Recent medical advances have made breast cancer a highly manageable disease, especially when detected early, as in the case of stages 0-to-II cancers.
Timely treatment also minimises disruptions to the patient's daily routine and quality of life. Advancements in digitalisation have also greatly benefited women, as they can easily access information through YouTube on how to self-examine themselves and learn about breast anatomy or changes in breast structure that should be brought to the notice of specialists immediately.
Women above the age group of 20 -25 years should examine themselves monthly, and those above 40 years of age should go for mammography at regular intervals. With earlier breast cancer detection, the survival rate increases to 80 per cent (Stage 1 and stage 2), as compared to 56 per cent in Stage 3 and stage 4.
In India, however, early treatment is the exception rather than the norm. By the time most patients are diagnosed, they are already in stage III or IV of the disease, where treatment modalities are more complex. Additionally, the stigma of living with breast cancer can hamper the patients' quality of life in physical, psychological, and social terms.
Mental health counselling, family and institutional support, and new drugs and modalities can help women at all stages of breast cancer to improve life expectancy, health, and overall happiness, thus ticking all the boxes for improved life quality.
Stigma And Suffering
One in 28 Indian women is at risk of developing breast cancer during her lifetime. As per a CII report, the median age for diagnosis is 46 years, and nearly half of all diagnosed women are premenopausal, i.e., relatively young compared to breast cancer patients in Western nations.
The concern, though, is that at the time of diagnosis, around 70 per cent of Indian women are already in stage III or stage IV (known as metastatic breast cancer, or cancer that has spread to other parts of the body). While getting screened early may seem like an evident solution, however, low awareness and culturally ingrained stigmas still prevent many women from getting the timely help they need.
Due to cultural factors and social taboos, women do not get checked for breast cancer or share their symptoms with others, thereby leading to delayed diagnosis. Unfortunately, the pandemic has only amplified the burden of our healthcare system, magnifying these delays.
A QOL-Itative Approach
Focusing on patients' QOL means helping them thrive on the physical, emotional and social parameters by improving their all-around experience of the disease. New hope has also come in the form of targeted therapies that shrink or remove tumours by disabling specific proteins on cancerous cells to block their growth.
These therapies, which can often be taken orally, allow patients to bypass chemotherapy and related harsh side effects. Targeted therapies are proving more effective than chemotherapy in extending the survival rates of patients with stage III or IV cancers up to 5-8 years even if a patient is diagnosed at a metastatic stage.
The rise of non-invasive, chemo-free targeted therapies is opening a new front in the battle against advanced and metastatic breast cancer. By reducing or eliminating frequent hospital visits and the side-effects they earlier took for granted, it is possible to enhance patients' physical and psychological well-being and to help them live longer with dignity and independence.
Breast cancer doesn't mean the end of life. Today, treatment options for breast cancer have advanced, giving hope to patients even in advanced stages. Nowadays, due to government policies (Ayushman Bharat), every woman, regardless of her social strata, can avail of world-class cancer treatment in medical facilities across the country.
Even in advanced stages, families should not lose hope, as newer drugs such as molecular therapy treatment have proven effective for patients suffering from hormone-positive breast cancer, which is the most common form of cancer among Indian women. As many as 60 to 90 per cent of patients respond to these advanced treatments positively, enabling them to lead an enhanced quality of life. With such innovations, cancer can be viewed as a chronic disease that needs management.
Awareness-building and sensitisation are key. Educating women and girls in urban and rural contexts about breast cancer, the importance of regular self-monitoring, and de-stigmatising medical examinations and advanced treatment options, so that they can maximise their chances of identifying and beating the disease.
It would also help address psychosocial impacts like anxiety, depression, or fear by making therapy or psychiatry facilities accessible, affordable, and un-stigmatised for patients. This would also include teaching families and communities to support patients by accompanying them for treatments, helping with chores, spending time with them, and not letting them feel like a "burden".
The late American writer John Diamond said that cancer is "a word and not a sentence". However, for lakhs of women, breast cancer is a life-changing reality. While conventional treatments for breast cancer are constantly evolving and their efficacy is undeniable, life after a breast cancer diagnosis is about more than survival (extending the patient's life) or pain management (alleviating physical discomfort). What's required is a holistic approach towards improving the quality of the patient's life and this is being understood today. (Padma Shri Pankaj Shah, Medical Oncology Haematology, Zydus Hospital, Ahmedabad)
Read More► Is Pregnancy Related Low Back Pain Sciatica?
Although the world is recovering from coronavirus pandemic, we must not lower our guards and stay alert when it comes to hand hygiene to curb the spread of the deadly virus. But are we paying sufficient attention to our nail hygiene? Our nails are the index of well-being for our entire body. The manifestations of several critical diseases were first detected within the dirty nails.
The ignorance towards our nails becomes the breeding ground of harmful bacteria. These germs enter our body through our hands because in India we eat through our bare hands. Therefore, nail hygiene is crucial and without it hand hygiene is incomplete.
Practising good nail hygiene involves following a systematic process to ensure the longevity of our nail health. It includes ensuring that food particles, dirt and dust are not sticking to our nails and there is no build-up of nail bacteria. Thankfully, contrary to popular belief, it is not that difficult to maintain good nail hygiene. A little diligence, awareness and attention are sufficient to keep our nails healthy.
Avoiding Nail Hygiene Makes You Prone to Viral Infections
Due to constant negligence towards the cleanliness of the nails, many serious issues like bacterial and viral infections arise. Often these lead to serious health problems. Our hand hygiene is not perfect till the time we clean the undersides of our nails besides washing hands regularly. Most people don't mind sharing nail clippers with others. This is however an extremely unhygienic practice. When we don't share any of our personal hygiene products then why do we share our nail clippers? Nails harbour abundant germs, bacteria and viruses and sharing nail clippers is equivalent to exchanging those microorganisms.
Keep Fingernails Dry and Clean
It prevents bacterial and fungal infections from growing under our nails. It has been observed that prolonged exposure to water can break nails. It is always recommended to wear cotton-lined rubber gloves when washing dishes, cleaning or using harsh chemicals. In order to follow good nail hygiene, we have to be careful about our nail care products. Use a sharp stainless-steel nail clipper with a grime remover, that can remove the hidden germs and grime below the nails. Trim nails straight, then round the tips into a gentle curve. Always wash hands and under nails with soap and water after a nail clipping session.
Keep hands and nails moisturized to avoid the cuticles from overgrowing. Frequent use of nail paint remover, hand sanitisers and harsh soaps can result in the dryness of cuticles along with nails. Keep nails short, trim them regularly and wash hands for at least 20 seconds and then moisturize them, This will make the chance of diseases slimmer and can prevent any kind of viruses. KAI India nail clipper comes with unique features like 100 per cent stainless steel, nail filer, grime remover, nail tray and non-chromium coating making them safe and most effective for maintaining proper nail hygiene.
Here are some of the more ways through which we can keep our nail hygiene intact, thereby protecting it from the damage to nails:
Stay Away From Chewing Fingernails
It has the potential of damaging the nail bed as a minor cut can cause infection. Moreover, when we bite our nails, germs enter our mouths directly.
Be Gentle Towards Hangnails
Never pull off your hangnails. Rather, be gentle towards them and carefully clip them off. Stop using those products which are harsh on nails. Always go for acetone-free products.
Go for A Regular Nail Checkup
If you have a persistent nail problem, consult a doctor or dermatologist for an evaluation.
Do Not Share
Try not to share your nail clipper, as they contain germs. Wash the nail clipper with lukewarm water and wipe with a soft cloth. (Rajesh U. Pandya is the Managing Director of Kai India)
Read More► Choose A Healthy Track to Manage Diabetes
In many households, including in India, it is a ritual to step out for a walk after dinner before hitting the sheets. Many also take a quick walk after lunch. The goal? To improve digestion.
But, is walking after eating really beneficial for digestion? Turns out it is, and here's why:
After you finish your meals, your body gets to work, it breaks down and absorbs the nutrients. A significant portion of the food breakdown or digestion takes place in the small intestine. Research suggests that walking after a meal can help in the faster transit of food from the stomach and into the small intestine.
How does this help? "The faster the food transits from your stomach into the small intestine, the lesser is you the likelihood of common complaints like bloating, gas, and acid reflux. Evidence also indicates that a post-meal 30-minute walk, coupled with routine exercise, can improve bowel function and lower the chances of constipation.
Postprandial walks not only ease digestive symptoms but can be quite beneficial for individuals with type-2 diabetes. Research from the New Zealand's University of Otago indicates that for people with type-2 diabetes, walking after meals is better at reducing blood sugar levels, especially following carb-rich meals. How does that happen? The body converts food into glucose, which is a major source of energy for the body. After consuming a meal, the blood glucose levels start rising.
In order to deal with this spike, the body secretes insulin, which helps drive the glucose into the cells. However, for diabetic individuals, the action of insulin is impaired, preventing the process of managing blood sugar levels. This can lead to high levels of glucose in the blood, increasing the risk of health problems. During a post-meal walk, glucose is utilized by the body to produce energy for the activity, aiding in lowering the level of glucose in the blood.
Now to address a key question - how long should you wait after a meal before you set off on your walk? Walking immediately following a meal may cause acid reflux and upset your stomach. "It is advisable to walk after a gap of 30-45 minutes after your lunch or dinner to experience the most benefits," says Singh.
It is also recommended to walk at an easy to moderate pace after your meals as increased intensity workouts may cause more blood to be drawn towards the working muscles and away from the gastrointestinal tract. This may cause your digestion to slow down and may also lead to indigestion.
Along with health benefits, a post-meal walk will also bring you closer to your goal of hitting 10,000 steps (a popular aspirational fitness goal) a day. Any sort of physical activity also triggers the release of endorphins, or ï¿½feel-good hormones', thereby relaxing the body. A post-meal walk is a positive step in that direction.
Now that you know the many benefits of a quick post-meal walk, it is time to make this small lifestyle change for better health and overall fitness.(By Vikas Singh)
Read More► Keeping A Balanced Diet While You Travel
Pregnancy is a beautiful experience during which a woman nurtures and grows a baby for a period of 9 months. During this time, the body experiences many changes both internally and externally as it turns into a space of nourishment and protection for the growing foetus.
Hormonal fluctuations, stretching of the skin, greater storage of fats, etc can also lead to significant and apparent changes in the skin. While many women often feel self-conscious and mourn the loss of their pre-pregnancy skin, it is important to know that these changes are completely normal and that many women feel the way you do! These issues can be managed during pregnancy and also minimised post-pregnancy.
Avoid comparing how your body reacts to pregnancy as it largely depends on factors beyond your control such as your genetics. Having said that, below are some of the most common skin issues that women face during and post-pregnancy with some simple steps that one can take to manage them-
Often known as "the mask of pregnancy," is a pigmentation disorder that is caused by a combination of hereditary, hormonal factors, as well as due to sun exposure. It shows up as mottled dark spots on the cheekbones, forehead, nasal bridge, upper lips and rarely, over the jawline.
How to Tackle It:
a) Sun protection is the most important step to avoid and prevent the worsening of melasma. Physical protection like opaque umbrellas, wide-rimmed hats, the scarf should be used while stepping out in the sun
b) Use liberal amounts of sunscreen with a minimum SPF 30, in the morning, at least 15 minutes before stepping out and repeat it in the afternoon after 3-4 hours. Sunscreen use should not be restricted to only while stepping outdoors or when it's sunny but also while indoors. Remember to use only physical sunscreen during your pregnancy and breastfeeding period.
c) Using skin lightening products that contain kojic acid, glycolic acid and vitamins C, E, and A in lower concentrations can assist to brighten and rejuvenate your complexion.
Stretch marks affect around 90 percent of women at some point in their life, with pregnancy being one of the most prevalent times when this occurs. These marks, reddish-purple scars become white over time and are produced by the damage to its elastic fibres when it is stretched due to weight increase. These are particularly noticeable on the abdomen after delivery.
How to Tackle It:
a) Prevention is better than cure. Start using moisturising lotions containing cocoa butter and Shea Butter during pregnancy itself and continue to post your delivery.
b) Massages will also enhance the elasticity of the skin, however, do take care to do it gently.
c) In the initial stages, the stretch marks are red in colour (striae rubra) and these respond best to treatment, so do visit your dermatologist early.
d) Various cosmetic procedures like lasers, PRP, micro-needling with a derma roller can be done to lighten the scars.
Acne or pimples is caused by an inflammation of the sebaceous glands of the face. While a few women report clearing of their pre-existing acne during pregnancy, others may experience a severe flare. This is due to the hormonal changes that occur during pregnancy.
How to Tackle It:
a) Always use cosmetics that are non-comedogenic.
b) Increased fluid intake and staying hydrated may help your acne naturally.
c) Remember to remove makeup before bedtime and avoid frequently touching your face.
d) Products containing benzoyl peroxide may be used to penetrate clogged pores and remove pollutants; it is also safe to use during and after breastfeeding.
e) Although products containing retinol are great for acne treatment, they are contraindicated during pregnancy and breastfeeding.
Eczema, also known as dermatitis, is a common yet non-infectious skin condition that will not transmit to the infant. It's usually the result of an underlying sensitive skin disease that's been there for a while. Hand eczema has become quite common of late due to frequent hand washing with harsh soaps and hand sanitisers.
How to Tackle It:
a) Use a mild soap with a skin-friendly pH.
b) Gently pat dry the skin after each wash and apply a moisturising cream immediately which helps to lock in the moisture content of the skin.
c) Topical steroid creams are used to treat severe eczemas, however, they should always be prescribed by a dermatologist after careful evaluation and never be taken OTC from pharmacies. They are safe during pregnancy and lactation.
d) Do not wear anything too tight or shape-fitting. Tight clothes may trap the heat and make the skin irritable. Better to pick natural fabrics, like cotton.
The most common pregnancy rash is PUPPPs, or pruritic urticarial papules and plaques of pregnancy. These itchy, red spots appear around stretch marks and can spread to the arms, legs, and buttocks. They generally appear at the end of pregnancy, when the tummy is stretched the most.
How to Tackle It:
a) Try applying something cold to your rash to receive some relief. Apply an ice pack for 15 to 20 minutes or cover the rash with a cold, damp cloth.
b) Have lukewarm water baths as very hot water dries the skin and aggravates the itching
c) Keep the skin moisturised with a good moisturiser or coconut oil.
d) Visit your dermatologist who will further guide you on use of safe treatment options during pregnancy and lactation.(Dr. Swathi Shivakumar, Consultant Dermatologist, Aster RV Hospital, JP Nagar, Bengaluru)
Read More► Skincare Tips for New Mothers and Their Babies
कोविड ने गैर-संचारी रोगों के रोगियों के लिए जटिलताओं और स्वास्थ्य जोखिमों को कई गुना बढ़ा दिया है। लगभग 75-80 प्रतिशत कोविड रोगियों को अस्पताल में भर्ती होने की आवश्यकता नहीं होती है। वे घर पर टेलीकंसल्टेशन से ठीक हो सकते हैं, लेकिन कोविड-19 संक्रमण रोगी को दीर्घकालिक दुष्प्रभावों के साथ छोड़ सकता है। ऐसे कई उदाहरण हैं जहां कोविड-19 के लक्षण कई महीनों से बने हुए हैं। फेफड़ों को नुकसान पहुंचाने के अलावा, वायरस तीव्र मायोकार्डियल चोट और हृदय प्रणाली को पुरानी क्षति भी पहुंचा सकता है।
यूरोपियन हार्ट जर्नल में प्रकाशित शोध के अनुसार, कार्डिएक अरेस्ट से पीड़ित कोविड-19 रोगियों की मृत्यु की संभावना उन लोगों की तुलना में अधिक होती है, जो इससे संक्रमित नहीं होते हैं, और विशेष रूप से महिलाओं में इसी कारण से मृत्यु का खतरा अधिक होता है। वायरस सीधे मायोकार्डियम ऊतक के भीतर एसीइ2 रिसेप्टर कोशिकाओं को भंग कर सकता है और सीधे वायरल नुकसान का कारण बन सकता है। कोविड के परिणाम स्वरूप हृदय की मांसपेशियों में सूजन हो सकता है जिसे मायोकार्डिटिस के रूप में जाना जाता है । यदि समय पर ध्यान न दिया जाए तो यह हृदय की विफलता का कारण बन सकता है।
पहले से हृदय रोग से पीड़ित लोगों को अतिरिक्त सावधानी बरतने की जरूरत है। ठीक होने की अवधि के दौरान बड़ी संख्या में रोगियों को कार्डियक अरेस्ट हुआ है, जिसके परिणामस्वरूप अक्सर मृत्यु हो जाती है। विशेषज्ञ सुझाव देते हैं कि भले ही कोविड वायरस कम हो जाए, लेकिन प्रतिरक्षा प्रतिक्रिया अति-सक्रिय बनी रहती है। यह अक्सर अन्य अंगों पर हमला करती है। यह देखा गया है कि इनमें से लगभग 80 प्रतिशत रोगियों को कोरोना पॉजिटिव परीक्षण के 2-3 सप्ताह बाद दिल का दौरान पड़ा है।
हम कुछ चेतावनी के संकेतों को नजरअंदाज कर देते हैं और जागरूकता की कमी के कारण, कभी-कभी, हम कोविड के दौरान या कोविड से ठीक होने के बाद भी कुछ हृदय संबंधी समस्याओं को रोकने में विफल होते हैं। किसी को कोविड-19 हो जाने के बाद, यदि वह रोगी तेज दिल की धड़कन या धड़कन का अनुभव कर रहा है, तो उसे तुरंत डॉक्टर से संपर्क करने की सलाह दी जाती है क्योंकि हृदय गति में एक अस्थायी वृद्धि भी कई अलग-अलग चीजों का संकेत दे सकती है, जिसमें बहुत बीमार होने के बाद भी शामिल है।
यह सुनिश्चित करना आवश्यक है कि रोगी पर्याप्त तरल पदार्थ पी रहा है, खासकर यदि बुखार है। कभी-कभी, जो लोग कोविड से ठीक हो रहे हैं, उनमें पोट्स (पोस्टुरल ऑर्थोस्टैटिक टैचीकार्डिया सिंड्रोम) नामक स्थिति के लक्षण दिखाई दे सकते हैं। हालाँकि, ढडÝर और उडश्कऊ के विकास के बीच की कड़ी अभी तक स्थापित नहीं हुई है। हालाँकि, पोट्स एक तंत्रिका संबंधी समस्या है, और यह सीधे तौर पर हृदय संबंधी समस्या नहीं है। यह तंत्रिका तंत्र के हिस्से को प्रभावित करता है और हृदय गति और रक्त प्रवाह में बाधा उत्पन्न कर सकता है। खड़े होने पर सिंड्रोम भी तेजी से दिल की धड़कन पैदा कर सकता है।
कोविड रिकवरी के बाद दिल का दौरा पड़ने के कई उदाहरणों ने हृदय स्वास्थ्य की लगातार निगरानी के महत्व पर जोर दिया है। विशेषज्ञों के अनुसार, मधुमेह और उच्च रक्तचाप जैसी पहले से मौजूद स्थितियों वाले उच्च जोखिम वाले व्यक्तियों में ईसीजी, एक्स-रे चेस्ट और लिपिड प्रोफाइल जैसे हृदय परीक्षण हर छह महीने में दोहराए जाने चाहिए ताकि यह पता लगाया जा सके कि हृदय को कोई नुकसान हुआ है या नहीं। नियमित निगरानी के अलावा, कोविड के बाद के रोगियों को सभी आवश्यक पोषक तत्वों से युक्त स्वस्थ आहार का पालन करना चाहिए और मसालेदार, तैलीय, डिब्बाबंद, कृत्रिम मिठास और प्रसंस्कृत स्वाद, या जंक फूड से सख्ती से बचना चाहिए। शारीरिक व्यायाम के लिए समय निकालना, शराब और धूम्रपान को कम करना आवश्यक है। यहां तक कि छोटे से छोटे लक्षणों को भी ध्यान में रखा जाना चाहिए और तुरंत एक विशेषज्ञ चिकित्सक को दिखाना चाहिए।
यह भी पढ़े► कोविड प्रकोप के कारण बच्चों में सीखने की हानि हुई : डॉ. के. कस्तूरीरंगन
A very common tip to improve heart health is to exercise regularly. But what form of exercise is best for the heart and how much exercise is too much? There have been several myths about the impact of exercise on the heart, while some sound reasonable, there are many that are inaccurate. One such myth is that one should avoid exercising after a heart attack.
Avoiding exercise for the first few weeks after a heart attack may be advised. However, studies show that supervised exercise helps in improving the outcome for all patients. It is important to note that after a heart attack, one should begin a regular activity program to reduce the chance of additional heart problems. Most patients are provided with a prescription for cardiac rehabilitation which entails an exercise program, diet instruction, educational classes on lifestyle changes and emotional support through a peer support group.
While everyone recovers at a different pace, here are a few guidelines that one may follow to get started:
Consult your doctor before starting exercise. Based on your heart disease, condition, heart function (ejection fraction), rhythm etc. Your doctor will give you an exercise prescription.
It is best to start slow. Once, you get used to walking regularly, you can increase your pace gradually over time. If shortness of breath is felt, it is best to slow down the walking pace.
Exercise should always be done in 3 phases warm-up, peak exercise and cool down, please.
What helps is walking at a moderate pace for the first 10 minutes the first time and each day tries to a few minutes more. At the end of the month aim to walk for 30 minutes on most days of the week.
It is important to keep in mind that one should cool down after finishing the exercise by gradually walking at a slower pace for the last 3 minutes.
If the patient walks outside the house, as a precaution they should walk with someone or in short distances close to home so they do not get too far away.
One should drink a glass of water to prevent dehydration before you start walking.
Choose an exercise or an activity that you enjoy doing. For example, walking, cycling, aerobics, etc.
Doctors' advice should be taken before lifting heavyweights.
Exercise should be done regularly to ensure benefits. 6 days a week of exercise is advisable.
Exercising at the same time daily is important to establish a habit. It also minimizes any variable that may impact the exercise.
If any symptoms such as shortness of breath, chest discomfort, palpitation occur and does not go away, one should stop the exercise and notify the doctor.
There are several changes that take place after a heart attack like energy levels and medications. This affects exercise tolerance. Therefore it is important to keep the exercise expectation day to day as one goes through the healing process.
If a patient does not go through cardiac rehabilitation, they should begin with gentle exercise after a heart attack. The amount of exercise that is advised to each patient will depend on how active the patient was before the cardiac event and how severe the event was. Overall, one must keep in mind that they should start exercising as soon as they can after a heart attack to get the energy and strength back.
Read More► Noise Pollution Increases Risk of Dementia