Benign Prostatic Hyperplasia

Introduction

The male organ or gland which produces a fluidly substance for carrying and nourishing your sperms during your sex act, is called Prostate gland. Prostate gland lies just below the urinary bladder and surround the urethra, which delivers urine from bladder and genital secretions from internal genital organs. It is very common occurrence for this gland to become enlarge in size with your advancing age. The most common variety of this increase in size of your prostate gland is known as Benign prostatic hyperplasia (BPH) or hypertrophy.

It is termed benign as it does not spreads even though its size increases like a tumor. It will keep growing after you get older than 25 years of age. Not infrequently it starts producing troublesome urinary symptoms after you reach the age of 50. Your doctor will make rectal examination  and inform you that you have developed BPH(benign prostatic hyperplasia). It may be regarded as one of the effects of male aging.

Ÿ  Incidence : It is estimated that if you are 60 years old, your chances of developing BPH is 50%, which rises to 90% as you age to 70 years.

Ÿ   Symptoms    :  Your severely enlarged prostate will cause you urinary complains, as it will press tight on your urethra. But sometimes, even if your prostate is not much enlarged it can create all the following troublesome complaints confined to urinary discharge:

                            

 ·delayed urine stream:  your urethra is clamped by enlarged   prostate. That makes you strain for urine stream. Commonly termed hesitancy..                                                                                                      .                               

·       Retention of urine  : At some stage ,due to straining , bladder  becomes weak and urine is not completely emptied out and  remains in your bladder.

                                     

  ·      Blood in urine    :  This is an indication that either you   have infection or some stone formation in your bladder due to retained, concentrated urine.                                              

•    Dribbling of urine :  you may loose control on your  bladder   as blockage by enlarged prostate results in left over  urine to constantly irritate your bladder. You may constantly  leak through urethra or fail to hold urine.

  ·    Weakening of stream of urine  : Due to pressure of  your  hypertrophied prostate on urethra, you fail to attain stream of  urine.

           .                                    

·     Frequency of micturation at night : retention of urine in your bladder irritates and cause more frequent desire to urinate during day and night.

 Causes and Risk factors

The major reason for your prostate to enlarge is a physiological or normal aging phenomenon. It keeps growing even after 25 years, but when it produces pressure symptoms on your urinary tract flow system, it is noticed and diagnosed as BPH.

Ÿ        Testes and BPH     : It has been observed that men whose testes have been removed do not develop benign prostatic hyperplasia. This just indicates some stimulating effect of your testes on your BPH.(National Kidney and Urologic information, US department of health.)

Ÿ        Hormones          :    With aging you start to loose your male hormone, testosterone. But ,the small amount of female hormone that is being produced now dominates. This female hormone, estrogen is secreted  through out your life and is known to enhance the activity of substances which promote cell growth in animal gland

Ÿ    Dihydrotestosterone      : This hormone is produced by your prostate and with age its concentration lowers . Interestingly, it has been observed that, while men loose testosterone, some still show higher concentration of DHT(dihydro-testosterone). This may result in your prostate growth. Men who do not have high DHT, don’t develop benign prostatic hypertrophy.

Risk factors

Ÿ          Age        : Your age is the main risk factor in development of enlarge prostate or benign prostattic hypertrophy(hyperplasia). The more older you get , more likely to  chance for you to suffer from BPH,  and viz-a viz(other way round). At 50 years you have 50% greater risk of BPH.

Ÿ         Family history    :  Your susceptibility increases if any of your siblings(father or brothers) have benign prostatic enlargement.

Ÿ         Heart diseases risk and BPH :  your chances of getting an enlarged prostate at later years of your life, if you have risk factor which play major role in heart disease. They can be, over weight, high cholesterol levels, high blood pressure, lower concentration of HDL( cardio-protective lipoproteins), diabetes and disease of peripheral arteries.

Ÿ          Race    :  If you belong to white race, you are at higher susceptibility of having benign prostatic hyperplasia with severe symptoms. You have more on risk of being on surgeon’s list for prostate removal due to BPH. Asians are least likely to have benign enlargement of prostate.

 complications

Your benign prostatic hyperplasia rarely causes any serious complication. When in case you start having severe symptoms attributed to your BPH, they are from pressure of your enlarged gland on urethra. These are entirely due to partial or complete blockage of your urine flow.

Ÿ                 Urinary retention   :  You may develop sudden and complete inability to pass urine, called acute urinary retention(AUR). This situation may cause severe pain at your bladder region( pubic area), which needs emergency measures like passing urethral catheter or supra-pubic needle at your bladder to empty your bladder and relieve the severe pain. If  your benign prostatic hyperplasia is blocking the urethra partially, then slow retention of urine in your bladder will complicate into CUR( chronic urinary retention).

Ÿ                   Urinary tract infection      :   The residual urine in your bladder may become seat of infection. This may produce some worrying symptoms of blood in your urine,  and painful micturation. It may cause ascending infection to your kidneys, resulting in its functional disturbances and damage.  If untreated, this kidney infection may cause waste products of protein metabolism to accumulate, which can make your health to get worse.

Ÿ           Urolithiasis (stone in urinary tract)  : The retained urine in your bladder because of BPH, is concentrated. The crystals of mineral present in this residual urine clump to form bladder stones. The stone may travel down to your urethra and block passage of urine. It is considered an emergency and needs immediate bladder relief via catheter.

Ÿ            Kidney damage    : benign prostatic hyperplasia and its blocking effect on your urine outflow passage secondarily causes damage to your kidneys. This is due to chronic(of long standing) back pressure of residual urine, on kidney’s normal filtration process.

You should keep this in mind, that, your benign prostatic hyperplasia will not effect your sexual ability nor it will become cancerous( progress to cancer). It will also not rreduce your fertility.

 Pharmaceutical therapies

                            It has been observed that you will consult your doctor not before you have urinary symptoms start bothering you. Your health care provide will not only take into account the extent and severity of your urinary complaints, but he will also have a physical examination done to make an initial assessment of your prostatic enlargement. He may advise test which will give a more confirm clue to diagnose your BPH.

Ÿ                        If your symptoms are milder and not bothering(American Urological Association score 0-7), all you will be advised is to make few changes in your daily routine, such as fluid intake, self controlling bladder urge, and avoiding night hours of tea, coffee or any liquid etc. you will not be given any medication or surgical options. All you will be asked is to keep regular follow up to your doctor. In case your symptoms get worse report.

Ÿ                       If your symptoms associated with BPH are not bothering you much (AUA score 8 or more) , your doctor advises you watchful waiting with or without medication. If symptoms get severe, specially night time visit or painful urination you will be given options for either surgery or transurethral prostate ablation(removal).

Ÿ                       In case you are unable to pass urine, or have blood in urine or stone in your bladder you will be cured of your symptoms by surgical means only.

                        

                         

                                                                                                                                                                     Medicine you will commonly be prescribed are following ;    

Ÿ                    Alpha (sympathetic) blockers     :  They will make easier flow of your urine from blocked urethra due to BPH. This effect is exerted by relaxation of smooth muscle of your enlarged prostate in BPH and bladder neck, loosening its grip on your urethra. They are given when you symptoms are moderate and bothersome. You will feel much better when the alpha blocker is given to you in combination with 5-alpha reductase. They give good result in improving symptoms in nearly 2-3 weeks. Commonly used alpha blockers are;

Ÿ                    Alphazosin

Ÿ                    Doxazosin 

Ÿ                    Silodozosin

Ÿ                   Tamsulosin

Ÿ                   Terazosin

Side effects of these alpha blockers you may face are, dizziness, fatigue and weakness, fainting due postural hypotension( lowering of BP after sudden standing from sitting position), headcahes, nausea, and upward semen discharge into bladder( retrograde ejaculation).

Ÿ                         5-alpha reductase inhibitors   :     The mode of action of these agents work through inhibition of testosterone conversion to dihydrotestosterone(DHT). DHT is shown in studies to be responsible for growth of your prostate. Hence by this action 5-alpha reductase reduces the size of  your benign prostatic hyperplasia to nearly 25% in about a year time. As mentioned their effects are better taken advantage of when given with alpha receptor blocking medicines.

Following are common drugs of this group ;

Ÿ                    Finasteride

Ÿ                    Dutasteride

Side effects of 5-alpha reductase inhibitors may cause , loss of sexual desire( libido), difficulties in ejaculation,  erection problems, and enlargement and tenderness of your breasts.

Ÿ                        Tedalafil  : This medicine has been in use for some years for erectile dysfunction. It has been approved recently for your benign prostatic hyperplasia. It is a phosphodiasterase-5(PDE5) inhibitor. Tedalafil has proven efficacy in relieving or minimizing your BPH related urinary symptoms. It is not prescribed with nitrites(nitroglycerine) or alpha blockers, as sudden and severe drop of your blood pressure may occur.

Side effects of tedalafil use are, headache, dyspepsia, back pain, muscular pain, nasal congestion, flushing and painful limbs. Loss in hearing and visual impairment have also  been reported. In such cases your doctor should immediately be informed for further advise.

Herpes and Folliculitis: Their Co-existence

The inflammation of hair follicles termed follicultis can effect an individual of any age, region or sex. It also can be initiated by one or more micro-organisms at a given instance. It is the damaged hair follicle, which is a pre-requisite to initiate folliculitis. It can then be invaded by staphylococcus aureus, the commonest infecting agent, fungus such candida, pityrosporum or malassezia , demodex mite, or virus of herpez class.

Herpes virus itself causes skin eruption. Its two different entities are seen in young children and adult age groups. Varicella (chickenpox) is one type which appears as systemic illness with typical skin eruption on face, trunk and other body parts. The rash  is quite distinct from typical folliculitis. It is vesiculo-papulo-pustular and a black scabbing at the end of this eruptive illness. All  forms of rash can be seen at one time on different parts of body. Face and trunk are mostly crowded with typical chickenpox rash as its commonly known name. This variety of herpes vericella skin eruption is most commonly confined to kids and young adults. The rash and the accompanying systemic illness is highly contagious in herpes vericella infection, either as droplets infection through coughing, sneezing or even the vesicular lesion can spread the illness.

The red pimple of folliculitis is papulo-pustular in appearance and it is seen in hairy parts of body, where injury to follicles gives way to invasion by micro-organism residing on skin as normal flora. Folliculitis can spread from one individual to another due to unhygienic lifestyle. Sharing the same toiletries, swimming pools, hot bath tubs are the common mode of its spread.

As for management is concerned, vericella (chicken pox) is self limiting, and rash resolve in about week to ten days time. Only supportive treatment is enough. Itching is controlled by some soothing agent, such as calamine lotion. A local anti-viral cream (zovirex) is also used when extensive facial eruption occur.

Treatment protocol for simple folliculitis stresses more on adopting better hygiene in daily life. Anti-septic soap baths and concurrent use of some solution of anti-infective property must be used along with warm damp washout of effected skin will help in faster healing. Itching is controlled with anti-allergic formulations.

Folliculitis and herpes varicella share common symptoms of severe itching and therefore spread from one part to another part of body. Same virus reactivates many years of being dormant after primary infection but it is localized to nerves and the rash is also distributed in same pattern of nerves. This is commonly called herpes zoster or shingles. Severe pain is predominant in shingles.

In some instances, herpes simplex virus itself causes inflammation of follicles commonly at bearded area. This  can become stubborn in responding to conventional methods of treatment unless a definitive diagnosis is made by isolating virus by doing smear of skin lesion and positive culture for infecting virus. Anti-viral drugs can effectively treat folliculitis of HSV, given for 5-10 days. Isolation of infected individual until active phase is over can save many  from getting troublesome skin condition

Types of Folliculitis & Their Remedy

Human skin is in most part covered with hair, whether small and silky or long and relatively tough. In all kinds they grow from small follicles, which has roots or attachments to deeper skin tissue. This gives some hint of what may occur if any damage takes place to follicles, opening an entry point for number of micro-organism harboring on normal skin or from  unhealthy environment. When a person gets folliculitis it can take the following shape or severity:

1) Superficial folliculitis,  80%  cases of folliculitis ,in which damage and subsequent infection remains limited to upper layer of skin,  as superficial pustular lesions. This may just appear as raised red area over skin in region of hair, a bump usually it is called. It has no specific location, as any area having hair follicle can become infected, like facial region specially shaving area including chin, scalp, buttocks, thighs, axilla, and trunk.

Treatment is based  on simple conservative approach, with more emphasis on taking shower regularly with some potent anti-bacterial soap, or regular application of benzyl peroxide, a potent local broad spectrum anti-bacterial preparation which effectively fasten healing process to full recovery without residual scaring or hair loss.

Occasionally, the simple form heals with simple measure but may leave a hardened nodular bump without any sign of redness or pain, seen at shaving area and also over the chest more commonly in dark skinned individuals.

As simple folliculitis or milder form is more itchy and tender,  using diphehydramine or some other anti-allergic and  pain killer is advisable. Applying moist hot compresses also help in clearing dead tissues as well as reduce itching.

2) Deep folliculitis, may morphologically be specific, occurring on its own causes or as complication of superficial folliculitis. The hallmark of deeper folliculitis is that infecting organism  penetrates deeper layers of  skin through damaged hair follicle, which in all probability may effect other parts of body once spread is not adequately treated. As it can be caused by different  classes of microbes, it can be discussed  individually. Even in all these different settings the basic principle of personal hygiene will apply, and use of conservative remedies used in superficial or simple folliculitis.

a) Bacterial folliculitis Most common micro-bacterium is staphylococcus , and anti-biotics of choice for treating folliculitis  by this organism are ciphalexin, dicloxicillin, or flocloxacillin in dose range of 250-500mg four times daily for ten days. Hot tub folliculitis is common incidence in person using public hot tub baths and swimming pools. The organism involved in such settings is usually pseudomonas aeruginosa  usually can be controlled with benzyl peroxide wash twice daily may suffice. But when it gets widespread as it commonly happens, suitable anti-biotic cover for 7-10 days is needed. Ciprofloxacillin is best choice, and dose  is 500mg two times /day.

b) Fungal folliculitis, most commonly on scalp, needs to be treated by topical ketoconazole shampoo 3-5 times per week/ econazole applied locally twice daily untill  condition heals up completely. If specific fungus is identified as in more severe infection oral anti-fungal drugs, such as fluconazole or itraconazole is given in dose range of 100mg -200mg once or twic daily for minimum of two weeks. As in most instances bacterial infection concurrently exist oral anti-biotics is also advisable as adjuvant treatment.

c) Viral folliculitis such as caused by herpes , has acyclovir available as treatment of choice in 200mg dose four times per day for 5-10 days duration.

d)Abscess can be one form of complicated   folliculitis, when  large collection of pus not only causes swelling of small bump but spreads into surrounding and deeper tissue. Most commonly  it is seen in facial and armpit region where not only the folliculitis becomes enlarged into swelling filled with increased amount of pus, even the lymph node draining the particular area becomes tender and enlarged too. The definitive approach to treatment is incision and drainage of pus filled cavity, until it is devoid of infected substance, sometimes surgeon may leave a sterile gauze to prevent refilling of space till healing is complete.  Use of anti-biotic may or may not be needed.

What ever type, severity , location folliculitis presents with, the corner stone of treatment is meticulous personal hygiene ,of which there is no alternative.

Pledge

Thirty years and looking ahead as a professional. It has been untiring, thrilling, gratifying. 55 years of being a son, a brother, a friend, and a father. It took along all and every bit. Making few more desires to fulfill, few more mountains to climb. So far, so great. Rating on the scale of satisfaction, giving away has always edged far ahead than taking from. Loving, caring, ignoring, forgiving, helping, healing and to be kind brought most comfort than opposite of all.

Beginning 2014, to remain at peace with myself and with people around, to remain positive on all matters of life, to be still selfless and devoted to my kids, to be kind and caring for someone in need, and to be a strong believer in One Might.

Kidney Cancer

Introduction

When ever cells of any organ or parts of your body regenerate or start multiplying faster than normal rate, they develop into abnormal mass called cancer. Your kidneys are two in number, located on both sides of spine in mid abdominal region.They have same potential to develop cancer if there are certain causative factors present. It is also known as renal cancer or malignancy because it has tendency to spread to different parts of your body. Most of kidney cancers begin inside the renal tubular cells, main body of kidney, and is know as renal cell carcinoma. They may also arise in renal pelvis, which is the collecting channel of urine. The encouraging aspect of kidney cancer, of which renal cell cancer is commonest variety, is that, it is detected early during some routine non-invasive laboratory examination. Which makes its treatment and prognosis (course and prediction) successful. This positive factor also helps preventing its spread beyond the kidney structure. Most commonly, one of your kidneys may develop cancer, but it is not unusual for both kidneys to be effected with it.

Ÿ  Incidence of your primary kidney cancer has been estimated to be 2%-3% of all cancerous growth in body. The age of occurrence of your renal cancer becomes more common after 45 years and reaches to maximum when you reach to the age of 65-70 years. The kidney cancer also effects children under 4-5 years, commonest being know as Wilm’s tumor. Renal cell carcinoma accounts for 85% of kidney cancers worldwide.

Ÿ  Gender wise male are more detected to be suffering from kidney cancer than females. The ratio is 1.5/1.

Ÿ  The survival for five years from your kidney cancer is about 70%, Which is due to early detection. In males, kidney cancer is the tenth most common cause of death. 100,000 people die each year due to renal cancer all over the world (kidney health Australia).

symptoms and signs of your renal cancer included are, blood in urine (hematuria), pain in flanks, abdominal mass on examination, fever of long standing not associated with any flu like illness, loss of your apatite, loss of weight for unknown reasons, anemia due chronic blood loss in urine, swelling in ankles and feet due to fluid retention, feeling extreme tiredness. When you kidney carcinoma spread to distant organs it may cause bone pain, breathing difficulty, and hemoptysis ( coughing of mucus with blood).

Risk factors

Ÿ  Age is easily the most common risk for any slow progressing disease. It has same predilections for development of your  renal cancer. The age risk begins after 40 years and peaks at 60 years. Some kidney cancer (Wilm’s tumor) is found in kids also.

Ÿ  If you are black colored race, you run greater risk for kidney cancer than white colored individuals. The reason for such predilection is not clear.

Ÿ  Obesity is a well proven risk for your kidney cancer. It is concluded from studies that about one fourth (25%) of total renal carcinomas are encountered in obese or overweight for height individuals (UK cancer research study published 2011). Obesity is generally considered if your BMI ( body mass index, the weight for height measure) is found 30 or greater. This is particularly more commonly observed in women, and is attributed to some hormonal changes with obesity. This might put further susceptibility for kidney cancers in females.

Smoking cigar or cigarettes, increases your chances for developing kidney cancers by twice more than non-smokers. There should be no surprise to note that smoking 20 or more cigarettes a day will double your risk for renal cell carcinoma (most common kidney cancer) than non-smokers.

Lifestyle factors, Support and Prevention

As long you are alive and getting treated for some intractable disease or defect, means  not to give up hopes. You have to try all possible means to make your life as comfortable as possible. This may require adopting big changes and habits that you were following before you were diagnosed as suffering from kidney cancer. There are certain factors other than therapeutics, that may help you live more relaxed, less stressed and depressed daily life. Your kidney cancer may be needing a long term treatment, hence your adoptability to all the side effects of chemo, surgery or radiotherapy is desired. 

Ÿ  Alternative treatment so far has no well established authentic curative or preventive value. They do have great supportive element in managing your kidney cancer before, during and after treatment has begun. Some of you may still decide to have chosen alternate treatments to get some comfort from pain and stress associated with your cancer. It is done almost always in conjunction with chemo, radiotherapy or surgical palliation of kidney cancer.

Ÿ  Acupuncture is one very old modality used to ease pain and stress of severe protracting illnesses, like your kidney cancer. It is achieved by inserting needles in your body at specific pressure points on skin(National Institute of Health). It will help you combat pain, depression, headaches during your renal cancer therapy and afterwards.

Ÿ  Massage therapy has not been linked to treat your kidney cancer. It will be definitely a way to reduce your distress of cancer diagnosis, side effects of treatment and overall feeling of well being. It also helps you get better sleep, lift your spirit from low ebb to greater levels. It involves pressing , softly squeezing and rubbing your soft body parts, which bring sense of aura and comfort.

Ÿ  Meditation helps to improve your life quality. It is a way of body and mind control. Its has been found to be very beneficial in all kinds of chronic pain, particularly so in your kidney  cancer condition (National Institute of Health). Your meditation guide can be your doctor, psychiatrist or an expert in meditation field. It is usually done in place/room where you are free of any external sounds or noise. It is shown to enhance your mood, immune system and increase your mental ability and alertness, a positive change in your kidney cancer condition.

Ÿ   Exercise regularly according to your state of health and stamina. This should be done with your health care provider’s advise. There is no doubt that exercise will counteract the feeling of fatigue you get from your renal cancer and its therapies you have gone through.

Coping and Support

Having the knowledge of one of kidney cancer patient is quite distressing on its own. You will have to come to terms with the situation by yourself. You will need equal support from your dear and loved ones around. Your doctor/oncologist will always be there, in case you need advise regarding any change in remedy or health complaints. You will be more stable mentally if you make free communication with your family members and friends. Share with them each and everything about your kidney cancer status, the progress and all the distresses of your condition.

Ÿ  Obtain information regarding your kidney cancer from your oncologist/healthcare provider. Internet is also a good source for gaining minute details about kidney cancer, treatment and associated side effects with each modality. This will make you more assure of what you will have to do to face these.

Ÿ  There are local cancer groups where you can join and share their experience, grievances. You will also be able to get some new information regarding you kidney cancer.

Prevention

There are well known risk factors for developing any cancer. Same is true for kidney cancer. Avoiding those risk will prevent occurrence of kidney cancer.

Ÿ  Quitting smoking will play a major role in preventing kidney cancer, as it is a well known and big risk for cancer development. It has some more benefits on your health, like positive effect on cardiac status and preventing lung cancer. In addition to your own will to quit you can take some slow nicotine release substances to quit smoking gradually. Your doctor will be guiding you how to use these.

Ÿ  If you are involved with occupation which exposes you to cancer causing toxins. These are steel manufacturing units, asbestos production work, benzene exposure in batteries making occupation. You need to take all standard safety measure to prevent long term accumulation of toxins which may cause kidney cancer. Wearing mask along with other measure will be very effective.

Ÿ  Alcohol in moderation should be the ideal prevention for avoiding this risk factor for cancer.

Ÿ  Well balanced diet which is rich in vitamins and minerals is healthy choice. Fresh fruits and vegetable, fish . Avoid meat, butter, cheese, cakes and fat rich biscuits. Having fish rich in omega-3 fatty acid concentration is shown to prevent kidney cancer.

Ÿ  Blood pressure control is well advised. This is risk for kidney cancer. Take your medicine for high blood pressure as advised by the doctor. Reduce your salt intake ,specially using table salt, exercise regularly to keep strong and stable cardiovascular status.

Ÿ  Reduce weight, if you have more weight for height. This is achieved effectively with taking good high fiber diet and avoiding calories. Exercise on daily basis for 20 minutes at stretch. Exercise techniques can brisk walk, swimming, cycling and walking uphill.

Natural Treatment

Black Cumin

Nature’s cure for just about any disease, black cumin is used as an anticancer, immunoprotectant agent. Also known as nigella sativa, it lessens oxidative stress during cancer and works towards the apoptosis of kidney cancer cells (Corder C, Benghuzzi H, Tucci M, Cason Z., University of Mississippi Medical Center, Jackson, MS 39216, USA). Black cumin contains all the essential fatty acids required by the human body. It also contains iron and manganese.

Curcumin

Curcumin is a substance from the Indian spice Turmeric. It is known to induce apoptosis in the most malign kidney cancers (Nutr Cancer. 1996;26(1):111-20). It also inhibits tumor growth and reduces inflammation caused by kidney cancer. Further research has acknowledged that it protects the kidneys from developing cancer and sensitizes the cancer to chemotherapeutic and radiotherapy agents (Nutr Cancer. 2010;62(7):919-30).

EGCG

Epigallocatechin gallate (EGCG) is a green tea catechin, or better known as an antioxidant. It has been proved to promote apoptosis (programmed cell death) of cancer cells. It is more effective when used with quercetin, which is also a green tea compound (Food & Function Issue 6, 2012). Research also proves that EGCG inhibits proliferation in renal cell carcinoma (Oncol Rep. 2009 Mar;21(3):635-40).

Genistein

 Found in a number of plants like soy beans, lupin, fava beans and kudzu, Genistein hails from a family of isoflavones that occur naturally in these plants. Genistein has been found to have anti-oxidant properties and has also been shown to exhibit anthelmintic reaction. The major role of Genistein is as a tyrosine kinase inhibitor. It inhibits the on/off function of enzyme tyrosine kinase, thus reducing the risk for the development of cancer. Also recognized as an angiogenesis inhibitor, Genistein reduces the cell's capacity to multiply and divide, and having an overall effect on its survivability.

Melatonin

 Produced by the pineal gland, Melatonin is a naturally produced hormone. Melatonin is produced for maintaining the body's circadian cycle (Sleep-wake cycle). Studies have also shown its powerful anti-oxidant and anti-inflammatory properties. Combined with anti-cancer drugs, melatonin has be shown to produce effective results in suppressing cancer cell growth in your renal malignancy, due to its anti-oxidant properties. Melatonin is naturally produced when the body is asleep at night, and this has been linked to higher cancer rates for individuals who work at night (Rosner B, 2009). Melatonin produced naturally usually satisfies the body's need for the chemical, but there are other sources for it such as almonds, peanuts, milk and other foods. Supplement form of Melatonin can also be taken under prescription of your doctor.

Omega-3 Fatty Acid

Omega 3 fatty acids are polyunsaturated fatty acids that are mainly obtained from marine and plant oils. Omega 3 fatty acid is considered very essential for the human body as it takes part in various bodily processes. Omega 3 fatty acids are are a part of three members consisting of alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). These fatty acids have been known to suppress the cell growth of cancerous cells. They are also linked to preserve the functioning of kidneys if taken in specific doses regularly.

Silibinin

 Occurring commonly in certain herbs, Silibinin is a flavonoligan and is a major component of silymarin. It is a potent anti-oxidant and has been found in various studies to have anti-cancer effects. A study reported on the Journal of National Cancer Institute in 2006, found Silibinins effectiveness in combating tumor growth by reducing the number of blood vessels that allow the tumor to grow. In-vitro Silibinin has also been shown to have wide anti-cancer effects against breast carcinoma cells, human lung carcinoma cells and other types of cancer (Zhao J, 1999).

Your kidney cancer needs different modalities of therapies at single given period after diagnosis. This can be hard on you. You need good diet to cope with side effects associated with each method of treatment you are going through. Diet rich in vitamins and minerals will surly provide the necessary strength. You can use supplements after taking your doctors advise. These will provide all in one combination form to make up for any dietary deficiency as they have proved good support in chronic ailments like kidney cancer.

Esophageal cancer

Introduction

Esophagus is the narrow muscular tube that runs from your mouth to stomach, forming passage to food you eat. It can be the site one of the lethal cancer of your body, called esophageal carcinoma or cancer of esophagus. It commonly begins to develop in the inner lining of your esophagus, but may involve other outer layers. It is malignant and have tendency to spread beyond esophagus to distant parts and organs of your body. Esophageal has very slow progress with minimal early symptoms. This one factor makes survival rate after treatment very low. By that time it is commonly diagnosed it has already spread to other parts of your body or to adjacent structure with serious and lethal effects.

Most common location of your esophageal cancer is lower third of the tube like structure.

The common factors which predict development of esophageal cancer are heavy alcohol and smoking. They act as chronic irritant in your cancerous esophagus.

Ÿ  Incidence of esophageal cancer ; The esophageal cancer has been encountered more commonly between age of 65 years-75 years. Men are effected more than women at ratio 4:1 worldwide. Being tenth most common cause of death due to cancer all over globe. It is very rarely seen in children.

Risk factors

Ÿ  Smoking of cigarettes, cigars and pipes are very strong provoking agents for your esophageal cancer. Among the leading risk factor smoking has been found to be greater risk in squamous cell carcinoma than in adenocarcinoma. The mechanism involves the release of carcinogens from tobacco smoke such as nitrosamines. These may initiate esophageal cancer growth in squamous cells layer of your esophagus. Duration of your smoking habit plays significant factor to increase your risk for esophageal malignancy.

Ÿ  Alcohol in excess has been risk factor for several cancers, likewise it plays its role in making you more susceptible for esophageal cancer. If you drink alcohol in larger volume even for short duration your risk for esophageal cancer increases greatly. The same will not be true if you drink alcohol in moderation for longer periods. Heavy drinking called binge together with cigarette smoking enhances your risk for squamous cells carcinoma of esophagus.

Ÿ  GERD syndrome is acquired condition in which acid from stomach reflexes back into esophagus causing chronic erosion at lower part of your esophagus. This constant irritation damages the squamous cells of esophagus converting them into cancer developing cells in long term. Adenocarcinoma is the type of esophageal cancer which grows due to this abnormality. Hyperacidity in lower esophagus thus can create risk for you esophageal cancer.

Ÿ   Barret’s esophagus is precancerous condition developing as result of acid reflux into esophagus from your stomach. During long standing exposure of the cells of lower esophagus to stomach content, changes into glandular columnar type. This cellular change or dysphasia  has great risk for esophagus cancer of adenocarcinoma type.

Ÿ  Obesity is risk for your developing esophageal cancer. This is attributed to gastro esophageal reflux. The heavier the weight you carry will put more intra-abdominal pressure on gastro-esophageal junction. This factor increases GERD symptoms and adeno-carcinoma risk.

Ÿ  Taking meals hot and drinking hot liquids like tea, coffee increases your esophageal cancer risk. Consumption of drinks with very high temperature has been shown as almost four fold increase in risk of esophageal cancer (study done in high risk areas of southern America, Argentine, Brazil, Uruguay and Paraguay).

Ÿ  Race of African origin is almost 3% more at risk of esophageal cancer than whites.

Ÿ  Age factor predisposes greatly on any chronic illness like cancer. Esophageal cancer will appear more commonly after your 45^th birth day. Risk becomes greater at 65 years and more.

Ÿ  Esophageal cancer is more common if you are living in developing country. This risk is based on nutritional deficiencies because of scarcity of fresh fruits and vegetable in your diet. There is more consumption of chewable tobacco, which is well known strong risk for esophageal cancer. Squamous cell carcinoma is more prevalent in dietary deficiency than adenocarcinoma variety.

Ÿ  Plummer Vinson syndrome, a triad of iron deficiency anemia, inflammation of tongue and dysphagia is linked with squamous cell cancer. It is an inherited condition( passed on from one generation to another).

Ÿ  Radiotherapy to your chest for some other cancer will put you in greater risk of esophageal cancer in later years of life. Risk of esophageal cancer in women who were treated for breast cancer by radiotherapy have shown two fold rise( study done in southeast of England). Similar studies done in north America have revealed that individual who underwent radiotherapy for Hodgkin’s lymphoma develop esophageal cancer in 15-20 years time.

Ÿ  Males are more at risk of developing esophageal cancer than women. It has occupational hazards, smoking and alcohol playing co-factors. Exposure to trichloethylene and soot dust(black dust particle fumes from coal, wood and oil burning) increases the risk in men.

Life style Support and Prevention

Life style and home remedies

Esophageal cancer carries grave prognostic outcome. you will be detailed about the seriousness of your esophageal carcinoma, the treatment and their side effects.You  should make yourself strong and understanding about prevailing condition on you. Your own composure and will to live and withstand all ill effects of your esophageal cancer can make your survival better and less distressing and depressing. This situation may create a change in your thought process how to cope. Making all positive changes that were missing or getting rid of negative and harmful habits will improve your health emotionally and physically, even with esophageal cancer.

Ÿ  The most common factor which may have caused your esophageal cancer is acid reflex disease. The best way to ease the difficulty is to avoid food which may increase your stomach acidity. Eat food which are not spicy. Small frequent meals will also combat the discomfort of GERD with your cancer. Sleeping with your headend raised will greatly help prevent gastroesophageal reflux.

Ÿ  Swallowing difficulty is most predominant complaint. Eat food item which are cooked to texture suited for your extent of ease to swallow. Take liquids which will not only be easy to swallow but also nutritious. Fresh fruit juices and milk shakes can be your best choices.

Ÿ  Seek advise from diet expert about how to cope with lack of deficiency of important vitamins which may result because of your slow and difficult food intake. If your oncologist/healthcare provider recommends take vitamin supplements to gain strength.

Ÿ  With consultation from your doctor keep active before and during treatment. This will keep your blood circulation to optimum best.

Ÿ  The surgical correction may cause dumping syndrome. This is combination of symptoms of sweating, flushing and diarrhea after taking food. Eating balanced diet and keeping lean weight will help you combat such distresses on long term management.

Ÿ  Take ample rest and avoid undue fatigue. Although the intense chemo, radiotherapy or surgical remedies must have wear you out significantly, but studies have shown that adopting some degree of physical exercise according to your suit will have dual effects of physical as well as mental well being.

Ÿ  Quit smoking forthwith. This will help you in your treatment outcome much better. It will also enhance your longevity after esophageal cancer treatment.

Ÿ  Post treatment consultation with your oncologist/healthcare provider should be maintained. Follow up physical examination and investigation such as scanning or endoscopy will indicate progress of effects of treatment, whether surgical or otherwise.

Alternative medicine

The alternative and complementary medicine has still not been proved to assist in curing your cancer. It surly does help to comfort you from pain, stress and physical and emotional fatigue from your esophageal cancer. They may also counteract the side effects of your treatment. Some time and tested alternative remedies in your esophageal cancer are ;

Ÿ  Acupuncture technique comprises of piercing needles into specific pressure points in your skin. This relieves symptoms of nausea, vomiting and pain accompanying your esophageal cancer and its conventional therapies.

Ÿ  Massage will help your tense muscle and nerves to relax. It involves gentle kneading, rubbing and pressure massage of various parts of your body. It helps minimize anxiety, fatigue and other emotional distresses of your esophageal cancer.

Ÿ  Meditation is done with help of some expert guidance. Breathing exercises, practicing to imagine peaceful surroundings happy events and images will bring back your spiritual well being.

Ÿ  Yoga and tai chi involves stretching and deep breathing exercise. It will keep you active during your esophageal cancer treatment. It will also allay your stress and assist in good sleep.

Ÿ  Aroma therapy is based on the logic of soothing effects of scents on your mind. It uses scents from plant extract, which will make you feel relaxed, control your nausea and stress.

Coping and Support

Ÿ  Stay connected to your friends and close relatives besides your own family. Share and care role will lift your own spirit. During recovery this will help you feel wanted and involved in life. Seek help from them if you want.

Ÿ  Keep yourself abreast with your esophageal cancer status. Asking your doctor in detail about your esophageal cancer prognosis will give you sense of anticipation and readiness of things to come and how to deal with them. Read magazine on esophageal cancer. Search internet for latest information on your esophageal carcinoma.

Ÿ  Join group specific for cancer or individuals with esophageal cancer. Listen to their feelings and be open to express your own. It will generate new energy and vitality of your thought process. Some of those discussions may bring new revelation about coping and modality towards improvement in your daily life.

Ÿ  Acquire some leisure habit. Having some fun will help enjoy life and stay calm. Chose reading good material as hobby. It will keep you stay focused in present.

Ÿ  Volunteer work at charity or helping out other cancer patient will make you feel happier and useful to community even with your own esophageal cancer handicap.

Prevention

The latest approach in medical practice is based on preventive aspect of any disease or disability. Same is true for your esophageal cancer.

Ÿ  Quitting smoking will remove one risk factor which will reduce risk from all kinds of cancers, including esophageal cancer. It will also keep you protected from some other health hazards of smoking. Sometimes giving up smoking is not that easy. There are alternate or replacement substances available that will help  you get rid or smoking in a way that would be less demanding on you. Nicotine  gums, skin patches and spray have proven record in your efforts to give up smoking.

Ÿ  Binge drinking is risk for esophageal cancer. Drinking in moderation and making it a strong habit will minimize your risk for esophageal cancer.

Ÿ  Reduce weight if your carry weight greater for your height. A BMI below 25 of standard should be the aim. Avoid calories, exercise regularly daily for 15-20 minutes, five days a week can easily help you achieve your goal. This one factor will counter your GERD very effectively.

Ÿ  Diet rich in fresh fruits and vegetables will go long way in helping weight management and acid reflux disease. Though seems difficult to you to have at least five daily servings of fruits and vegetables but its worth a price for preventing esophageal cancer.

Ÿ  Having constant complains of heartburn and stomach pain is risk for GERD. Get it treated in proper way by your family doctor/healthcare provider. This is one of major rsik for esophageal cancer and Barret’s esophagus.

Natural treatment

Black Cumin

Being used since the earliest of times, Black cumin seeds (Nigella Sativa) have shown to be a remarkable cure for many diseases. More than several studies have shown the specific benefit of black cumin seeds in countering Esophageal cancer. The oil of the black cumin seeds enhances the production of immune cells, anti-bodies and bone marrow. For cancer therapies it has been shown to suppress tumor growth by 50%. Increased immune response leads of better cancer targeting. Black cumin seeds can also effectively help reduce the aggressiveness of cancer cells that lean on angiogenesis.

Curcumin

The essential curcuminoid of the spice turmeric, curcumin has been known for ages for its use in treating a variety of illnesses. Its greatest benefit is its anti-carcinogenic effects. Its effectiveness in treating esophageal and other cancers lies in its property of causing apoptosis in cancerous cells without harming healthy cells. A study conduction in 2009 on the effects of curcumin states that, " curcumin modulates growth of tumor cells through regulation of multiple cell signaling pathways including cell proliferation pathway (cyclin D1), cell survival pathway (Bcl-2, Bcl-xL, cFLIP, XIAP, c-IAP1), caspase activation pathway (caspase-8, 3, 9), tumor suppressor pathway (p53, p21) death receptor pathway (DR4, DR5), mitochondrial pathways, and protein kinase pathway (JNK, Akt, and AMPK)"(Ravindran J., 2009).

Quercetin

Also known as Meletin and Sophretin, Quercetin is a flavaniod, found in most plants, where onions, apples and tea are some of its sources. Preliminary studies have shown the effectiveness of Quercetin against cancer and other diseases, due to its anti-inflammatory and anti-oxidant properties.  Quercetin can either be found in the skins of plants, or can be taken in supplement form. Supplements range in doses of 50-500mg, although appropriate dosage of Quercetin is unknown. Studies conducted in-vitro against the effectiveness of Quercetin has shown positive results. It has been shown to foster apoptosis (cell death) in cancerous cells. Knowledge of the benefits of Quercetin has been limited though, due to the lack of conclusive research.

Resveratrol

 Resveratrol, a natural phenol, is a chemical that is produced naturally by plants when they are attacked by pathogens like fungi and bacteria. The effectiveness of Resveratrol is a widely discussed topic in human and animal studies. Initial research has shown the anti-inflammatory and anti-cancer properties of this natural chemical. Sources for Resveratrol are the skins of red grapes and other fruits. Preliminary studies on rats treated with a carcinogen have shown that Resveratrol (1mg/kg orally) has reduced the size and number of esophageal tumors to a substantial degree (Hong T., 2002). It has also been shown to cause apoptosis in smooth muscle and platelets (Huang Y., 2002).

Although esophageal cancer has very poor prognosis. This is due to its early spread as well as slow progress and late diagnosis. Even then as long as healthcare is being given, you should keep your spirits high and take good care of yourself. A good nutrition will play a major role in maintaining your energy level high. With your doctors advise use supplements to boost any deficiency anticipated. They have proven efficacy to help you overcome the stress and side effects of your esophageal cancer and its treatment.