Role of Radiotherapy in Gynecological Cancer

Introduction:
Radiotherapy is the art of using ionizing radiation to destroy malignant tumors while minimizing damage to normal tissues ( J.coate).
CIN and Cancer Difference
CIN and Cancer Difference
Radiotherapy is the important modalities of therapy for human cancers apart from surgery. It is very useful in the treatment of many cancer specially female reproductive tract.

fibroscopic visualization technique for urinary bladder visualization
fibroscopic visualization technique for urinary bladder visualization

Mechanism action of radiotherapy

1)Radiation causes ionization of water of the cancer cells into hydrogen and hydroxyl ions which are toxic and causes damage to DNA of the cell and thereby cell death. [The target for radiation is injury to DNA, which is responsible for cell mitosis. So injury to DNA causes mitotic cell death.]
2)It stimulates fibrous tissue reaction in the surrounding stroma and resulting filorosis causes entanglement of the tumour cells and prevents local spread.
3)Reducing vascularity by radiation end arteritis.

Technique/Methods of radiotherapy

For gynecological cancers therapeutic
radiation is delivered as –
  • a) External radiation (Teletherapy)
  • b) Internal radiation (Brachytherapy)
a) Teletherapy- The goal of teletherapy is to ensure that radiation is delivered to the target tissue without affecting uninvolved tissues from distance (usually 100cm). Cobalt 60 is the common teletherapy source for external radiation; other one is cesium 137. External radiation is used to treat large volumes of tumours, lymph nodes, parametrium.
b) Brachy therapy (internal radiation)

Here source of therapeutic ionizing radiation is placed close to the treatment area, chief advantages of it is that a relatively high dose of radiation can be applied to a limited anatomic region.
Commonly used sources are caesium-137
Cobalt - 60
The application may be
  1. Intracavitary
  2. Interstitial Intracavitary – The devices for brachytherapy consists of hollow stem; intrauterine tandem, which is placed within the uterine cavity. Special devices used for vaginal placements are called vaginal ovoids or colpostats.
    Interstitial – Using needles, wires or seeds used as radio active sources within tissues.

    Indication of radiotherapy

    a) Cervical cancer- It is used in all stages. In squmous cell type, response is best for radiotherapy.
    b) Endometrial cancer- Adenocarcinoma response to radiohterapy.
    c) Vaginal cancer – Here radiotherapy is best than surgery.
    d) Vulval cancer – Generally radiothery is not used, as vulval skin is moist, Causing irritation & distort the shape of vulva.
    e) Orarian cancer – Actualy no role of radiotherapy but in dysgerminoma, responsed of radiotherapy is good.
    f) Choreocarcinoma – When metastasis to liver & brain.

    Uses of radiotherapy in specific cancer

    Cervical cancer: Treatment of cervical cancer is a prime example of successful application of radiotherapy.
    Radio therapy can be used in all stages of carcinoma of cervix but in stage 0 or pre-invasive carcinoma we do not use radiotherapy due to damage of ovarian tissue.
    In cancer cervix
     
    In early stage – option of stage 1 + upto stage II A
    Mode of treatment –
    a) Only surgery
    b) surgery + Radiotherapy
    c) Only Radiotherap
    But stage IIB & on wards option of mode of treatment
    •Only radiothery
    •Here surgery is not possible.
    Goal of external radiation – in cervical cancer is to Sterilize metastatic disease to pelvic lymphnode and parametrium and to decrease the size for cervix to allow placement of intracavitary radio active sources.
    It is also used as palliative radiation for
    advanced cervical cancer for-
    •Control of bleeding
    •Pain relief.
    Radiotherapy combined with chemotherapy specially platinum based cisplatin or carboplatin provides better survival.
    Dose of radiotherapy
    Bnachytherapy – in the form of intracavitary.
    The goal is to deliver a dose of 70-80 Gy at point A, which is situated 2 cm above the mucosa of lateral vaginal fornices & 2 cm lateral to the central uterine canal.

Obesity can decrease Vitamin D of your body

Over weight

People who have scored B.M.I (Body Mass Index) 30 or more than 30 are counted as obese person in medical science. This obesity or fattiness can decrease your level of vitamin D in your body.

Recently scientists have found that by researching  genetic data of human body and examine about 42 thousand people. They said that about 10% increasing of B.M.I (Body Mass Index) can cause decreasing of 4% vitamin D of total level.

fast food habit

It is considered that maximum amount of vitamin D is stored in fatty tissue of body. But in case of obese or fatty people have got more fatty tissue than normal. So, it caused obstacles in passing vitamin D trough fatty tissue to blood circulation in proper manner.  In relation with that condition Professor David Has-lam, Member of National Obesity Forum said, “ Food habit and genetic factors both are responsible for obesity of human body.”


In blood the normal level of Vitamin D is 50 nano mol per liter. If it decease less than 30 it will cause weakness of bone, Rickets of children and another bone diseases.

Human Body

                                                                                                                [Source: Health Journal PLOS]

Pacemaker of its own heart....!!





Now scientists have revolutionary thinking about using a new type of pacemaker. It is already used in animal to gain assurance about its further uses. It's called pacemaker of its own heart.

 

Pacemaker or artificial pacemaker, its not heart's natural pacemaker. It is a medical device that uses electrical impulses, delivered by electrodes contacting the heart muscles, to keep the normal beating of the heart. The primary function of a pacemaker is to maintain an adequate heart rate, if there natural pacemaker of hearts is not fast enough, or there is a heart block. A group of Scientists of Seder- Sinai Heart Institute have got a success. Human heart is made of millions of cell. But among them only 10 thousand cell contribute to pacemaker and make heart beats. For aging or other heart diseases when heart rate become high or low then electronic pacemaker is used to keep it normal.. But using this electronic device there remain some complications to risk. For consideration to low the risk scientists have used genetic recombination by replacing T BX-18 gene via a virus to cells of the heart, which can make normal heart rate in its own heart.....


Are you concious about Oral Cancer....!!!!!




 Oral Cancer

carcinoma


Oral cancer in medical term most commonly recognized as oral carcinoma. In Asian countries like India, Sri Lanka and Bangladesh cancer of the mouth accounts for approximately 40% or more. And it also accounts for only about 25 of all malignant tumours in such countries as the UK and the USA. Over 70% of oral cancers arised from on the lateral borders of the tongue and asjacent alveolar region and floor of the mouth. 95% cases are well or moderately well-differentiated squamous cell carcinoma.

Oral cancer is a age-related disease and more frequenty seen in those aged 30-50.

Probable Causes are Tobacco chewing, alcohol consumption, betel quid habit.

Infections like Shyphilis, Candidosis and other viral infections are sometimes responsible.

Other mucosal dieseases like Oral epithelial dysplasia, Lichen planus, Oral submucous fibrosis can cause oral cancer.

 Clinical features

In earky stage it appears as white or red paches or ulcers, sometimes may be painless or sligthly sore. later it become large and painful. It may spreads by diresct invasion by surrounding tissue and by lymphatic metastasis. The submandibular and jugolodigastric lymphnode are most commonly involved.

Investigation

  • Investigation is done by Biopsy  

  • Imaging for oral cavity cancers and FNAC

Treatment

Hemi-mandibulectomyreconstruction plate

In practice most cases are trested by surgery combined wuth radiotherapy. surgery alone is preffered for small carcinomas of the tongue thet may be easily excised. And if it involed bones then it depend upon surrounding region. Sometimes partial mandibulectomy( removal of a part of mandible) or hemi-mandibulectomy(removal of half portion of lower jaw in figure) is done. Partial parts of removed jaw is retained by re-construction plate(Radiographic figure).

How to Overcome Sciatica


How to Overcome Sciatica

Sciatica

Sciatica is a disorder characterized by low back pain combined with a pain through the buttock and down one leg. It occurs when there is any damage or compression of the sciatic nerve, a huge nerve that runs from the lower back down the back of each leg.
Sciatic Nerve
Nerve Comes From Scarum

The Sciatic nerve controls muscles in the back of your knee and lower leg and delivers feeling to the back of your thigh, part of your lower leg and the sole of your foot. You will feel discomfort, faintness, coldness or burning sensation in those parts of the body when you have sciatica.
Heriniated Disc
Disc Prolapse
The most common reason of sciatica is a herniated disk. Natural wear and tear of the vertebrae can lead to a tapering of the spinal canal. This narrowing, called spinal stenosis, may put compression on the roots of the sciatic nerve and may yield symptoms. In rare cases, sciatica may result from lumps growing inside or along the vertebral cord or sciatic nerve, septicity or injury to nerve due to fracture of bone.
Sciatica Image
Sciatic Nerve Pain Region
There are stages you can proceeds at home to comfort the pain of sciatica. A warming pad or ice pack may be specifically supportive. Although bed rest is not suggested, decrease your activity for the first pair of days. Then, slowly start your usual events after that. Avoid weight lifting or twisting of your back for the first 6 weeks after the pain begins. You should start routine exercising again after 2-3 weeks. A physiotherapist can show you how to gently stretch the hamstring and lower back. Depending on your medical condition, certain exercises may not be recommended. Over-the-counter pain relievers can deliver short-term relief from sciatica. Injections, surgery may be needed in definite cases.
If you have had sciatica once, there is a coincidence that it will reappear. But there are steps you can take to reduce the odds:
* Exercise regularly.
* Maintain good posture.
* Bend at the knees to lift heavy objects.

Now the pain of Insulin taking may be reduce…





Insulin taking
Now may be the taking of Insulin drug can end. By the combined research of both USA and Australia it reveals. Accompanied scientists have told that they are trying to release most of the diabetes patients from daily painful insertion of Insulin injection to body.
Insulin which is a hormone release from Pancreas and addition with superficial surface of cells of human body and help to preserve carbohydrate or glucose. Then glucose transformed into energy to human body. For the first time scientists has discovered the three-dimensional view of insulin bound to its receptor. In the last edition of ‘Nature’ magazine the research was published. Previously, scientists were unsure about how insulin binds to the receptor on the surface of cells to allow them to take up sugar from the blood and generate energy. Now the scientists have the clear knowledge about the absorption of insulin in surface of cell. 
Scientist Mike Lawrence of Walter and Eliza Hall Medical Research Institute in Melbourne, has told that they are trying to discover new and active treatment method for diabetes and they are doing researches for a long time often 20 years. They got the idea of molecular reaction between the human body cell and insulin hormone by powerful rays like X-rays. Treatment of diseases like Alzheimer and cancer caused by Insulin disorder can be progressed. 
Mike Lawrence also said, “ For the developing country  it is need to discover new and long duration active Insulin which does not require refrigeration.”
Diabetes patients