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Cancer’s Big Five

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cancer types poster

Cancer is one of the most dreaded ailments, and from amongst the very many types of cancer, there are a few that Indian women are predisposed to.

47.2 percent of cancer in women is accounted for amongst the five types. The surprising fact is that these cancers can be prevented by early screening. Early detection and treatment reduces not only the death rate but the quality of life post cancer treatment. Dr Neena Singh, Associate Director, Obstetrics & Gynecology, Fortis La Femme, Delhi sheds some light on this.

She reveals the following are the top five types of cancer in women in India:

  • Breast Cancer
  • Cervical Cancer
  • Uterine Cancer
  • Ovarian Cancer
  • Colorectal cancer

BREAST CANCER :

Breast cancer is the most common cancer in women in India and accounts for 27 percent of all cases of cancer in women. It is more common in urban areas than rural areas.

High risk factors:

  • Family history of breast cancer
  • Long period of OCP (Oral contraceptive pills)

Screening test for breast cancer:

Self-examination of the breasts. If any abnormality found like lump, pain or change in shape, consult a doctor who would examine clinically if it is cancer.

  • Mammography is done which can detect small lesions.
  • MRI Breast is done for staging the disease.
  • Treatment at early stages carries good prognosis.

CERVICAL CANCER

Cervical cancer is the second most common cancer in India in women accounting 22.86 percent of all cancer cases in women. It is more common in rural women than urban women.

Risk Factors:

  • Young age at first intercourse (less than 16 years)
  • Multiple Sexual partners
  • Cigarette smoking
  • Human papillomavirus infection (HPV)
  • Immunosuppression

Screening test for cervical cancer:

Any abnormal symptoms like abnormal vaginal bleeding, vaginal discharge and contact bleeding (bleeding after intercourse) report to a gynecologist who would do a clinical examination and do some test on cervix.

  • Visual inspection with acetic acid (VIA)
  • Visual inspection with legal Iodine (VILI)
  • Magnified VI! Under colposcopy
  • Exfoliative cytology (Pap smear)-is gold standard for screening.
  • HPV-DNA testing

Do Cervical biopsy for confirmation. Early detection and treatment have very good prognosis.

Prevention by prophylactic vaccinations in childhood.

UTERINE CANCER (CANCER OF UTERUS)

Uterine cancer is a type of cancer that begins in the uterus in its lining called the endometrium. Hence also named as endometrial carcinoma.

Risk Factors:

It is an estrogen dependent cancer. Persistent unopposed stimulation of endometrium with estrogen is the single most important factor for development of cancer endometrium:

Polycystic ovaries

  • Granulosa cell tumor of the ovary which secret estrogen
  • Hormone replacement therapy-unopposed estrogen therapy
  • Early onset of periods & late menopause (after the age of 50)
  • Age: – 75 percent women are post-menopausal

Nulliparity

  • Obesity, Hypertension & Diabetes (corpus cancer syndrome)
  • Tamoxifen therapy given in breast cancer
  • Endometrial hyperplasia especially atypical
  • Following radiation exposure to the pelvis
  • Family history of cancer uterus breast, ovary & colon

Screening test for uterine cancer:

If any irregularity in menstrual cycle, post-menopausal bleeding, contact bleeding and unhealthy vaginal discharge report to a gynecologist who would do

  • Clinical examination
  • Transvaginal sonography (TVS) to know endometrial thickness or irregularity.
  • MRI pelvis can be done for more details
  • Fractional curettage of uterus for histopathology examination or Hysteroscopy & directed biopsy from suspicious area. Early diagnosis & treatment has very good prognosis.

OVARIAN CANCER

Ovarian cancer constitutes 15-20 percent of all genital cancers. 85-90 percent of all cancers are epithelial in origin. Germ cell constitutes 5-7 percent.

Risk Factors:

Unfortunately, ovarian cancer doesn’t produce any specific symptoms. By the time symptoms appear its already in advanced stages. However, if patients have pain in the abdomen, back ache, indigestion, bloating not responding to basic treatment and lasts for more than two weeks then consult a gynecologist.

Screening test for uterine cancer:

No specific screening method is available. Doctor would do a pelvic examination to feel for ovarian mass.

  • Transvaginal sonography (TVS) to confirm ovarian mass solid or cystic.
  • Blood test like CA125 which is found raised in ovarian cancer.
  • CT Scan /MRI to know spread of cancer

Treatment:

Early diagnosis and treatment carry good prognosis.

COLORECTAL Cancer

When a cancerous growth originates in the colon and then spreads to the rectum, it leads to colorectal cancer. The risk of colorectal cancer is higher after the age of fifty years.

Risk Factors:

  • Smoking
  • Fat rich diet
  • Crohn’s disease
  • Colitis
  • Family history of colorectal cancer or polyp
  • Non residual diet
  • Chronic constipation

Screening test for Colon Cancer:

  • Frank blood in stools
  • Fecal occult blood test is positive
  • Double contrast barium enema (DCBE)
  • CT Scan
  • Colonoscopy
  • Stool DNA test

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Belarus President wins Sixth term, Opposition alleges vote-rigging

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Russian President Putin

Soon after the Presidential election was held in Belarus on Sunday. several Belarusian cities saw unauthorized protests. In Minsk, protesters returned and the police used tear gas and flash grenades to disperse the demonstrations.

Belarusian President Alexander Lukashenko is being predicted to have won sixth reelection, according to official preliminary results released Monday, with 80 percent of the votes but the outcome been widely disputed amid accusations of vote-rigging.But the clear picture of the results willl be out on Friday.

President of the European Council Charles Michel on Monday urged the Belarusian authorities to respect civil rights and freedoms.”Violence against protesters is not the answer #Belarus Freedom of speech, freedom of assembly, basic human rights must be upheld,” Michel wrote on Twitter.

Belarusian President Alexander Lukashenko accused Russia, Ukraine and Poland for orchestrating protests in Belarus that emerged soon after the election.

According to preliminary results revealed by the Belarusian Central Election Commission, Lukashenko secured 80.23 percent of votes, followed by opposition candidate Svetlana Tikhanovskaya with 9.90 percent.

Lukashenko also blamed foreign interference for the Internet shut-off.

Sergey Lebedev, the head of the observers mission from the Commonwealth of Independent States (CIS) to the presidential election in Belarus, said on Monday that the vote had been conducted in an open, lawful and competitive manner.

The preliminary results of the Belarusian presidential election, held this past Sunday, suggest incumbent president Alexander Lukashenko won over 80 percent of the vote.

“The August 9 election was conducted in compliance with the constitution and electoral code of Belarus. It was open and competitive and ensured that Belarus citizens could freely express their will,” Lebedev said at a briefing.

Candidates, too, had the opportunity to “freely promote their campaigns and speak on the national television,” according to Lebedev.

The team of CIS observers has concluded that both the preparation and process of the election was overall conducted “decently,” as quoted by the mission’s chief.

At the same time, Lebedev pointed out that the vote stood out from Belarus’ previous campaigns by its “political heat.”

“Unfortunately, the vote featured — and we have mentioned it in our statement — statements which were obviously incorrect, provocative and conducive to the escalation of political heat and tension among the public,” the CIS chief observer said.

Lebedev said the detection of inconsistencies in the electoral procedures was a “scattered” occurrence, both for domestic Belarusian observers and CIS observers, whereas in the latter case he said the staff at the polling stations reacted to all voiced critical comments “positively” and promptly corrected any detected inconsistencies.

Meanwhile, the European Union is considering sanctions against Minsk.

Denying any role in Belarus ahead of the presidential election, Kremlin spokesman Dmitry Peskov had said that Russia did not send people to Belarus to destabilize the situation there.

“Belarus and Russia are the Union State. It is an ally, the closest partner. Therefore, this is surely out of the question,” Peskov has told.

He said that Moscow is aware of 33 Russian citizens being detained in Belarus and 200 others are still wanted.

“There is no information about any illegal actions of them that could become a reason for the detention,” he said, adding he looks forward to clarification of the incident.

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China furious over US Health and Human Services Secretary Taiwan’s visit

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China Xi Jinping

The tensions between US and China has been potentially at the peak and relations are being worsened with every passing day.

The latest visit by US Health and Human Services Secretary Alex Azar in Taiwan on Sunday, the first highest-level visit by a US cabinet official since 1979 has sparked outrage in China.

The controversial visit to Taiwan about the island’s response to the COVID-19 pandemic, Azar extended words of “strong support and friendship” from President Donald Trump to Taiwanese leader Tsai Ing-wen. The health secretary appreciated Taiwan’s successful fight against COVID-19, calling it “a tribute to the open, transparent, democratic nature” of its society and culture.

AS China has been saying that Taipei have no separate international relations from Beijing, viewing the island as a part of China. Beijing does not recognize Taiwanese independence, therefore more reactions are expected from China.

“Thank you, President Tsai, for welcoming me to Taiwan today. It is a true honor to be here to convey a message of strong support and friendship from the United States to #Taiwan,” he wrote on Twitter.
During the meeting, Azar congratulated Tsai on beginning her second term earlier this year.
“Under President Trump, the United States has expressed our admiration for Taiwan’s democratic success in tangible ways,” he noted, as broadcast by the Taiwanese administration.

China and US have embroiled in a brittle battle over coronavirus, trade, stealing of intellectual rights, and engaging in tit-for-tat expulsions of diplomats and staging bigger and bigger war games in the western Pacific. President Donald Trump signed executive orders prohibiting US residents from doing any business with TikTok, WeChat or the apps’ Chinese owners.China’s state-run media branded US demands for the sale of TikTok’s American operations to Microsoft Corp. as “theft” and suggested Beijing may block the transaction.

China imposed sanctions on the US in response to the restrictions imposed by Washington over an alleged effort to undermine Hong Kong’s autonomy, the spokesman for the Chinese Foreign Ministry, Zhao Lijian, said Monday. US moves has so far invited sanctions targeting senators Marco Rubio and Ted Cruz, among others.

On Friday, the United States has imposed sanctions on 11 individuals in response to an alleged effort to “undermine” Hong Kong’s autonomy.

There are also talks of U.S. regulators are considering that stock exchanges should set new rules that could delist the Chinese companies citing that investors are exposed to frauds.

Arti Bali

Sr Journalist

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Every citizen must fight the Covid war: Experts

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COVID-19 pandemic

Bengaluru, Aug 9 : With the government easing more restrictions under Unlock3.0 to further revive the economy since August 1, the war against the Coronavirus pandemic has to be fought by each and every citizen across the country, according to health experts, including epidemiologists.

“As the war against the elusive virus is going to be long and hard, the government alone cannot fight it, and the onus is on each and every citizen to join the battle even after a vaccine is found to treat it,” Karnataka health task force chairman M.K Sudarshan told IANS here.

By enforcing the lockdown since March 25 and extending it up to May 31 with stringent measures, ostensibly, to contain the virus spread, the government managed to control the situation initially and ensured that the country’s woeful healthcare infrastructure was not overwhelmed by lakhs of positive cases.

“The government, its agencies and healthcare warriors have been doing their best over the last 4 months, risking their lives to contain the pandemic, as is evident from the case data during the lockdown and after it was gradually lifted to revive socio-economic activities and restore livelihood.

“The onus to carry on the fight is more on all citizens by wearing masks, sanitising their hands and maintaining social distancing,” asserted Sudarshan, former head of the community medicine department in the state-run KIMS (Kempegowda Institute of Medical Sciences) hospital in the city centre.

The Karnataka government had set up the 6-member committee in mid-April to analyse the Covid-19 data from the southern state and across the country to study the epidemiology of the virus cases, how different patients got infected, what measures for breaking the chain and suggest changes, if required.

Though testing of swab samples to find who got the virus was less and results took longer time due to shortage of diagnostic labs, the stringent lockdown forced most of the people across the country to stay home, wash hands frequently and maintain social distancing at any cost.

“When lockdown was lifted and unlock 1.0 began on June 1, like a genie coming out of a bottle, thousands of citizens stepped out of houses, violated the norms and exposed themselves to the infection. With people travelling again in cities and states in their vehicles, buses, cabs and autos, select trains and flights, the number of citizens who tested positive soared by the day, as they too contracted the virus for violating the norms such as failing to isolate, quarantine and get treated if they were asymptomatic or get admitted in any designated hospital if they were symptomatic,” noted epidemiologist Giridhar Babu.

For instance, till the lockdown was in force up to May 31, the southern state with 7 crore population had just 3,221 positive cases and Bengaluru only 358 cases out of 1.2 crore (120 lakh) people. By June 30, the numbers shot up to 15,242 for state and 4,555 for the city.

“Within a fortnight by July 14, the cases shot up to 44,077 and 20,969, to a whopping 71,069 and 34,943 by July 19 or 5 days during unlock 2.0 and to a massive 1,64,924 and it is now 69,572 as on August 6 in Unlock 3.0,” Babu recalled.

Babu is also a member of the task force and faculty of the New Delhi-based Public Health Foundation of India.

With hundreds of people returning from most-infected neighouring states like Maharashtra, Tamil Nadu and Andhra Pradesh in cars, buses, trains or flights, the number of Covid cases zoomed in the state, especially in this tech hub by the day as they carried the virus like super spreaders and became a source of local transmission.

“Though a 9-day lockdown was again re-imposed from July 14 to July 22 in this tech city, 4 Sundays in July and night curfew was maintained till July 31, there was no let-up in the cases as they continue to climb, while recoveries also have been going up steadily,” reiterated Babu.

Admitting that lockdowns, shutdowns and night curfew do not reduce the cases but only delay them, noted pediatric cardiologist Vijayalakshmi I. Balekundri told IANS that the only way to be safe from the dreadful pandemic was to do “SMS” (sanitization of hands, mask-wearing and social distancing) as corona virus was a communicable disease and fatal as it attacks the respiratory system (lungs) and affects all other vital organs of the body.

“The onus of winning the war against the pandemic is more on 130-crore+ citizens than anyone else across the country. God helps those who help themselves is an old adage, as each has to take care of himself or herself from being infected by the virus till a vaccine is found, because it is preventable but not curable,” Balekundri said.

The Bengaluru Medical College and Research Institute Emeritus Professor said though all five fingers are not same or equal, they become a force as a fist when together and converge themselves into a weapon.

“Similarly, the thumb is for mask, index finger for washing hands, middle finger for social distancing, ring finger for maintaining toilet hygiene and little finger to avoid travelling to the extent possible or unless warranted,” Balekundri added.

By Fakir Balaji

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