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Woman Breast Pain

click & seeBreast pain can range from mild tenderness to a dull ache to a stabbing sensation in the breasts (milk-producing glands composed of fat and other tissue). According to the U.S. Department of Health and Human Services  Office on Women’s Health, approximately 50 percent of all women experience breast pain at some point in their lives.

In most cases, breast pain is caused by hormonal changes, such as those associated with the onset of puberty, menstruation, menopause, pregnancy and breastfeeding. In addition, certain medications, such as antidepressants, cardiovascular agents or oral contraceptives (birth control pills), can cause breast pain. However, women should notify their physician immediately if they experience breast pain that is persistent, more intense than usual or recurrent, especially if it is exhibited in only one breast…..click & see

Diagnosis of breast pain typically begins with a complete medical history and physical examination. Treatment for breast pain is directly related to the cause of the pain. For less serious causes of breast pain, treatment may be as simple as wearing a support bra or taking a pain reliever. For more severe cases of breast pain, there are medications that can relieve the discomfort. For women who are pregnant or breastfeeding, all drugs should be approved by a physician prior to use to avoid possible harm to the baby.
About breast pain
Breasts are milk-producing glands that are made up of fat and other tissue, including nerves, blood vessels and milk ducts (small tube-like paths). Breast pain can occur in a variety of forms – from a slight tenderness to a dull ache to a stabbing pain. Approximately half of all women experience breast pain at some point in their lives, according to the U.S. Department of Health and Human Services  Office on Women’s Health.

The medical terms for breast pain include mastalgia, mastodynia and mammalgia. It is usually caused by normal hormonal changes in a woman’s body, such as those associated with menstruation. Because of its strong association with hormones, breast pain or tenderness is more common in premenopausal women than in postmenopausal women. Some experts believe that stress can be another factor that affects the development and severity of breast pain. Other conditions that commonly cause breast pain include:

Pregnancy
Breastfeeding
Fibrocystic breast changes
Breast cysts (fluid-filled sacs inside the breast)
Breast infection (mastitis)
Injury or trauma to the breast
Hormone replacement therapy (HRT)
Water retention (common during menstruation)
Surgery to the breast (e.g., breast implants)


Other, less common conditions that can cause breast pain include:

Poorly fitting bra or uncomfortable clothing
Medications, such as antidepressants, cardiovascular agents or oral contraceptives
Excessive caffeine consumption
Breast cancer
Nipple piercing that becomes infected
Mondor’s disease (a blood clot in the breast)
Liver damage from alcoholism
Shingles
Arthritis or a pinched nerve in the neck area
Inflammation of a rib joint
Muscle pulls or strains
Source:www.healthline.com

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Gene test for lung cancer

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A new gene test developed by Taipei researchers can predict a lung cancer patient’s  outcome after surgery and the survival time……... Sanjit Bagchi reports.

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85% OF LUNG CANCER DEATHS ARE ATTRIBUTABLE TO SMOKING.

Lung cancer is the most common cancer affecting people, especially in big cities. It is treatable, depending on the type, stage and severity, but researchers have always been on the lookout for a measure to predict or tailor the treatment of the disease.

Recently, researchers in Taiwan came up with a simple but effective gene test, which can work wonders in the treatment of lung cancer. The study has been published in the New England Journal of Medicine.

Based on the biology, therapy and prognosis, lung cancer is broadly divided into two classes  non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), explains Dr A.K. Pathak and associates at the All India Institute of Medical Sciences (AIIMS), New Delhi. Three types of lung cancer    squamous cell carcinoma, adenocarcinoma and large cell carcinoma    are classified as NSCLC and account for 75-80 per cent of all lung cancer cases.

The clinical profile of lung cancer in India differs from that in the West. Generally, in India, the disease sets in in the fifth or sixth decade of a person’s life, almost 15-20 years earlier than in the West, the AIIMS researchers write in Indian Journal of Chest Diseases and Allied Sciences. Squamous cell carcinoma continues to be the commonest type in India whereas adenocarcinoma is gradually becoming the predominant subtype in the Western world,   they add. Dr Pathak and co-workers also note that  of all lung cancer deaths, 85 per cent are attributable to smoking tobacco, which contains harmful carcinogens.

Hsuan-Yu Chen of the National Taiwan University College of Public Health, Taipei, and his team studied more than 600 genes, which seem to influence survival in NSCLC patients. Of these, they singled out five genes   together called the  5-gene signature   which could significantly predict the patient’s outcome after surgery.

The new 5-gene test indicates if there is a need for chemotherapy. Patients belonging to the high-risk  group have a shorter overall survival (20 months) rate than those in the low-risk group (40 months).   This signature could be useful in stratifying patients according to risk in trials of treatment of the disease,   the researchers write, adding it   may reveal targets for the development of therapy for lung cancer.

After surgical resection, adjuvant chemotherapy is often administered  by chemotherapeutic drugs like cisplatin,   says Prof. Kalyan Dasgupta, former head of the department, chest medicine, Calcutta Medical College, Calcutta. However, it’s difficult to determine which patient is an ideal candidate for chemotherapy, as chemotherapy is helpful in only those who are at a high risk of cancer recurrence.  According to Chen and colleagues, The identification of the 5-gene signature has clinical implications. Cisplatin-based adjuvant chemotherapy is effective in some patients with NSCLC. We propose that patients who have tumours with a high-risk gene signature could benefit from this type of therapy, whereas those with a low-risk gene signature could be spared what may be called unnecessary treatment.

Prof. Dasgupta explains, Unnecessary use of chemotherapy may lead to side effects such as bone marrow suppression, fever, nausea and vomiting. Cost is another important factor.  He adds,  The new gene test can solve this problem. Since it can predict the patient’s surgery outcome and survival, it can determine if he/she needs chemotherapy or not. Treatment can thus be tailored accordingly.

The 5-gene test developed by Chen and co-workers is carried out through a technique known as reverse-transcriptase polymerase chain reaction (RT-PCR). This test needs a small number of genes for analysis, a very small amount of specimen (of the tumour) and yields accurate results.

Dr Bikram Saha, assistant professor of medicine, North Bengal Medical College and Hospital, Darjeeling, says, As the test profiles gene expression, it may be relied on. Moreover, it seems to be acceptable in clinical practice since it does not involve complicated procedures. However, further studies are needed before it can be implemented in general clinical practice.

Source:The Telegraph (Kolkata,India)

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Pancreatic cancer stem cells found

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Researchers have discovered a small population of stem cells in pancreatic cancer that appear to drive tumour growth, opening the door for a potential new approach for treating this particularly deadly disease.

Writing in Cancer Research, University of Michigan scientists said finding cancer stem cells in pancreatic tumours could lead to the development of drugs intended to target and kill these cells.

Scientists have toiled with little success to find better ways to treat cancer of the pancreas, which has the lowest survival rate of any major form of cancer.

It kills 97% of people diagnosed with it within five years half within six months of diagnosis. Pancreatic cancer spreads quickly and is rarely is detected at an early stage. In the United States alone, it kills 33,000 people a year.

The pancreas is a gland located behind the stomach that secretes a digestive fluid and the hormone insulin.
“The implications of this work are significant,” Diane Simeone, director of the Gastrointestinal Oncology Program at the University of Michigan Comprehensive Cancer Centre and lead author of the study, said.

“We’ve made baby steps in improving the survival in these patients over the past decade or so. But we really haven’t had a major breakthrough in coming up with something that has the potential to provide a cure,” she said.

Simeone said there is emerging evidence that within cancers, there is a small subset of cells that are responsible for the growth and propagation of tumours.

The idea is that these cells with stem-cell characteristics the ability to self-renew and differentiate into other cell types are the ones fuelling tumour formation.

Source:The Times Of India

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SHOULD YOUNG WOMEN GET MAMMOGRAMS?

Research from The Lancet questions the benefit of women starting annual mammograms at age 40. New data from a large United Kingdom study of more than 160,000 women finds that mammogram screening in younger women may provide little benefit in terms of reducing breast cancer risk, while at the same time exposing women to more radiation and the possibility of false alarms. Overall, women in the 40s who received mammograms saw a small drop in breast cancer deaths, around 17 percent, a figure that was not statistically different from chance. Also, 23 percent of the women had at least one false alarm   higher than the rate of 12 percent seen in women in their 50s. A related editorial says that it’s not clear that women in the 40s get a net benefit from mammogram screening because the potential harms may offset any benefit, and that women should decide individually whether they want the peace of mind from screening or the possibility of unnecessary radiation exposure from additional mammograms.

Source:   ABC News

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Breast cancer strikes younger women too.

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How to spot signs of trouble: In November 1999, Jennifer Johnson seemed to be living her dream. She was 27 years old, happily married to her college sweetheart and expecting her first child. Johnson also tried to give back to her community by volunteering for the Susan G. Komen Breast Cancer Foundation. Because of that work, she understood the importance of monthly breast self-exams. Though breast cancer is unusual in young women, she was vigilant about the task. And that was how, one day in the shower, she found what she describes as a “rock” in her left breast. It was a devastating discovery  and it also saved her life.

A biopsy revealed that Johnson had invasive ductal carcinoma, which means that malignant cells had formed in a milk duct and then spread. Her tumor measured 3.5 centimeters (about 1.4 inches), she says. Once she had gotten over the initial shock of her diagnosis and begun treatment, Johnson met and joined forces with three other young women fighting breast cancer: Patti Balwanz, Jana Peters and Kim Carlos. They formed their own private support group, meeting regularly for lunch at the Nordstrom’s store near their Kansas City homes. The friendship inspired their moving new book, “Nordie’s at Noon,” published this month by Da Capo Press. “We felt such comfort in being able to talk to each other and share our stories,” says Carlos. “We felt there weren’t enough resources out there for young women.”

Breast cancer is generally considered an older women’s disease; the median age of diagnosis is 63. But younger women are not immune. In fact, according to the National Cancer Institute, one in 229 women in their 30s will be diagnosed with a malignancy in their breasts. Young women also have special concerns that don’t affect older breast cancer patients. If they haven’t had children, they worry that chemotherapy or radiation will send them into early menopause. If they  are single and dating, they may have to contend with feeling less attractive after surgery. Breast cancer in younger women tends to be more aggressive, which makes early diagnosis all the more critical. But getting that early diagnosis is often difficult. In general, women with no special risk factors for breast cancer don’t start getting mammograms, the most widely used screening, until they’re in their 40s. (Before then, younger women’s denser breast tissue makes mammograms less reliable.)

Even if women do notice something suspicious during a self-exam, doctors don’t always take their complaints seriously. “The doctor will say, ‘Oh, let’s just watch that lump for three or six months or a year and see what happens’,” says Carlos. That often means that young women are diagnosed at a later stage and face a grimmer prognosis. In fact, breast cancer is the leading cause of cancer deaths among women aged 15 to 54, according to the National Cancer Institute. However, if the tumor is detected early enough, the odds are good: 83 percent of women under 45 whose cancers are found early will survive for at least five years.

Without mammograms, what’s the best tool for spotting signs of trouble? All four of the Nordie’s authors found lumps themselves. But among breast cancer groups, there is disagreement over whether self-exams should be included in screening recommendations; studies have not proven that the exams reduce deaths. However, no one disputes that self-exams help you become aware of the geography of your breast so you can detect any abnormalities early on. “The most important thing is to understand what kind of lumps or bumps are normal for you and if something is different, you need to consult a doctor,” says Randi Rosenberg, a founding member and former president of the Young Survival Coalition, a network of young breast cancer survivors(www.youngsurvival.org) (For tips on how to check your breasts, go to the Komen Foundation site,www.komen.org   and click on the breast-self exam link.)

(As published in the Newsweek)

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