The Need For Cancer Care In India

The diagnosis of cancer shocks every family.

Every year, lakhs of Indians are devastated by the news of cancer. On an average, more than 1,300 Indians succumb to the dreaded disease every day. With new cancer cases or its incidence in India estimated to grow by 25% by 2020 cancer has become one of the major causes of death occurring in the country. Women, especially, are being increasingly diagnosed with cancer.

Cancer will claim 9.6 million lives in the world this year and India’s share in it will be a worrying 8.17 per cent, warns the World Health Organization’s (WHO) International Agency for Research on Cancer.

The cancer scenario in India:

Ignorance and denial leads to delayed diagnosis and treatment; most Indians change doctors when asked to go in for a screening or biopsy. Other than the fear of invasive treatment, disfigurement and financial burden, the ill-placed belief that a cancer patient will always die makes patients and their families refuse specialised treatment. The importance of awareness can be seen from the fact that in highly literate Kerala, 40% cases are detected early, a fact that ultimately leads to fewer deaths.

Oncologists suggest that if you notice any major changes in the way your body functions or feels, you should seek medical help. As early detection means better chances of cure.

The shortcomings:

• The symptoms in more than half of India’s cancer patients go undetected due to a shortage of adequate screening technology in rural or underdeveloped areas, or worse, a lack of awareness about the disease itself.
• According to a study conducted in 2015 there were only 2,700 mammograms, a breast cancer screening device, in India at the time.
• More surprisingly, there were only 120 PET-CT scanners, most of which were in Tier-1 cities.
• A study conducted in 2014 concluded that around 70% of India’s cancer cases lead to death due to lack of medical resources as well as the fact that most people don’t seek medical treatment until the late-stage symptoms start manifesting themselves.

Women and Cancer care:

• India accounts for the third highest number of cancer cases among women after china and US, growing annually at 4.5-5%. Cancer cases as well as mortality are increasing rapidly among Indian women, primarily because of low awareness and late detection.
• The report states that out of the 2000 new women diagnosed with cancer every day, 1200 are detected in late stages.
• This reduces five-year survival rate by 3 to 17 times for breast and cervical cancer. Late detection also adds to the cost of the treatment.
• Estimates show that cost for late-stage cancers is 1.5 to 2 times higher than the cost for early stage cancers.
• Another pressing issue among women in India is poor menstrual hygiene. Sadly only 12 per cent of women in India use sanitary pads leading to infections.

Cancer – post operative care:

Despite all medical advancements, detection of cancer still rings in a fear of death. But overcoming the phobia and undergoing a successful surgery of the cancerous tumour can be considered as half the battle won. Getting completely cured of Cancer is a long process spanning from two to five years after surgery. Post operative care and support is of utmost importance as the chemotherapy and radiotherapy sessions are not just painful but financially and emotionally taxing as well. For most kinds of cancer, after surgery one needs to look into the aspects such as reconstruction of the operated area, nutritious diet, light exercise, physiotherapy, supportive treatment, regular follow-ups, counselling and so on.

Cancer Care in rural Maharashtra:

The new Reliance Cancer Care Centres, Akola and Gondia, managed and operated by Kokilaben Dhirubhai Ambani Hospital are now open and the rest will follow in a few years. We continuously endeavour to bring world class cancer care accessible to all Indians. Cancer is one of the biggest public health challenges of our times and we are ready to tackle it head on with our medical talent and world-class technology. Please find below link for more details on Reliance Cancer centre:

https://www.reliancehospitals.com/akola/

https://www.reliancehospitals.com/gondia/

The word arthritis literally means inflammation of a joint. The most common type, osteoarthritis, involves degeneration of the particular cartilage protecting the bone ends within a joint. Without cartilage protection, tendons and ligaments have to work harder, and severe loss of cartilage can lead to bone rubbing on the bone, causing friction and eventual swelling and inflammation.

Arthritis can also rear its ugly head when parts of a joint are wrongly identified as a ‘foreign’ threat and are attacked by immune processes – which is the case with rheumatoid arthritis. While far more common in older age groups, anybody, even children, can get arthritis.

Arthritis worsens in winter

During the winter season, joint pains and stiffened muscles are the most common health problem plaguing the lives of older people. There is a 50 per cent spike in the number of senior citizens seeking treatment for bone and joint problems during winter. For many Rheumatoid arthritis patients, pain, swelling, stiffness, fatigue and other common rheumatoid arthritis symptoms are harder to control during the winter. Some people feel more joint pain, as the cold weather sets in.

Why this happens

Here are a few reasons why arthritis flares up in winter:

• The pain receptors become more sensitive during the winters.
• The drop in the atmospheric pressure causes painful joints. When pressure decreases, tissues swell, building tension between joints, causing pain.
• There are more muscle spasms in colder temperatures, which worsens the pain and stiffness the joints.
• The cold reduces the blood circulation to the fingers and toes, which amplifies arthritis pain.
• Less sunlight during winters means lower vitamin D levels and leads to weakened bones and joints.

How to find relief in the winters

1. Dress warmly – Depending on the climate in your city, choose to wear warm winter clothes or dress in layers. Always ensure that you cover your hands, knees, legs and all arthritis prone areas.

2. Hydrate – Staying hydrated helps keep you more active. Even mild dehydration might make you more sensitive to pain.

3. Exercise – While it’s understandable to want to avoid winter chill, people with joint pain should still stay active. Exercise indoors to improve the symptoms like joint stiffness and muscle weakness.

4. Keep yourself warm and cosy – Use an electric heating pad, hot water bag or an electric blanket to keep yourself warm while resting or sleeping. Heating pads are more useful for localized areas where joints have become stiff and painful from the cold weather.

5. Let warm baths comfort you – Swimming in a heated pool is both great exercise and soothing to your joints. You can also get great relief from warm baths.

6. Supplement Vitamin D – Low levels of vitamin D might play a role in how sensitive you are to arthritis pain. Being deficient in vitamin D also raises the risk for osteoporosis. Talk to your doctor about the best supplement options.

7. Increase your intake of omega-3 fatty acids – Omega-3 fatty acids are highly beneficial in reducing the inflammation level in your joints. Include avocado, flaxseeds, walnuts and fish in your diet.

Enjoy winter while taking the above precautions for Arthritis. If you are facing extreme discomfort in your joints due to arthritis, do consult our experts at our Centre for Bone and Joint. Please find below link:

https://www.kokilabenhospital.com/departments/centresofexcellence/centrefor_bonejoint.html

Acquired immunodeficiency syndrome (AIDS) is a chronic, potentially life-threatening condition caused by the human immunodeficiency virus (HIV). By damaging your immune system, HIV interferes with your body’s ability to fight the organisms that cause disease. HIV is a sexually transmitted infection (STI). It can also be spread by contact with infected blood or from mother to child during pregnancy, childbirth or breast-feeding. There are 36.7 million people living with HIV worldwide.

There’s no cure for HIV/AIDS, but there are medications that can dramatically slow the progression of the disease. Combination antiretroviral therapy (ART) prevents HIV from multiplying in the body. If the reproduction of HIV stops, then the body’s immune cells are able to live longer and provide the body with protection from infections.

How HIV spreads

• Unprotected sexual intercourse (vaginal or anal) or oral sex with an infected person.
• Transfusions of contaminated blood.
• Sharing of contaminated needles or syringes or tattooing equipment.
• Transmission between a mother and child during pregnancy, childbirth and breastfeeding.

How HIV doesn’t spread

You can’t become infected with HIV through ordinary contact. That means you can’t catch HIV or AIDS by hugging, kissing, dancing or shaking hands with someone who has the infection. HIV isn’t spread through the air, water or insect bites.

Symptoms

The symptoms of HIV and AIDS vary, depending on the phase of infection.

• Primary infection (Acute HIV)

Most people infected by HIV develop a flu-like illness within a month or two after the virus enters the body. This illness, known as primary or acute HIV infection, may last for a few weeks. Possible signs and symptoms include fever, headache, rash, joint pain, mouth sores or swollen lymph glands. These symptoms can be so mild that you might not even notice them. However, the amount of virus in your bloodstream (viral load) is quite high at this time. As a result, the infection spreads more easily during primary infection than during the next stage.

• Clinical latent infection (Chronic HIV)

In some people, persistent swelling of lymph nodes occurs during this stage. Otherwise, there are no specific signs and symptoms. HIV remains in the body and in infected white blood cells. This stage of HIV infection generally lasts around 10 years if you’re not receiving antiretroviral therapy. But sometimes, even with this treatment, it lasts for decades.

• Symptomatic HIV infection

As the virus continues to multiply and destroy your immune cells — the cells in your body that help fight off germs — you may develop mild infections or chronic signs and symptoms such as fever, fatigue, swollen lymph nodes, diarrhoea, weight loss or thrush.

• Progression to AIDS

Thanks to better antiviral treatments, most people with HIV don’t develop AIDS. Untreated, HIV typically turns into AIDS in about 10 years. When AIDS occurs, your immune system has been severely damaged. You’ll be more likely to develop opportunistic infections or opportunistic cancers — diseases that wouldn’t usually trouble a person with a healthy immune system.

The signs and symptoms of some of these infections may include:

• Soaking night sweats.
• Recurring fever.
• Chronic diarrhoea.
• Persistent white spots or unusual lesions on your tongue or in your mouth.
• Persistent, unexplained fatigue.
• Weight loss.
• Skin rashes or bumps.

Infections common to HIV/AIDS

• Tuberculosis (TB). In resource-limited nations, TB is the most common opportunistic infection associated with HIV. It’s a leading cause of death among people with AIDS.
• Cytomegalovirus. This common herpes virus is transmitted in body fluids such as saliva, blood, urine, semen and breast milk. A healthy immune system inactivates the virus, and it remains dormant in your body. If your immune system weakens, the virus resurfaces — causing damage to your eyes, digestive tract, lungs or other organs.
• Candidiasis. Candidiasis is a common HIV-related infection. It causes inflammation and a thick, white coating on the mucous membranes of your mouth, tongue, esophagus or vagina.
• Cryptococcal meningitis. Meningitis is an inflammation of the membranes and fluid surrounding your brain and spinal cord (meninges).
• Cryptosporidiosis. This infection is caused by an intestinal parasite that’s commonly found in animals. You get it when you eat or drink contaminated food or water. It causes severe, chronic diarrhoea in people with AIDS.

Cancers common to HIV/AIDS include Kaposi’s sarcoma and Lymphoma. Other complications include neurological complications and kidney diseases.

Prevent HIV

There’s no vaccine to prevent HIV infection and no cure for AIDS. But you can protect yourself and others from infection.

• Practise safe sexual behaviour, use a condom, avoid multiple partners.
• Get tested an treated for sexually transmitted diseases.
• Avoid injecting drugs, if you do use only sterile needles and syringes.
• Ensure that any blood transfusions have been tested for HIV.
• Talk to your gynaecologist to prevent HIV transmission to your unborn child.

Risk factors

Anyone of any age, race, sex or sexual orientation can be infected. However, you’re at greatest risk of HIV/AIDS if you:

• Have unprotected sex. Use a condom every time you have sex. Your risk of HIV increases if you have multiple sexual partners.
• Have an STI. Many STIs produce open sores on your genitals. These sores act as doorways for HIV to enter your body.
• Use intravenous drugs. People who use intravenous drugs often share needles and syringes. This exposes them to droplets of other people’s blood.

India and AIDs

With prevalence of 0.26% in the adult population, India has an estimated 2.1 million living with HIV. The key populations most affected by HIV in India are sex workers (HIV prevalence of 2.2%), gay men and other men who have sex with men (HIV prevalence of 9.9%) and transgender people (HIV prevalence of 7.2%)

Get yourself tested. Be safe. Talk to experts at our Internal Medicine Department for more details, diagnosis and treatment of HIV. Please find below link:

https://www.kokilabenhospital.com/departments/clinicaldepartments/internalmedicine/hiv.html

Chronic obstructive pulmonary disease (COPD) is a chronic lung disease that makes breathing progressively more difficult. COPD isn’t a single lung disease. It’s really two diseases that cause airflow blockage and breathing problems. It includes emphysema, which makes it hard to breathe, and chronic bronchitis, which is a mucus-producing cough that doesn’t go away. Most people with COPD have both. Roughly one-third, or 30%, of adults don’t know what COPD is, hence awareness of the diseases is the first step towards recovery.

Symptoms of COPD

COPD makes it harder to breathe by reducing the flow of air through the lungs. Reduced airflow may be caused by inflammation (airways may thicken and lose elastic quality), destroyed lung tissue and blockages of mucus.

Often, people don’t recognize the symptoms of COPD until later stages of the disease. Here are some symptoms to look out for:

• Chest tightness.
• Shortness of breath.
• Blueness of the lips or fingernail beds.
• Wheezing.
• The need to clear the throat of mucus first thing in the morning.
• A chronic cough that may produce mucus.
• Frequent respiratory infections.
• Lack of energy.
• Unintended weight loss (in later stages)
• Swelling in ankles, feet or legs.

Symptoms can be worse for a few days and become more manageable, then worsen again.

Causes of COPD

1. Smoking

About 85 to 90 percent of all COPD cases are caused by cigarette smoking. When a cigarette burns, it creates more than 7,000 chemicals, many of which are harmful. The toxins in cigarette smoke weaken your lungs’ defense against infections, narrow air passages, cause swelling in air tubes and destroy air sacs—all contributing factors for COPD.

2. Your Environment

What you breathe every day at work, home and outside can play a role in developing COPD. Long-term exposure to air pollution, second hand smoke and dust, fumes and chemicals (which are often work-related) can cause COPD. In rural India the burning of coal and wood for fuel also causes air pollution.

3. Alpha-1 Deficiency

A small number of people have a rare form of COPD called alpha-1 deficiency-related emphysema. This form of COPD is caused by a genetic (inherited) condition that affects the body’s ability to produce a protein (Alpha-1) that protects the lungs.

Treat COPD

There is no cure for COPD, but it can be treated. Those with COPD are at increased risk of developing heart disease, lung cancer and other conditions. Patients with COPD are encouraged to stop smoking and are often given medications to help with the symptoms and complications of the disease. Doctors may also prescribe lung rehabilitation or surgery to relieve symptoms. Sometimes, people with COPD receive lung transplants.

Prevent COPD

Here are some tips to keep your lungs healthy:

• Total abstinence from smoking. It is the worst possible thing someone can do to their lungs. Even second hand smoke is harmful.
• Patients with chronic lung disease such as asthma or COPD should try to minimize exposure to air of poor quality.
• Exercise, it allows your lungs to more efficiently supply the heart and muscles with needed oxygen.
• Eat antioxidant-rich foods, such as berries, other fruits with skins, leafy green vegetables, sweet potatoes, nuts, pomegranate juice. It is good for your lung health.
• Wear protective equipment (mask) when exposed to threats to the lungs at work (i.e., dust, particles, paint fumes and diesel exhaust).

COPD in India

Currently, COPD is the third largest killer affecting an estimated 210 million people worldwide. Almost 90 percent of COPD deaths occur in low and middle-income countries. In India, it is the second largest killer and causes 22 million deaths. However, the alarming fact is that 25-50 percent of people with clinically significant COPD are ignorant about the disease and there is rampant misdiagnosis too.

Quick facts on COPD

• COPD can make daily activities, such as walking up stairs, getting dressed, and doing chores around the house difficult.
• Inflammation in the lungs smolders on chronically for decades, resulting in progressive damage to the tissue that supports airway structures and the gas exchange surface of the lung.
• A characteristic of the inflammatory response of COPD is that it is not responsive to long-term medication with drugs such as corticosteroids, which are used successfully for prevention of asthma.
• As it takes many years for the inflammation in the lungs to have an effect, COPD is primarily a disease affecting people over the age of 40.
• Cessation of smoking is the only significant therapeutic intervention that can retard the accelerated decline in lung function experienced by smokers with COPD.
• Although there is no cure for COPD, there are medicines, procedures, and lifestyle changes that can slow the progress of the disease and lead to a higher quality of life.

Do not miss the warning signs of COPD. COPD is often not found until the disease is very advanced because people do not know the early warning signs. Shortness of breath is many times mistaken as a sign of aging. Consult experts at our Department of Pulmonary Medicine. Please find below link for more details:

https://www.kokilabenhospital.com/departments/clinicaldepartments/pulmonarymedicine/copd.html

Diabetes is India’s fastest growing disease with 72 million cases recorded in 2017. The prevalence of diabetes in adult Indians is 10.4%. It is estimated that by 2035, there will be a staggering 109 million diabetics in India.

Diabetes is a chronic medical condition, that is, it can be curbed at the initial level by introducing lifestyle changes and controlled after its incidence through medicines in early stages and administration of external insulin in advanced stages.

Over the years, occurrence diabetes has more than doubled for men (3.7 per cent to 9.1 per cent). It has also increased by 80 per cent among women in India (4.6 per cent to 8.3 per cent).

According to a World Health Organization (WHO) fact sheet on diabetes, an estimated 3.4 million deaths are caused due to high blood sugar in the world.

What is Diabetes?

Diabetes is a medical condition that is caused due to insufficient production and secretion of insulin from the pancreas in case of Type-I diabetes and defective response of insulin for Type-2 diabetes. Under normal body circumstances, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level.

When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas to normalize the glucose level. In patients with diabetes, the absence or insufficient production of insulin causes hyperglycemia.

Why Indians are prone to Diabetes:

• Genetic or Ethnic Factor – Indians have a higher genetic predisposition to diabetes. According to researchers, our ethnicity appears to play a role in this current diabetes epidemic.
• Increased Insulin Resistance -Another factor that is not under our control is that we Indians have a greater degree of insulin resistance which means our cells do not respond to the hormone insulin. And when compared to Europeans, our blood insulin levels also tend to rise higher and more persistently when we eat carbohydrates.
• Lifestyle Changes – With the social and economic development and urbanization, our nutrition has improved, and we are living longer. However our lifestyle has changed and our diets have become unhealthy. Our traditional diet of unrefined grains is now substituted with refined varieties of the same and calorie rich foods.
• Obesity – Body mass index (BMI) is an indicator of our body fat. The relative risk of diabetes increases as the BMI increases. Indians comparatively have a higher body fat (especially around the waist) for any BMI. This, coupled with our inherent higher insulin resistance, significantly puts us at a higher risk of developing diabetes.

Take your health in your own hands. Be more conscious of your diet and make efforts to have a strict fitness regime. You age, family history, blood pressure, cholesterol, body weight determines your risk of getting Type 2 Diabetes. You can help reduce your risk of type 2 diabetes by understanding your risk and making changes to your lifestyle.

Here is how you can reduce your risk of type 2 diabetes:

• Manage your weight. Excess body fat, particularly if stored around the abdomen, can increase the body’s resistance to the hormone insulin. This can lead to type 2 diabetes.
• Exercise regularly. Moderate physical activity on most days of the week helps manage weight, reduce blood glucose levels and may also improve blood pressure and cholesterol.
• Eat a balanced, healthy diet. Reduce the amount of fat in your diet, especially saturated and trans fats. Eat more fruit, vegetables and high-fibre foods. Cut back on salt.
• Limit takeaway and processed foods. Fast foods are usually high in salt, fat and kilojoules. It’s best to cook for yourself using fresh ingredients whenever possible.
• Limit your alcohol intake. Too much alcohol can lead to weight gain and may increase your blood pressure and triglyceride levels. Men should have no more than two standard drinks a day and women should have no more than one.
• Quit smoking. Smokers are twice as likely to develop diabetes as non-smokers.
• Control your blood pressure. Most people can do this with regular exercise, a balanced diet and by keeping a healthy weight. In some cases, you might need medication prescribed by your doctor.
• Be regular in your medical checkups. As you get older, it’s a good idea to regularly check your blood glucose, blood pressure and blood cholesterol levels.

Diabetes is preventable. Let us fight this devil together. Talk to our experts at our Diabetes Clinic to know more about Diabetes. Please check the below link:

https://www.kokilabenhospital.com/departments/clinicaldepartments/endocrinologydiabetes/diabeticclinic.html