Archive for October, 2019

How To Have A Safe Diwali

Friday, October 25th, 2019

Diwali, the festival of lights is here! Diwali means delicious food, rangoli, lights, and a display of colourful fireworks. Are you looking forward for the festivities and family time? As you get busy in the celebrations it is also important to take some safety precautions. Many accidents take place during Diwali.

Did you know? These dazzling fireworks lead to thousands of emergency room visits each year during Diwali. They may cause serious injuries, some of which are irreversible. Firecrackers cause noise pollution as well as air pollution and they are best avoided. However, some families continue to burst firecrackers for their children. Here are a few ways to celebrate Diwali in a healthy and safe manner. As a responsible parent and citizen, you must ensure that everyone enjoys the festivities wholeheartedly and safely:

Firecracker safety

Here are a few safety tips recommended while handling firecrackers:

  • Store firecrackers in a closed box in a safe location, away from the reach of children.
  • Maintain a distance of an arm’s length while lighting firecrackers, and at least five metres while watching.
  • Make sure a responsible adult accompanies children bursting firecrackers.
  • Always light firecrackers in open spaces.
  • Keep buckets of water and blankets ready, in case a fire breaks out.
  • Keep small portable extinguishers handy for urgent use.
  • Make sure you buy fireworks from a licensed shop.
  • Discard used fireworks in a bucket of water. This saves people from unknowingly stepping on it.
  • Don’t burn firecrackers in crowded, congested places or narrow lanes.
  • Don’t light firecrackers on your hands.
  • Do not light firecrackers near electric wires or poles.
  • Avoid firecrackers with high decibel sounds.

This Diwali let us celebrate the festivities with care and caution towards the environment, towards other people as well towards pets also.

Diwali safety

Here are some additional safety tips:

1. Lamps/diyas: These can lead to accidental fires. Follow these safety rules:

  • Make sure you keep the lamps away from curtains and other inflammable objects.
  • Avoid lighting diyas or candles near electrical wiring.
  • Place lamps on the ground or on a flat surface.
  • Keep babies and pets away from diyas.
  • Keep doorways clear, so that small children don’t trip on diyas.

2. Clothing: Dress right for Diwali as well as while lighting firecrackers. Here are a few tips:

  • Avoid wearing clothes made of synthetic material, as these can catch fire easily.
  • Choose comfortable cotton clothes.
  • Be cautious with dupattas and long sarees as these could brush against candles or lamps.
  • Dress up your children in comfortable cotton clothes, which are not too loose or flowy.

3. Food safety: Make sure that all your meals are prepared hygienically and are safe to eat. Here is what you can do:

  • Buy sweets and other snacks from reputed stores that maintain hygiene.
  • Avoid street food as much as possible.
  • Always keep your food covered.

4. Infants and elders: The noise pollution and the extreme smoke during Diwali may harm the elderly, pregnant women as well as infants. Follow these health tips:

  • Stay indoors as much as possible.
  • Avoid congested areas high in pollution.
  • Wear ear plugs if required.

In case of any untoward incident, please visit our Centre for Accident and Emergency. Call us on 022-30919191 for any assistance. Please find below link for more details:

Breast Cancer Awareness FAQs

Wednesday, October 23rd, 2019
1. How common is breast cancer in India? I thought it is a disease of the west

Breast cancer is the most common cancer among women worldwide. In India, it has overtaken cervical cancer to become the commonest cancer amongst urban women. 1/22 women will develop breast cancer in their lifetime. This incidence is predicted to rise to 1/7 women by 2020

2. What are the risk factors for breast cancer?

Majority of the cases are random with no identifiable cause. Some of the known risk factors are:

  • Age – Incidence increases after 40 years of age
  • Previous history of breast cancer
  • Reproductive history
  • Family history
  • Genetic abnormality
  • Postmenopausal Obesity
  • Hormone replacement therapy
3. What does “Being breast aware” mean?

It can be explained in a 5 step rule of self examination to be done once a month

  • Know what is normal for you
  • Look and feel your breasts (upper chest & armpits too)
  • Know what changes to look for
  • Report any changes without delay
  • Make sure you attend breast screening if you’re 50 or over
4. What abnormalities do I have to look for?

Any obvious lumps in breast, armpits or above the collar bone

  • Skin thickening
  • Dimpling
  • Nipple inversion
  • Asymmetry
  • Spontaneous nipple discharge
  • Rash around the nipple
5. What if I find something abnormal?

Report it immediately to your doctor. Most of the time, it will be non cancerous , but needs checking out by an expert

6. How often should one have a mammogram?

Every year from the age of 50. Younger women can opt for ultrasonography done at a good centre

7. How is breast cancer treated?

Treatment depends on the stage of diagnosis, which means that the treatment will be different for each patient. Usually it is a combination of surgery, chemotherapy, radiotherapy and hormone pills.

8. Do I have to have the full breast removed if I have breast cancer?

Treatment has advanced over the last 20 years & we no longer recommend mastectomy for majority of the patients. They will just need removal of the lump & testing of the lymph nodes in the armpit.

9. How long do I have to stay in hospital after surgery?

You can be discharged the same day or the next day after surgery.

10. Can men get breast cancer?

Yes. Though rare (1-2%), men can still get breast cancer & unfortunately usually present at a later stage.

Dr Archana Shetty

Consultant Breast Oncosurgeon

Breast Cancer Awareness Month

Wednesday, October 23rd, 2019
1. What is Breast Cancer?

A group of rapidly dividing cells that may form a lump or mass of extra tissue in the breast is called as breast cancer. Under normal circumstances majority of cells in the human body multiply in a regulated manner phasing out the old ones and replacing them with new normal cells.

Cancer is a group of diseases in which cells lose the ability to regulate their own growth and multiply out of control. Usually, cancer is named after the body part in which it originated; thus, breast cancer refers to the erratic growth and proliferation of cells that originate in the breast tissue.

2. What are the survival rates of breast cancer?

There are statistics available that sum up survival rates by breast cancer stage. The following are based on studies of a 5 year survival rate.

  • Stage 0: 100%
  • Stage I: 95%
  • Stage IIA: 92%
  • Stage IIB: 81%
  • Stage IIIA: 67%
  • Stage IIIB: 54%
  • Stage IV: 20%

These statistics are from the American College of Surgeons National Cancer Data Base and are based on patients diagnosed from 1995-1998.

3. Am I at Risk of Breast Cancer?

Ideally both men and women can get breast cancer. But more than 99% of the cases occur in women. The greatest risk factors for developing breast cancer are the ‘FEMALE’ sex and increasing ‘AGE’.

People who think they may be at risk should discuss this with their doctor. Risk factors for breast cancer include the following:

  • Older age.
  • Menstruating at an early age.
  • Older age at first birth or never having given birth.
  • A personal history of breast cancer or benign (noncancer) breast disease.
  • A mother or sister with breast cancer.
  • Treatment with radiation therapy to the breast/chest.
  • Breast tissue that is dense on a mammogram.
  • Taking hormones such as estrogen and progesterone after menopause (not oral contraceptive pills).
  • Drinking alcoholic beverages.
4. What are the tests available for detection and diagnosis breast cancer?

The simplest method of reaching a definitive diagnosis is by performing a “Triple Test”. A triple test includes a thorough Clinical Examination, a Fine Needle Aspiration Cytology (FNAC) or Core Biopsy (CB) of the lump and a Mammography (of both breasts). If all three of the afore-mentioned tests are suggestive of cancer, the accuracy of diagnosis is almost 100%. Two or more of the above, if suspicious for malignancy, mandate at least an excision biopsy (surgical removal of the lump) for histological confirmation of cancer or otherwise. Of the above, clinical examination carries maximum weight i.e. even if mammography and FNAC suggest benign pathology, a breast lump that feels clinically suspicious requires to be biopsied before declaring it benign.

A mammogram helps in many ways. It can detect impalpable lumps in the same breast or opposite breast and necessitate revision of the treatment plan. It can detect impalpable DCIS (seen as pleomorphic microcalcification) in the breast and can help in altering the decision to perform a breast conserving surgery in those patients. Contrary to wide-spread belief, the radiation emitted from a mammography machine is not harmful to patients.

5. If I get Breast Cancer how long will I live?

The greatest misconception that the common person has about cancer is that all patients eventually die of cancer. It is very important to realize that breast cancer is one of the most curable cancers in the human body. All patients who are cured live a normal life to their entire lifespan. As for those who relapse (recur), it is known that 90% of relapses occur within the first 3 years and after relapse the average survival is approximately 2 years.

6. What are the treatment options for a person suffering from breast Cancer?

Treatment of breast cancer involves a multidisciplinary approach. Patients suffering from breast cancer have the option of being treated by one or all of Surgery, Radiation Therapy (RT), Chemotherapy (CT), Hormonal Therapy (HT) and Biological Therapy (BT). The choice of treatment depends on the type and location of the cancer, whether the disease has spread, the patient’s age and general health, and other factors.

Surgery for breast cancer essentially includes two procedures; either modified radical mastectomy (MRM) or breast conservation therapy (BCT). A modified radical mastectomy (MRM) involves removal of the entire breast (with nipple and areola) along with the lymph nodes in the axilla. This treatment is reserved for patients with extensive disease (large tumours not responding to pre-operative chemotherapy) or patients with DCIS (which tends to be diffuse and involves the entire breast). The majority of patients (patients with small tumours or with large tumours downsized using pre-operative chemotherapy) undergo breast conservation therapy (BCT). BCT includes lumpectomy (removal of the breast lump with a 1 cm margin of normal breast around), axillary lymph-node dissection followed by radiotherapy to the entire breast with a boost to the lumpectomy site. This technique offers survival and relapse rates similar to a mastectomy, while at the same time preserving the breast which helps maintain the patient’s self-image, self-esteem and quality of life. Patients undergoing mastectomy also can be offered whole breast reconstruction that can be successfully performed using microvascular surgical techniques.

Radiation Therapy (RT) is given to all patients undergoing BCT to minimize chances of relapse in the remainder of the surgically untreated breast. However a few patients undergoing MRM also require to be treated with RT if the tumour is large (over 5 cm) or locally advanced or if more than three of the dissected axillary nodes harbour cancer. If RT is withheld in such patients there is a substantial risk that the disease will recur at the site of operation. The axilla (armpit) is not routinely radiated (except in certain circumstances) owing to the huge morbidity associated with it.

Apart from surgery and radiation therapy (both of which act locally) many patients also require treatment with agents that get distributed to all parts of the body via the blood circulation in order to tackle any microscopic disease that may be present there. This is called as systemic therapy. Systemic therapy is indicated in all patients who have established metastatic disease or in those who have a significant risk of relapse in distant organs (lungs, liver etc). In general, patients with tumours more than a couple of centimeters in size or with lymph nodes involved by disease have been shown to benefit after adjuvant systemic therapy. Systemic therapy can be provided using either cytotoxic chemotherapy (CT) or hormonal therapy (HT) or both sequentially. Standard CT protocols (first-line, second-line etc.) using a variety of chemotherapeutic drugs can be successfully administered to appropriate patients. Available evidence recommends a maximum of six cycles of chemotherapy per regimen or schedule. Hormonal therapy is beneficial only in a select group of patients whose tumors are hormone-receptor (Estrogen receptor or Progesterone receptor) positive. As part of hormonal therapy, a variety of drugs are available today, each with its own established indication. Ovarian ablation (by surgical removal or radiotherapy) can be considered as a line of hormonal treatment in premenopausal women above 40 years of age with hormone-receptor positive breast cancer. Temporary ovarian suppression (using injectable drugs given monthly for two years) can be offered to young patients with hormone-receptor positive early breast cancer who choose to maintain their fertility.

7. Can Breast Cancer happen to me only after 35yrs of age?

Not necessarily. One can have Breast Cancer even before that age but the chances are very slim. Internationally it has been seen that for over the last three decades the incidence rate has been stable in women under 50 years of age but is rapidly increasing over 50 years of age.

8. If my family member has BC does that mean I will also have it?

If any female relative in your family (including your grandmother, mother, aunt, sister, or daughter) has had breast cancer, you have a higher risk of getting it, too. Your risk doubles if the woman is your mother, sister, or daughter. And it’s even higher if your relative had cancer in both breasts or was diagnosed before she went through menopause. Research has shown that there is a genetic link between women in the same family who have breast cancer. If breast cancer runs in your family, you can have genetic testing to find out if you have that abnormal gene. If you do, you can explore options to help prevent the disease. But just because you have the abnormal gene doesn’t mean you’ll get breast cancer. Therefore, it’s best to have genetic counseling first to know whether or not to get tested and to know what to do following testing. Some women choose to have one or both breasts surgically removed. Another method of reducing the risk of developing breast cancer in such women is by performing a prophylactic bilateral oophorectomy (removal of ovaries) that reduces risk of developing both breast and ovarian cancer. Since surgery carries its own set of risks, talk about it with your doctor before making a decision.

9. What is screening for breast cancer?

Screening is the checking for the presence of breast cancer in order
to catch it early for treatment. Screening mammography has come in a big way in the west and has even been promoted as a perfect screening tool in our country. Over 88% of the female population within India is under 50 years of age (i.e. pre-menopausal) and we need to understand that the sensitivity of mammography in premenopausal patients, at best, is only 60%. This means that at least forty out of a hundred premenopausal women with breast cancer undergoing mammography will have normal mammograms and a false sense of security. Thus mammography cannot be considered as a screening method for all age groups in India. In postmenopausal women screening can be employed but definitely not in women less than 50 years of age (premenopausal). In our country breast self examination (performed monthly) and a clinical breast examination (performed annually) continue to be the best screening methods. However international screening recommendations mandate annual screening mammography for women over forty years of age.

10. What are the signs of breast cancer?

Breast cancer isn’t always detected with the naked eye. Its early signs are often hidden within your breast tissues. Changes to your breasts that you do see may not be the result of breast cancer at all. Lumps and bumps may come and go, as your hormones ebb and flow as you age. Breast skin may change texture due to sunburn, radiation treatments, or infections that cause rashes. So how would you know for sure whether or not a lump, skin rash, skin dimpling or nipple discharge is benign or cancerous? Sometimes a small tumor in the breast gets diagnosed after picking out a node in the armpit. You will need help from your medical professionals to get a clear diagnosis.

11. At what Stage of cancer am I?

Staging is the process physicians use to assess the size and location of a patient’s cancer. Identifying the cancer stage is one of the most important factors in selecting treatment options. Several tests may be performed to help stage breast cancer including clinical breast exams, mammogram, biopsy, and certain imaging tests such as an isotope bone scan, CT scan of chest abdomen and pelvis and Liver function tests. These tests are not performed on every patient but only those who have extensive disease within the breast i.e. breast lump more than 5 cm or tumour involving skin or presence of large matted axillary or neck nodes.

12. What is special about KDAH? Why should I only visit KDAH and not any other hospital or clinic?

The Kokilaben Hospital Comprehensive Breast Care Unit is a dedicated service that has been created to specifically diagnose and treat the entire spectrum of conditions affecting the mammary gland. The breast unit has been designed on the guidelines laid down by the European Union Society of Mastology (EUSOMA) and is based on two fundamental principles – Evidence Based Medicine and Multidisciplinary Approach.

Evidence Based Medicine – Over the years a lot of research has been carried out in the field of breast diseases, both benign and malignant, spanning diagnosis to treatment. It is important for all clinicians to keep up with this vast reservoir of knowledge, understand it and translate it into practice guidelines that are applicable in day-to-day clinical practice. This is called evidence based medicine. At the Kokilaben Hospital, we follow the model of evidence based medicine so that our patients can receive the highest level of care in surgery, chemotherapy or radiotherapy that is prevalent in the world e.g. In the field of breast cancer management, the next step of individualizing treatment for each and every patient has already been taken using new molecular predictors of recurrence by techniques such as microarrays and RT-PCR. Such advances in technology have allowed us to quantify the risk of relapse for an individual patient and tailor her therapy accurately e.g. avoid chemotherapy in patients who are at low risks of relapse on these new assays. Such advances in management are practiced on a regular basis in the Breast unit at the Kokilaben Hospital.

Multidisciplinary Approach – The days of surgeons treating breast cancer patients on their own are long gone. Today, centers of excellence all over the world treat their patients based using multidisciplinary teams. With growing awareness about breast cancer more and more patients are being diagnosed in early stages and consequently cure rates have risen to up to 85 -90%. This has made post-treatment quality of life and rehabilitation very important and relevant in addition to treatment issues.

The Kokilaben Hospital Breast Unit Team – At the Kokilaben Hospital, the breast unit multidisciplinary team includes a

  • Breast Surgeon (specializing in benign and malignant diseases of the breast) – Dr Mandar Nadkarni, Dr Archana Shetty
  • Plastic Surgeon – Dr Quazi Ahmed
  • Medical Oncologist – Dr Sandeep Goyle, Dr Imran Shaikh, Dr Sewanti Limaye
  • Radiation Oncologist – Dr Kaustava Talapatra, Dr Pranav Chadha
  • Breast Radiologist – Dr Sheffali Shah Sardar, Dr Jigna Rathod, Dr Rolly Choudhary
  • Breast Pathologist – Dr Bijal Kulkarni, Dr Meenal Hastak, Dr Nevitha Athikari
  • Psychologist/counselor – Ms Priyadarshini
  • Psychiatrist – Dr Shaunak Ajinkya
  • Rehabilitation Therapist (occupational and physiotherapist) – Dr Abhishek Srivastava
  • Breast Nurses

Each member of the team is an expert in his/her line of specialty and being a team encourages healthy interaction amongst all members in making and executing therapeutic decisions for individual patients. The main purpose of multidisciplinary team is to impart the best possible ‘state of art’ care to the patient from diagnosis to treatment and even post-treatment rehabilitation.


Information is designed for educational purposes only. Any decisions should be made in conjunction with your physician or therapist. We will not be liable for any complications, injuries or other medical accidents arising from or in connection with, the use of or reliance upon, any information in this brochure.

For further information and Doctor Appointment

You may call the hospital number +91-22-30999999/30666666. A convenient appointment date and time will be given to you. You can visit the hospital website

World Osteoporosis Day

Saturday, October 19th, 2019
What is Osteoporosis?

Osteoporosis causes a decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis makes your bones abnormally porous bone that is compressible, like a sponge. This disorder of the skeleton weakens the bone and results in frequent fractures in the bones.

Normal bone is composed of protein, collagen, and calcium, all of which give bone its strength. Bones that are affected by osteoporosis can break with relatively minor injuries that normally would not cause a bone to fracture. The spine, hips, ribs, and wrists are common areas of bone fractures from osteoporosis.

Common Osteoporosis Symptoms

Treating osteoporosis at the earliest is the best way to prevent some of the more serious consequences, such as loss of height or bone breakages. However, don’t know they have weak bones until they’ve broken their hip, spine, or wrist.

Here are a few signs or symptoms of Osteoporosis:

  • Loss of height.
  • Fracture from a minor fall.
  • Back or neck pain.
  • Stooped posture or compression fracture.
What are the risk factors for osteoporosis?

Both men and women can get osteoporosis, but this condition is more common in women. Here are some common risk factors of Osteoporosis:

  • Older age.
  • Having low testosterone in men.
  • Having low oestrogen in women.
  • Taking certain medications that decrease hormone levels.
  • Smoking cigarettes.
  • Having a family history of osteoporosis.
  • Excessive alcohol intake.
  • Low physical activity.
How do you treat osteoporosis?

Treatment for osteoporosis includes medications to help build bone mass. The medications often have hormonal influences, stimulating or acting like estrogen in the body to encourage bone growth.

How to Prevent Osteoporosis?

Having strong bones is one of the most important things to help prevent Osteoporosis:

1. Get enough Calcium.

You must strive to hit the daily intake recommendation:

  • 1,000 mg for women 50 and younger.
  • 1,200 mg for women 51 and older.

Foods high in calcium include milk and dairy products, soya beans, green leafy vegetables, nuts etc. Have a well-balanced diet and if required, take a supplement for calcium. Consult a nutritionist if required.

2. Don’t Forget Vitamin D

Vitamin D helps your body absorb calcium and use it to strengthen your bones. When your skin is exposed to sunlight, your liver and kidneys help make vitamin D. If required take supplements too.

3. Protein is important for Bone Health

Protein is in every cell in your body, including your bones. Studies have shown that eating protein helps increase bone mineral density.

4. Exercise regularly

Exercise helps stimulate the cells responsible for building bones. To promote bone health, try doing weight-bearing and resistance exercises 3 or 4 days a week.

  • Weight-bearing exercises focus on carrying the weight of your body against gravity. Walking is a great weight-bearing activity, as are running, dancing, aerobics, hiking and tennis.
  • Resistance exercises use an opposing force, such as weights, an elastic band, or water, to strengthen your muscles and build bone. Having strong muscles and a good balance may also help you avoid falls or minimize injury.

5. Build healthy life habits

The choices you make, beginning as early as childhood, can affect your bone health in the future. To protect it, consider making the following adjustments to your lifestyle:

  • Quit smoking.
  • Limit alcohol consumption.
  • Maintain a healthy weight.
  • Eat a well-balanced diet.
  • Stay active.


Are you concerned about your bone health? Do you think you may not be getting the recommended levels of calcium and vitamin D? Consult experts at our Osteoporosis Clinic to help prevent osteoporosis and treat it if you already have it. Please find below the link for more details:

Eat Healthy This Diwali

Monday, October 14th, 2019

Are you excited about the festive season?

Are you already planning your Diwali parties?

Or are you worried about your ongoing diet plan?

Diwali – the festival of lights and joy, rituals and celebrations brings everyone together. The festive season means many dinners and parties and yes a lot of festive eating. The festive season tempts you with delicious mithais and desserts, crispy namkeens and other calorie-rich foods. Are you going to abstain from the festive treats? Or are you going to enjoy guilt-free this season?

We believe that moderation is the key. Celebrate your Diwali and enjoy everything in a limit. Here are a few healthy hacks to eat well this Diwali:

1. Don’t give in to your sweet tooth

Choose mithais and ladoos made with sugar substitutes or dates that are available in the market.

2. Make your mithais at home

Choose to make healthy mithais at home with no added artificial colours.

3. Stay hydrated

Drinking water at short intervals will leave you feeling full, preventing you from overeating.

4. Focus on fibre-rich food

Limit your intake of fried foods and foods made from refined ingredients. While at a party choose to have salad and stir-fried vegetables instead of fried snacks. Fibre leaves you feeling full without causing you to gain weight.

5. Snack before you go out

Eating a light meal at home ensures you don’t reach hungry at a party and start binge eating. This helps exercise self-control at parties.

6. Think before you drink

Diwali is synonymous with parties. Before you raise your glass, remember alcohol is made by fermenting sugar and starch, so being high on alcohol is equivalent to being high on sugars and calories. Drink alcohol in limit.

7. Watch your portion sizes

The sight of your favourite dishes can challenge even those most dedicated to their diets. If you can’t control what you eat, manage how much you consume. Start by choosing a small plate to serve yourself.

8. Avoid talking when you eat

Eating while chatting with family and friends makes you overeat too quickly. Also, chew slowly for five to ten times to allow the brain more time to recognise when you have eaten enough.

9. Exercise

Apart from controlling your food intake during the festive season, it is important to burn calories too. So don’t skip your workout. Take half-an-hour out to walk, jog or cycle every day as cardio is the quickest way to burn calories.

10. Make your snacks

Use whole flours like wheat, bajra, jowar instead of refined flours to make traditional family recipes. You can also bake your snacks instead of deep-frying them.

Are you hosting a Diwali Party?

Here are a few tips to cook healthy:

  • Avoid using any processed foods.
  • Use low-fat or skimmed milk to make desserts instead of full cream milk.
  • Use healthy cooking methods like stir fry or baking instead of deep-frying.
  • Replace sugar in mithais with dates, jaggery or any natural sweetener.

While we agree that Diwali means celebrations and indulgence one must not lose track of their fitness goals. This is especially true for patients suffering from diabetes, obesity and high cholesterol levels. Diwali comes for a few days but the havoc it may create in your health numbers may be detrimental for your health. Be attentive towards your food choices and balance your Diwali festivities.

Do you want a personalised diet plan for Diwali? Consult our expert nutritionists who can guide you with a complete diet plan for the festive season.