Thursday, June 28, 2018

What are the different types of cancer?


Cancers are often described by the organ they originated from. However, some body parts contain multiple types of tissue. So for greater precision, cancers are additionally classified by the type of cell that the tumour cells originated from. These types include:-

#Carcinoma:
1) This refers to malignant neoplasm that begins in the epithelium (skin) or in tissues that line internal organs.
2) Carcinomas are divided into two major subtypes.
3) Adenocarcinomas generally occur in mucus membrane of an organ or gland.
4) Squamous  cell carcinoma originates in the squamous epithelium.
5) examples are skin cancer, lung cancer, colon cancer, pancreatic cancer, ovarian cancers, Basal cell carcinomas, Melanoma.
  

#Sarcoma:
1) This refers to Cancer that originates in supportive and mesenchymal tissues such as bone, cartilage, fat, muscle, blood vessels, or other connective tissues. Examples: Osteosarcoma or osteogenic sarcoma (bone)
2) Chondrosarcoma (cartilage)
3) Leiomyosarcoma (smooth muscle)
4) Rhabdomyosarcoma (skeletal muscle)
5) Mesothelial sarcoma or mesothelioma (membranous lining of body cavities)
6) Fibrosarcoma (fibrous tissue)
7) Angiosarcoma or hemangioendothelioma (blood vessels)
8) Liposarcoma (adipose tissue)
9) Glioma or astrocytoma (neurogenic connective tissue found in the brain)
10) Myxosarcoma (primitive embryonic connective tissue)
11) Mixed mesodermal tumour (mixed connective tissue types
 #Leukaemia:
1) Cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of abnormal blood cells to be produced and enter the blood.
2) The disease is often associated with the overproduction of immature white blood cells. These immature white blood cells do not perform as well as they should, therefore the patient is often prone to infection. Leukaemia also affects red blood cells and can cause poor blood clotting and fatigue due to anaemia. Examples of leukaemia include:
3) Myelogenous or granulocytic leukaemia (malignancy of the myeloid and granulocytic white blood cell series)
4) Lymphatic, lymphocytic, or lymphoblastic leukaemia (malignancy of the lymphoid and lymphocytic blood cell series)
Polycythemia vera (malignancy of various blood cell products, but with red cells predominating)
#Lymphoma and myeloma:

 
 


Sunday, June 10, 2018

surgery for Hernia


Is it necessary to use the mesh in all the cases?

Yes. Now world over, there is consensus that the use of mesh is desirable in majority of patients to strengthen the wall whether surgery is done conventionally or endoscopically. Only the childhood hernias are repaired without using mesh.

Is endoscopic surgery safe?

Yes. Done by a properly trained surgeon in a well equipped centre, it is a safe surgery with excellent results.

What happens after admission for surgery?

Patients are admitted in the hospital on the day of surgery of a day prior to surgery. On admission, patients are examined and investigations reviewed by one of the team members. A member of the Anaesthesia Team conducts the pre-anaesthetic check-up. Pre-operative investigations before the surgery. Next morning, he/she will be shifted to the operation theatre half an hour prior to surgery. After surgery, they are shifted to the recovery room for 2-4 hours under the care and supervision of our Anaesthesia Team for observation and then shifted back to the room. It takes about 4-8 hours before the patient comes back to his/her room. Patient is given sips of water orally on returning to the room and progresses to drinking all liquids on the same evening as surgery. They may sit up, visit the toilet and move around for a few hours after surgery and are encouraged to do so early.

Patients are given a normal breakfast next morning and discharged from hospital after a visit by one of the team members. On discharge, a discharge summary with the advised medication is handed over to the patient.

Can the surgery be performed as a day care procedure?

Yes, day care surgery is being performed on young and fit patient. The patient is called to the operation theatre in the morning in a fasting state of more than 8 hours. After the operation, patient is observed for 4-6 hours post operatively in the day care facility before getting discharged. In case the need arises, there is a provision for overnight admission as well.

Post operative instructions and information

1. After the operation you will be kept in the recovery room. This period may vary from few minutes to few hours. The anaesthetist decides about your shifting to room. The decision depends on many technical factors.

2. You will be sleepy immediately after the operation due to sedation given during anaesthesia and during the recovery period.

3. You may have some discomfort when coming out of the effect of sedation. It gradually reduces to tolerable level within a few minutes without any pain killer. However, if necessary you may ask for pain killer injections/ tablets. You should try to avoid these drugs because they produce drowsiness and you may sleep for a longer period which is not desirable.

4. You may feel nauseated in the immediate post-operative period, and you may even vomit which should not cause any worry. This generally gets over after few hours.

5. You are generally allowed to have sips of water immediately after the operation and liquids on day of operation. In case of vomiting the liquid intake may be stopped and restarted after 30 minutes. The liquids may include water/cold drinks/tea/coffee / milk / juices or some clear soups.

6. You are allowed to have normal home cooked meals of your choice from the next morning at breakfast.

7. You should have small frequent meals for few days after operation following which you can resume your normal diet gradually. This is vital because you may feel bloated and distended if the quantity of food is in large quantities at a time.