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CHEMO THERAPY

Chemotherapy-31

INTRODUCTION

Chemotherapy is a drug treatment that uses powerful chemicals to kill fast growing cells in your body.Chemotherapy is most often used to treat cancer  since cancer cells grow and multiply much more quickly than most cells in the body.

Chemotherapy is often used in combination with other therapies, such as surgery, radiation or hormone therapy.The use of combination therapy depends on

  • The stage and type of cancer you have
  • your overall health
  • previous cancer treatments you have had
  • the location of the cancer cells
  • your personal treatment preferences

Chemotherapy has been proven to effectively attack cancer cells, but it can cause serious side effects that can severely impact your quality of life.

WHY CHEMOTHERAPY IS USED ?

Chemotherapy is primarily used to

  • lower the total number of cancer cells in your body
  • reduce the likelihood of cancer spread
  • shrink tumor size
  • reduce current symptoms

SIDE EFFECTS

  • Fatigue
  • Hair loss
  • infection
  • anemia
  • nausea and vomiting
  • appetite changes
  • constipation
  • diarrhea
  • mouth,tongue and throat problems such as sores and with swallowing
  • Peripheral neuropathy
  • skin and nail changes
  • weight changes mood changes
  • fertility problems

PROCEDURE

Chemotherapy is typically given in pill form or directly into veins by injection or an IV.In addition to these two  forms, chemotherapy may also be administered in several other ways.

Chemotherapy delivery option include the following

  • Chemotherapy can be delivered directly into the tumor ,depending on the tumors location
  • Some skin cancers can be treated with chemotherapy creams
  • Chemotherapy can be delivered to a specific part of the body through localized treatments such as directly into abdomen ,chest ,CNS or into bladder through urethra
  • some types of chemotherapy can be taken by mouth through pills.
  • liquid chemotherapy drugs can be delivered in single shots

GOALS

The goal of chemotherapy depends on the type of cancer , its location and persons unique circumstances.Based on the specific goal there are three main categories of chemotherapy treatment

  • Curative: the therapy attempts to destroy all cancer cells so that a person is cancer free
  • Adjuvant or neoadjuvant :The therapy  targets cancer cells remaining in the body after surgery or attempts to shrink cancerous growths prior to surgery
  • Palliative:If the cancer cells cant be eliminated ,treatment can focus on relieving symptoms slowing cancer  growth

Chemotherapy is often just one part of a larger treatment plan.It may be given with other treatments like radiation surgery or other medication

For getting opinion from our network of hospitals visit www.mvtbooking.com or send email to query@gtsmeditour .com

Prepared by: Dr Sajna Hamza

BONE MARROW TRANSPLANTATION

Bmt 3

DEFINITION

A Bone marrow transplant is a medical treatment that replaces your bone marrow with healthy cells.The replacement cells can either come from your body or from a donor .

TYPES

  • Allogeneic stem cell transplant
  • Autologous stem cell transplant

ALLOGENEIC STEM CELL TRANSPLANT

An allogeneic stem cell transplant uses healthy blood stem cells from a donor to replace your diseased or damaged bone marrow.A donor may be a family member, an acquaintance or someone you dont know

AUTOLOGOUS STEM CELL TRANSPLANT

An autologous stem cell transplant uses healthy blood stem cells from your own body to replace your diseased or damaged bone arrow.An autologous stem cell transplant is also called an autologous bone marrow transplant

USES

  • Safely allow treatment of your condition with high dose of chemotherapy or radiation by replacing or rescuing the bone marrow damaged by treatment
  • Replace diseased or damaged marrow with new cells
  • Provide new stem cells which can help kill cancer cells directly

Bone marrow transplants can benefit people with a variety of both cancerous and non cancerous diseases including

  • Acute  leukemia
  • Aplastic anaemia
  • Bone marrow failure syndrome
  • Chronic leukemias
  • Hemoglobinoplathies
  • Hodgkins lymphoma
  • Immune deficiencies
  • Multiple myeloma
  • Neuro blastoma
  • Non hodgkins lymphoma
  • Plasma cell disorders

COMPLICATIONS

Short complications

  • drop in blood pressure
  • headache
  • nausea
  • pain
  • shortness of breath
  • chills
  • fever

Long term complications

  • Graft versus host disease (GVHD) which is a condition in which donor cells attack your body
  • Graft failure which occurs when transplanted cells dont begin producing new cells as planned
  • Bleeding in lungs ,brain and other parts of body
  • Cataracts
  • Damage of vital organs
  • Early menopause
  • Anemia
  • Infections

PROCEDURE

When your doctor thinks you are ready  you will have the transplant .The procedure is similar to a blood transfusion.If you are having an allogeneic transplant bone marrow cells will be harvested from your donor a day or two before your procedure .If your own cells are being used, they will be retrieved from the stem cell bank

Cell are collected in two ways.During a bone marrow harvest cells are collected from both hipbones through   needle.Your are under anesthesia for this procedure meaning you will be asleep and free of any pain

OUTLOOK

The body’s response to a bone marrow transplant varies greatly from person to person .Factors such as age overall health and the reason for the transplant can all affect a persons long term outlook.If a person receives a bone marrow transplant to treat cancer ,their outlook depends in part on how far the cancer has spread .Cancer  that has spread far from its origin for example respond less to the treatment

For getting opinion from our network of hospitals visit www.mvtbooking.com or send email to query@gtsmeditour.com

Prepared by : Dr Sajna Hamza

 

ELECTRO SURGERY

electrosurgery 4

 

DEFINITION

Electro surgery is the use of a high frequency electrical energy in the radio transmission frequency band applied directly to tissue to induce histological effects.Current is in the range 1.5-7.5 million per second or megahertz

WORKING

High frequency electro surgery works by using electrical current and make it pass through the body tissue so as to create the desired clinical effect. Occurring biological in nature once the current is converted into heat ,the tissue will have thermal damage.It is important to note that there should be a sufficient amount of frequency to avoid causing muscle contraction .With inappropriate amount of frequency ,it can stop the heart from beating.Contrarily instead of merely causing heat through electrical current,  electro cautery involves the usage of a hand held element to apply the heat directly to the affected area.Other modalities that can be combined are electro surgery such as scalpel, scissors and curette. In combining there a specimen can be preserved for  histo pathological examination and this can also have better hold into the coverage of detruction

ADVANTAGES

  • Electro surgery offers less operating time and limited bleeding,which is advantageous to parents
  • Compared to laser surgery this procedure is also much cheaper
  • A less post operative time for recovery can also be expected
  • Recurrence rates are reported to be low

RISKS

  • Because of utilization of electric currents ,electric shock can be a risk when there is no grounding pad and if the current is being randomly sent to any part of the body
  • Burns can also be evident
  • In order to prevent burns , the skin must be cleaned and then a conductive gel should be used to enhance the contact with return electrode
  • All in all to avoid any unwanted side effects, proper handling of equipment and precise way of executing should always be achieved

To get opinion from our network of hospitals visit mvtbooking.com or send a email to query@gtsmeditour.com

Prepared by :Dr Sajna Hamza

 

CRYOSURGERY

cryo1

DEFINITION

Cryosurgery is a type of surgery that involves the use of extreme cold to destroy abnormal tissue such as tumors.The surgery most often involves the use of liquid nitrogen ,although carbon dioxide and argon may also be used

WHAT TYPES OF CANCER CAN BE TREATED WITH CRYOSURGERY

It is used to treat several types of cancer and some precancerous or noncancerous conditions.In addition to prostate and liver tumors cryosurgery can be an effective treatment for

  • Retinoblastoma- childhood cancer that affect retina of eye
  • Early stage skin cancers
  • Precancerous skin growths known as actinic keratosis
  • Precancerous conditions of the cervix known as cervical intra epithelial neoplasia
  • Low grade cancerous and non cancerous tumors of the bone

ADVANTAGES

  • It is less invasive than surgery  involving only a small incision or insertion of the cryoprobe through the skin
  • Consequently pain,bleeding and other complications of surgery are minimized
  • Cryosurgery is less expensive than other treatments and requires shorter recovery time and a shorter hospital stay
  •  Some times it can be done using  only local anesthesia
  • Because physicians can focus cryosurgical treatment on a limited area,they can avoid the destruction of nearby areas
  • Treatment can be safely repeated and may be used along with standard treatments such as surgery,chemotherapy,hormone therapy and radiation
  • It can be used for patients who are not good candidates for conventional surgery because of their age or other medical conditions

DISADVANTAGES

The major disadvantage of cryosurgery is the uncertainty surrounding its long term effectiveness.While cryosurgery may be effective in treating tumors the physician can see by using imaging tests,it can miss microscopic cancer spread

HOW A CRYOSURGERY IS PERFORMED

Your doctor will place liquid nitrogen on your skin using a cotton swab or spray.A numbing medicine may be used to prevent any pain or discomfort.

If an internal area is being treated your surgeon will use a scope which is a flexible tube that can fit into various openings in your body such as urethra,rectum or a surgical incision.The liquid nitrogen is fed to the area under treatment and applied to the targeted cells.The cells freeze ,die and then will be slowly absorbed in your body.Your doctor will use imaging equipment such as ultrasound as a guide for carrying out the procedure

RISKS ASSOCIATED

Risk include

  • blisters
  • damage of nearby healthy tissue
  • Pain
  • Scarring
  • Sexual dysfunction
  • Ulcers
  • White skin at the site of surgery

For getting opinion from our network of hospitals visit www.mvtbooking.com or send email to query@gtsmeditour.com

Prepared by : Dr Sajna Hamza

ROBOTIC SURGERY

robot 3

DEFINITION

Robotic surgery or robot assisted surgery allows doctors to perform many types of complex procedures  with more precision ,flexibility and control than is possible with conventional techniques.Robotic surgery is usually associated with minimally invasive surgery procedures performed through tiny incision

WORKING

Robotic surgery has been rapidly adopted y hospitals in US and Europe for use in the treatment of a wide range of conditions

The most widely used clinical robotic surgical system includes a camera arm and mechanical arm with surgical instruments attached to them.The surgeon controls the arms while seated at a computer console near the operating table.The console gives the surgeon a high definition ,magnified 3-D view of the surgical site.The surgeon leads other team members who assist during the operation

ADVANTAGES

Surgeons who use the robotic system find that for many  procedures it enhances precision,flexibility and control during the operation and allows  them to better see the site compared with traditional techniques.Using robotic surgery ,surgeons can perform delicate and complex procedures

  • Fewer complications such s surgical site infection
  • Less pain and blood loss
  • Quicker recovery
  • Smaller ,less noticeable scars

RISKS

Robotic surgery involves risk ,some which may be similar to those of convectional open surgery such as a small risk of infection and other complications

CONDITIONS WHERE ROBOTIC SURGERY IS USED

There are many conditions that have had success with robotic surgery .The following are types of surgeries that have been successfully performed with the help of robotic surgical systems

  • Heart surgery
  • Urologic surgery
  • Endometriosis
  • Gynaecological surgery
  • Thoracic surgery
  • General surgery
  • Colorectal surgery
  • Head and neck surgery

IS ROBOTIC SURGERY SAFE?

Robotic surgery and its safety depends on the surgeon who is performing it.People confuse the robotic surgical system by assuming that it is a robot that does the actual decision making.But that is not the case. It is the surgeon every single time.Robotic surgery is safe when the surgeon has been given proper training to control the robotic surgical system and he is given information about how to use it thoroughly

For getting opinion from our network of hospitals visit www,mvtbooking.com or send a email to query@gtsmeditour.com

Prepared by :Dr Sajna Hamza

PROTON THERAPY IN CANCER

proton therapy 1

Proton therapy also called proton beam therapy is a type of radiation therapy.It uses protons rather than x rays to treat cancer

A proton is a positively charged particle.At high energy protons can destroy cancer cells.Like x-ray radiation , proton therapy is a type of external beam radiation therapy.It painlessly delivers radiation through skin from a machine outside the body

HOW PROTON THERAPY WORKS

A machine called synchroton or cyclotron speeds up protons.The high speed of the protons creates high energy.This energy makes the protons travel to the desired depth in the body.The protons then give the targeted radiation dose in the tumor

CANCERS TREATED WITH PROTON THERAPY

It is useful for treating tumors that have not spread and are near important parts of body

Proton therapy also may be used to treat these cancers

  • Central nervous system cancers including chordoma,chordosarcoma and malignant meningeoma
  • Eye cancer including uveal melanoma or choroidal melanoma
  • Head and neck cancers including nasal cavity and paranasal sinus cancers and nasopharyngeal cancers
  • Lung cancer
  • Liver cancer
  • Prostate cancer
  • Spinal and pelvic sarcomas
  • Non cancerous brain tumors

SIDE EFFECTS

The treatment itself is painless.Afterwards you  may experience fatigue.You may also have skin problems including redness,irritation,swelling ,dryness,or blistering and peeling.The side effects of the proton therapy depend on the part of the body being treated ,the size of the tuor and the types of healthy tissue near the tumor

RISKS AND BENEFITS

Compare with x-ray radiation therapy proton therapy has several benefits.

  • Usually upto 60% less radiation can be delivered to the healthy tissues around the tumor.This lowers the risk of radiation damage to these tissues
  • It may allow for a higher radiation dose to the tumor.This increases the chances that all of these tumor cells targeted by the proton therapy will be destroyed
  • It may cause fewer and less severe side effects such as low blood counts, fatigue and nausea during and after treatment

But there are also some drawbacks to proton therapy

  • Because proton therapy requires highly specialized and costly equipments.It is available at just a few medical centers.
  • Cost is high compared to x ray radiation therapy
  • Not all cancers can be treated with proton therapy

For getting opinion from our network of hospitals visit mvtbooking.com or  to query@gtsmeditour.com.

Prepared by Dr Sajna Hamza

 

SURGERY TO TREAT CANCER

surgery to treat

Surgery is used to treat many types of cancer .It works best for solid tumors that are contained in one area.

HOW IT IS USED

  • Prevention : If you have a high risk of developing cancer in certain tissues or organs your Doctor my recommend removing those tissues or organs before cancer develops.
  • Diagnosis: Your doctor may use a form of cancer surgery to remove all or part of a tumor allowing to be studied under microscope to determine whether it is cancerous or not
  • Staging : It helps in determining the stage of cancer .By evaluating the size and extend of spread Doctor can able to determine the current stage
  • Primary treatment :If cancer is localized and didnt spread much the doctor can to remove that part completely
  • Debulking: Surgery helps in debulking the cancerous tumor if it is very large
  • Helps in relieving symptoms or side effects

COSTS

Cost depend  on many factors, including

  • The type of surgery you have
  • How many specialists are involved in your surgery
  • If you need local regional or general anesthesia
  • Where you have surgery
  • If you need to stay in hospital and for how long

RISKS

In general most cancer operations carry a risk of

  • Pain -It is the common side effect of mast operations
  • Infections-The site of your surgery can become infected.Your health care team will show you how to care for your wound after surgery.Follow this routine closely to avoid infection
  • Loss of organ function-In order to remove your cancer,the surgeon may need to remove an entire organ
  • Bleeding
  • Blood clots-While you are recovering from surgery you are at an increased risk of developing blood clot.Though the risk is small this complication can be serious
  • Altered bowel and bladder functions-Immediately after your surgery you may experience difficulty having a bowel movement or emptying your bladder.This typically resolves in a few days ,depending on your specific operation.

For getting opinion from our network of hospitals visit mvtbooking.com or send email to query@gtsmeditour.com

Prepared by:Dr Sajna Hamza

 

LEPTOSPIROSIS

rat

DEFINITION

It is a bacterial disease that affects humans and animals.It is caused by bacteria of the genus Leptospira. In humans, it can cause a wide range of symptoms.Some infected persons, however may have no symptoms at all.

CAUSATIVE AGENT

Various members of the species L.interrogans can cause leptospirosis. L.icterohemorrhagiae cause the particularly severe type called Well’s disease.The organism can survive for weeks to months in contaminated water or soil.It enters the human body through the abraded skin mostly due to occupational exposure to rat urine contaminated soil or water

PATHOGENESIS

It causes endothelial damage to the small blood vessels,resulting in vital organ damage

CLINICAL FEATURES

The manifestations have a bi phasic pattern

  • After an incubation period of 7-12 days, the first phase is septicemic phase due to leptospiremia lasting for a few days to a week.It is characterized by fever, conjunctival suffussion, severe myalgia and rashes. Lymphadenopathy and hepatosplenomegaly may be there
  • The person may be relatively well for 1-3 days
  • Now the immune phase starts with recurrence of fever

The immune phase may remain just as a non specific fever or progress to:

  1. Aseptic meningitis or
  2. Wells disease( jaundice, hemorrhage and renal failure). There may be hematuria, oliguria, proteinuria, casts and raised urea

COMPLICATIONS

Complications of leptospirosis include aseptic meningitis, hepatic failure, renal failure, bleeding from various sites etc

INVESTIGATIONS

  1. Liver enzymes are only mildly elevated as compared to viral hepatitis.
  2. Creatine phosphokinase is elevated to very high levels.
  3. Serological test by slide agglutination may be positive after the second week.False positive results are common
  4. Detection of specific antibody and its rise in convalescent serum is diagnostic
  5. Identification by dark ground illumination is plagued by frequent false positive results
  6. Cultures take weeks and is difficult to perform

TREATMENT

  • Treatment should be started within first week itself if it is to be effective.Intravenous benzyl penicillin for 7 days is the treatment of choice
  • Tetracycline for  7 days is an option for the grown up child
  • Prophylaxis with weekly doxycycline may be considered if occupational exposure is likely

Prepared by:Dr  Sajna Hamza A

 

 

WORLD VACCINATION DAY

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##On march 16 th every year, India observes National Vaccination Day.It was on this day in 1995 that the first dose of Oral Polio Vaccine was given in India##

DENGUE FEVER

MOS

Dengue is a mosquito borne viral disease. It is transmitted by female mosquitoes mainly of species Aedes aegypti to a lesser extent Aedes albopictus. These mosquitoes are also vectors of chikungunya,yellow fever etc

SYMPTOMS

Symptoms range from mild to severe

MILD DENGUE FEVER

Symptoms can appear upto 7 days after being bitten by the mosquito that carries the virus

They include

  • aching muscles and joints
  • body rash that can disappear and then reappear
  • high fever
  • intense headache
  • pain behind the eyes
  • vomiting and feeling nauseous

Symptoms usually disappear after a week and mild dengue rarely involves serious or fatal complications

DENGUE HEMORRHAGIC FEVER

At first symptoms may be mild but they gradually worsen within a few days.s well as mild dengue symptoms there may be signs of internal bleeding.

  • bleeding from mouth,gums or nose
  • clammy skin
  • damage to lymph and blood vessels
  • internal bleeding which can lead to black vomit and feces or stools
  • a lower number of platelets in the blood
  • sensitive stomach
  • small blood spots under the skin
  • weak pulse

DENGUE SHOCK SYNDROME

It is a severe form of dengue.Apart from symptoms of mild dengue fever,the person may experience

  • intense stomach pain
  • disorientation
  • sudden hypotension or a fast drop in blood pressure
  • heavy bleeding
  • regular vomiting
  • blood vessels leaking fluid

TREATMENT

Dengue is a viral disease,so there is no specific treatment or cure.However intervention can help depending upon how severe the disease is

For milder forms ,treatment include

  • Preventing dehydration-The person should drink clean water. Re hydration salts can also help replace fluids and minerals
  • Pain killers such as Tylenol or paracetamol.They can help lower pain and fever

More severe form of dengue fever may need

  • Intravenous(IV) fluid supplementation or drip , if the person cannot take fluid by mouth
  • blood transfusion, for patients with severe dehydration

HIGH RISK AREAS

  • Central and South America
  • The Caribbean
  • Tropical Asia,including Bangladesh,Indonesia and parts of China
  • Northern Australia

PREVENTION

  • Clothing :Reduce the amount of skin exposed by wearing long pants,long sleeved shirts and socks
  • Use of mosquito repellents
  • Use of mosquito traps and nets
  • Door and window screens
  • Timing:Try to avoid being outside at dawn,dusk and early morning
  • Stagnant water-Cleaning stagnant water can help to reduce risk

Prepared by Dr Sajna Hamza

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