVP *Renal scan *Ultrasound of the kidneys *Abdominal CT scan This disease may also alter the results of the following tests: *Creatinine – urine *Radionuclide cystogram Treatment: The goal of treatment is to relieve the blockage, which will allow urine to drain from the urinary tract. You may need to stay in a hospital for a short while. Short-term treatment may include: *Antibiotics and other medications to treat symptoms *Catheterization– the placement of a tube into the body to drain urine (See: Urinary catheters) Long-term treatment involves correcting the cause of the blockage and this may involve: *Surgery such as transurethral resection of the prostate (TURP) *Laser or heat therapy to shrink the prostate if the problem is due to an enlarged prostate Surgery may also be needed for other disorders that cause blockage of the urethra or bladder neck.

 

Prognosis: If the acute obstruction is quickly relieved, symptoms usually go away within hours to days. If untreated, the disorder causes progressive damage to the kidneys. It may eventually lead to high blood pressure or kidney failure.

Possible Complications : *Acute kidney failure *Chronic bilateral obstructive uropathy *High blood pressure *Reflux nephropathy *Urinary tract infection *Urinary retention or incontinence

When to Contact a Medical Professional : Call your health care provider if you have decreased urine output, difficulty urinating, flank pain, or other symptoms of acute bilateral obstructive uropathy.

Prevention You may not be able to prevent this condition. Routine annual physicals with a primary care doctor are recommended. If your doctor finds you have acute obstructive uropathy, you should be referred to the nearest emergency room and seen by a urologist.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources: http://www.umm.edu/ency/article/000485.htm http://www.nlm.nih.gov/medlineplus/ency/article/000485.htm

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