Breast Composition - a mass of glandular, fatty, and fibrous tissues.
Lobules – milk glands that produce milk
Ducts – transport milk from lobules to nipple
Nipple
Areola – pink or brown pigmented region surrounding the nipple.
Connective (fibrous) tissue that surrounds the lobules and ducts.
Fats
(will show the photo of the composition of breast on friday, sorry, the internet connection here is too terrible)
What is Breast Cancer ?
-Uncontrolled growth of breast cells, forming tumor.
-mutations, abnormal changes in the gene
-Benign (not dangerous)
*Grow slowly
*Do not invade nearby tissues
-Malignant ( dangerous , cancerous)
*Spread to other parts of the body
Where does breast cancer begin ?
-Cell of lobules
-ducts
-Less commonly :
Stromal tissues ( fatty and fibrous connective tissues)
Common form of breast cancer :
-Ductal Carsinoma In Situ (DCIS)
Ductal epithelial cells undergo malignant transformation and proliferate intraluminally.
Debris can calcify (tiny calcium deposits)
5 pathologic subtypes : comedo, papillary, micropapillary, solid and cribriform.
Lesions represent a combination of at least 2 of these subtypes
-Lobular Carsinoma In Situ (LCIS)
↑ in the no. of cells within the lobules
Lobular pattern
Rarely detected by examination or mammography
As a marker for development of invasive cancer
-Infiltrating Ductal Carsinoma
Most commonly diagnosed breast tumor.
Invasive
Lobules ?? wall of ducts ?? fatty tissue of breast (possible to other regions of the body)
Tendency to metastasize via lymphatics
-Infiltratiltrating Lobular Carsinoma
Invasive
Begins in lobules , able to metastasize (lymph nodes)
Tendency to be more multifocal.
Indian file arrangement of small tumor cells
Less common form of breast cancer :
-Tubular Carcinoma
Invasive
Forms distinct boundary between tumor tissue and normal tissue.
Rarely metastasize.
-Mucinous Carcinoma
Slow growing lesions
Mucus-producing cancer cells
Bulky
Rarely metastasize.
Better prognosis (expected outcome) than other common types of invasive carsinoma.
-Medullary Carcinoma
Invasive
Poorly differentiate tumor
Distinct boundary between tumor tissue and normal tissue.
-Inflammatory breast cancer
Inflamed breast
Red and warm
Dimples
Thick ridges
Cancer cells blocking the lymph vessels
Extremely fast growing
-Paget’s disease of the nipple
Milk duct → skin of nipple and aerola
Breast skin may appear crusted, red or oozing.
Nipple changes
No lump is felt
-Phylloides tumor
Can be benign or malignant
Develop in the connective tissues of the breast.
Treated by surgical remove.
Link :
http://emedicine.medscape.com/article/1276001-overview
http://www.imaginis.com/breasthealth/dcis.asp
http://www.breastcancer.org
Thursday, March 26, 2009
Wednesday, March 25, 2009
Coping with the possibilities of having cancer!
How am I supposed to cope with this?
There are so many things that you can do in order to cope with the fact that your mum has been diagnosed with cancer. Below are some suggestions about what might help you to cope. Try these out, or talk to your friends and family about new ideas you have. Email us about what works for you.
* Look after your own health - maybe go to bed a little bit earlier and try to eat a healthy diet. When your body is under emotional stress, it can also be under extra physical stress too. If you are not feeling well, see your doctor or talk to another adult who can help you.
* Give yourself time to adjust and understand what is happening - don’t expect that you should be able to deal with this straight away. Some people take years to work through their emotions, you have a head start because you are reading this website. Keep reading, exploring your feelings and talking to other people and it will slowly start to make sense.
* Express your feelings - be prepared to talk about the tough stuff, otherwise you might start to think your feelings don’t matter.
* Get information - find out as much as you feel you need in order to understand what is happening to your mum. Some people prefer not to know the detail. Others like to learn everything. It is totally up to you.
* Keep a diary - write down all of your thoughts and feelings each day. Look back over your notes and see how far you have come since you first found out about your mum.
* Do some exercise - swim, ride, beach, surf, walk, run, play a sport at school etc. It is amazing how good you will feel after you get some of your negative energy out and forget about life for a little while.
* Get creative - write a story, play some music, draw a picture, design a new computer game etc.
* Connect with other young people who have coped with cancer in their family. Feeling alone is one of the worst things, but you are not the only one. You don’t always have to talk about the cancer with them, but just having fun with someone who knows what it’s all about can be such a relief.
* Spend time with your friends. It might just be hanging out, going to a movie or listening to music. It’s good to do something that feels ‘normal’ when everything around you is changing.
* Let yourself be sad. Being sad won’t make it worse, and most times people who bottle up their feelings get stressed out later on anyway. Sometimes you can feel that if you start to cry you will never stop. That’s OK. You won’t feel this sad forever. You just won’t.
* Have some fun. Having fun doesn’t mean that you are selfish or don’t care about your mum. It is a way of building up some supplies of good things inside to help you get through the tough times. It will also make her feel better to see you enjoying yourself.
* Keep going to school, doing the things you used to do where possible. Working hard at school can be a way of having a break from thinking about the cancer, and when you do well, it makes you feel more confident that you really will be able to handle things.
* Find your own way of coping - even if it seems strange. Some people write on little bits of paper about what is really getting to them. Then they fold up that piece of paper and put it in a special little box called a worry box. Other people just go somewhere private or outdoors and yell and scream and shout until they feel better!
* Work out what used to relax you - it might have been listening to music, going to the beach, going to the movies, whatever it is - try it again. It will usually make you feel much better.
* Sometimes it might seem like a good idea to drink away your problems or take drugs to forget about things for a while. Sometimes drinking and taking drugs can seem a release from all the stress, but they lead to health problems themselves and that then just adds to all the drama you’re already dealing with. It just doesn’t work. You have to work through the tough stuff before you can feel better.
Source: http://www.myparentscancer.com.au/cope.html
There are so many things that you can do in order to cope with the fact that your mum has been diagnosed with cancer. Below are some suggestions about what might help you to cope. Try these out, or talk to your friends and family about new ideas you have. Email us about what works for you.
* Look after your own health - maybe go to bed a little bit earlier and try to eat a healthy diet. When your body is under emotional stress, it can also be under extra physical stress too. If you are not feeling well, see your doctor or talk to another adult who can help you.
* Give yourself time to adjust and understand what is happening - don’t expect that you should be able to deal with this straight away. Some people take years to work through their emotions, you have a head start because you are reading this website. Keep reading, exploring your feelings and talking to other people and it will slowly start to make sense.
* Express your feelings - be prepared to talk about the tough stuff, otherwise you might start to think your feelings don’t matter.
* Get information - find out as much as you feel you need in order to understand what is happening to your mum. Some people prefer not to know the detail. Others like to learn everything. It is totally up to you.
* Keep a diary - write down all of your thoughts and feelings each day. Look back over your notes and see how far you have come since you first found out about your mum.
* Do some exercise - swim, ride, beach, surf, walk, run, play a sport at school etc. It is amazing how good you will feel after you get some of your negative energy out and forget about life for a little while.
* Get creative - write a story, play some music, draw a picture, design a new computer game etc.
* Connect with other young people who have coped with cancer in their family. Feeling alone is one of the worst things, but you are not the only one. You don’t always have to talk about the cancer with them, but just having fun with someone who knows what it’s all about can be such a relief.
* Spend time with your friends. It might just be hanging out, going to a movie or listening to music. It’s good to do something that feels ‘normal’ when everything around you is changing.
* Let yourself be sad. Being sad won’t make it worse, and most times people who bottle up their feelings get stressed out later on anyway. Sometimes you can feel that if you start to cry you will never stop. That’s OK. You won’t feel this sad forever. You just won’t.
* Have some fun. Having fun doesn’t mean that you are selfish or don’t care about your mum. It is a way of building up some supplies of good things inside to help you get through the tough times. It will also make her feel better to see you enjoying yourself.
* Keep going to school, doing the things you used to do where possible. Working hard at school can be a way of having a break from thinking about the cancer, and when you do well, it makes you feel more confident that you really will be able to handle things.
* Find your own way of coping - even if it seems strange. Some people write on little bits of paper about what is really getting to them. Then they fold up that piece of paper and put it in a special little box called a worry box. Other people just go somewhere private or outdoors and yell and scream and shout until they feel better!
* Work out what used to relax you - it might have been listening to music, going to the beach, going to the movies, whatever it is - try it again. It will usually make you feel much better.
* Sometimes it might seem like a good idea to drink away your problems or take drugs to forget about things for a while. Sometimes drinking and taking drugs can seem a release from all the stress, but they lead to health problems themselves and that then just adds to all the drama you’re already dealing with. It just doesn’t work. You have to work through the tough stuff before you can feel better.
Source: http://www.myparentscancer.com.au/cope.html
Some things YOU SHOULD KNOW before removing your BREASTS!
Here are a variety of types of mastectomy in use, and the type that a patient decides to undergo (or whether he or she will decide instead to have a lumpectomy) depends on factors such as size, location, and behavior of the tumor (if there is one), whether or not the surgery is prophylactic, and whether or not the patient intends to undergo reconstructive surgery.
* Simple mastectomy (or "total mastectomy"): In this procedure, the entire breast tissue is removed, but axillary contents are undisturbed. Sometimes the "sentinel lymph node"--that is, the first axillary lymph node that the would be expected to drain into--is removed. This surgery is sometimes done bilaterally (on both breasts) on patients who wish to undergo mastectomy as a cancer-preventative measure. Patients who undergo simple mastectomy can usually leave the hospital after a brief stay. Frequently, a drainage tube is inserted during surgery in their chest and attached to a small suction device to remove subcutaneous fluid. These are usually removed several days after surgery as drainage decrease to less than 20-30 ml per day.
* Modified radical mastectomy: The entire breast tissue is removed along with the axillary contents (fatty tissue and lymph nodes). In contrast to a radical mastectomy, the pectoral muscles are spared.
* Radical mastectomy (or "Halsted mastectomy"): First performed in 1882, this procedure involves removing the entire breast, the axillary lymph nodes, and the pectoralis major and minor muscles behind the breast. This procedure is more disfiguring than a modified radical mastectomy and provides no survival benefit for most tumors. This operation is now reserved for tumors involving the pectoralis major muscle or recurrent breast cancer involving the chest wall.
* Skin-sparing mastectomy: In this surgery, the breast tissue is removed through a conservative incision made around the areola (the dark part surrounding the nipple). The increased amount of skin preserved as compared to traditional mastecomy resections serves to facilitate breast reconstruction procedures. Patients with cancers that involve the skin, such as inflammatory cancer, are not candidates for skin-sparing mastectomy.
* Subcutaneous mastectomy: Breast tissue is removed, but the nipple-areola complex is preserved. This procedure was historically done only prophylactically or with mastecomy for benign disease over fear of increased cancer development in retained areolar ductal tissue. Recent series suggest that it may be an oncologically sound procedure for tumors not in the subareolar position.
* Simple mastectomy (or "total mastectomy"): In this procedure, the entire breast tissue is removed, but axillary contents are undisturbed. Sometimes the "sentinel lymph node"--that is, the first axillary lymph node that the would be expected to drain into--is removed. This surgery is sometimes done bilaterally (on both breasts) on patients who wish to undergo mastectomy as a cancer-preventative measure. Patients who undergo simple mastectomy can usually leave the hospital after a brief stay. Frequently, a drainage tube is inserted during surgery in their chest and attached to a small suction device to remove subcutaneous fluid. These are usually removed several days after surgery as drainage decrease to less than 20-30 ml per day.
* Modified radical mastectomy: The entire breast tissue is removed along with the axillary contents (fatty tissue and lymph nodes). In contrast to a radical mastectomy, the pectoral muscles are spared.
* Radical mastectomy (or "Halsted mastectomy"): First performed in 1882, this procedure involves removing the entire breast, the axillary lymph nodes, and the pectoralis major and minor muscles behind the breast. This procedure is more disfiguring than a modified radical mastectomy and provides no survival benefit for most tumors. This operation is now reserved for tumors involving the pectoralis major muscle or recurrent breast cancer involving the chest wall.
* Skin-sparing mastectomy: In this surgery, the breast tissue is removed through a conservative incision made around the areola (the dark part surrounding the nipple). The increased amount of skin preserved as compared to traditional mastecomy resections serves to facilitate breast reconstruction procedures. Patients with cancers that involve the skin, such as inflammatory cancer, are not candidates for skin-sparing mastectomy.
* Subcutaneous mastectomy: Breast tissue is removed, but the nipple-areola complex is preserved. This procedure was historically done only prophylactically or with mastecomy for benign disease over fear of increased cancer development in retained areolar ductal tissue. Recent series suggest that it may be an oncologically sound procedure for tumors not in the subareolar position.
Management of Breast Cancer (Treatment and Aftercare)
TREATMENT
Many women receive more than one type of treatment.
-Divided to either Local Therapy or Systemic Therapy
Local Therapy
- Remove, destroy cancer in the breast.
- Used to control disease in specific areas of metastasis occurs
Systemic Therapy
- Destroy/control cancer throughout the body.
Surgery
Breast sparing surgery
- Remove cancer(lump) but not the breast.
- Underarm lymph nodes are removed as well (axillary lymph node dissection)
- Usually coupled with radiation therapy after surgery to destroy remaining cancer cells.
Mastectomy
Simple (total) mastectomy
-removal of whole breast, some lymph nodes under arm removed removed.
Radical Mastectomy
-removal of whole breast, most/all of lymph nodes under arm
-often lining over the chest muscles is removed
Radiation Therapy (radiotherapy)
- high energy rays to kill cancer cells by damaging cell DNA,
hence loses ability to grow and divide
- cancer cells less organized, harder to repair compared to normal cells.
- may be performed before surgery to destroy cancer cells and shrink tumour.
- may be used after breast sparing surgery or mastectomy
to destroy cancer cells that remain in the area.
External radiation
Radiation from large machine, linear accelerator, outside body
Internal radiation (implant radiation)
Implants (thin plastic tubes, catheters) containing radioactive substance (pellets, seeds) put directly into breast.
Chemotherapy
- Anticancer drugs used to kill cancer cells
- A combination of drugs is used
- Drugs given as a pill or injection into a vein (IV) – enter bloodstream and travel through body
- Stops growth/multiplication of cancer cells - kill them
- Used to reduce size of breast tumour before surgery
- Used after surgery to destroy cancer cells that may have spread
- Possibility of killing normal cells which divide rapidly (eg. blood cells)
Classes of drugs
Alkylators
- Damage proteins that control growth in the genes of the tumour cell
(eg. cyclophosphamide)
Antimetabolites
- Act as false building blocks (bases in nucleotides) in a cancer cell’s genes, causing it to die as it gets ready to divide .
(eg. fluorouracil)
Antibiotics (against growth, not those that fight infection)
-potent inhibitors of gene replication
(eg. Adriamycin)
Antimiototic agents
-natural agents that rob cellular genes of the ability to reproduce themselves during division (stops mitosis)
(eg. vincristine fr periwinkle plant)
Antimicrotubule
-natural agents which interfere with cell structure, microtubules, during cell division.
(eg. Taxol (paclitaxel) fr yew tree)
Hormone Therapy
- For hormone-receptor-positive breast cancer
- some tumours need hormones(estrogen, progesterone) to grow
- uses drugs OR surgery to lower the amount of hormone in body OR block action of estrogen on body
Type of Hormonal therapy medicines
Aromatase inhibitors
-aromatase is enzyme that synthesizes estrogen
Selective Estrogen Receptor Modulators (SERMs)
- ability to selectively inhibit or stimulate estrogen like action in various tissues
(eg. Tamoxifen)
Estrogen Receptor Downregulators (ERDs)
- sit in estrogen receptors in breast cells, blocks effect of estrogen in breast tissues
Targeted Therapy (Biologycal Therapy)
- helps immune system fight cancer
Herceptin (trastuzumab)
-monoclonal antibody that binds to cancer cells
- for breast tumours that have too much of a specific protein (HER2),
Blocks ability of cancer cells to receive chemical signals that tell the cells to grow.
CARE AFTER TREATMENT
Breast Reconstruction
- Reasons for breast reconstruction
~ maintain self-esteem and confidence
~body image reinforcement
~appearance for professional reasons
~avoid inconvenience of mammary prosthesis
- Two types of breast reconstruction:
~using implants (saline or silicon or both)
~using either the stomach or back muscles
External Prostheses
- helps restore body image
- made of silicon gel
- may be worn inside bra and closely copies natural contours of breast
Follow Up Treatment
- to look after emotional wellbeing and support
- regular checkups (mammograms, clinical examinations)
Many women receive more than one type of treatment.
-Divided to either Local Therapy or Systemic Therapy
Local Therapy
- Remove, destroy cancer in the breast.
- Used to control disease in specific areas of metastasis occurs
Systemic Therapy
- Destroy/control cancer throughout the body.
Surgery
Breast sparing surgery
- Remove cancer(lump) but not the breast.
- Underarm lymph nodes are removed as well (axillary lymph node dissection)
- Usually coupled with radiation therapy after surgery to destroy remaining cancer cells.
Mastectomy
Simple (total) mastectomy
-removal of whole breast, some lymph nodes under arm removed removed.
Radical Mastectomy
-removal of whole breast, most/all of lymph nodes under arm
-often lining over the chest muscles is removed
Radiation Therapy (radiotherapy)
- high energy rays to kill cancer cells by damaging cell DNA,
hence loses ability to grow and divide
- cancer cells less organized, harder to repair compared to normal cells.
- may be performed before surgery to destroy cancer cells and shrink tumour.
- may be used after breast sparing surgery or mastectomy
to destroy cancer cells that remain in the area.
External radiation
Radiation from large machine, linear accelerator, outside body
Internal radiation (implant radiation)
Implants (thin plastic tubes, catheters) containing radioactive substance (pellets, seeds) put directly into breast.
Chemotherapy
- Anticancer drugs used to kill cancer cells
- A combination of drugs is used
- Drugs given as a pill or injection into a vein (IV) – enter bloodstream and travel through body
- Stops growth/multiplication of cancer cells - kill them
- Used to reduce size of breast tumour before surgery
- Used after surgery to destroy cancer cells that may have spread
- Possibility of killing normal cells which divide rapidly (eg. blood cells)
Classes of drugs
Alkylators
- Damage proteins that control growth in the genes of the tumour cell
(eg. cyclophosphamide)
Antimetabolites
- Act as false building blocks (bases in nucleotides) in a cancer cell’s genes, causing it to die as it gets ready to divide .
(eg. fluorouracil)
Antibiotics (against growth, not those that fight infection)
-potent inhibitors of gene replication
(eg. Adriamycin)
Antimiototic agents
-natural agents that rob cellular genes of the ability to reproduce themselves during division (stops mitosis)
(eg. vincristine fr periwinkle plant)
Antimicrotubule
-natural agents which interfere with cell structure, microtubules, during cell division.
(eg. Taxol (paclitaxel) fr yew tree)
Hormone Therapy
- For hormone-receptor-positive breast cancer
- some tumours need hormones(estrogen, progesterone) to grow
- uses drugs OR surgery to lower the amount of hormone in body OR block action of estrogen on body
Type of Hormonal therapy medicines
Aromatase inhibitors
-aromatase is enzyme that synthesizes estrogen
Selective Estrogen Receptor Modulators (SERMs)
- ability to selectively inhibit or stimulate estrogen like action in various tissues
(eg. Tamoxifen)
Estrogen Receptor Downregulators (ERDs)
- sit in estrogen receptors in breast cells, blocks effect of estrogen in breast tissues
Targeted Therapy (Biologycal Therapy)
- helps immune system fight cancer
Herceptin (trastuzumab)
-monoclonal antibody that binds to cancer cells
- for breast tumours that have too much of a specific protein (HER2),
Blocks ability of cancer cells to receive chemical signals that tell the cells to grow.
CARE AFTER TREATMENT
Breast Reconstruction
- Reasons for breast reconstruction
~ maintain self-esteem and confidence
~body image reinforcement
~appearance for professional reasons
~avoid inconvenience of mammary prosthesis
- Two types of breast reconstruction:
~using implants (saline or silicon or both)
~using either the stomach or back muscles
External Prostheses
- helps restore body image
- made of silicon gel
- may be worn inside bra and closely copies natural contours of breast
Follow Up Treatment
- to look after emotional wellbeing and support
- regular checkups (mammograms, clinical examinations)
Screening, Diagnostic Tests and Staging for Breast Cancer
SCREENING
Breast cancer and medical tests go hand in hand.
Most tests will fall into the following categories:
1.Screening tests (ST) :
- For people who appear healthy
- Purpose to find breast cancer early
2.Diagnostic tests (DT):
- For people who are suspected of having breast cancer
due to symptoms or screening test results.
- to determine whether breast cancer is present
- if Yes, has the cancer travelled outside the breast
- to gather more information to make decisions for treatment
Will first focus on screening tests
Clinical Breast Examination
- Doctor looks for differences in size/shape between breasts.
- Skin checked for rahs, dimpling or abnormal signs.
- Nipples checked for fluid
- Breasts felt for lumps, including underarm and collarbone area.
Screening Mammogram
- Picture of breasts made with X-rays
- Aged >40 to undergo screening every 1-2 years.
- Might show lumps before it is felt (early detection)
Breast Self Examination
- Performed monthly to check for any change in breasts.
DIAGNOSTIC TESTS
Clinical Breast Exam
- Doctor feels each breast for lumps and looks for other problems.
- If lump is present, feel its size, shape and texture
- Benign lumps – soft, smooth, round and movable.
- Malignant lumps – firmly attached and oddly shaped
Diagnostic Mammograms
- X-ray pictures of the breast
- To learn more about unusual breast changes
- Focus on specific area of the breast
(may have special techniques and more views than screening mammograms)
Ultrasound
- Pictures made from reflected sound waves off tissues and processed by a
computer.
- Shows whether lump is solid or filled with fluid (cyst-not cancer).
- May be used along with a mammogram.
Magnetic Resonance Imaging (MRI)
- Uses powerful magnet linked to a computer.
- Makes detailed pictures showing different planes of the tissue.
- May be used along with a mammogram.
Biopsy
- Fluid or tissue removed from breast to determine whether it is cancer
- Fine-needle aspiration
~ thin needle used to remove fluid from a breast lump
(checked for cancer by a pathologist)
- Core biopsy/needle biopsy
~ thick needle used to remove breast tissue (checked for cancer cells)
- Surgical biopsy
~ surgeon removes a sample tissue (checked for cancer cells)
Hormone receptor test
- Test done on breast tissue if it is determined to be cancerous
- Shows whether tissue has certain hormone receptors
~Tissues with these receptors needs hormones (estrogen/progesterone)
to grow
STAGING
Before treatment can be carried out, the extent (stage) of cancer needs to be known.
Stages based on SIZE of the tumour and whether it has SPREAD.
Involves X-rays and lab tests.
Stage 0 (carcinoma in situ-abnormal cells remain in the tissue where they first formed)
-Lobular carcinoma in situ
-Ductal carcinoma in situ
Stage I
- Early stage of invasive breast cancer
- Tumour no more than 2cm
Stage II (4types)
Size of Tumour Spread to lymph nodes under the arm?
<2cm Yes
2-5cm No
2-5cm Yes
>5cm No
Stage III (locally advanced cancer - spread from where it started to nearby tissue or lymph nodes)
IIIA
- No more than 5 cm across/ more than 5cm
- Spread to underarm lymph nodes that are attached to each other or other
structures
- Spread to lymph nodes behind to breastbone.
IIIB
- Grown into chest wall OR skin of the breast.
(swelling and lumps in breast skin)
- Spread to underarm lymph nodes that are attached to each other or other
structures
- Spread to lymph nodes behind to breastbone.
- Inflammatory breast cancer (red and swollen because cancer cell blocks
lymph vessels)
IIIC
- Tumour of any size.
- Spread to lymph nodes behind breastbone and under the arm.
- Spread to lymph nodes above or below the collarbone.
Stage IV (distant metastatic cancer)
-spread to other parts of the body.
Recurrent cancer
Links
http://www.breastcancer.org/
http://ncipoet.org/cancertopics/types/breast
Breast cancer and medical tests go hand in hand.
Most tests will fall into the following categories:
1.Screening tests (ST) :
- For people who appear healthy
- Purpose to find breast cancer early
2.Diagnostic tests (DT):
- For people who are suspected of having breast cancer
due to symptoms or screening test results.
- to determine whether breast cancer is present
- if Yes, has the cancer travelled outside the breast
- to gather more information to make decisions for treatment
Will first focus on screening tests
Clinical Breast Examination
- Doctor looks for differences in size/shape between breasts.
- Skin checked for rahs, dimpling or abnormal signs.
- Nipples checked for fluid
- Breasts felt for lumps, including underarm and collarbone area.
Screening Mammogram
- Picture of breasts made with X-rays
- Aged >40 to undergo screening every 1-2 years.
- Might show lumps before it is felt (early detection)
Breast Self Examination
- Performed monthly to check for any change in breasts.
DIAGNOSTIC TESTS
Clinical Breast Exam
- Doctor feels each breast for lumps and looks for other problems.
- If lump is present, feel its size, shape and texture
- Benign lumps – soft, smooth, round and movable.
- Malignant lumps – firmly attached and oddly shaped
Diagnostic Mammograms
- X-ray pictures of the breast
- To learn more about unusual breast changes
- Focus on specific area of the breast
(may have special techniques and more views than screening mammograms)
Ultrasound
- Pictures made from reflected sound waves off tissues and processed by a
computer.
- Shows whether lump is solid or filled with fluid (cyst-not cancer).
- May be used along with a mammogram.
Magnetic Resonance Imaging (MRI)
- Uses powerful magnet linked to a computer.
- Makes detailed pictures showing different planes of the tissue.
- May be used along with a mammogram.
Biopsy
- Fluid or tissue removed from breast to determine whether it is cancer
- Fine-needle aspiration
~ thin needle used to remove fluid from a breast lump
(checked for cancer by a pathologist)
- Core biopsy/needle biopsy
~ thick needle used to remove breast tissue (checked for cancer cells)
- Surgical biopsy
~ surgeon removes a sample tissue (checked for cancer cells)
Hormone receptor test
- Test done on breast tissue if it is determined to be cancerous
- Shows whether tissue has certain hormone receptors
~Tissues with these receptors needs hormones (estrogen/progesterone)
to grow
STAGING
Before treatment can be carried out, the extent (stage) of cancer needs to be known.
Stages based on SIZE of the tumour and whether it has SPREAD.
Involves X-rays and lab tests.
Stage 0 (carcinoma in situ-abnormal cells remain in the tissue where they first formed)
-Lobular carcinoma in situ
-Ductal carcinoma in situ
Stage I
- Early stage of invasive breast cancer
- Tumour no more than 2cm
Stage II (4types)
Size of Tumour Spread to lymph nodes under the arm?
<2cm Yes
2-5cm No
2-5cm Yes
>5cm No
Stage III (locally advanced cancer - spread from where it started to nearby tissue or lymph nodes)
IIIA
- No more than 5 cm across/ more than 5cm
- Spread to underarm lymph nodes that are attached to each other or other
structures
- Spread to lymph nodes behind to breastbone.
IIIB
- Grown into chest wall OR skin of the breast.
(swelling and lumps in breast skin)
- Spread to underarm lymph nodes that are attached to each other or other
structures
- Spread to lymph nodes behind to breastbone.
- Inflammatory breast cancer (red and swollen because cancer cell blocks
lymph vessels)
IIIC
- Tumour of any size.
- Spread to lymph nodes behind breastbone and under the arm.
- Spread to lymph nodes above or below the collarbone.
Stage IV (distant metastatic cancer)
-spread to other parts of the body.
Recurrent cancer
Links
http://www.breastcancer.org/
http://ncipoet.org/cancertopics/types/breast
Risk Factors of Breast Cancer
A risk factor is anything that affects your chance of getting a disease, such as breast cancer. However, having a risk factor, or even several, does not mean that you will get the disease. Most women who have one or more breast cancer risk factors never develop the disease, while many women with breast cancer have no apparent risk factors. Even when a woman with risk factors develops breast cancer, it is hard to know just how much these factors may have contributed to her cancer.
General risk factors:
1. Gender
-Simply being a woman is a main risk factor for the development of breast cancer.
- Women’s breast cells are constantly exposed to the growth-promoting effects of the female hormones estrogen and progesterone, which increases the chances of getting breast cancer.
2. Aging
-The risk of getting breast cancer increases as you age
3. Genetic risk factors
-About 5-10% of breast cancer cases are thought to be hereditary, resulting from gene mutation.
• BRCA 1 and BRCA 2
These are the most common inherited mutations. In normal cells, these genes help to prevent cancer by making proteins that help keep the cells from growing abnormally. When a mutated copy of this gene is inherited, there is increased chances (about 80%)of getting breast cancer and ovarian cancer.
• Changes in other genes
o ATM: The ATM gene normally helps repair damaged DNA. Certain families with a high rate of breast cancer have been found to have mutations of this gene.
o CHEK2: Increases breast cancer risk about twofold when it is mutated. In women who carry the CHEK2 mutation and have a strong family history of breast cancer, the risk is greatly increased.
o p53: Inherited mutations of the p53 tumor suppressor gene can also increase the risk of developing breast cancer, as well as several other cancers such as leukemia, brain tumors, and sarcomas (cancer of bones or connective tissue).
o PTEN: The PTEN gene normally helps regulate cell growth. Inherited mutations in this gene cause Cowden syndrome, a rare disorder in which people are at increased risk for both benign and malignant breast tumors, as well as growths in the digestive tract, thyroid, uterus, and ovaries.
4. Family history of breast cancer
• Breast cancer risk is higher among women whose close blood relatives have this disease.
• Having one first-degree relative (mother, sister, or daughter) with breast cancer approximately doubles a woman's risk. Having 2 first-degree relatives increases
• About 20% to 30% of women with breast cancer have a family member with this disease. (It's important to note this means that 70% to 80% of women who get breast cancer do not have a family history of this disease.)
5. Race and ethnicity
• White women are slightly more likely to develop breast cancer than are African-American women.
• African-American women are more likely to die of this cancer.
• African-American women tend to have more aggressive tumors, although why this is the case is not known
• Asian, Hispanic, and Native-American women have a lower risk of developing and dying from breast cancer.
6. Personal History of Breast Cancer
• A woman with cancer in one breast has a 3- to 4-fold increased risk of developing a new cancer in the other breast or in another part of the same breast. This is different from a recurrence (return) of the first cancer.
7. Dense breast tissue
• Women with denser breast tissue (as seen on a mammogram) have more glandular tissue and less fatty tissue, and have a higher risk of breast cancer.
• Dense breast tissue can also make it harder for doctors to spot problems on mammograms.
8. Certain benign breast conditions
• Women diagnosed with certain benign breast conditions may have an increased risk of breast cancer.
o Non-proliferative lesions
o Proliferative lesions without atypia
o Proliferative lesions with atypia
9. Menstrual periods
• Women who have had more menstrual cycles because they started menstruating at an early age (before age 12) and/or went through menopause at a later age (after age 55) have a slightly higher risk of breast cancer.
• This may be related to a higher lifetime exposure to the hormones estrogen and progesterone.
10. Previous chest radiation
• had radiation therapy to the chest area as treatment for another cancer, increased risk for breast cancer
Lifestyle-related factors and breast cancer risks:
1. Not having children, or having them later in life
• Women who have had no children or who had their first child after age 30 have a slightly higher breast cancer risk.
• Having many pregnancies and becoming pregnant at an early age reduces breast cancer risk.
• Pregnancy reduces a woman's total number of lifetime menstrual cycles, which may be the reason for this effect.
2. Recent oral contraceptive use
• Studies have found that women using oral contraceptives (birth control pills) have a slightly greater risk of breast cancer than women who have never used them, but this risk seems to decline once their use is stopped.
3. Using post-menopausal hormone therapy
• Post-menopausal hormone therapy (PHT), (hormone replacement therapy (HRT)), has been used for many years to help relieve symptoms of menopause and to help prevent osteoporosis (thinning of the bones).
• 2 main types of PHT:
For women who still have a uterus (womb), doctors generally prescribe estrogen and progesterone (known as combined PHT). Because estrogen alone can increase the risk of cancer of the uterus, progesterone is added to help prevent this.
For women who no longer have a uterus (those who've had a hysterectomy), estrogen alone can be prescribed. This is commonly known as estrogen replacement therapy (ERT).
• Combined PHT: Long-term use (several years or more) of combined post-menopausal hormone therapy increases the risk of breast cancer and may also increase the chances of dying of breast cancer. Large studies have found that there is an increased risk of breast cancer related to the use of combined PHT. It also increases the likelihood that the cancer may be found at a more advanced stage, possibly because it reduces the effectiveness of mammograms.
The increased risk from combined PHT appears to apply only to current and recent users. A woman's breast cancer risk seems to return to that of the general population within 5 years of stopping combined PHT.
• ERT: The use of estrogen alone does not appear to increase the risk of developing breast cancer significantly, if at all. But when used long term (for more than 10 years), ERT has been found to increase the risk of ovarian and breast cancer in some studies.
At this time there appear to be few strong reasons to use post-menopausal hormone therapy (combined PHT or ERT), other than possibly for the short-term relief of menopausal symptoms. The decision to use PHT should be made by a woman and her doctor after weighing the possible risks and benefits (including the severity of her menopausal symptoms), and considering her other risk factors for heart disease, breast cancer, and osteoporosis. If a woman and her doctor decide to try PHT for symptoms of menopause, it is usually best to use it at the lowest dose that works for her and for as short a time as possible.
4. Not breast-feeding
• Some studies suggest that breast-feeding may slightly lower breast cancer risk, especially if breast-feeding is continued for 1½ to 2 years. But this has been a difficult area to study, especially in countries such as the United States, where breast-feeding for this long is uncommon.
• The explanation for this possible effect may be that breast-feeding reduces a woman's total number of lifetime menstrual cycles (similar to starting menstrual periods at a later age or going through early menopause).
5. Alcohol
• Use of alcohol is clearly linked to an increased risk of developing breast cancer. The risk increases with the amount of alcohol consumed.
• Compared with non-drinkers, women who consume 1 alcoholic drink a day have a very small increase in risk. Those who have 2 to 5 drinks daily have about 1½ times the risk of women who drink no alcohol.
6. Being overweight or obese
• Being overweight or obese has been found to increase breast cancer risk, especially for women after menopause.
• Before menopause, your ovaries produce most of your oestrogen and fat tissues produces a small amount of estrogen. After menopause (when the ovaries stop making estrogen), most of a woman's estrogen comes from fat tissue. Having more fat tissue after menopause can increase your estrogen levels and thereby increase your likelihood of developing breast cancer.
The connection between weight and breast cancer risk is complex. For example, the risk appears to be increased for women who gained weight as an adult but may not be increased among those who have been overweight since childhood. Also, excess fat in the waist area may affect risk more than the same amount of fat in the hips and thighs. Researchers believe that fat cells in various parts of the body have subtle differences that may explain this.
7. Lack of physical activity
• Evidence is growing that physical activity in the form of exercise reduces breast cancer risk.
There are other unproven, controversial and uncertain effect on breast cancer risk. For full text, see http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_What_are_the_risk_factors_for_breast_cancer_5.asp
General risk factors:
1. Gender
-Simply being a woman is a main risk factor for the development of breast cancer.
- Women’s breast cells are constantly exposed to the growth-promoting effects of the female hormones estrogen and progesterone, which increases the chances of getting breast cancer.
2. Aging
-The risk of getting breast cancer increases as you age
3. Genetic risk factors
-About 5-10% of breast cancer cases are thought to be hereditary, resulting from gene mutation.
• BRCA 1 and BRCA 2
These are the most common inherited mutations. In normal cells, these genes help to prevent cancer by making proteins that help keep the cells from growing abnormally. When a mutated copy of this gene is inherited, there is increased chances (about 80%)of getting breast cancer and ovarian cancer.
• Changes in other genes
o ATM: The ATM gene normally helps repair damaged DNA. Certain families with a high rate of breast cancer have been found to have mutations of this gene.
o CHEK2: Increases breast cancer risk about twofold when it is mutated. In women who carry the CHEK2 mutation and have a strong family history of breast cancer, the risk is greatly increased.
o p53: Inherited mutations of the p53 tumor suppressor gene can also increase the risk of developing breast cancer, as well as several other cancers such as leukemia, brain tumors, and sarcomas (cancer of bones or connective tissue).
o PTEN: The PTEN gene normally helps regulate cell growth. Inherited mutations in this gene cause Cowden syndrome, a rare disorder in which people are at increased risk for both benign and malignant breast tumors, as well as growths in the digestive tract, thyroid, uterus, and ovaries.
4. Family history of breast cancer
• Breast cancer risk is higher among women whose close blood relatives have this disease.
• Having one first-degree relative (mother, sister, or daughter) with breast cancer approximately doubles a woman's risk. Having 2 first-degree relatives increases
• About 20% to 30% of women with breast cancer have a family member with this disease. (It's important to note this means that 70% to 80% of women who get breast cancer do not have a family history of this disease.)
5. Race and ethnicity
• White women are slightly more likely to develop breast cancer than are African-American women.
• African-American women are more likely to die of this cancer.
• African-American women tend to have more aggressive tumors, although why this is the case is not known
• Asian, Hispanic, and Native-American women have a lower risk of developing and dying from breast cancer.
6. Personal History of Breast Cancer
• A woman with cancer in one breast has a 3- to 4-fold increased risk of developing a new cancer in the other breast or in another part of the same breast. This is different from a recurrence (return) of the first cancer.
7. Dense breast tissue
• Women with denser breast tissue (as seen on a mammogram) have more glandular tissue and less fatty tissue, and have a higher risk of breast cancer.
• Dense breast tissue can also make it harder for doctors to spot problems on mammograms.
8. Certain benign breast conditions
• Women diagnosed with certain benign breast conditions may have an increased risk of breast cancer.
o Non-proliferative lesions
o Proliferative lesions without atypia
o Proliferative lesions with atypia
9. Menstrual periods
• Women who have had more menstrual cycles because they started menstruating at an early age (before age 12) and/or went through menopause at a later age (after age 55) have a slightly higher risk of breast cancer.
• This may be related to a higher lifetime exposure to the hormones estrogen and progesterone.
10. Previous chest radiation
• had radiation therapy to the chest area as treatment for another cancer, increased risk for breast cancer
Lifestyle-related factors and breast cancer risks:
1. Not having children, or having them later in life
• Women who have had no children or who had their first child after age 30 have a slightly higher breast cancer risk.
• Having many pregnancies and becoming pregnant at an early age reduces breast cancer risk.
• Pregnancy reduces a woman's total number of lifetime menstrual cycles, which may be the reason for this effect.
2. Recent oral contraceptive use
• Studies have found that women using oral contraceptives (birth control pills) have a slightly greater risk of breast cancer than women who have never used them, but this risk seems to decline once their use is stopped.
3. Using post-menopausal hormone therapy
• Post-menopausal hormone therapy (PHT), (hormone replacement therapy (HRT)), has been used for many years to help relieve symptoms of menopause and to help prevent osteoporosis (thinning of the bones).
• 2 main types of PHT:
For women who still have a uterus (womb), doctors generally prescribe estrogen and progesterone (known as combined PHT). Because estrogen alone can increase the risk of cancer of the uterus, progesterone is added to help prevent this.
For women who no longer have a uterus (those who've had a hysterectomy), estrogen alone can be prescribed. This is commonly known as estrogen replacement therapy (ERT).
• Combined PHT: Long-term use (several years or more) of combined post-menopausal hormone therapy increases the risk of breast cancer and may also increase the chances of dying of breast cancer. Large studies have found that there is an increased risk of breast cancer related to the use of combined PHT. It also increases the likelihood that the cancer may be found at a more advanced stage, possibly because it reduces the effectiveness of mammograms.
The increased risk from combined PHT appears to apply only to current and recent users. A woman's breast cancer risk seems to return to that of the general population within 5 years of stopping combined PHT.
• ERT: The use of estrogen alone does not appear to increase the risk of developing breast cancer significantly, if at all. But when used long term (for more than 10 years), ERT has been found to increase the risk of ovarian and breast cancer in some studies.
At this time there appear to be few strong reasons to use post-menopausal hormone therapy (combined PHT or ERT), other than possibly for the short-term relief of menopausal symptoms. The decision to use PHT should be made by a woman and her doctor after weighing the possible risks and benefits (including the severity of her menopausal symptoms), and considering her other risk factors for heart disease, breast cancer, and osteoporosis. If a woman and her doctor decide to try PHT for symptoms of menopause, it is usually best to use it at the lowest dose that works for her and for as short a time as possible.
4. Not breast-feeding
• Some studies suggest that breast-feeding may slightly lower breast cancer risk, especially if breast-feeding is continued for 1½ to 2 years. But this has been a difficult area to study, especially in countries such as the United States, where breast-feeding for this long is uncommon.
• The explanation for this possible effect may be that breast-feeding reduces a woman's total number of lifetime menstrual cycles (similar to starting menstrual periods at a later age or going through early menopause).
5. Alcohol
• Use of alcohol is clearly linked to an increased risk of developing breast cancer. The risk increases with the amount of alcohol consumed.
• Compared with non-drinkers, women who consume 1 alcoholic drink a day have a very small increase in risk. Those who have 2 to 5 drinks daily have about 1½ times the risk of women who drink no alcohol.
6. Being overweight or obese
• Being overweight or obese has been found to increase breast cancer risk, especially for women after menopause.
• Before menopause, your ovaries produce most of your oestrogen and fat tissues produces a small amount of estrogen. After menopause (when the ovaries stop making estrogen), most of a woman's estrogen comes from fat tissue. Having more fat tissue after menopause can increase your estrogen levels and thereby increase your likelihood of developing breast cancer.
The connection between weight and breast cancer risk is complex. For example, the risk appears to be increased for women who gained weight as an adult but may not be increased among those who have been overweight since childhood. Also, excess fat in the waist area may affect risk more than the same amount of fat in the hips and thighs. Researchers believe that fat cells in various parts of the body have subtle differences that may explain this.
7. Lack of physical activity
• Evidence is growing that physical activity in the form of exercise reduces breast cancer risk.
There are other unproven, controversial and uncertain effect on breast cancer risk. For full text, see http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_What_are_the_risk_factors_for_breast_cancer_5.asp
Tuesday, March 24, 2009
PCL Week 4- Structure of Debate on Friday
Hey guys.
Due to some confusion over which styles of debate we should adopt, I am here to clarify how it will happen during the debate session.
There are 2 groups, Pro vs Anti. Each group is consisted of 4 members, with the first one being the captain of his respective teams. Namely, Majid(Pro) and Viran(Anti).
Each speaker is given 3 minutes to voice out their views, starting from the Pro Speaker 1, then Anti Speaker 1, followed by Pro Speaker 2, then Anti Speaker 2, and so on till Anti Speaker 4.
Speakers are allowed to rebut the points given by their opposing teams, while also to express their own views based on their stance WITHIN their 3 mins period. Speakers are to decide on how long they should spend rebutting in their given 3 mins period; or not rebutting at all. However if all 3 minutes are spent only on rebutting, and no points are given at all, it would disadvantage that particular team.
When all speakers are done, both teams are given 1 minute to prepare their summary speeches. One person from each team shall present the speech in 2 minutes time.
I will be reminding every speaker when his/her time is 15 seconds from up, therefore he/she should end his/her speech within the remaining 15 seconds.
In this way, it would be more in order and easier to regulate. So in the end the debate session will take slightly more than 30 minutes to finish.
Please let me know if you have any questions. Tata :)
From Lam
Thursday, March 19, 2009
Prevalence and Incidence of Alcoholism and Tolerence
Prevalence and Incidence
What is Prevalence?
Prevalence is a frequently used epidemiological measure of how commonly a disease or condition occurs in a population. Prevalence measures how much of some disease or condition there is in a population at a particular point in time. The prevalence is calculated by dividing the number of persons with the disease or condition at a particular time point by the number of individuals examined.
What is Incidence?
The incidence of a disease is another epidemiological measure. Incidence measures the rate of occurrence of new cases of a disease or condition. Incidence is calculated as the number of new cases of a disease or condition in a specified time period (usually a year) divided by the size of the population under consideration who are initially disease free.
Epidemiology: The study of disease as it occurs in populations, rather than in individuals.
c) Alcohol
Objectives : The objectives of alcohol module are to determine the prevalence of alcohol use, the pattern of alcohol consumption in the general population, and to explore the determinants for starting and continuing alcohol use.
Method : Population-based cross-sectional survey covering all genders aged 13 years and above using pre-design self administered questionnaire.
Result : The response rate for this module was 52.5%. The prevalence of ever consume alcohol was 16.2% while current drinker was 7.4% and 29.1% of ever consume alcohol had stopped drinking for the past one year. For current drinker the prevalence was higher in Sarawak state (15.0%), in urban area (8.9%), among males (11.8%), Chinese (23.8%), age group between 70 – 74 years old (10.4%), Christians (25.6%), senior officer / manager (24.8%), and those married (7.9%). The respondents with tertiary level of education reported the highest prevalence (13.7%). Generally it was noted that the prevalence was highest among those who earned RM 5000 and above per month with a prevalence of 16.3% increased with household income. Similar trend was observed when the comparison was based on the personnel income. The reported mean age of starting to drink alcohol in Malaysia was 20.98 years old. Peer influenced was the main reason for initiation (53.4%) as well as continuing consumption of alcohol (37.1%). A group consists of Beer, Stout, Lager, Ale, Shandy was the most being consumed by the respondents with a prevalence of (93.3%) followed by a group of Red, White, Rose Wine/Champagne/Sherry/Vermouth And Tuak (55.8%) then by group of Whisky, Rum, Toddy ( 29.9% ). Prevalence of binge drinker was 30.6%. It was more common in rural (32.7%) and higher among males (31.8%). Overall, 46.0% of the respondents claimed that they had attempted to stop drinking with an average of 3.4 quit attempts. Among the successful quitters, 51.2% cited negative health effects as the main reason for quitting.
http://www.blackwellpublishing.com/specialarticles/jcn_9_188.pdf
http://www.nih.gov.my/NHMS/abstracts_14.html
Tolerence
Tolerance means that more of a drug is required to achieve an effect. Tolerance to alcohol can be demonstrated in two ways. First, the effect of a given dose of alcohol decreases as tolerance develops. Second, a greater dose of alcohol is required to produce a given effect. People may become tolerant to the desired effects of alcohol as well as to its aversive (unpleasant) effects. Tolerance can develop after a period of chronic alcohol exposure (protracted tolerance) or after a single dose (acute tolerance). It also can be expressed as strong individual and animal strain differences in initial sensitivity to alcohol (innate tolerance).
The development of tolerance allows and encourages increased intake of alcohol because more of the drug is required to achieve the same effect. There are several consequences of tolerance. The first is that higher blood levels of alcohol, maintained for longer periods of time, result in increased damage to many organ systems. Particularly vulnerable are the stomach, where bleeding occurs, and the liver, where fat deposition and cirrhosis occur. In addition, chronic alcohol consumption results in increased alcohol metabolism, as explained below. The metabolism of alcohol upsets the energy balance of the cell and results in altered metabolism of hormones and other compounds by the liver.
http://findarticles.com/p/articles/mi_m0847/is_n2_v14/ai_9858901
Summary
Alcoholism
What is Alcohol Abuse?
Drinking is most often done by many to enhance their social activities and to relax one self. Using alcohol in this way is not harmful for most adults.
However some people tend to drink over their limits which at times lead to negative effects on the different aspects of their lives, including health, relationships, work or school and money, and are considered to have an alcohol Problem. These problems can range from mild to severe
What is Alcoholism?
It is also known as Alcohol Dependence syndrome which is characterized by Craving, Loss of Control, Physical Dependence and the need for increasing amounts of alcohol to get high. Basically it is the “Uncontrollable need of a person for Alcohol”.
Prevalence and Incidence of Alcoholism in Malaysia
Prevalence is a frequently used epidemiological measure of how commonly a disease or condition occurs in a population. The incidence of a disease is another epidemiological measure. Incidence measures the rate of occurrence of new cases of a disease or condition.
How do you Diagnose Alcoholism?
This is done using a few different methods such as the CAGE questions, the Michigan Alcohol Screening Test (MAST) and also the Alcohol Use Disorder Identification test. The CAGE questions are the basic and most common tool for Doctors to realize that a patient has a high likelihood of having Alcoholism. Cage questions are not a diagnostic Tool for Alcoholism.
How is Alcohol Metabolized?
Alcohol is readily absorbed in the gastro intestinal tract, however it cannot be stored and therefore the body must oxidize it first. Oxidation of Alcohol occurs in the Liver. This is because the enzymes needed to catalyze the oxidation of alcohol are only present in the liver.
CH3CH2OH + NAD+ ---> CH3CH=O + NADH + H+
A number of metabolic effects from alcohol are directly linked to the production of an excess of both NADH and acetaldehyde.
Nutritional Effects of Alcohol Consumption?
Proper Nutrition is needed for providing energy and to maintain body structure and function. Alcohol interferes with the normal metabolism such as absorptions and storage of essential Nutrients. It does this by either reducing the secretion of digestive enzymes from the pancreas, damaging the cells lining the stomach and by disabling transport of nutrients into blood. This combined with the fact that alcohol contains calories which do not provide any vital nutrients but does lead to a decrease in demand for other nutritional foods can lead to malnutrition.
Toxic Effects of Alcohol
Complications with the Liver, Pancreas, Heart, Brain and related blood vessels can arise due to the toxic effects of Alcohol. This is mainly due to the excess NADH and acetaldehyde. Other known diseases due to the toxicity of alcohol are Fatty Liver, Hypoglycemia, Neuro degeneration, Hyperlipidermia, damage to the Heart, Hepatitis C. Sometimes Alcoholics have sudden black outs also known as Amnesic Episodes.
What are Hangovers?
Unpleasant physical and mental symptoms like fatigue, headache, dizziness, muscle aches, and thirst after heavy alcohol drinking. The symptoms experienced and their intensity varies according to the person, occasion, type of alcoholic beverage consumed and the amount a person drinks.
How Does Alcohol Contribute to Hangovers?
The impact of alcohol can be seen in 4 different areas which are;
1. Dehydration and fluid Imbalance,
2. Gastrointestinal Disturbances,
3. Low Blood Sugar levels and
4. Disruption of sleep and other biological rhythms.
Management & Treatments Available for Alcoholism.
Since most people drink alcoholic beverages as a social activity reduction of alcohol consumption can be done moderately by having drinks with less alcohol, alternate between alcoholic and soft drinks, consider cutting down social activities that involve drinking.
Some people who have been drinking a lot of alcohol suddenly stops drinking, they may have symptoms that are commonly known as withdrawal symptoms. These range from mild to sever physical and psychological aspects and sometimes some alcoholics experience Delirium tremens which is a more severe withdrawal symptom. Alcohol Rehab process mainly focuses on the physical and psychological dependency.
What are the primary elements of Alcohol Rehab?
Alcohol Detoxification - This is the initial part of the recovery process. Detox involves stopping the consumption of alcohol and giving the body the time it needs to cleanse itself of the harmful toxins associated with wine, liquor or beer.
Counseling - The core of any alcohol rehabilitation programs is counseling. During sessions with a counselor or therapist, the individual learns relapse prevention skills, receives education about alcoholism, and discovers the triggers that cause their unwanted behavior. Counseling in alcohol rehab takes two forms: individual and group sessions.
Aftercare - When an individual "graduates" from alcohol rehab, they must then return to the outside world. This is not always as easy as it sounds, as individuals face a number of challenges when they return home after treatment, including Temptation, Stress and distraction, a lack of understanding.
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