Diagnonistic Test

Transrectal Ultrasound and Biopsy of the Prostate

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What is the test?
Your doctor is likely to recommend this test if you’ve had a rectal exam or blood tests that suggest that you might have prostate cancer. For this test, a urologist takes tissue samples from several places in your prostate, to be examined for cancer. A transrectal ultrasound helps the urologist see the prostate during the procedure.

How do you prepare for the test?
Some doctors recommend that you have an enema before the test. Tell your doctor if you have any allergies, especially to antibiotics.

What happens when the test is performed?
In most cases, you lie on your side with your knees bent up to your chest. An ultrasound machine’s sensor-a short rod about the width around of two fingers-is covered with a condom and clear jelly and gently inserted into your rectum. You may feel some pressure similar to the sensation before a bowel movement. Once the sensor is in place, an image of your prostate appears on a video screen.

The ultrasound sensor surveys the whole prostate gland and pinpoints specific areas for biopsy. Then the doctor removes this ultrasound sensor and replaces it with a slightly smaller one. In addition to generating an ultrasound image, the smaller sensor has a small tube on its side called a needle guide. Your doctor points the needle guide at specific parts of your prostate. The guide releases a spring-loaded needle to take biopsies from different parts of the prostate. The spring-loading allows this needle to move into and out of the prostate very quickly. You are likely to feel some discomfort from each biopsy, but because the needle moves so quickly, any pain lasts only for a second at a time. Doctors usually collect multiple samples.Your doctor will probably give you antibiotics at the end of this procedure to prevent infection.

What risks are there from the test?
Many people have some blood in their urine or stool for a day or two after the biopsy. The only significant risk is the possibility of an infection in the prostate, but antibiotics can help prevent this.

Must you do anything special after the test is over?
Call your doctor if you develop a fever.

How long is it before the result of the test is known?
A pathologist will examine the biopsies under a microscope for cancer. This process usually requires several days.

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Diagnonistic Test


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An anoscopy is an examination of the rectum in which a small tube is inserted into the anus to screen, diagnose, and evaluate problems of the anus and anal canal.


Anoscopy views the anus and anal canal by using an anoscope. An anoscope is a plastic, tube-shaped speculum that is a smaller version of a sigmoidscope. Before the anoscope is used, the doctor completes a digital rectal examination with a lubricated, gloved index finger. The anoscope is then lubricated and gently inserted a few inches into the rectum. This procedure enlarges the rectum to allow the doctor to view the entire anal canal with a light. If any suspicious areas are noticed, a piece of tissue can be biopsied.
What is the Purpose of the test?
Doctors use anoscopy to diagnose rectal cancer and cancer of the anus. This procedure can also help the doctor:

*:detect any lesions that could not be felt during a digital examination

*determine whether squamous cell carcinomas involving lymph nodes in or near the groin (inguinal lymph nodes) originated in the genital area or in or near the anus or rectum

*confirm the source of malignancies that have spread to the anorectal area from other parts of the body
Doctors also perform anoscopy to determine whether a patient has hemorrhoids or anal:

*growths or nodules (polyps)
*ulcer-like grooves (fissures)

.How do you prepare for the test?
Before the test, you might want to empty your bladder or have a bowel movement to make yourself more comfortable. The doctor may suggest using:

*a laxative,
*an enema,
*or some other preparationto clear the rectum.

What happens when the test is performed?
This test is usually done in a doctor’s office. You need to remove your underwear.After removing underwear, the patient bends forward over the examining table or lies on one side with knees drawn up to the chest. The doctor performs a digital examination to make sure no tumor or other abnormality will obstruct the passage of a slender lubricated tube (anoscope). As the doctor gently guides the anoscope a few inches into the rectum, the patient is told to bear down as though having a bowel movement, thenrelax.


By tensing and relaxing, the patient makes it easier for the doctor to insert the anoscope, and discover growths in the lining of the rectum that could not be detected during the digital examination.

Directing a light into the anoscope gives the doctor a clear view of any tears or other irregularities in the lower anus or rectum. A doctor who suspects that a patient may have cancer will remove tissue for biopsy in the course of this procedure.

Slowly withdrawing the anoscope allows the doctor to thoroughly inspect the entire anal canal. As the procedure is being performed, the doctor explains what is happening, and why the patient feels pressure.

Removing tissue samples for biopsy can pinch, but anoscopy does not usually cause pain. Patients do experience the sensation of needing to have a bowel movement.

Risk Factors:
There are no significant risks from anoscopy. Sometimes, especially if you have hemorrhoids, you may have a small amount of bleeding after the anoscope is pulled out.

Must you do anything special after the test is over?
You can return to your normal activities immediately.
How long is it before the result of the test is known?
Your doctor can tell you about your anoscopy exam right away.


Normal Results

A normal anoscopy reveals NO evidence of:

*tissue irregularities
*infectionor other abnormalities. The size, color, and shape of the anal canal look like they should.

Abnormal Results

Abnormal results of anoscopy can indicate the PRESENCE of:



News on Health & Science

Early Prostate Test Little Relief

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A blood test used to screen men for prostate cancer helps in early diagnosis, but doesn’t appear to tellingly lower deaths from the disease, two foreign medical studies have found.
CLICK TO SEE THE PICTURES..(1)………...(2)…….(3).…….(4)
The new studies come at a time the Urological Society of India is preparing to launch a nationwide prostate disease awareness campaign to encourage men to have themselves screened for prostate disease. The week-long drive is to begin on April 1.

A large US study examining the benefits of the prostate specific antigen (PSA) test found no detectable mortality benefits among men who opted for an annual test in comparison to men who did not undergo PSA screening.

The PSA, a protein made by prostate gland cells, is elevated in prostate cancer.

Another, even larger, seven-country European study has revealed only a 20 per cent reduction in deaths from prostate cancer after screening, but with a high risk of over-diagnosis and potentially risky over-treatment.

The studies, published in the New England Journal of Medicine on Wednesday, have raised a question mark over the belief that early diagnosis of prostate cancer through routine PSA screening will help reduce deaths through early start of treatment.

The US study monitored the health of more than 76,000 men — roughly half of whom received annual PSA tests, while the other half had no recommendation for or against annual prostate cancer screening. At the end of 10 years, there were 92 prostate cancer deaths in the annual PSA test group, and 82 in the usual-care group. The difference between the numbers is not statistically significant.

“(We) want to understand why some prostate cancers are lethal even when found early by annual screening,” said Christine Berg, the senior author of the study at the National Cancer Institutes (NCI) in the US.

“There may be some men who are diagnosed with prostate cancer and have the side effects of treatment, such as impotence or incontinence, with little chance of benefit,” said John Niederhuber, the NCI director.

Earlier studies have suggested that routine PSA screening may lead to diagnosis of prostate cancer in men who would not have otherwise experienced its symptoms — and thus have never known about the disease — throughout their lives.

“Over-diagnosis and over-treatment are probably the most important adverse effects of prostate cancer screening, and are vastly more common than in screening for breast, colorectal or cervical cancer,” Fritz Schroder from the Erasmus Medical Centre in the Netherlands and his colleagues wrote in their report based on tracking the health of more than 162,000 men between the ages of 55 and 69 years.

“Here in India, we’re not advocating the PSA test as a routine screening test to all above 40,” said Rajeev Sood, the head of urology at Ram Manohar Lohia Hospital, New Delhi, and national convener of the prostate disease awareness campaign.

“A digital rectal exam is routinely offered to all men above 40 — we recommend the PSA only when we find evidence for hardness or nodules on the prostate or when a patient has lower urinary tract symptoms,” Sood told The Telegraph.

In a digital rectal exam, a doctor inserts a lubricated and gloved finger into the rectum to feel for any abnormalities.

Under the prostate disease awareness campaign in India, urologists across the country plan to organise special camps, deliver public outreach talks and offer advisory and diagnostic services.

You may click to see:->Benign prostatic hyperplasia

Sources: The Telegraph (Kolkata, India)

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New Cure for Prostate Cancer

Scientists have developed a potential new treatment for prostate cancer, offering hope to thousands of patients.

It is a monoclonal antibody to a unique tumor marker for prostate cancer, said Pei Xiang Xing, associate professor who heads Burnet Institute‘s Cancer Immunotherapy Lab, Melbourne and led the research team.


The monoclonal antibody is directed at cancer-producing cells carrying the specific molecule known as PIM-1, which is responsible for cell survival, proliferation and differentiation.

Over-expression of PIM-1 plays a critical role in the development, progression and metastasis of prostate cancer and other cancers such as leukemia. The monoclonal antibody significantly inhibited cancer cell growth when used in laboratory models of prostate cancer.

Xing’s group demonstrated that the monoclonal antibody binds to PIM-1 present in cancer cells and creates a chain of events leading to the death of the cells. In particular, the therapeutic effect was improved by combination of the antibody with other drugs currently used to treat prostate cancer.

Prostate cancer is one of the most frequently diagnosed invasive cancers and the third leading cause of death in men worldwide, which claims more than 3,000 lives every year, equal to the number of women who die from breast cancer.

A new strategy to treat prostate cancer is urgently needed as there is no efficient method to treat advanced prostate cancer, said a Burnet release.

Burnet Institute’s director Brendan Crabb described it as “an exciting step in the development of new treatments for patients with prostate cancer with very promising laboratory-test results”.

Sources: The Times Of India

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Growing Old Gracefully

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Indians haven’t reached the stage of Methuselah (who, the Bible says, lived for 969 years), but our life expectancy has increased from 32 years in 1940 to 65 years in 2000. Seven per cent of the 1.1 billion Indian population is today over the age of 60. We now have better access to health care but can we look forward to fun, health, dignity, economic independence and a peaceful death?
Today children work far away from home, the joint family system is breaking down, and women (traditional care-givers) have joined the work force. The old have to fend for themselves.

They cannot afford to be ill as sickness is expensive. Preventive medicine and maintenance of health is, therefore, a priority

Good vision and hearing prevent accidents, but unfortunately they are the first senses that fail. After the age of 60, 30 per cent of the people are unable to hear a conversation. Leaning slightly forward and turning to the right side does help initially, but eventually hearing aids may be needed. Eyes too should be checked regularly and defects corrected promptly.

The skin loses its elasticity with age, becoming dry and wrinkled. Itching and scratching cause mechanical injury and secondary bacterial infection. Apply a small quantity of a mixture of 500ml of coconut oil, 500ml of sesame oil and 100ml of olive oil half an hour before bath. Add a teaspoon of coconut oil to the bath water. Use a moisturising soap. Apply body lotion or baby oil after bath.

Despite good care, regular brushing and flossing, the teeth may become discoloured, brittle, and may decay and recede. Visit the dentist at least once a year.

Sleep becomes less relaxing with early waking up and relative insomnia. Extrinsic factors like a snoring spouse or frequent essential trips to the toilet may compound the problem. Intrinsic factors like reduction in the restful delta rhythm, depression, pain, anxiety and stress can be tackled with exercise, meditation, yoga and prayer instead of getting addicted to sleeping pills.

With age the heart and blood vessels become less efficient even in the absence of obvious diseases. The heart tends to get enlarged and the pumping action decreases. The blood vessels become less pliable and elastic. This can result in the swelling of feet, high blood pressure and heart failure. Restricting salt consumption to 5gm (one teaspoon in 24 hours) and avoiding salty fried food, pickles and chutneys will help alleviate this problem.

The digestive tract also slows down. When this is compounded with a decrease in fibre content of the food and insufficient fluid intake, constipation becomes a problem. The oesophageal sphincter becomes inefficient, allowing acid to regurgitate from the stomach, causing burning and chest pain. Digestive problems are aggravated by smoking, drinking, untimely meals or lying down immediately after food.

Bones weaken with age, arthritis sets in, flexibility is lost and muscle strength reduces. These can lead to pain, falls and fractures. Supplements of calcium (1.2gms/day), walking for 40 minutes a day, and strengthening and flexibility exercises will help.

If you have a chronic disease like diabetes or high blood pressure, regular health checkups are a must.

Men need an annual digital exam of the prostate and a PSA (prostate specific antigen) test to rule out cancer of the prostrate.

Women need a pelvic examination and a PAP smear starting at 35-40 years, repeated every three years.

A breast self examination should be done every month. A screening mammogram at 40 years, and then every two years after that, is needed to detect breast cancer early enough.

Annual haemoglobin, blood sugar, lipid profile, urea, creatinine and thyroid function tests are also needed.

A baseline chest X-ray will help detect tuberculosis, emphysema and cancer.

A baseline ECG should be done around the age of 50 years and then repeated every 2-3 years.

An annual faecal occult blood test helps detect colorectal cancer.

Flexible sigmoidoscopy/colonoscopy at 50 and every 4 years thence is advisable.

Bone densitometry evaluates the risk of osteoporosis. It should be done every 1-2 years after menopause.

Immunisation does not stop in childhood. After the age of 65 years, pneumococcal vaccine will help prevent pneumonia, and “flu” vaccine influenza. Both are debilitating and can be fatal in the elderly.

To age healthily, control your weight, blood pressure and diabetes, eat four to six portions of fruit or vegetables daily, do not smoke, avoid salt, drink alcohol in moderation, walk daily, maintain muscle strength and flexibility with exercise and sleep for six or seven hours a night.

Sources: The Telegraph (Kolkata, India)