Bladder cancer is one of the most common cancers known to medical science. It is reported that men are at a higher risk of developing bladder cancer than women. Although it can affect individuals of any age, older adults are at a greater risk to have bladder cancer.
The bladder is located in the lower abdomen region and is a muscular organ. The internal lining of the organ is the first site where bladder cancer starts developing. While most of the time the problem is reported in the bladder region only, cancer can also affect other parts of the urinary tract drainage system in humans.
What are the key symptoms of bladder cancer?
The common signs and symptoms of bladder cancer include:
Blood in the urine (hematuria)
Painful urination
Pelvic pai
If you are passing bloodied urine or urine that is cola coloured, you must consult your doctor at the earliest. It is not necessary that blood in urine is only because of bladder cancer as there can be any other infection or growth that can induce this condition.
Back pain and frequent urination are also common symptoms of bladder cancer.
Different types of bladder cancer?
There are three types of bladder cancer Urothelial carcinoma, Squamous cell carcinoma, and Adenocarcinoma. The origin cells of cancer decided that type of cancer in the bladder.
Who are at a higher risk of developing bladder cancer?
Some of the key risk factors of bladder cancer include:
Smoking is one of the common reason as to when you smoke, you inhale a range of hazardous chemicals into your system.
Age is also a common risk factor as the immunity of the body decreases with age.
It is reported that white people are at a higher risk of developing bladder cancer than people of other races.
Men are also more exposed to the risk of bladder cancer than women.
Exposure to dyes, rubber, leather, textiles and paint products and chemicals used in their production can also increase your chances to get bladder cancer.
It is important to seek the right help at the right time to fight bladder cancer.
There is nothing new in acknowledging “diabetes” as a looming health crisis despite many recent advances in medicine and technology. Apart from being a pocket pincher, it has been identified as an incurable and progressive chronic disease, requiring medicines and insulin for the rest of life. It is looked upon as a life sentence once the diagnosis is made.
To give it a little sigh, a new section has been added in the 2016 WHO global report on “Diabetes Reversal”, a promising way to save the lives of many patients caught in this unprecedented epidemic.
Basics in diabetes, an old story yet relevant-
Known by “lifestyle disease” or simply “sugar” in common parlance, diabetes is a condition characterized by chronically elevated blood sugar levels. The mechanism behind high sugar varies depending on the type of diabetes. The major chunk of the disease is made by type 2 diabetes. The main driving force is “Insulin Resistance”, which means the body has normal insulin production but cells are resistant to its actions. All this has been linked to obesity, physical inactivity, and consumption of high-calorie foods.
What is diabetes reversal?
Means achieving glucose level below the diabetic range in the absence of active pharmacologic or surgical therapy. It’s more like inducing a drug-free period of remission in the already diagnosed patients.
Methods of reversal?
Bariatric surgery has a well-documented role in diabetes reversal. The basic idea in reversibility is to target the root cause that is insulin resistance. By achieving substantial weight loss, one can reduce the fat inside body cells and make it more sensitive to insulin action. This includes an intensive phase of strict calorie restriction and the burning of fats. Everyone knows that diet and exercise are the cornerstones for the treatment of all lifestyle diseases including diabetes. But unfortunately, many of the diabetics don’t aim for reversibility at any point of treatment. Reasons being unawareness and lack of self-motivation. Successful attempts of reversibility have been observed in type 2, obese patients, and even diabetes of 6 yrs duration.
Roadmap for reversibility
Aim for significant weight reduction
Cut down calories consumption to around 700-800/day
Indulge in at least moderate-intensity exercise (2-21/2 hrs /week)
Say NO to ALL sugar
Eliminate refined carbohydrates (flour, white rice, pasta) from your diet.
Stick to whole, natural, unprocessed foods
Include high-quality proteins and fats with each meal
Opt for intermittent fasting or time-restricted feeding i.e going empty stomach for a set amount of time in a day
Beware of illegally marketed formulations which claim to cure diabetes
It’s high time to stimulate interest in achieving remission as a treatment target at both provider and patient-level by addressing the root cause. A stern move by all of us can definitely revolutionize the way diabetes will be treated in the coming years.
Vaccination is the safest and most effective way of disease prevention. It is the prime mode of making an individual immune and is the success story of the 21st century. Everyone is aware of childhood immunization, however, very few know about the need for immunization as an adult. In fact, adult vaccination coverage in our country is the most ignored part of health care services.
Why immunize an adult?
Immunity from some of the childhood vaccinations can wear off with time and thus might fail to protect us in adulthood. So, revaccination in the form of booster doses is required.
Better and safer vaccines keep on adding to the armamentarium, which may not have been available when we were children.
Vaccines and their recommendations keep changing with time according to the changing pattern of the different infections. So, we need to keep ourselves updated.
Just because we are adults doesn’t mean we aren’t at risk for certain diseases. Depending on the age and other factors, adults may be more at risk than children.
Which vaccines do you need?
Vaccines are recommended for adults on the basis of age, prior vaccinations, co-existing health problems, lifestyle, occupation, and travel plans. Following is the list of few important vaccines which are recommended for all healthy, non-pregnant adults at different ages groups:
Influenza (seasonal flu) vaccine – for all adults over the age of 50 yrs annually.
Pneumococcal vaccine – for all adults age 65 years or older, as well as adults age 19 to 64 years who smoke or have diabetes or chronic heart, lung, liver, or kidney disorders.
Chickenpox vaccine – for all adults who have not had chickenpox or the vaccine previously.
Herpes zoster (shingles) vaccine – for adults age 60 years and older (whether or not they report a prior episode of shingles).
Tetanus vaccine – for all adults every 10 years, with at least one shot against whooping cough (Tdap) if not received during adolescence.
HPV (human papillomavirus) vaccine – for women age 26 or younger and men age 21 and younger (HPV virus can cause cervical, anal, oral, and throat cancers).
MMR – If you have not had an MMR vaccine and have never had measles, mumps or rubella, you may need the vaccine.
The best way to decide exactly what you need and how to get fully immunized is to talk with your healthcare provider.
Protect yourself and your loved ones
Some people in our family or community e.g. Infants, elderly, people with weakened immune systems (undergoing cancer treatment) are especially vulnerable to infections, at the same time vaccines are contraindicated for them due to their age or health condition. Thus they rely on our immunity to help prevent the spread of disease to them.
Make sure you are vaccinated for the best protection!
Adult vaccination must become part of routine immunization because these vaccines alone can save millions of lives and reduce the economic burden on the world’s healthcare systems.
Although stones in gallbladder have been known to cause symptoms and complications for centuries, our understanding of its natural history and clinical associations continues to evolve till now. The gallbladder is a small, pear-shaped pouch that hangs out just under the liver. It stores a green-colored liquid known as bile, which helps in fat digestion. The liver produces approximately 500 ml to 1,000 ml of bile per day, but gallbladder concentrates it ten times and stores 30 to 50 ml of denser bile, which is best suited for fat digestion. Bile contains two important constituents, cholesterol and bilirubin. Bilirubin is a pigment formed by the breakdown of red blood cells in the liver. After meals, the gallbladder squeezes stored bile into the small intestine through a series of tubes called ducts and itself gets empty and flat.
Gallstones are a very common problem worldwide and considered to be a major affliction in modern society. They are in fact, hardened deposits of cholesterol or bilirubin or both which get supersaturated in bile whenever there is an imbalance in its composition. Thereby, there are three types of gallstones: pure cholesterol (more common in the western world), pure bilirubin/pigment stones and mixed stones. These deposits may vary in size, shape or number.
People at risk for gallstones are
Elderly
Females
Pregnant females
Obese
Diabetics
Western diet (high-fat content with more refined carbohydrates and less fiber)
Certain drugs like contraceptive pills, lipid-lowering agents
Rapid weight loss
Even diet extremely low in fats can increase gallstone risk as it leads to less usage of the gallbladder and prolonged stasis of bile, which may cause precipitation of cholesterol.
Natural history
In most cases, gallstones do not cause symptoms (silent stones) and go unnoticed unless incidentally detected on routine ultrasound. Only 10% and 20% will eventually become symptomatic within 5 years and 20 years of diagnosis respectively. The average risk of developing symptoms is 2.0-2.6% per year. Female gender, presence of multiple stones, and stones greater than 10 mm are associated with a higher risk of complications
Complications of gallstones
Gallstones usually cause symptoms when they get moved and become lodged within a duct that carries bile. It may cause inflammation/infection/rupture of gallbladder. Symptoms are abdominal pain (within an hour of eating a large meal or in the middle of the night), nausea, indigestion, or fever.
The blockage of the common bile duct may cause jaundice (cholangitis).
Inflammation of the pancreas can occur if stone happens to block the pancreatic duct (pancreatitis).
Rarely, a large gallstone can reach the intestine and cause blockage there with resultant gangrene and infection.
Gallstones, especially those larger than > 3 cm are risk factors for gallbladder cancer.
Clinical associations
Newer data suggest a broad association of gallstones with overall mortality, cardiovascular disease, gastrointestinal cancers, and non-alcoholic fatty liver disease. In fact, these associations reflect the presence of shared underlying risk factors like diabetes, obesity and insulin resistance in all the above-mentioned medical problems. So, gallstone disease is now emerging as an important marker of an increased future risk for medical comorbidities which signals for early and aggressive lifestyle modifications.
Medical and surgical management
Laparoscopic removal of the gallbladder is an outpatient, minimally invasive, safe procedure with a short hospital stay. Contrary to the popular belief, removal of gall bladder does not lead to any significant digestive problems. Only about 1-2% of people can have loose or greasy stools after fatty meals, and fatty foods may take a little longer time to digest. It does not lead to any vitamin deficiencies.
Stones impacted in major ducts are also easily amenable to removal by endoscopic measures (E.R.C.P.).
Medical options for the prevention and treatment of gallstones continue to evolve as well. But drug therapies have fallen out of favor because of lower efficacy and higher recurrence rates.
