Ayurveda (Sanskrit: आयुर्वेद; Āyurveda, the "the complete knowledge for long life") or ayurvedic medicine is a system of traditional medicine native to India[1] and practiced in other parts of the world as a form of alternative medicine.[2] In Sanskrit, the word ayurveda consists of the words āyus, meaning "longevity", and veda, meaning "related to knowledge" or "science".[1] Evolving throughout its history, ayurveda remains an influential system of medicine in South Asia.[3] The earliest literature on Indian medical practice appeared during the Vedic period in India.[2] The Suśruta Saṃhitā and the Charaka Saṃhitā were influential works on traditional medicine during this era.[2] Over the following centuries, ayurvedic practitioners developed a number of medicinal preparations and surgical procedures for the treatment of various ailments and diseases.[4]
In Western medicine, ayurveda is classified as a system of complementary and alternative medicine (CAM) that is used to complement, rather than replace, the treatment regimen and relationship that exists between a patient and their existing physician.[5]
Ayurveda is grounded in a metaphysics of the "five great elements" (Devanāgarī: [महा] पञ्चभूत;Prithvi- earth, Aap-water, Tej-fire, Vaayu-air and Akash-ether)—all of which compose the Universe, including the human body.[1] Chyle or plasma (called rasa dhatu), blood (rakta dhatu), flesh (mamsa dhatu), fat (medha dhatu), bone (asthi dhatu), marrow (majja dhatu), and semen or female reproductive tissue (shukra dhatu) are held to be the seven primary constituent elements -- saptadhatu (Devanāgarī: सप्तधातु) of the body.[6] Ayurveda deals elaborately with measures of healthful living during the entire span of life and its various phases. Ayurveda stresses a balance of three elemental energies or humors: vata (air & space – "wind"), pitta (fire & water – "bile") and kapha (water & earth – "phlegm"). According to ayurveda, these three regulatory principles— doshas (literally that which deteriorates - Devanāgarī: त्रिदोष)—are important for health, because when they are in a more balanced state, the body will function to its fullest, and when imbalanced, the body will be affected negatively in certain ways. Ayurveda holds that each human possesses a unique combination of doshas. In ayurveda, the human body perceives attributes of experiences as 20 Guna (Devanāgarī: गुण, meaning qualities).[7] Surgery and surgical instruments are employed.[7] It is believed that building a healthy metabolic system, attaining good digestion, and proper excretion leads to vitality.[7] Ayurveda also focuses on exercise, yoga, meditation, and massage.[8] Thus, body, mind, and spirit/consciousness need to be addressed both individually and in unison for health to ensue.
The practice of Panchakarma (Devanāgarī: पंचकर्म) is believed to eliminate toxic elements from the body.[9]
Eight disciplines of ayurveda treatment, called ashtangas (Devanāgarī: अष्टांग), are given below:[10]
* Internal medicine (Kaaya-chikitsa)
* Paediatrics (Kaumarabhrtyam)
* Surgery (Shalya-chikitsa)
* Eye and ENT (Shalakya tantra)
* Demonic possession (Bhuta vidya): Bhuta vidya has been called psychiatry.[2]
* Toxicology (Agadatantram)
* Prevention diseases and improving immunity and rejuvenation (rasayana)
* Aphrodisiacs and improving health of progeny (Vajikaranam)
In Hindu mythology, the origin of ayurvedic medicine is attributed to the physician of the gods,
Thursday, January 6, 2011
Monday, January 3, 2011
Penis Enlargement Exercise - What it Does and Why it Works
When looking to increase penis size, there's no shortage of solutions out there (pills, pumps, stretchers, penis enlargement exercises, etc.). Unfortunately, too many of these methods will simply take your money and offer little or no real results. Most programs offer a 14 day guarantee, which would be great if this was a realistic time frame for achieving enlargement, but alas, it is not. This article should help you understand the logic behind natural penis enlargement exercise and how it can help you.
So many methods fail because they are a quick-fix. Men are perfectly happy thinking a "miracle pill" or a gimmicky device will do the work for them, only to find out that if you want something done right, you have to do it yourself. A permanent and substantial solution manipulates the basic anatomy of the penis to encourage natural growth. Bigger penis exercises help to achieve this but understanding why requires a familiarity with the workings of your penis.
The penis consists of three chambers, each of these fills with blood when you are sexually aroused. While the tissue that makes up the chamber walls is coaxable into stretching and molding, it is generally rigid and once the cambers fill you have reached your maximum size. It stands to reason, then, that the key to actually getting a bigger penis is enlarging these chambers (this will allow them to hold more blood and thus increase your maximum size).
The reason so many methods fail to work is that they either A) only increase blood flow to the penis (which does nothing when the chambers are of a set size) or B) they only manipulate the tissue in one direction (like stretchers and extenders that result in a possibly longer, but overall skinny penis).
Penis enlargement exercise works by gently manipulating the tissues through exercises (performed with your hands) and slowly breaking down sections of the chamber walls; I have been through this process and it is completely painless. Like a muscle, the cell walls of these chambers grow back larger to accommodate for the new stresses. The next time blood fills your penis during an erection, the chambers are larger and thus your penis' length and girth are increased.
So many methods fail because they are a quick-fix. Men are perfectly happy thinking a "miracle pill" or a gimmicky device will do the work for them, only to find out that if you want something done right, you have to do it yourself. A permanent and substantial solution manipulates the basic anatomy of the penis to encourage natural growth. Bigger penis exercises help to achieve this but understanding why requires a familiarity with the workings of your penis.
The penis consists of three chambers, each of these fills with blood when you are sexually aroused. While the tissue that makes up the chamber walls is coaxable into stretching and molding, it is generally rigid and once the cambers fill you have reached your maximum size. It stands to reason, then, that the key to actually getting a bigger penis is enlarging these chambers (this will allow them to hold more blood and thus increase your maximum size).
The reason so many methods fail to work is that they either A) only increase blood flow to the penis (which does nothing when the chambers are of a set size) or B) they only manipulate the tissue in one direction (like stretchers and extenders that result in a possibly longer, but overall skinny penis).
Penis enlargement exercise works by gently manipulating the tissues through exercises (performed with your hands) and slowly breaking down sections of the chamber walls; I have been through this process and it is completely painless. Like a muscle, the cell walls of these chambers grow back larger to accommodate for the new stresses. The next time blood fills your penis during an erection, the chambers are larger and thus your penis' length and girth are increased.
Safer Sex Tips and Methods to Prevent From HIV and STD
There are many people who don't see the point of having safe sex and they argue that it takes away the pleasure of making love. They are deeply wrong because unsafe sex, especially with unstable partners can pose a lot of threats to one's health. HIV and sexual transmitted diseases are one of the most serious dangers, not to mention the fact that there are many women who want to avoid pregnancy.
Staying healthy and making sure you don't conceive babies can only be done by adopting and putting in practice tips and methods for safe sex. The first step is to get informed about what safe sex means and about how to stay away from different threats. You need to do this regardless of the fact that you are a man or a woman because safe sex is the responsibility of both partners. It is not at all enough to know what you are supposed to do for protecting yourself of HIV, STDs and an unwanted pregnancy; you also have to put that information into practice.
In order to be able to enjoy safer sex, you have to know the cases in which viruses and diseases are transmitted. Many believe that oral sex is safer and it can't infect someone with HIV. Things are different because especially if you have sores or open in juries in your mouth, you are very likely to get HIV from an infected partner by practicing oral sex. Unprotected anal sex can also spread the virus and other infections.
Dental dam is a way of practicing safer sex because it keeps you away from all the infections and virus that can be transmitted through oral stimulation or sex. It is made of latex and it can easily be found in drugstores. Condoms are also one of the safest protective methods. The most efficient ones are made of latex. When using condoms for safer sex, you have to pay great attention to wearing them correctly because otherwise they might not offer any protection at all. It is never safe to use the same condom for practicing both vaginal and oral or anal sex. Lubricants are recommended to be used because they prevent condoms for breaking. Other contraceptive methods, like the pills or the diaphragm are indeed protecting the woman against unwanted pregnancy, but they leave the partners exposed to both HIV and other sexual transmitted diseases.
Staying healthy and making sure you don't conceive babies can only be done by adopting and putting in practice tips and methods for safe sex. The first step is to get informed about what safe sex means and about how to stay away from different threats. You need to do this regardless of the fact that you are a man or a woman because safe sex is the responsibility of both partners. It is not at all enough to know what you are supposed to do for protecting yourself of HIV, STDs and an unwanted pregnancy; you also have to put that information into practice.
In order to be able to enjoy safer sex, you have to know the cases in which viruses and diseases are transmitted. Many believe that oral sex is safer and it can't infect someone with HIV. Things are different because especially if you have sores or open in juries in your mouth, you are very likely to get HIV from an infected partner by practicing oral sex. Unprotected anal sex can also spread the virus and other infections.
Dental dam is a way of practicing safer sex because it keeps you away from all the infections and virus that can be transmitted through oral stimulation or sex. It is made of latex and it can easily be found in drugstores. Condoms are also one of the safest protective methods. The most efficient ones are made of latex. When using condoms for safer sex, you have to pay great attention to wearing them correctly because otherwise they might not offer any protection at all. It is never safe to use the same condom for practicing both vaginal and oral or anal sex. Lubricants are recommended to be used because they prevent condoms for breaking. Other contraceptive methods, like the pills or the diaphragm are indeed protecting the woman against unwanted pregnancy, but they leave the partners exposed to both HIV and other sexual transmitted diseases.
Home Remedies for Skin Care Keep You Beautiful!
Home Remedies for Skin Care Keep You Beautiful!
Avocado
Avocado has many medicinal uses. For skin care use the oil from the seed of this fruit. The oil of the avocado seed nourishes the skin and eating the fruit will nourish the body and skin from with-in. Massage this into the affected area if you have rough, dry or flaking conditions. It will make your skin soft and supple again.
Calendula
This herb has many medicinal uses, but above all this herb is used to restore the skin to health. As one of the best home remedies for skin care this herb helps heal minor burns including sunburn, cuts and scrapes.
It is very useful for inflamed skin or skin with rashe including diaper rash. It is effective for many with athletes foot. And for mothers breast feeding it helps soothe nipples. For conditions like acne or eczema, this herb can be used both externally or internally to reduce outbreaks.
Ceylon Leadwort
It is an evergreen shrub in-which the oil from it`s leaves can be made into a paste for scabies. This paste is also used to relieve some kinds arthritis pain, but for the skin it`s use is to heal scabies. One word of caution: this herb should only be used internally under doctors care and should not be used if pregnant.
Eat more fruits and vegetables for healthier skin.
Some of the best home remedies for skin are not exciting, but none the less they are what you need to have if you want great skin. Vitamins A-C-E are your ace in the whole when it comes to youthful skin. These fight free radicals along with other nutrients in the different whole foods that will keep you looking and feeling your best.
Drink more water. You knew it was coming and here it is. You should drink half your body weight in ounces of water ever day.
Daily Meditation.
Stress is one of the biggest contributors to wrinkles and other problems of the skin. Take 12 - 30 minutes a day and relax. Learning to meditate will seem strange and even uncomfortable at first, but once you get into a routine you begin to immediately see it`s value and it will become one of the favorite times of day for you. Truly one of the great home remedies for skin care.
Our skin is the largest organ in our bodies and the only one that is exposed to outside conditions. It is often the early signal to what is going on inside us with body, mind and spirit. If we want beautiful skin then we have to find balance with the total self.
Kazuko is a former professional dancer in Japan who has studied and used natural medicine and home remedies for many years. Click here for more Home Remedies for Skin Care If you like this article and would like to know more about the author or home remedies for conditions
Avocado
Avocado has many medicinal uses. For skin care use the oil from the seed of this fruit. The oil of the avocado seed nourishes the skin and eating the fruit will nourish the body and skin from with-in. Massage this into the affected area if you have rough, dry or flaking conditions. It will make your skin soft and supple again.
Calendula
This herb has many medicinal uses, but above all this herb is used to restore the skin to health. As one of the best home remedies for skin care this herb helps heal minor burns including sunburn, cuts and scrapes.
It is very useful for inflamed skin or skin with rashe including diaper rash. It is effective for many with athletes foot. And for mothers breast feeding it helps soothe nipples. For conditions like acne or eczema, this herb can be used both externally or internally to reduce outbreaks.
Ceylon Leadwort
It is an evergreen shrub in-which the oil from it`s leaves can be made into a paste for scabies. This paste is also used to relieve some kinds arthritis pain, but for the skin it`s use is to heal scabies. One word of caution: this herb should only be used internally under doctors care and should not be used if pregnant.
Eat more fruits and vegetables for healthier skin.
Some of the best home remedies for skin are not exciting, but none the less they are what you need to have if you want great skin. Vitamins A-C-E are your ace in the whole when it comes to youthful skin. These fight free radicals along with other nutrients in the different whole foods that will keep you looking and feeling your best.
Drink more water. You knew it was coming and here it is. You should drink half your body weight in ounces of water ever day.
Daily Meditation.
Stress is one of the biggest contributors to wrinkles and other problems of the skin. Take 12 - 30 minutes a day and relax. Learning to meditate will seem strange and even uncomfortable at first, but once you get into a routine you begin to immediately see it`s value and it will become one of the favorite times of day for you. Truly one of the great home remedies for skin care.
Our skin is the largest organ in our bodies and the only one that is exposed to outside conditions. It is often the early signal to what is going on inside us with body, mind and spirit. If we want beautiful skin then we have to find balance with the total self.
Kazuko is a former professional dancer in Japan who has studied and used natural medicine and home remedies for many years. Click here for more Home Remedies for Skin Care If you like this article and would like to know more about the author or home remedies for conditions
Sunday, January 2, 2011
Home Remedy for Weight Loss - Natural Home remedies for Weight Loss
Home Remedy for Weight Loss - Natural Home remedies for Weight Loss
Quick homemade weight loss diet plan
For a shapely and beautiful body and shedding obesity related ugliness:
(1) Take balanced and healthful food that will bring about internal purification and expel toxins from the body.
(2) Relaxation: Allow the body and mind to relax completely. It removes tension and improves blood circulation and expels toxins from the body.
(3) Bitter gourd: Take the juice of bitter gourd with lemon every morning to shed weight.
(4) Take exercise regularly. It makes the body shapely and beautiful and then depletes the accumulation of fat from certain parts of the body.
(5) Massage the body well with oil. Take special care of the particular parts of body where fat has accumulated.
(6) Take long and deep breaths to inhale more of oxygen and destroy toxins in the body.
(7) Both overweight men and women should do skipping on empty stomach or five hours after meals.
Natural remedies for maintaining weight loss
Expel the toxins in the body through stool, urine and sweating. For this, tackle constipation and take more of diuretic substances and liquids for increased flow of urine. Allow the body to sweat out the toxins. This will helps in the reduction of weight.
Salt: It is quite helpful. Take salt-free food to lose weight.
Vegetables and Fruits: Vegetables and fruits are low calorie foods, therefore, eat more of them. Banana and cheeku increase the weight, hence do not eat them. Do not add salt to fruits and vegetables for taste. Reduce the salt intake to the minimum. Also do not consume sugar, oily and fatty substances like clarified butter, butter and sweet potato. This will helpful in normalizing the body weight.
Home Remedies for the treatment of ----using Lemon
This is simple home remedy for weight loss using Lemon : (1) Squeeze a lemon into a glass of warm water, add rock salt to taste and drink it in the morning every day for two months. It will be beneficial in reducing weight. It is much more helpful in the summer.
(2) Squeeze a lemon into a glass of warm water and add 2 tsp. of honey to it. Take it daily for four months to shed obesity. This will prevents weight loss
.
Quick homemade weight loss diet plan
For a shapely and beautiful body and shedding obesity related ugliness:
(1) Take balanced and healthful food that will bring about internal purification and expel toxins from the body.
(2) Relaxation: Allow the body and mind to relax completely. It removes tension and improves blood circulation and expels toxins from the body.
(3) Bitter gourd: Take the juice of bitter gourd with lemon every morning to shed weight.
(4) Take exercise regularly. It makes the body shapely and beautiful and then depletes the accumulation of fat from certain parts of the body.
(5) Massage the body well with oil. Take special care of the particular parts of body where fat has accumulated.
(6) Take long and deep breaths to inhale more of oxygen and destroy toxins in the body.
(7) Both overweight men and women should do skipping on empty stomach or five hours after meals.
Natural remedies for maintaining weight loss
Expel the toxins in the body through stool, urine and sweating. For this, tackle constipation and take more of diuretic substances and liquids for increased flow of urine. Allow the body to sweat out the toxins. This will helps in the reduction of weight.
Salt: It is quite helpful. Take salt-free food to lose weight.
Vegetables and Fruits: Vegetables and fruits are low calorie foods, therefore, eat more of them. Banana and cheeku increase the weight, hence do not eat them. Do not add salt to fruits and vegetables for taste. Reduce the salt intake to the minimum. Also do not consume sugar, oily and fatty substances like clarified butter, butter and sweet potato. This will helpful in normalizing the body weight.
Home Remedies for the treatment of ----using Lemon
This is simple home remedy for weight loss using Lemon : (1) Squeeze a lemon into a glass of warm water, add rock salt to taste and drink it in the morning every day for two months. It will be beneficial in reducing weight. It is much more helpful in the summer.
(2) Squeeze a lemon into a glass of warm water and add 2 tsp. of honey to it. Take it daily for four months to shed obesity. This will prevents weight loss
.
How to Breast Feed your infant. Basics you must know
People are very much organized nowadays that they look for information about breast feeding already while still searching for information about How to Get Pregnant. Years ago, perhaps when you were a child, breastfeeding was not very popular. Breastfeeding was not encouraged as it is in todays society.
More so, there are fewer complications associated with breast milk than with cow?s milk. Because of this, and a few other reasons, there were many new mothers that went directly to feeding with the bottle, most often new mothers didn't even try to breastfeed their new baby. Breastfeeding helps protect and nurture your baby in innumerable ways.
After the feed your breast feels sore. You dread the next feed, and then you begin shivering. Another advantage breast milk has over cow?s milk is that it allows the mother to save as cow?s milk can be expensive. The baby can better adapt to breast milk.
Consequently the milk is not properly drained from the breast and a milk duct becomes blocked. Breast milk is very special, every mother's milk is slightly different, tailored to her own baby's needs. Since breastfeeding has been given so much importance, many women have been made aware. Every feeding time is an extremely important time of the day, it allows the mother and baby time to bond to each other without any distractions.
You may feel a small lump which disappears as the duct becomes unblocked. In order to lower down the incidence of breast related problems due to lactation, it is important that mothers observe the proper techniques of breast feeding. Another effective technique is to try expressing milk with the aid of an electric or hand pump.
If you are still struggling to get pregnant, a great infertility treatment guide you can use is available by the name Pregnancy Miracle. Breastfeeding will instill a naptime but you'll find yourself continuing to rock your precious little one, it's calming to mother as well. One of these exercises would involve routinely pinching the nipple.
You'll detect these problems early on and you'll find that most hospitals have a nursing specialist that will help to determine if your baby is latching on wrong. However, the last thing you may want to do is to feed from the affected side at all as it is so painful. This will only make things worse and you may end up with an abscess.
Breast milk is not only good for your baby, but it's also good for the mother as well. If you are worried about your baby drinking milk from the affected breast a good alternative is to express and dispose of the milk and to feed only from the unaffected side.
Your body will adapt. To aid your baby in latching on properly, you should make use of their rooting reflex.
This is manifested in the first few months of life. There may even come a time later in life when you look back on this wonderful experience and wish that you had breast fed your baby longer.
More so, there are fewer complications associated with breast milk than with cow?s milk. Because of this, and a few other reasons, there were many new mothers that went directly to feeding with the bottle, most often new mothers didn't even try to breastfeed their new baby. Breastfeeding helps protect and nurture your baby in innumerable ways.
After the feed your breast feels sore. You dread the next feed, and then you begin shivering. Another advantage breast milk has over cow?s milk is that it allows the mother to save as cow?s milk can be expensive. The baby can better adapt to breast milk.
Consequently the milk is not properly drained from the breast and a milk duct becomes blocked. Breast milk is very special, every mother's milk is slightly different, tailored to her own baby's needs. Since breastfeeding has been given so much importance, many women have been made aware. Every feeding time is an extremely important time of the day, it allows the mother and baby time to bond to each other without any distractions.
You may feel a small lump which disappears as the duct becomes unblocked. In order to lower down the incidence of breast related problems due to lactation, it is important that mothers observe the proper techniques of breast feeding. Another effective technique is to try expressing milk with the aid of an electric or hand pump.
If you are still struggling to get pregnant, a great infertility treatment guide you can use is available by the name Pregnancy Miracle. Breastfeeding will instill a naptime but you'll find yourself continuing to rock your precious little one, it's calming to mother as well. One of these exercises would involve routinely pinching the nipple.
You'll detect these problems early on and you'll find that most hospitals have a nursing specialist that will help to determine if your baby is latching on wrong. However, the last thing you may want to do is to feed from the affected side at all as it is so painful. This will only make things worse and you may end up with an abscess.
Breast milk is not only good for your baby, but it's also good for the mother as well. If you are worried about your baby drinking milk from the affected breast a good alternative is to express and dispose of the milk and to feed only from the unaffected side.
Your body will adapt. To aid your baby in latching on properly, you should make use of their rooting reflex.
This is manifested in the first few months of life. There may even come a time later in life when you look back on this wonderful experience and wish that you had breast fed your baby longer.
Can A Natural Diabetes Treatment Work Effectively
Diabetes is becoming more and more prevalent in our society. The numbers of sufferers are rising every year, and a lot of people are unaware that they have it as they do not recognise any symptoms they might have. There is not a permanent cure for this disease yet, so people with diabetes have to rely on synthetic insulin or consider a natural diabetes treatment.
Diabetes is caused by the body being unable to produce or use insulin effectively. Insulin is a hormone that is very important for converting sugar and carbohydrates into usable energy for the body. If the sugar is not converted then a diabetic may have dangerously high levels of sugar in their blood.
The result is that the extra sugar can cause hyperglycemia. The extra sugar is eventually eliminated by the body through urination. The body is unable to extract any goodness from food so a person suffering from untreated diabetes is likely to lose weight.
This is just one symptom of diabetes. Others include feeling very thirsty all the time, needing to urinate a lot, and feeling a deep sense of fatigue. Type two diabetes used to be found in older people who were overweight and whose health was bad. It is being found in a lot of younger people, and has even been found in children which even a few years ago would have been unthinkable.
You may have been warned by your doctor that you are at risk of developing type two diabetes or are developing it. It can be a major shock to hear, and for most people it will mean a radical overhaul of their lifestyle and diet is needed. This will almost certainly mean losing weight and getting more exercise, but you may be wondering what else you can do.
A supplement such as Diamaxol could help you . These kinds of all natural supplements can be a useful aid in regulating blood sugar without any harmful side effects. They can help you to get your weight under control and also boost your health.
The main aim of these supplements is to keep blood sugar at a constant level during the day.If you know you have this under control then you can start to deal with the other factors. A natural supplement can help your pancreas to become a little healthier, so it may feel like producing more insulin again.
A natural supplement can help to reduce the amount of insulin necessary over time, as the effects of diet and exercise start to work with it. It is proven that being near to your ideal weight can make a huge difference to healthy blood sugar management. Natural supplements can contain a powerful antioxidant that can help to lessen any complications caused by diabetes.
As these complications can be very serious it could be well worth considering a supplement. Diabetes can affect the eyes, kidneys, the liver and blood vessels. It is also well known that many diabetics can develop nerve damage in their feet and hands. Diabetes is a very serous disease so it is worth giving yourself every chance to get it under control. If left untreated it can cause serious complications. Developing a healthy lifestyle in conjunction with a natural diabetes treatment could help lessen the need for insulin. Always check with your doctor first before changing any of your medications.
Do you have diabetes? Then you may need type 2 diabetes treatment. There is a natural diabetes treatment that we would like to tell you about.
Diabetes is caused by the body being unable to produce or use insulin effectively. Insulin is a hormone that is very important for converting sugar and carbohydrates into usable energy for the body. If the sugar is not converted then a diabetic may have dangerously high levels of sugar in their blood.
The result is that the extra sugar can cause hyperglycemia. The extra sugar is eventually eliminated by the body through urination. The body is unable to extract any goodness from food so a person suffering from untreated diabetes is likely to lose weight.
This is just one symptom of diabetes. Others include feeling very thirsty all the time, needing to urinate a lot, and feeling a deep sense of fatigue. Type two diabetes used to be found in older people who were overweight and whose health was bad. It is being found in a lot of younger people, and has even been found in children which even a few years ago would have been unthinkable.
You may have been warned by your doctor that you are at risk of developing type two diabetes or are developing it. It can be a major shock to hear, and for most people it will mean a radical overhaul of their lifestyle and diet is needed. This will almost certainly mean losing weight and getting more exercise, but you may be wondering what else you can do.
A supplement such as Diamaxol could help you . These kinds of all natural supplements can be a useful aid in regulating blood sugar without any harmful side effects. They can help you to get your weight under control and also boost your health.
The main aim of these supplements is to keep blood sugar at a constant level during the day.If you know you have this under control then you can start to deal with the other factors. A natural supplement can help your pancreas to become a little healthier, so it may feel like producing more insulin again.
A natural supplement can help to reduce the amount of insulin necessary over time, as the effects of diet and exercise start to work with it. It is proven that being near to your ideal weight can make a huge difference to healthy blood sugar management. Natural supplements can contain a powerful antioxidant that can help to lessen any complications caused by diabetes.
As these complications can be very serious it could be well worth considering a supplement. Diabetes can affect the eyes, kidneys, the liver and blood vessels. It is also well known that many diabetics can develop nerve damage in their feet and hands. Diabetes is a very serous disease so it is worth giving yourself every chance to get it under control. If left untreated it can cause serious complications. Developing a healthy lifestyle in conjunction with a natural diabetes treatment could help lessen the need for insulin. Always check with your doctor first before changing any of your medications.
Do you have diabetes? Then you may need type 2 diabetes treatment. There is a natural diabetes treatment that we would like to tell you about.
Cervical Cancer Natural Treatments
Invasive cervical cancer is the second most common type of cancer in women and accounts of over 11 percent of all cancers around the world. Cervical cancer is the growth of malignant cells in the cervix, the narrow opening of the uterus. Cervical cancer develops slowly from a distinct precancerous stage (dysplasia). Cancer confined to the surface of the cervix is classified as preinvasive, while cancer that has spread into deeper layers or other organs is termed invasive. Symptoms may not appear until the cancer reaches the more dangerous invasive phase; however, with early diagnosis and treatment, long – term prognosis is extremely favorable.
Women who are sexually active, over age 18, or whose mothers took drugs DES during pregnancy should have a pap smear at least once a year. The cure, preinvasive cervical cancer may be treated by cauterization (burning away cancerous cells), cryosurgery (freezing and destroying cancerous cells) or laser surgery. Preinvasive cancers may also be totally removed during conization or with hysterectomy (removal of the cervix and uterus). Surgery for invasive cervical cancer is usually treated by radical hysterectomy; very severe cases may also require removal of the bladder and rectum. Radiation and chemotherapy may be used if cancer has spread throughout the uterus or to other organs.
Recommended dietary and nutritional factors for natural cervical cancer treatments
A diet low in fatty meats (especially pork), red meat, cheeses, and white bread, and high soy products, fruits, dark green vegetables, tomatoes, whole grains, and yogurt offers the best dietary protection. Shiitake mushrooms are also a good source of protection.
If you do not consume 3-5 servings of fruits and vegetables daily, you should take vitamin C (500-1,000 milligrams daily) E, A, and beta carotene (25,000-50,000 international units daily) in supplemental form. Folic acid, one of the B vitamins (400-800 micrograms daily), can not only aid in prevention, but it has been known to reverse precancerous changes in cervical cells. Shark cartilage may also be helpful in fighting or preventing cervical cancer.
More recommendations for natural cervical cancer treatments
Some people are combining the conventional and natural alternative therapy and they found it very powerful. Others say that natural alternative treatment alone is enough to deal with all diseases. But sometimes we have to be balance to our approach pertaining to prevention and treatment. Natural and alternative prevention and treatment are increasing and are now gaining respect in the medical world. The treatments are not only dealing with the effects but are treating the cause. That's why all of it is effective if applied properly. All alternative prevention and cure are non invasive and it's the highly recommended treatment by almost European doctors. But, this approach is suppressed in the U.S. Natural cervical cancer treatments as provided by the "cure within one minute for all diseases" has gain respect and prominence to a lot of people. The principle is so simple; studies showed that if you deprive a cell 35% of its required levels of oxygen for 2 to 3days, the cell would become cancerous. Almost all people don't know that lack of oxygen is not only the cause of cancer but is also the cause of most diseases and sickness. When the body is supplied and delivered with abundant amounts of oxygen, no cancer cells, viruses, harmful bacteria, toxins, pathogens and disease microorganisms can survive because they cannot survive in a highly oxygenated environment.
Take the time to discover and study this one, we highly recommend this therapy as one of your best options for natural cervical cancer treatments. Just follow the link and watch also the 5minute video presentation for final assessment:
Women who are sexually active, over age 18, or whose mothers took drugs DES during pregnancy should have a pap smear at least once a year. The cure, preinvasive cervical cancer may be treated by cauterization (burning away cancerous cells), cryosurgery (freezing and destroying cancerous cells) or laser surgery. Preinvasive cancers may also be totally removed during conization or with hysterectomy (removal of the cervix and uterus). Surgery for invasive cervical cancer is usually treated by radical hysterectomy; very severe cases may also require removal of the bladder and rectum. Radiation and chemotherapy may be used if cancer has spread throughout the uterus or to other organs.
Recommended dietary and nutritional factors for natural cervical cancer treatments
A diet low in fatty meats (especially pork), red meat, cheeses, and white bread, and high soy products, fruits, dark green vegetables, tomatoes, whole grains, and yogurt offers the best dietary protection. Shiitake mushrooms are also a good source of protection.
If you do not consume 3-5 servings of fruits and vegetables daily, you should take vitamin C (500-1,000 milligrams daily) E, A, and beta carotene (25,000-50,000 international units daily) in supplemental form. Folic acid, one of the B vitamins (400-800 micrograms daily), can not only aid in prevention, but it has been known to reverse precancerous changes in cervical cells. Shark cartilage may also be helpful in fighting or preventing cervical cancer.
More recommendations for natural cervical cancer treatments
Some people are combining the conventional and natural alternative therapy and they found it very powerful. Others say that natural alternative treatment alone is enough to deal with all diseases. But sometimes we have to be balance to our approach pertaining to prevention and treatment. Natural and alternative prevention and treatment are increasing and are now gaining respect in the medical world. The treatments are not only dealing with the effects but are treating the cause. That's why all of it is effective if applied properly. All alternative prevention and cure are non invasive and it's the highly recommended treatment by almost European doctors. But, this approach is suppressed in the U.S. Natural cervical cancer treatments as provided by the "cure within one minute for all diseases" has gain respect and prominence to a lot of people. The principle is so simple; studies showed that if you deprive a cell 35% of its required levels of oxygen for 2 to 3days, the cell would become cancerous. Almost all people don't know that lack of oxygen is not only the cause of cancer but is also the cause of most diseases and sickness. When the body is supplied and delivered with abundant amounts of oxygen, no cancer cells, viruses, harmful bacteria, toxins, pathogens and disease microorganisms can survive because they cannot survive in a highly oxygenated environment.
Take the time to discover and study this one, we highly recommend this therapy as one of your best options for natural cervical cancer treatments. Just follow the link and watch also the 5minute video presentation for final assessment:
Knowing about the Disease Called Diabetes
Anything that is not normal inside the body can cause complications and diseases. For instance, if your blood cholesterol level is higher than the usual, then there is a big chance for you to have hypertension. Also, if your blood sugar level is not normal, the chances of having diabetes are also high. Let us take a look at this disease that we call diabetes. What is this disease and how can we prevent it? Like with any other concerns, proper awareness is always a good way start. We have to earn about the disease first so we can understand the cure and prevention.
As we all know, more and more people are suffering from diabetes. It is a disease wherein the pancreas stops functioning normally because of the unhealthy lifestyle of people and some other unknown reasons. Actually, several projects for diabetes research are conducted each year in order to provide better diabetes treatment. The most alarming thing about this disease is that the symptoms even show up on children when it is supposed to only affect adults who are in their middle age.
A person can acquire diabetes because of some occurrences inside the body. One is when the pancreas stops working and therefore cannot produce insulin. Insulin is essential in converting sugar contents from foods like glucose into energy. If the body fails to utilize sugar effectively, Glucose can accumulate into the blood stream. We all know that our blood travels around the body through the blood vessels to supply food and oxygen to various body parts. If too much of a certain nutrient such as Glucose is supplied to a body part, then there will be a malfunction. This can lead to complications as stroke, blindness, impotence, nerve damage, wounds that don’t heal, etc. Diabetes also happens if the body itself rejects the insulin produced by the pancreas.
There are two types of diabetes, the type 1 diabetes and the type 2 diabetes. Type 1 diabetes happens when the pancreas stops producing insulin for the body while type 2 diabetes happens when the body rejects insulin and therefore fails to utilize sugar effectively.
As the saying goes, prevention is always better than cure. Living a healthy lifestyle is the key to prevention of various diseases. For people who have already acquired the disease, glucose level monitoring and insulin supply are necessary. There are also some pills and food supplements that help minimize the full effect of the disease. For people who have greater chances of acquiring diabetes which may be due to family history, unhealthy routines and sedentary lifestyle, it is time to change your ways as early as now. It is recommended to avoid too much sugar in your foods and try to live a healthy and active lifestyle.
Diabetes is a dreaded disease. It would be great if we can know something about it as early as now. There is diabetes information that could help us understand this type of disease so we can find out about the ways to prevent it.
As we all know, more and more people are suffering from diabetes. It is a disease wherein the pancreas stops functioning normally because of the unhealthy lifestyle of people and some other unknown reasons. Actually, several projects for diabetes research are conducted each year in order to provide better diabetes treatment. The most alarming thing about this disease is that the symptoms even show up on children when it is supposed to only affect adults who are in their middle age.
A person can acquire diabetes because of some occurrences inside the body. One is when the pancreas stops working and therefore cannot produce insulin. Insulin is essential in converting sugar contents from foods like glucose into energy. If the body fails to utilize sugar effectively, Glucose can accumulate into the blood stream. We all know that our blood travels around the body through the blood vessels to supply food and oxygen to various body parts. If too much of a certain nutrient such as Glucose is supplied to a body part, then there will be a malfunction. This can lead to complications as stroke, blindness, impotence, nerve damage, wounds that don’t heal, etc. Diabetes also happens if the body itself rejects the insulin produced by the pancreas.
There are two types of diabetes, the type 1 diabetes and the type 2 diabetes. Type 1 diabetes happens when the pancreas stops producing insulin for the body while type 2 diabetes happens when the body rejects insulin and therefore fails to utilize sugar effectively.
As the saying goes, prevention is always better than cure. Living a healthy lifestyle is the key to prevention of various diseases. For people who have already acquired the disease, glucose level monitoring and insulin supply are necessary. There are also some pills and food supplements that help minimize the full effect of the disease. For people who have greater chances of acquiring diabetes which may be due to family history, unhealthy routines and sedentary lifestyle, it is time to change your ways as early as now. It is recommended to avoid too much sugar in your foods and try to live a healthy and active lifestyle.
Diabetes is a dreaded disease. It would be great if we can know something about it as early as now. There is diabetes information that could help us understand this type of disease so we can find out about the ways to prevent it.
Saturday, January 1, 2011
11 mistakes women make in middle age
Let’s not kid ourselves. Getting older is a drag, and middle age is particularly fraught with tension.
Do the sexy clothes you wore in the past now seem just plain wrong? Will smoky eye makeup that looks great on 19-year-olds make you appear just plain crazy?
Part of the problem is that aging often requires change, but most women don’t want to move to a frumpy town called Middle Age, where sensible shoes and boring clothes are de rigueur.
Here are the 11 most common mistakes aging women make—and how to avoid them.
Not realizing you need to change
The biggest mistake women make is not doing anything at all. Hair, makeup, and clothing that made you look fantastic in your younger years, often won’t cut it as you grow older.
If you want to age gracefully, you’ll need to make some changes.
“Many women keep doing the same things they’ve been doing for decades, which very often no longer works and may not be as flattering for a woman over 50,” says Barbara Grufferman, author of The Best of Everything After 50: The Experts’ Guide to Style, Sex, Health, Money, and More.
“They often don’t even realize they are making mistakes, so it’s all about finding what those mistakes are before they can happen.”
Not spending enough on your clothes
Remember the good old days, when you could snag a bikini off the sale rack and look like hot stuff on the beach? Unfortunately, those days are gone. (Unless you’re Madonna, Helen Mirren, or happen to look like them.)
The rest of us need to invest in clothing that’s a bit more, well, constructed. Think Lycra panels, butt-boosting jeans, and Spanx.
It’s a challenge to find flattering clothes at any age, but it’s even harder in middle age. You’ll probably need to fork over more dough for body-squeezing swimsuits and well-fitted business clothes that do the trick.
Health.com: The best jeans for your body
Comparing yourself to you in your 20s
Have your kids ever asked, “Who’s that pretty lady in your photo album?” You’re not alone.
Few people look as attractive in middle age as they did in their younger years. So take a walk down memory lane if you must, but don’t get depressed if you run into your younger self.
The goal is to look as good as you can—and be as healthy as you can—not recreate the body and face you had decades ago.
Skipping exercise
Tempted to stop working out as you get older? (Or use it as another excuse not to start?) Sorry, that won’t cut it.
You’ll have to exercise despite the aches and pains of middle age—the bum knee, tricky back, or it-just-makes-me-feel-like-hell feeling.
Exercising can actually relieve pain, and stave off health problems in coming years, such as creeping weight gain, diabetes, heart disease, or dementia.
If you can manage a marathon, great. If not, now is the time to check out the gym pool, start taking yoga, or fall in love with power walking.
Health.com: Your 50s strength workout
Not getting enough sleep
Gone are the days when you could stay up all night and still make it to work with a glowing complexion and a spring in your step.
The fact is, you may have heard a “you look tired” comment even after a good night’s sleep. (It’s OK to grit your teeth on that one.)
While it may be tempting to shortchange sleep, particularly if you’re juggling parent- and child-care duties, this may be one more thing you need to change.
Fewer hours of sleep are more likely to show up on your face, true. But it’s also linked to a greater risk of diabetes and other health problems, which become even more important as you age.
Health.com: 8 things keeping you up at night
Ignoring your teeth
You may be focusing on your wrinkles or thinning hair, but don’t forget to smile at yourself in the mirror.
One thing that can make you appear older is yellowing teeth, but it is about more than just looks. Dental health is closely linked with overall health, and gum disease—which gets more common as you age—has been associated with a higher risk of heart problems.
So don’t skip those visits to the dentist.
Overdoing anti-aging efforts
This is a common mistake made by celebrities and real women alike.
No one likes crow’s-feet or laugh lines, but a frozen Botox face or scary lip plumping isn’t a great look either.
The right skin products (such as those containing retinol) can help diminish fine lines and wrinkles. If you’re not happy with the result, then explore other alternatives—but don’t aim to look like a teen again.
“No wrinkles can be unrealistic and unnatural,” says Grufferman.
Health.com: 14 health products you probably don't need
Thinking there are hair “rules”
Do you have to cut your tresses short or above the shoulders once you’re 50? No, because there aren’t really any hair “rules” for middle-aged women, says Grufferman. “It depends on a woman’s height, shape, lifestyle, and the condition of her hair.”
The fact is that your hair will probably get more gray and thin as you age, and the texture may get coarser as well.
Choose a cut and color that’s flattering, keeping in mind that it probably won’t be the cut and color that worked for you in your 20s and 30s.
Using the wrong makeup
The makeup colors and brands you’ve been wearing for years probably don’t reflect what’s best for your skin anymore.
And resist the urge to slather on heavy-duty powders and concealers to cover up wrinkles and under-eye circles as caked-on or dark makeup can make you seem even older. For a more natural look, Grufferman suggests using a magnifying mirror and having a “lighter touch” when applying. Keep your cosmetic bag current—replace foundations, powders, and concealers every 6 months to a year, and steer clear of dated makeup styles too.
Health.com: The best colors for your complexion
Settling for a boring sex life
Our culture tends to sell the message that young equals sexy, but you don’t have to buy into it.
You should have the confidence and freedom to dress and feel as sexy as you want to, and explore your sexual needs as well.
“Women over 50 can have the best sex of their lives,” Grufferman says. “For many women, it’s the first time they are having sex for fun and enjoyment, not for a result (children)."
Health.com: 8 reasons sex is better after 50
Wearing the wrong bra
It’s inevitable—gravity has an impact on our bodies. But while you might be saggy where you were once perky, that doesn’t mean you have to stay that way.
“Many women continue to wear the same size and brand they’ve always worn, without considering that our bodies change as we age,” says Grufferman.
The right underwear can help lift and slim your body, so re-evaluate your undergarments and invest in some new pieces. Most large department stores and lingerie shops offer free bra-fitting services.
Do the sexy clothes you wore in the past now seem just plain wrong? Will smoky eye makeup that looks great on 19-year-olds make you appear just plain crazy?
Part of the problem is that aging often requires change, but most women don’t want to move to a frumpy town called Middle Age, where sensible shoes and boring clothes are de rigueur.
Here are the 11 most common mistakes aging women make—and how to avoid them.
Not realizing you need to change
The biggest mistake women make is not doing anything at all. Hair, makeup, and clothing that made you look fantastic in your younger years, often won’t cut it as you grow older.
If you want to age gracefully, you’ll need to make some changes.
“Many women keep doing the same things they’ve been doing for decades, which very often no longer works and may not be as flattering for a woman over 50,” says Barbara Grufferman, author of The Best of Everything After 50: The Experts’ Guide to Style, Sex, Health, Money, and More.
“They often don’t even realize they are making mistakes, so it’s all about finding what those mistakes are before they can happen.”
Not spending enough on your clothes
Remember the good old days, when you could snag a bikini off the sale rack and look like hot stuff on the beach? Unfortunately, those days are gone. (Unless you’re Madonna, Helen Mirren, or happen to look like them.)
The rest of us need to invest in clothing that’s a bit more, well, constructed. Think Lycra panels, butt-boosting jeans, and Spanx.
It’s a challenge to find flattering clothes at any age, but it’s even harder in middle age. You’ll probably need to fork over more dough for body-squeezing swimsuits and well-fitted business clothes that do the trick.
Health.com: The best jeans for your body
Comparing yourself to you in your 20s
Have your kids ever asked, “Who’s that pretty lady in your photo album?” You’re not alone.
Few people look as attractive in middle age as they did in their younger years. So take a walk down memory lane if you must, but don’t get depressed if you run into your younger self.
The goal is to look as good as you can—and be as healthy as you can—not recreate the body and face you had decades ago.
Skipping exercise
Tempted to stop working out as you get older? (Or use it as another excuse not to start?) Sorry, that won’t cut it.
You’ll have to exercise despite the aches and pains of middle age—the bum knee, tricky back, or it-just-makes-me-feel-like-hell feeling.
Exercising can actually relieve pain, and stave off health problems in coming years, such as creeping weight gain, diabetes, heart disease, or dementia.
If you can manage a marathon, great. If not, now is the time to check out the gym pool, start taking yoga, or fall in love with power walking.
Health.com: Your 50s strength workout
Not getting enough sleep
Gone are the days when you could stay up all night and still make it to work with a glowing complexion and a spring in your step.
The fact is, you may have heard a “you look tired” comment even after a good night’s sleep. (It’s OK to grit your teeth on that one.)
While it may be tempting to shortchange sleep, particularly if you’re juggling parent- and child-care duties, this may be one more thing you need to change.
Fewer hours of sleep are more likely to show up on your face, true. But it’s also linked to a greater risk of diabetes and other health problems, which become even more important as you age.
Health.com: 8 things keeping you up at night
Ignoring your teeth
You may be focusing on your wrinkles or thinning hair, but don’t forget to smile at yourself in the mirror.
One thing that can make you appear older is yellowing teeth, but it is about more than just looks. Dental health is closely linked with overall health, and gum disease—which gets more common as you age—has been associated with a higher risk of heart problems.
So don’t skip those visits to the dentist.
Getty Images
Overdoing anti-aging efforts
This is a common mistake made by celebrities and real women alike.
No one likes crow’s-feet or laugh lines, but a frozen Botox face or scary lip plumping isn’t a great look either.
The right skin products (such as those containing retinol) can help diminish fine lines and wrinkles. If you’re not happy with the result, then explore other alternatives—but don’t aim to look like a teen again.
“No wrinkles can be unrealistic and unnatural,” says Grufferman.
Health.com: 14 health products you probably don't need
Thinking there are hair “rules”
Do you have to cut your tresses short or above the shoulders once you’re 50? No, because there aren’t really any hair “rules” for middle-aged women, says Grufferman. “It depends on a woman’s height, shape, lifestyle, and the condition of her hair.”
The fact is that your hair will probably get more gray and thin as you age, and the texture may get coarser as well.
Choose a cut and color that’s flattering, keeping in mind that it probably won’t be the cut and color that worked for you in your 20s and 30s.
Using the wrong makeup
The makeup colors and brands you’ve been wearing for years probably don’t reflect what’s best for your skin anymore.
And resist the urge to slather on heavy-duty powders and concealers to cover up wrinkles and under-eye circles as caked-on or dark makeup can make you seem even older. For a more natural look, Grufferman suggests using a magnifying mirror and having a “lighter touch” when applying. Keep your cosmetic bag current—replace foundations, powders, and concealers every 6 months to a year, and steer clear of dated makeup styles too.
Health.com: The best colors for your complexion
Settling for a boring sex life
Our culture tends to sell the message that young equals sexy, but you don’t have to buy into it.
You should have the confidence and freedom to dress and feel as sexy as you want to, and explore your sexual needs as well.
“Women over 50 can have the best sex of their lives,” Grufferman says. “For many women, it’s the first time they are having sex for fun and enjoyment, not for a result (children)."
Health.com: 8 reasons sex is better after 50
Wearing the wrong bra
It’s inevitable—gravity has an impact on our bodies. But while you might be saggy where you were once perky, that doesn’t mean you have to stay that way.
“Many women continue to wear the same size and brand they’ve always worn, without considering that our bodies change as we age,” says Grufferman.
The right underwear can help lift and slim your body, so re-evaluate your undergarments and invest in some new pieces. Most large department stores and lingerie shops offer free bra-fitting services.
Endometrial cancer
Endometrial cancer
Definition
Endometrial cancer develops when the cells that make up the inner lining of the uterus (the endometrium) become abnormal and grow uncontrollably.
Description
Endometrial cancer (also called uterine cancer) is the fourth most common type of cancer among women and the most common gynecologic cancer. Approximately 34, 000 women are diagnosed with endometrial cancer each year. In 1998, approximately 6, 300 women died from this cancer. Although endometrial cancer generally occurs in women who have gone through menopause and are 45 years of age or older, 30% of the women with endometrial cancer are younger than 40 years of age. The average age at diagnosis is 60 years old.
The uterus, or womb, is the hollow female organ that supports the development of the unborn baby during pregnancy. The uterus has a thick muscular wall and an inner lining called the endometrium. The endometrium is very sensitive to hormones and it changes daily during the menstrual cycle. The endometrium is designed to provide an ideal environment for the fertilized egg to implant and begin to grow. If pregnancy does not occur, the endometrium is shed causing the menstrual period.
More than 95% of uterine cancers arise in the endometrium. The most common type of uterine cancer is adenocarcinoma. It arises from an abnormal multiplication of endometrial cells (atypical adenomatous hyper-plasia) and is made up of mature, specialized cells (well-differentiated). Less commonly, endometrial cancer arises without a preceding hyperplasia and is made up of poorly differentiated cells. The more common of these types are the papillary serous and clear cell carcinomas. Poorly differentiated endometrial cancers are often associated with a less promising prognosis.
Demographics
The highest incidence of endometrial cancer in the United States is in Caucasians, Hawaiians, Japanese, and African Americans. American Indians, Koreans, and Vietnamese have the lowest incidence. African-American and Hawaiian women are more likely to be diagnosed with advanced cancer and, therefore, have a higher risk of dying from the disease.
Causes and symptoms
Although the exact cause of endometrial cancer is unknown, it is clear that high levels of estrogen, when not balanced by progesterone, can lead to abnormal growth of the endometrium. Factors that increase a woman's risk of developing endometrial cancer are:
* Age. The risk is considerably higher in women who are over the age of 50 and have gone through menopause.
* Obesity. Being overweight is a very strong risk factor for this cancer. Fatty tissue can change other normal body chemicals into estrogen, which can promote endometrial cancer.
* Estrogen replacement therapy. Women receiving estrogen supplements after menopause have a 12 times higher risk of getting endometrial cancer if progesterone is not taken simultaneously.
* Diabetes. Diabetics have twice the risk of getting this cancer as nondiabetic women. It is not clear if this risk is due to the fact that many diabetics are also obese and hypertensive. One 1998 study found that women who were obese and diabetic were three times more likely to develop endometrial cancer than women who were obese but nondiabetic. This study also found that nonobese diabetics were not at risk of developing endometrial cancer.
* Hypertension. High blood pressure (or hypertension) is also considered a risk factor for uterine cancer.
* Irregular menstrual periods. During the menstrual cycle, there is interaction between the hormones estrogen and progesterone. Women who do not ovulate regularly are exposed to high estrogen levels for longer periods of time. If a woman does not ovulate regularly, this delicate balance is upset and may increase her chances of getting uterine cancer.
* Early first menstruation or late menopause. Having the first period at a young age (a 1997 Pediatrics article identified the mean age of menses as 12.16 years in African-American girls and 12.88 years in white girls) or going through menopause at a late age (over age 51 according to a 2001 Prevention article) seem to put women at a slightly higher risk for developing endome-trial cancer.
* Tamoxifen . This drug, which is used to treat or prevent breast cancer , increases a woman's chance of developing endometrial cancer. Tamoxifen users tend to have more advanced endometrial cancer with an associated poorer survival rate than those who do not take the drug. In many cases, however, the value of tamoxifen for treating breast cancer and for preventing the cancer from spreading far outweighs the small risk of getting endometrial cancer.
* Family history. Some studies suggest that endometrial cancer runs in certain families. Women with inherited mutations in the BRCA1 and BRCA2 genes are at a higher risk of developing breast, ovarian, and other gynecologic cancers . Those with the hereditary nonpolyposis colorectal cancer gene have a higher risk of developing endometrial cancer.
* Breast, ovarian, or colon cancer . Women who have a history of these other types of cancer are at an increased risk of developing endometrial cancer.
* Low parity or nulliparity. Endometrial cancer is more common in women who have born few (low parity) or no (nulliparity) children. The high levels of progesterone produced during pregnancy has a protective effect against endometrial cancer. The results of one study suggest that nulliparity is associated with a lower survival rate.
* Infertility. Risk is increased due to nulliparity or the use of fertility drugs.
* Polycystic ovary syndrome. The increased level of estrogen associated with this abnormality raises the risk of cancers of the breast and endometrium.
The most common symptom of endometrial cancer is unusual vaginal spotting, bleeding or discharge. In women who are near menopause (perimenopausal), symptoms of endometrial cancer could include bleeding between periods (intermenstrual bleeding), heavy bleeding that lasts for more than seven days, or short menstrual cycles (fewer than 21 days). For women who have gone through menopause, any vaginal bleeding or abnormal discharge is suspect. Pain in the pelvic region and the presence of a lump (mass) are symptoms that occur late in the disease.
Diagnosis
If endometrial cancer is suspected, a series of tests will be conducted to confirm the diagnosis. The first step will involve taking a complete personal and family medical history. A physical examination, which will include a thorough pelvic examination, will also be done.
The doctor may order an endometrial biopsy . This is generally performed in the doctor's office and does not require anesthesia. A thin, flexible tube is inserted through the cervix and into the uterus. A small piece of endometrial tissue is removed. The patient may experience some discomfort, which can be minimized by taking an anti-inflammatory medication (like Advil or Motrin) an hour before the procedure.
If an adequate amount of tissue was not obtained by the endometrial biopsy, or if the biopsy tissue looks abnormal but confirmation is needed, the doctor may perform a dilatation and curettage (D & C). This procedure is done in the outpatient surgery department of a hospital and takes about an hour. The patient may be given general anesthesia. The doctor dilates the cervix and uses a special instrument to scrape tissue from inside the uterus.
The tissue that is obtained from the biopsy or the D & C is sent to a laboratory for examination. If cancer is found, then the type of cancer will be determined. The treatment and prognosis depends on the type and stage of the cancer.
Transvaginal ultrasound may be used to measure the thickness of the endometrium. For this painless procedure, a wand-like ultrasound transducer is inserted into the vagina to enable visualization and measurement of the uterus, the thickness of the uterine lining, and other pelvic organs.
Other possible diagnostic procedures include sonohysterography and hysteroscopy. For sonohysteroscopy, a small tube is passed through the cervix and into the uterus. A small amount of a salt water (saline) solution is injected through the tube to open the space within the uterus and allow ultrasound visualization of the endometrium. For hysteroscopy, a wand-like camera is passed through the cervix to allow direct visualization of the endometrium. Both of these procedures cause discomfort, which may be reduced by taking an anti-inflammatory medication prior to the procedure.
Treatment team
The treatment team for endometrial cancer may include a gynecologist, gynecologic oncologist, surgeon, radiation oncologist, gynecologic nurse oncologist, sexual therapist, psychiatrist, psychological counselor, and social worker.
Clinical staging, treatments, and prognosis
Clinical staging
The International Federation of Gynecology and Obstetrics (FIGO) has adopted a staging system for endometrial cancer. The stage of cancer is determined after surgery. Endometrial cancer is categorized into four stages (I, II, III, and IV) which are subdivided (A, B, and possibly C) based on the depth or spread of cancerous tissue. Seventy percent of all uterine cancers are stage I, 10% to 15% are stage II, and the remainder are stages III and IV. The cancer is also graded (G1, G2, and G3) based upon microscopic analysis of the aggressiveness of the cancer cells.
The FIGO stages for endometrial cancer are:
* Stage I. Cancer is limited to the uterus.
* Stage II. Cancer involves the uterus and cervix.
* Stage III. Cancer has spread out of the uterus but is restricted to the pelvic region.
* Stage IV. Cancer has spread to the bladder, bowel, or other distant locations.
Treatments
The mainstay of treatment for most stages of endometrial cancer is surgery. Radiation therapy , hormonal therapy, and chemotherapy are additional treatments (called adjuvant therapy). The necessity of adjuvant therapy is a controversial topic which should be discussed with the patient's treatment team.
SURGERY.
Most women with endometrial cancer, except those with stage IV disease, are treated with hysterectomy. A simple hysterectomy involves the removal of the uterus. In a bilateral salpingo-oophorectomy with total hysterectomy, the ovaries, fallopian tubes, and uterus are removed. This may be necessary because endometrial cancer often spreads to the ovaries first. The lymph nodes in the pelvic region may also be biopsied or removed to check for metastasis . Hysterectomy is traditionally performed through an incision in the abdomen (laparotomy), however, endoscopic surgery (laparoscopy ) with vaginal hysterectomy is also being used. Women with stage I disease may require no further treatment. However, those with higher grade disease will receive adjuvant therapy.
RADIATION THERAPY.
The decision to use radiation therapy depends on the stage of the disease. Radiation therapy may be used before surgery (preoperatively) and/or after surgery (postoperatively). Radiation given from a machine that is outside the body is called external radiation therapy. Sometimes applicators containing radioactive compounds are placed inside the vagina or uterus. This is called internal radiation therapy or brachytherapy and requires hospitalization.
Side effects are common with radiation therapy. The skin in the treated area may become red and dry. Fatigue , upset stomach, diarrhea , and nausea are also common complaints. Radiation therapy in the pelvic area may cause the vagina to become narrow (vaginal stenosis), making intercourse painful. Premature menopause and some problems with urination may also occur.
CHEMOTHERAPY.
Chemotherapy is usually reserved for women with stage IV or recurrent disease because this therapy is not a very effective treatment for endome-trial cancer. The anticancer drugs are given by mouth or intravenously. Side effects include stomach upset, vomiting, appetite loss (anorexia ), hair loss (alopecia ), mouth or vaginal sores, fatigue, menstrual cycle changes, and premature menopause. There is also an increased chance of infections.
HORMONAL THERAPY.
Hormonal therapy uses drugs like progesterone to slow the growth of endometrial cells. These drugs are usually available as pills. This therapy is usually reserved for women with advanced or recurrent disease. Side effects include fatigue, fluid retention, and appetite and weight changes.
Prognosis
Because it is possible to detect endometrial cancer early, the chances of curing it are excellent. The five year survival rates for endometrial cancer by stage are: 90%, stage I; 60%, stage II; 40%, stage III; and 5%, stage IV. Endometrial cancer most often spreads to the lungs, liver, bones, brain, vagina, and certain lymph nodes.
Alternative and complementary therapies
Although alternative and complementary therapies are used by many cancer patients, very few controlled studies on the effectiveness of such therapies exist. Mind-body techniques such as prayer, biofeedback, visualization, meditation, and yoga, have not shown any effect in reducing cancer but they can reduce stress and lessen some of the side effects of cancer treatments. Clinical studies of hydrazine sulfate found that it had no effect on cancer and even worsened the health and well-being of the study subjects. One clinical study of the drug amygdalin (Laetrile) found that it had no effect on cancer. Laetrile can be toxic and has caused deaths. Shark cartilage, although highly touted as an effective cancer treatment, is an improbable therapy that has not been the subject of clinical study.
The American Cancer Society has found that the "metabolic diets" pose serious risk to the patient. The effectiveness of the macrobiotic, Gerson, and Kelley diets and the Manner metabolic therapy has not been scientifically proven. The FDA was unable to substantiate the anti-cancer claims made about the popular Cancell treatment.
There is no evidence for the effectiveness of most over-the-counter herbal cancer remedies. Some herbals have shown an anticancer effect. As shown in clinical studies, Polysaccharide krestin, from the mushroom Coriolus versicolor, has significant effectiveness against cancer. In a small study, the green alga Chlorella pyrenoidosa has been shown to have anticancer activity. In a few small studies, evening primrose oil has shown some benefit in the treatment of cancer.
For more comprehensive information, the patient should consult the book on complementary and alternative medicine published by the American Cancer Society listed in the Resources section.
Coping with cancer treatment
The patient should consult her treatment team regarding any side effects or complications of treatment. Vaginal stenosis can be prevented and treated by vaginal dilators, gentle douching, and sexual intercourse. A water-soluble lubricant may be used to make sexual intercourse more comfortable. Many of the side effects of chemotherapy can be relieved by medications. Women should consult a psychotherapist and/or join a support group to deal with the emotional consequences of cancer and hysterectomy.
Clinical trials
Because endometrial cancer is a common type of cancer there are many studies underway to optimize its treatment. Women should consult with their treatment team to determine if they are candidates for any ongoing studies.
Prevention
Women (especially postmenopausal women) should report any abnormal vaginal bleeding or discharge to the doctor. Controlling obesity, blood pressure, and diabetes can help to reduce the risk of this disease. Women on estrogen replacement therapy have a substantially reduced risk of endometrial cancer if progestins are taken simultaneously. Long-term use of birth control pills has been shown to reduce the risk of this cancer. Women who have irregular periods may be prescribed birth control pills to help prevent endometrial cancer. Women who are taking tamoxifen and those who carry the hereditary nonpolyposis colorectal cancer gene should be screened regularly, receiving annual pelvic examinations.
Special concerns
Of special concern to the young woman with endometrial cancer is the impact that a hysterectomy will have on her fertility, sexuality , and body image . Depression is common. Symptoms caused by the sudden onset of menopause, due to removal of the ovaries, can be more severe than with natural menopause. Estrogen replacement therapy is not commonly used due to the potential risk of cancer recurrence. Without estrogen replacement, osteoporosis becomes a concern and calcium supplements should be considered. Weight bearing exercise and alendronate (Fosamax) will also decrease the development rate of osteoporosis. Vaginal stenosis following radiation treatment is a concern.
Resources
BOOKS
Bruss, Katherine, Christina Salter, and Esmeralda Galan, eds. American Cancer Society's Guide to Complementary and Alternative Cancer Methods. Atlanta: American Cancer Society, 2000.
Burke, Thomas, Patricia Eifel, and Muggia Franco. "Cancers of the Uterine Body." In Cancer: Principles & Practice of Oncology, ed. Vincent DeVita, Samuel Hellman, and Steven Rosenberg. Philadelphia: Lippincott Williams & Wilkins, 2001, pp.1573- 86.
Long, Harry. "Carcinoma of the Endometrium." In Current Therapy in Cancer, ed. John Foley, Julie Vose, and James Armitage. Philadelphia: W. B. Saunders Company, 1999, pp.162-66.
Primack, Aron. "Complementary/Alternative Therapies in the Prevention and Treatment of Cancer." In Complementary/Alternative Medicine: An Evidence-Based Approach, ed. John Spencer and Joseph Jacobs. St. Louis: Mosby, 1999, pp.123-69.
Definition
Endometrial cancer develops when the cells that make up the inner lining of the uterus (the endometrium) become abnormal and grow uncontrollably.
Description
Endometrial cancer (also called uterine cancer) is the fourth most common type of cancer among women and the most common gynecologic cancer. Approximately 34, 000 women are diagnosed with endometrial cancer each year. In 1998, approximately 6, 300 women died from this cancer. Although endometrial cancer generally occurs in women who have gone through menopause and are 45 years of age or older, 30% of the women with endometrial cancer are younger than 40 years of age. The average age at diagnosis is 60 years old.
The uterus, or womb, is the hollow female organ that supports the development of the unborn baby during pregnancy. The uterus has a thick muscular wall and an inner lining called the endometrium. The endometrium is very sensitive to hormones and it changes daily during the menstrual cycle. The endometrium is designed to provide an ideal environment for the fertilized egg to implant and begin to grow. If pregnancy does not occur, the endometrium is shed causing the menstrual period.
More than 95% of uterine cancers arise in the endometrium. The most common type of uterine cancer is adenocarcinoma. It arises from an abnormal multiplication of endometrial cells (atypical adenomatous hyper-plasia) and is made up of mature, specialized cells (well-differentiated). Less commonly, endometrial cancer arises without a preceding hyperplasia and is made up of poorly differentiated cells. The more common of these types are the papillary serous and clear cell carcinomas. Poorly differentiated endometrial cancers are often associated with a less promising prognosis.
Demographics
The highest incidence of endometrial cancer in the United States is in Caucasians, Hawaiians, Japanese, and African Americans. American Indians, Koreans, and Vietnamese have the lowest incidence. African-American and Hawaiian women are more likely to be diagnosed with advanced cancer and, therefore, have a higher risk of dying from the disease.
Causes and symptoms
Although the exact cause of endometrial cancer is unknown, it is clear that high levels of estrogen, when not balanced by progesterone, can lead to abnormal growth of the endometrium. Factors that increase a woman's risk of developing endometrial cancer are:
* Age. The risk is considerably higher in women who are over the age of 50 and have gone through menopause.
* Obesity. Being overweight is a very strong risk factor for this cancer. Fatty tissue can change other normal body chemicals into estrogen, which can promote endometrial cancer.
* Estrogen replacement therapy. Women receiving estrogen supplements after menopause have a 12 times higher risk of getting endometrial cancer if progesterone is not taken simultaneously.
* Diabetes. Diabetics have twice the risk of getting this cancer as nondiabetic women. It is not clear if this risk is due to the fact that many diabetics are also obese and hypertensive. One 1998 study found that women who were obese and diabetic were three times more likely to develop endometrial cancer than women who were obese but nondiabetic. This study also found that nonobese diabetics were not at risk of developing endometrial cancer.
* Hypertension. High blood pressure (or hypertension) is also considered a risk factor for uterine cancer.
* Irregular menstrual periods. During the menstrual cycle, there is interaction between the hormones estrogen and progesterone. Women who do not ovulate regularly are exposed to high estrogen levels for longer periods of time. If a woman does not ovulate regularly, this delicate balance is upset and may increase her chances of getting uterine cancer.
* Early first menstruation or late menopause. Having the first period at a young age (a 1997 Pediatrics article identified the mean age of menses as 12.16 years in African-American girls and 12.88 years in white girls) or going through menopause at a late age (over age 51 according to a 2001 Prevention article) seem to put women at a slightly higher risk for developing endome-trial cancer.
* Tamoxifen . This drug, which is used to treat or prevent breast cancer , increases a woman's chance of developing endometrial cancer. Tamoxifen users tend to have more advanced endometrial cancer with an associated poorer survival rate than those who do not take the drug. In many cases, however, the value of tamoxifen for treating breast cancer and for preventing the cancer from spreading far outweighs the small risk of getting endometrial cancer.
* Family history. Some studies suggest that endometrial cancer runs in certain families. Women with inherited mutations in the BRCA1 and BRCA2 genes are at a higher risk of developing breast, ovarian, and other gynecologic cancers . Those with the hereditary nonpolyposis colorectal cancer gene have a higher risk of developing endometrial cancer.
* Breast, ovarian, or colon cancer . Women who have a history of these other types of cancer are at an increased risk of developing endometrial cancer.
* Low parity or nulliparity. Endometrial cancer is more common in women who have born few (low parity) or no (nulliparity) children. The high levels of progesterone produced during pregnancy has a protective effect against endometrial cancer. The results of one study suggest that nulliparity is associated with a lower survival rate.
* Infertility. Risk is increased due to nulliparity or the use of fertility drugs.
* Polycystic ovary syndrome. The increased level of estrogen associated with this abnormality raises the risk of cancers of the breast and endometrium.
The most common symptom of endometrial cancer is unusual vaginal spotting, bleeding or discharge. In women who are near menopause (perimenopausal), symptoms of endometrial cancer could include bleeding between periods (intermenstrual bleeding), heavy bleeding that lasts for more than seven days, or short menstrual cycles (fewer than 21 days). For women who have gone through menopause, any vaginal bleeding or abnormal discharge is suspect. Pain in the pelvic region and the presence of a lump (mass) are symptoms that occur late in the disease.
Diagnosis
If endometrial cancer is suspected, a series of tests will be conducted to confirm the diagnosis. The first step will involve taking a complete personal and family medical history. A physical examination, which will include a thorough pelvic examination, will also be done.
The doctor may order an endometrial biopsy . This is generally performed in the doctor's office and does not require anesthesia. A thin, flexible tube is inserted through the cervix and into the uterus. A small piece of endometrial tissue is removed. The patient may experience some discomfort, which can be minimized by taking an anti-inflammatory medication (like Advil or Motrin) an hour before the procedure.
If an adequate amount of tissue was not obtained by the endometrial biopsy, or if the biopsy tissue looks abnormal but confirmation is needed, the doctor may perform a dilatation and curettage (D & C). This procedure is done in the outpatient surgery department of a hospital and takes about an hour. The patient may be given general anesthesia. The doctor dilates the cervix and uses a special instrument to scrape tissue from inside the uterus.
The tissue that is obtained from the biopsy or the D & C is sent to a laboratory for examination. If cancer is found, then the type of cancer will be determined. The treatment and prognosis depends on the type and stage of the cancer.
Transvaginal ultrasound may be used to measure the thickness of the endometrium. For this painless procedure, a wand-like ultrasound transducer is inserted into the vagina to enable visualization and measurement of the uterus, the thickness of the uterine lining, and other pelvic organs.
Other possible diagnostic procedures include sonohysterography and hysteroscopy. For sonohysteroscopy, a small tube is passed through the cervix and into the uterus. A small amount of a salt water (saline) solution is injected through the tube to open the space within the uterus and allow ultrasound visualization of the endometrium. For hysteroscopy, a wand-like camera is passed through the cervix to allow direct visualization of the endometrium. Both of these procedures cause discomfort, which may be reduced by taking an anti-inflammatory medication prior to the procedure.
Treatment team
The treatment team for endometrial cancer may include a gynecologist, gynecologic oncologist, surgeon, radiation oncologist, gynecologic nurse oncologist, sexual therapist, psychiatrist, psychological counselor, and social worker.
Clinical staging, treatments, and prognosis
Clinical staging
The International Federation of Gynecology and Obstetrics (FIGO) has adopted a staging system for endometrial cancer. The stage of cancer is determined after surgery. Endometrial cancer is categorized into four stages (I, II, III, and IV) which are subdivided (A, B, and possibly C) based on the depth or spread of cancerous tissue. Seventy percent of all uterine cancers are stage I, 10% to 15% are stage II, and the remainder are stages III and IV. The cancer is also graded (G1, G2, and G3) based upon microscopic analysis of the aggressiveness of the cancer cells.
The FIGO stages for endometrial cancer are:
* Stage I. Cancer is limited to the uterus.
* Stage II. Cancer involves the uterus and cervix.
* Stage III. Cancer has spread out of the uterus but is restricted to the pelvic region.
* Stage IV. Cancer has spread to the bladder, bowel, or other distant locations.
Treatments
The mainstay of treatment for most stages of endometrial cancer is surgery. Radiation therapy , hormonal therapy, and chemotherapy are additional treatments (called adjuvant therapy). The necessity of adjuvant therapy is a controversial topic which should be discussed with the patient's treatment team.
SURGERY.
Most women with endometrial cancer, except those with stage IV disease, are treated with hysterectomy. A simple hysterectomy involves the removal of the uterus. In a bilateral salpingo-oophorectomy with total hysterectomy, the ovaries, fallopian tubes, and uterus are removed. This may be necessary because endometrial cancer often spreads to the ovaries first. The lymph nodes in the pelvic region may also be biopsied or removed to check for metastasis . Hysterectomy is traditionally performed through an incision in the abdomen (laparotomy), however, endoscopic surgery (laparoscopy ) with vaginal hysterectomy is also being used. Women with stage I disease may require no further treatment. However, those with higher grade disease will receive adjuvant therapy.
RADIATION THERAPY.
The decision to use radiation therapy depends on the stage of the disease. Radiation therapy may be used before surgery (preoperatively) and/or after surgery (postoperatively). Radiation given from a machine that is outside the body is called external radiation therapy. Sometimes applicators containing radioactive compounds are placed inside the vagina or uterus. This is called internal radiation therapy or brachytherapy and requires hospitalization.
Side effects are common with radiation therapy. The skin in the treated area may become red and dry. Fatigue , upset stomach, diarrhea , and nausea are also common complaints. Radiation therapy in the pelvic area may cause the vagina to become narrow (vaginal stenosis), making intercourse painful. Premature menopause and some problems with urination may also occur.
CHEMOTHERAPY.
Chemotherapy is usually reserved for women with stage IV or recurrent disease because this therapy is not a very effective treatment for endome-trial cancer. The anticancer drugs are given by mouth or intravenously. Side effects include stomach upset, vomiting, appetite loss (anorexia ), hair loss (alopecia ), mouth or vaginal sores, fatigue, menstrual cycle changes, and premature menopause. There is also an increased chance of infections.
HORMONAL THERAPY.
Hormonal therapy uses drugs like progesterone to slow the growth of endometrial cells. These drugs are usually available as pills. This therapy is usually reserved for women with advanced or recurrent disease. Side effects include fatigue, fluid retention, and appetite and weight changes.
Prognosis
Because it is possible to detect endometrial cancer early, the chances of curing it are excellent. The five year survival rates for endometrial cancer by stage are: 90%, stage I; 60%, stage II; 40%, stage III; and 5%, stage IV. Endometrial cancer most often spreads to the lungs, liver, bones, brain, vagina, and certain lymph nodes.
Alternative and complementary therapies
Although alternative and complementary therapies are used by many cancer patients, very few controlled studies on the effectiveness of such therapies exist. Mind-body techniques such as prayer, biofeedback, visualization, meditation, and yoga, have not shown any effect in reducing cancer but they can reduce stress and lessen some of the side effects of cancer treatments. Clinical studies of hydrazine sulfate found that it had no effect on cancer and even worsened the health and well-being of the study subjects. One clinical study of the drug amygdalin (Laetrile) found that it had no effect on cancer. Laetrile can be toxic and has caused deaths. Shark cartilage, although highly touted as an effective cancer treatment, is an improbable therapy that has not been the subject of clinical study.
The American Cancer Society has found that the "metabolic diets" pose serious risk to the patient. The effectiveness of the macrobiotic, Gerson, and Kelley diets and the Manner metabolic therapy has not been scientifically proven. The FDA was unable to substantiate the anti-cancer claims made about the popular Cancell treatment.
There is no evidence for the effectiveness of most over-the-counter herbal cancer remedies. Some herbals have shown an anticancer effect. As shown in clinical studies, Polysaccharide krestin, from the mushroom Coriolus versicolor, has significant effectiveness against cancer. In a small study, the green alga Chlorella pyrenoidosa has been shown to have anticancer activity. In a few small studies, evening primrose oil has shown some benefit in the treatment of cancer.
For more comprehensive information, the patient should consult the book on complementary and alternative medicine published by the American Cancer Society listed in the Resources section.
Coping with cancer treatment
The patient should consult her treatment team regarding any side effects or complications of treatment. Vaginal stenosis can be prevented and treated by vaginal dilators, gentle douching, and sexual intercourse. A water-soluble lubricant may be used to make sexual intercourse more comfortable. Many of the side effects of chemotherapy can be relieved by medications. Women should consult a psychotherapist and/or join a support group to deal with the emotional consequences of cancer and hysterectomy.
Clinical trials
Because endometrial cancer is a common type of cancer there are many studies underway to optimize its treatment. Women should consult with their treatment team to determine if they are candidates for any ongoing studies.
Prevention
Women (especially postmenopausal women) should report any abnormal vaginal bleeding or discharge to the doctor. Controlling obesity, blood pressure, and diabetes can help to reduce the risk of this disease. Women on estrogen replacement therapy have a substantially reduced risk of endometrial cancer if progestins are taken simultaneously. Long-term use of birth control pills has been shown to reduce the risk of this cancer. Women who have irregular periods may be prescribed birth control pills to help prevent endometrial cancer. Women who are taking tamoxifen and those who carry the hereditary nonpolyposis colorectal cancer gene should be screened regularly, receiving annual pelvic examinations.
Special concerns
Of special concern to the young woman with endometrial cancer is the impact that a hysterectomy will have on her fertility, sexuality , and body image . Depression is common. Symptoms caused by the sudden onset of menopause, due to removal of the ovaries, can be more severe than with natural menopause. Estrogen replacement therapy is not commonly used due to the potential risk of cancer recurrence. Without estrogen replacement, osteoporosis becomes a concern and calcium supplements should be considered. Weight bearing exercise and alendronate (Fosamax) will also decrease the development rate of osteoporosis. Vaginal stenosis following radiation treatment is a concern.
Resources
BOOKS
Bruss, Katherine, Christina Salter, and Esmeralda Galan, eds. American Cancer Society's Guide to Complementary and Alternative Cancer Methods. Atlanta: American Cancer Society, 2000.
Burke, Thomas, Patricia Eifel, and Muggia Franco. "Cancers of the Uterine Body." In Cancer: Principles & Practice of Oncology, ed. Vincent DeVita, Samuel Hellman, and Steven Rosenberg. Philadelphia: Lippincott Williams & Wilkins, 2001, pp.1573- 86.
Long, Harry. "Carcinoma of the Endometrium." In Current Therapy in Cancer, ed. John Foley, Julie Vose, and James Armitage. Philadelphia: W. B. Saunders Company, 1999, pp.162-66.
Primack, Aron. "Complementary/Alternative Therapies in the Prevention and Treatment of Cancer." In Complementary/Alternative Medicine: An Evidence-Based Approach, ed. John Spencer and Joseph Jacobs. St. Louis: Mosby, 1999, pp.123-69.
REMEDY
REMEDY
The manner in which a right is enforced or satisfied by a court when some harm or injury, recognized by society as a wrongful act, is inflicted upon an individual.The law of remedies is concerned with the character and extent of relief to which an individual who has brought a legal action is entitled once the appropriate court procedure has been followed, and the individual has established that he or she has a substantive right that has been infringed by the defendant.
Categorized according to their purpose, the four basic types of judicial remedies are (1) damages; (2) restitution; (3) coercive remedies; and (4) declaratory remedies.
The remedy of damages is generally intended to compensate the injured party for any harm he or she has suffered. This kind of damages is ordinarily known as compensatory damages. Money is substituted for that which the plaintiff has lost or suffered. Nominal damages, generally a few cents or one dollar, are awarded to protect a right of a plaintiff even though he or she has suffered no actual harm. The theory underlying the award of punitive damages is different since they are imposed upon the defendant in order to deter or punish him or her, rather than to compensate the plaintiff.
The remedy of restitution is designed to restore the plaintiff to the position he or she occupied before his or her rights were violated. It is ordinarily measured by the defendant's gains, as opposed to the plaintiff's losses, in order to prevent the defendant from being unjustly enriched by the wrong. The remedy of restitution can result in either a pecuniary recovery or in the recovery of property.
Coercive remedies are orders by the court to force the defendant to do, or to refrain from doing, something to the plaintiff. An injunction backed by the contempt power is one kind of coercive remedy. When issuing this type of remedy, the court commands the defendant to act, or to refrain from acting, in a certain way. In the event that the defendant willfully disobeys, he or she might be jailed, fined, or otherwise punished for contempt. A decree for specific performance commands the defendant to perform his or her part of a contract after a breach thereof has been established. It is issued only in cases where the subject matter of a contract is unique.
Declaratory remedies are sought when a plaintiff wishes to be made aware of what the law is, what it means, or whether or not it is constitutional, so that he or she will be able to take appropriate action. The main purpose of this kind of remedy is to determine an individual's rights in a particular situation.
Nature of Remedies
Remedies are also categorized as equitable or legal in nature.Monetary damages awarded to a plaintiff because they adequately compensate him or her for the loss are considered a legal remedy. An equitable remedy is one in which a recovery of money would be an inadequate form of relief.
Courts design equitable remedies to do justice in specific situations where money does not provide complete relief to individuals who have been injured. Injunctions, decrees of specific performance, declaratory judgments, and constructive trusts are typical examples of some kinds of equitable remedies. Restitution is regarded as either a legal or equitable remedy, depending upon the nature of the property restored.
The distinction between legal and equitable remedies originally came about because courts of law only had the power to grant legal remedies, whereas courts of equity granted equitable remedies to do justice in situations where money would be inadequate relief. The courts of law and the courts of equity have merged, but the distinction still has some importance because in a number of courts, a trial by jury is either granted or refused, according to whether the remedy sought is legal or equitable. When a legal remedy is sought, the plaintiff is entitled to a jury trial, but this is not true when an equitable remedy is requested.
Sometimes a plaintiff might have both legal and equitable remedies available for the redress of personal grievances. In such a case, a plaintiff might have to exercise an election of remedies.
Provisional Remedies
A provisional remedy is one that is adapted to meet a specific emergency. It is the temporary process available to the plaintiff in a civil action that protects him or her against loss, irreparable injury, or dissipation of the property while the action is pending. Some types of provisional remedies are injunction, receivership, arrest, attachment, and garnishment.Liver cancer Definition
Liver cancer
Definition
Liver cancer is a form of cancer with a high mortality rate. Liver cancers can be classified into two types. They are either primary, when the cancer starts in the liver itself, or metastatic, when the cancer has spread to the liver from some other part of the body.
Description and demographics
Primary liver cancer
Primary liver cancer is a relatively rare disease in the United States, representing about 2% of all malignancies and 4% of newly diagnosed cancers. Hepatocellular carcinoma (HCC) is one of the top eight most common cancers in the world. It is, however, much more common outside the United States, representing 10% to 50% of malignancies in Africa and parts of Asia. Rates of HCC in men are at least two to three times higher than for women. In high-risk areas (East and Southeast Asia, sub-Saharan Africa), men are even more likely to have HCC than women.
TYPES OF PRIMARY LIVER CANCER.
In adults, most primary liver cancers belong to one of two types: hepatomas, or hepatocellular carcinomas (HCC), which start in the liver tissue itself; and cholangiomas, or cholangiocarcinomas, which are cancers that develop in the bile ducts inside the liver. About 80% to 90% of primary liver cancers are hepatomas. In the United States, about five persons in every 200, 000 will develop a hepatoma (70% to 75% of cases of primary liver cancers are HCC). In Africa and Asia, over 40 persons in 200, 000 will develop this form of cancer (more than 90% of cases of primary liver are HCC). Two rare types of primary liver cancer are mixed-cell tumors and Kupffer cell sarcomas .
One type of primary liver cancer, called a hepatoblastoma, usually occurs in children younger than four years of age and between the ages of 12 and 15. Unlike liver cancers in adults, hepatoblastomas have a good chance of being treated successfully. Approximately 70% of children with hepatoblastomas experience complete cures. If the tumor is detected early, the survival rate is over 90%.
Metastatic liver cancer
The second major category of liver cancer, metastatic liver cancer, is about 20 times more common in the United States than primary liver cancer. Because blood from all parts of the body must pass through the liver for filtration, cancer cells from other organs and tissues easily reach the liver, where they can lodge and grow into secondary tumors. Primary cancers in the colon, stomach, pancreas, rectum, esophagus, breast, lung, or skin are the most likely to metastasize (spread) to the liver. It is not unusual for the metastatic cancer in the liver to be the first noticeable sign of a cancer that started in another organ. After cirrhosis, metastatic liver cancer is the most common cause of fatal liver disease.
Causes and symptoms
Risk factors
The exact cause of primary liver cancer is still unknown. In adults, however, certain factors are known to place some individuals at higher risk of developing liver cancer. These factors include:
* Male sex.
* Age over 60 years.
* Exposure to substances in the environment that tend to cause cancer (carcinogens). These include: a substance produced by a mold that grows on rice and peanuts (aflatoxin); thorium dioxide, which was once used as a contrast dye for x rays of the liver; vinyl chloride, used in manufacturing plastics; and cigarette smoking.
* Use of oral estrogens for birth control.
* Hereditary hemochromatosis. This is a disorder characterized by abnormally high levels of iron storage in the body. It often develops into cirrhosis.
* Cirrhosis. Hepatomas appear to be a frequent complication of cirrhosis of the liver. Between 30% and 70% of hepatoma patients also have cirrhosis. It is estimated that a patient with cirrhosis has 40 times the chance of developing a hepatoma than a person with a healthy liver.
* Exposure to hepatitis viruses: Hepatitis B (HBV), Hepatitis C (HCV), Hepatitis D (HDV), or Hepatitis G (HGV). It is estimated that 80% of worldwide HCC is associated with chronic HBV infection. In Africa and most of Asia, exposure to hepatitis B is an important factor; in Japan and some Western countries, exposure to hepatitis C is connected with a higher risk of developing liver cancer. In the United States, nearly 25% of patients with liver cancer show evidence of HBV infection. Hepatitis is commonly found among intravenous drug abusers. The increase in HCC incidence in the United States is thought to be due to increasing rates of HBV and HCV infections due to increased sexual promiscuity and illicit drug needle sharing. The association between HDV and HGV and HCC is unclear at this time.
Symptoms of liver cancer
The early symptoms of primary, as well as metastatic, liver cancer are often vague and not unique to liver disorders. The long period between the beginning of the tumor's growth and the first signs of illness is the major reason why the disease has a high mortality rate. At the time of diagnosis, patients are often fatigued, with fever , abdominal pain, and loss of appetite (anorexia ). They may look emaciated and generally ill. As the tumor enlarges, it stretches the membrane surrounding the liver (the capsule), causing pain in the upper abdomen on the right side. The pain may extend into the back and shoulder. Some patients develop a collection of fluid, known as ascites , in the abdominal cavity. Others may show signs of bleeding into the digestive tract. In addition, the tumor may block the ducts of the liver or the gall bladder, leading to jaundice. In patients with jaundice, the whites of the eyes and the skin may turn yellow, and the urine becomes dark-colored.
Diagnosis
Physical examination
If the doctor suspects a diagnosis of liver cancer, he or she will check the patient's history for risk factors and pay close attention to the condition of the patient's abdomen during the physical examination. Masses or lumps in the liver and ascites can often be felt while the patient is lying flat on the examination table. The liver is usually swollen and hard in patients with liver cancer; it may be sore when the doctor presses on it. In some cases, the patient's spleen is also enlarged. The doctor may be able to hear an abnormal sound (bruit) or rubbing noise (friction rub) if he or she uses a stethoscope to listen to the blood vessels that lie near the liver. The noises are caused by the pressure of the tumor on the blood vessels.
Laboratory tests
Blood tests may be used to test liver function or to evaluate risk factors in the patient's history. Between 50% and 75% of primary liver cancer patients have abnormally high blood serum levels of a particular protein (alpha-fetoprotein or AFP). The AFP test, however, cannot be used by itself to confirm a diagnosis of liver cancer, because cirrhosis or chronic hepatitis can also produce high alpha-fetoprotein levels. Tests for alkaline phosphatase, bilirubin, lactic dehydrogenase, and other chemicals indicate that the liver is not functioning normally. About 75% of patients with liver cancer show evidence of hepatitis infection. Again, however, abnormal liver function test results are not specific for liver cancer.
Imaging studies
Imaging studies are useful in locating specific areas of abnormal tissue in the liver. Liver tumors as small as an inch across can now be detected by ultrasound or computed tomography scan (CT scan). Imaging studies, however, cannot tell the difference between a hepatoma and other abnormal masses or lumps of tissue (nodules) in the liver. A sample of liver tissue for biopsy is needed to make the definitive diagnosis of a primary liver cancer. CT or ultrasound can be used to guide the doctor in selecting the best location for obtaining the biopsy sample.
Chest x rays may be used to see whether the liver tumor is primary or has metastasized from a primary tumor in the lungs.
Liver biopsy
Liver biopsy is considered to provide the definite diagnosis of liver cancer. A sample of the liver or tissue fluid is removed with a fine needle and is checked under a microscope for the presence of cancer cells. In about 70% of cases, the biopsy is positive for cancer. In most cases, there is little risk to the patient from the biopsy procedure. In about 0.4% of cases, however, the patient develops a fatal hemorrhage from the biopsy because some tumors are supplied with a large number of blood vessels and bleed very easily.
Laparoscopy
The doctor may also perform a laparoscopy to help in the diagnosis of liver cancer. First, the doctor makes a small cut in the patient's abdomen and inserts a small, lighted tube called a laparoscope to view the area. A small piece of liver tissue is removed and examined under a microscope for the presence of cancer cells.
Clinical staging
Currently, the pathogenesis of HCC is not well understood. It is not clear how the different risk factors for HCC affect each other. In addition, the environmental factors vary from region to region.
Treatment
Treatment of liver cancer is based on several factors, including the type of cancer (primary or metastatic); stage (early or advanced); the location of other primary cancers or metastases in the patient's body; the patient's age; and other coexisting diseases, including cirrhosis. For many patients, treatment of liver cancer is primarily intended to relieve the pain caused by the cancer but cannot cure it.
Surgery
Few liver cancers in adults can be cured by surgery because they are usually too advanced by the time they are discovered. If the cancer is contained within one lobe of the liver, and if the patient does not have either cirrhosis, jaundice, or ascites, surgery is the best treatment option. Patients who can have their entire tumor removed have the best chance for survival. Unfortunately, only about 5% of patients with metastatic cancer (from primary tumors in the colon or rectum) fall into this group. If the entire visible tumor can be removed, about 25% of patients will be cured. The operation that is performed is called a partial hepatectomy, or partial removal of the liver. The surgeon will remove either an entire lobe of the liver (a lobectomy ) or cut out the area around the tumor (a wedge resection).
Chemotherapy
Some patients with metastatic cancer of the liver can have their lives prolonged for a few months by chemotherapy , although cure is not possible. If the tumor cannot be removed by surgery, a tube (catheter) can be placed in the main artery of the liver and an implantable infusion pump can be installed. The pump allows much higher concentrations of the cancer drug to be carried to the tumor than is possible with chemotherapy carried through the bloodstream. The drug that is used for infusion pump therapy is usually floxuridine (FUDR), given for 14-day periods alternating with 14-day rests. Systemic chemotherapy can also be used to treat liver cancer. The medications usually used are 5-fluorouracil (Adrucil, Efudex) or methotrexate (MTX, Mexate). Systemic chemotherapy does not, however, significantly lengthen the patient's survival time.
Radiation therapy
Radiation therapy is the use of high-energy rays or x rays to kill cancer cells or to shrink tumors. Its use inliver cancer, however, is only to give short-term relief from some of the symptoms. Liver cancers are not sensitive to radiation, and radiation therapy will not prolong the patient's life.
Liver transplantation
Removal of the entire liver (total hepatectomy) and liver transplantation can be used to treat liver cancer. However, there is a high risk of tumor recurrence and metastases after transplantation.
Other Therapies
Other therapeutic approaches include:
* Hepatic artery embolization with chemotherapy (chemoembolization).
* Alcohol ablation via ultrasound-guided percutaneous injection.
* Ultrasound-guided cryoablation.
* Immunotherapy with monoclonal antibodies tagged with cytotoxic agents.
* Gene therapy with retroviral vectors containing genes expressing cytotoxic agents.
Prognosis
Liver cancer has a very poor prognosis because it is often not diagnosed until it has metastasized. Fewer than 10% of patients survive three years after the initial diagnosis; the overall five-year survival rate for patients with hepatomas is around 4%. Most patients with primary liver cancer die within several months of diagnosis. Patients with liver cancers that metastasized from cancers in the colon live slightly longer than those whose cancers spread from cancers in the stomach or pancreas.
Alternative and complementary therapies
Many patients find that alternative and complementary therapies help to reduce the stress associated with illness, improve immune function, and boost spirits. While there is no clinical evidence that these therapies specifically combat disease, activities such as biofeedback, relaxation, therapeutic touch, massage therapy and guided imagery have no side effects and have been reported to enhance well-being.
Several other healing therapies are sometimes used as supplemental or replacement cancer treatments, such as antineoplastons, cancell, cartilage (bovine and shark), laetrile, and mistletoe. Many of these therapies have not been the subject of safety and efficacy trials by the National Cancer Institute (NCI). The NCI has conducted trials on cancell, laetrile, and some other alternative therapies and found no anticancer activity. These treatments have varying effectiveness and safety considerations. (Laetrile, for example, has caused deaths and is not available in the U.S.) Patients using any alternative remedy should first consult their doctor in order to prevent harmful side effects or interactions with traditional cancer treatment.
Coping with cancer treatment
Side effects of treatment, nutrition, emotional well-being, and other issues are all parts of coping with cancer. There are many possible side effects for a cancer treatment that include:
* constipation
* delirium
* fatigue
* fever, chills, sweats
* nausea and vomiting
* mouth sores, dry mouth, bleeding gums
* pruritus (itching)
* affected sexuality
* sleep disorders
Anxiety, depression , feelings of loss, post-traumatic stress disorder, affected sexuality, and substance abuse are all possible emotional side-effects. Patients should seek out a support network to help them through treatment. Loss of appetite before, during, and after a treatment can also be of concern. Other complications of coping with cancer treatment include fever and pain.
Clinical trials
There are many clinical trials in place studying new types of radiation therapy and chemotherapy, new drugs and drug combinations, biological therapies, ways of combining various types of treatment for liver cancer, side effect reduction, and quality of life. Information on clinical trials can be acquired from the National Cancer Institute at <http://www.nci.nih.gov> or (800) 4-CANCER.
Prevention
There are no useful strategies at present for preventing metastatic cancers of the liver. Primary liver cancers, however, are 75% to 80% preventable. Current strategies focus on widespread vaccination for hepatitis B, early treatment of hereditary hemochromatosis (a metabolic disorder), and screening of high-risk patients with alpha-fetoprotein testing and ultrasound examinations.
Lifestyle factors that can be modified in order to prevent liver cancer include avoidance of exposure to toxic chemicals and foods harboring molds that produce aflatoxin. Most important, however, is avoidance of alcohol and drug abuse. Alcohol abuse is responsible for 60% to 75% of cases of cirrhosis, which is a major risk factor for eventual development of primary liver cancer. Hepatitis is a widespread disease among persons who abuse intravenous drugs.
See Also CT-guided biopsy; Hepatic arterial infusion; Immunologic therapy; Alcohol consumption
Resources
BOOKS
Berkow, Robert, et al., eds. "Hepatic and Biliary Disorders:Neoplasms of the Liver." In The Merck Manual of Diag nosis and Therapy. Rahway, NJ: Merck Research Laboratories, 1997.
Dollinger, Malin. Everyone's Guide to Cancer Therapy. Kansas City: Somerville House Books Limited, 1994.
Friedman, Lawrence S. "Liver, Biliary Tract, & Pancreas." InCurrent Medical Diagnosis & Treatment 1998. Stamford, CT: Appleton & Lange, 1997.
Isselbacher, K.J., and J.L. Dienstag. "Tumors of the Liver and Biliary Tract." In Harrison's Principles of Internal Medi cine. Fauci, Anthony S., et al., eds. New York:McGraw-Hill, 1998.
Loeb, Stanley, et al., eds. "Liver Cancer." In Professional Guide to Diseases. Springhouse, PA: Springhouse Corporation, 1991.
Rudolph, Rebecca E., and Kris V. Kowdley. "Cirrhosis of the Liver." In Current Diagnosis 9. Conn, Rex B., et al., eds. Philadelphia: W. B. Saunders Company, 1997.
Way, Lawrence W. "Liver." In Current Surgical Diagnosis & Treatment. Stamford, CT: Appleton & Lange, 1994.
PERIODICALS
El-Serag, H.B. "Epidemiology of Hepatocellular Carcinoma"Clinics in Liver Disease (February 2001): 87-107.
Macdonald, G.A. "Pathogenesis of Hepatocellular Carcinoma"Clinical Liver Disease (February 2001): 69-85.
Yu, M.C., et al. "Epidemiology of Hepatocellular Carcinoma"Canadian Journal of Gastroenterology (September 2000):703-9.
Definition
Liver cancer is a form of cancer with a high mortality rate. Liver cancers can be classified into two types. They are either primary, when the cancer starts in the liver itself, or metastatic, when the cancer has spread to the liver from some other part of the body.
Description and demographics
Primary liver cancer
Primary liver cancer is a relatively rare disease in the United States, representing about 2% of all malignancies and 4% of newly diagnosed cancers. Hepatocellular carcinoma (HCC) is one of the top eight most common cancers in the world. It is, however, much more common outside the United States, representing 10% to 50% of malignancies in Africa and parts of Asia. Rates of HCC in men are at least two to three times higher than for women. In high-risk areas (East and Southeast Asia, sub-Saharan Africa), men are even more likely to have HCC than women.
TYPES OF PRIMARY LIVER CANCER.
In adults, most primary liver cancers belong to one of two types: hepatomas, or hepatocellular carcinomas (HCC), which start in the liver tissue itself; and cholangiomas, or cholangiocarcinomas, which are cancers that develop in the bile ducts inside the liver. About 80% to 90% of primary liver cancers are hepatomas. In the United States, about five persons in every 200, 000 will develop a hepatoma (70% to 75% of cases of primary liver cancers are HCC). In Africa and Asia, over 40 persons in 200, 000 will develop this form of cancer (more than 90% of cases of primary liver are HCC). Two rare types of primary liver cancer are mixed-cell tumors and Kupffer cell sarcomas .
One type of primary liver cancer, called a hepatoblastoma, usually occurs in children younger than four years of age and between the ages of 12 and 15. Unlike liver cancers in adults, hepatoblastomas have a good chance of being treated successfully. Approximately 70% of children with hepatoblastomas experience complete cures. If the tumor is detected early, the survival rate is over 90%.
Metastatic liver cancer
The second major category of liver cancer, metastatic liver cancer, is about 20 times more common in the United States than primary liver cancer. Because blood from all parts of the body must pass through the liver for filtration, cancer cells from other organs and tissues easily reach the liver, where they can lodge and grow into secondary tumors. Primary cancers in the colon, stomach, pancreas, rectum, esophagus, breast, lung, or skin are the most likely to metastasize (spread) to the liver. It is not unusual for the metastatic cancer in the liver to be the first noticeable sign of a cancer that started in another organ. After cirrhosis, metastatic liver cancer is the most common cause of fatal liver disease.
Causes and symptoms
Risk factors
The exact cause of primary liver cancer is still unknown. In adults, however, certain factors are known to place some individuals at higher risk of developing liver cancer. These factors include:
* Male sex.
* Age over 60 years.
* Exposure to substances in the environment that tend to cause cancer (carcinogens). These include: a substance produced by a mold that grows on rice and peanuts (aflatoxin); thorium dioxide, which was once used as a contrast dye for x rays of the liver; vinyl chloride, used in manufacturing plastics; and cigarette smoking.
* Use of oral estrogens for birth control.
* Hereditary hemochromatosis. This is a disorder characterized by abnormally high levels of iron storage in the body. It often develops into cirrhosis.
* Cirrhosis. Hepatomas appear to be a frequent complication of cirrhosis of the liver. Between 30% and 70% of hepatoma patients also have cirrhosis. It is estimated that a patient with cirrhosis has 40 times the chance of developing a hepatoma than a person with a healthy liver.
* Exposure to hepatitis viruses: Hepatitis B (HBV), Hepatitis C (HCV), Hepatitis D (HDV), or Hepatitis G (HGV). It is estimated that 80% of worldwide HCC is associated with chronic HBV infection. In Africa and most of Asia, exposure to hepatitis B is an important factor; in Japan and some Western countries, exposure to hepatitis C is connected with a higher risk of developing liver cancer. In the United States, nearly 25% of patients with liver cancer show evidence of HBV infection. Hepatitis is commonly found among intravenous drug abusers. The increase in HCC incidence in the United States is thought to be due to increasing rates of HBV and HCV infections due to increased sexual promiscuity and illicit drug needle sharing. The association between HDV and HGV and HCC is unclear at this time.
Symptoms of liver cancer
The early symptoms of primary, as well as metastatic, liver cancer are often vague and not unique to liver disorders. The long period between the beginning of the tumor's growth and the first signs of illness is the major reason why the disease has a high mortality rate. At the time of diagnosis, patients are often fatigued, with fever , abdominal pain, and loss of appetite (anorexia ). They may look emaciated and generally ill. As the tumor enlarges, it stretches the membrane surrounding the liver (the capsule), causing pain in the upper abdomen on the right side. The pain may extend into the back and shoulder. Some patients develop a collection of fluid, known as ascites , in the abdominal cavity. Others may show signs of bleeding into the digestive tract. In addition, the tumor may block the ducts of the liver or the gall bladder, leading to jaundice. In patients with jaundice, the whites of the eyes and the skin may turn yellow, and the urine becomes dark-colored.
Diagnosis
Physical examination
If the doctor suspects a diagnosis of liver cancer, he or she will check the patient's history for risk factors and pay close attention to the condition of the patient's abdomen during the physical examination. Masses or lumps in the liver and ascites can often be felt while the patient is lying flat on the examination table. The liver is usually swollen and hard in patients with liver cancer; it may be sore when the doctor presses on it. In some cases, the patient's spleen is also enlarged. The doctor may be able to hear an abnormal sound (bruit) or rubbing noise (friction rub) if he or she uses a stethoscope to listen to the blood vessels that lie near the liver. The noises are caused by the pressure of the tumor on the blood vessels.
Laboratory tests
Blood tests may be used to test liver function or to evaluate risk factors in the patient's history. Between 50% and 75% of primary liver cancer patients have abnormally high blood serum levels of a particular protein (alpha-fetoprotein or AFP). The AFP test, however, cannot be used by itself to confirm a diagnosis of liver cancer, because cirrhosis or chronic hepatitis can also produce high alpha-fetoprotein levels. Tests for alkaline phosphatase, bilirubin, lactic dehydrogenase, and other chemicals indicate that the liver is not functioning normally. About 75% of patients with liver cancer show evidence of hepatitis infection. Again, however, abnormal liver function test results are not specific for liver cancer.
Imaging studies
Imaging studies are useful in locating specific areas of abnormal tissue in the liver. Liver tumors as small as an inch across can now be detected by ultrasound or computed tomography scan (CT scan). Imaging studies, however, cannot tell the difference between a hepatoma and other abnormal masses or lumps of tissue (nodules) in the liver. A sample of liver tissue for biopsy is needed to make the definitive diagnosis of a primary liver cancer. CT or ultrasound can be used to guide the doctor in selecting the best location for obtaining the biopsy sample.
Chest x rays may be used to see whether the liver tumor is primary or has metastasized from a primary tumor in the lungs.
Liver biopsy
Liver biopsy is considered to provide the definite diagnosis of liver cancer. A sample of the liver or tissue fluid is removed with a fine needle and is checked under a microscope for the presence of cancer cells. In about 70% of cases, the biopsy is positive for cancer. In most cases, there is little risk to the patient from the biopsy procedure. In about 0.4% of cases, however, the patient develops a fatal hemorrhage from the biopsy because some tumors are supplied with a large number of blood vessels and bleed very easily.
Laparoscopy
The doctor may also perform a laparoscopy to help in the diagnosis of liver cancer. First, the doctor makes a small cut in the patient's abdomen and inserts a small, lighted tube called a laparoscope to view the area. A small piece of liver tissue is removed and examined under a microscope for the presence of cancer cells.
Clinical staging
Currently, the pathogenesis of HCC is not well understood. It is not clear how the different risk factors for HCC affect each other. In addition, the environmental factors vary from region to region.
Treatment
Treatment of liver cancer is based on several factors, including the type of cancer (primary or metastatic); stage (early or advanced); the location of other primary cancers or metastases in the patient's body; the patient's age; and other coexisting diseases, including cirrhosis. For many patients, treatment of liver cancer is primarily intended to relieve the pain caused by the cancer but cannot cure it.
Surgery
Few liver cancers in adults can be cured by surgery because they are usually too advanced by the time they are discovered. If the cancer is contained within one lobe of the liver, and if the patient does not have either cirrhosis, jaundice, or ascites, surgery is the best treatment option. Patients who can have their entire tumor removed have the best chance for survival. Unfortunately, only about 5% of patients with metastatic cancer (from primary tumors in the colon or rectum) fall into this group. If the entire visible tumor can be removed, about 25% of patients will be cured. The operation that is performed is called a partial hepatectomy, or partial removal of the liver. The surgeon will remove either an entire lobe of the liver (a lobectomy ) or cut out the area around the tumor (a wedge resection).
Chemotherapy
Some patients with metastatic cancer of the liver can have their lives prolonged for a few months by chemotherapy , although cure is not possible. If the tumor cannot be removed by surgery, a tube (catheter) can be placed in the main artery of the liver and an implantable infusion pump can be installed. The pump allows much higher concentrations of the cancer drug to be carried to the tumor than is possible with chemotherapy carried through the bloodstream. The drug that is used for infusion pump therapy is usually floxuridine (FUDR), given for 14-day periods alternating with 14-day rests. Systemic chemotherapy can also be used to treat liver cancer. The medications usually used are 5-fluorouracil (Adrucil, Efudex) or methotrexate (MTX, Mexate). Systemic chemotherapy does not, however, significantly lengthen the patient's survival time.
Radiation therapy
Radiation therapy is the use of high-energy rays or x rays to kill cancer cells or to shrink tumors. Its use inliver cancer, however, is only to give short-term relief from some of the symptoms. Liver cancers are not sensitive to radiation, and radiation therapy will not prolong the patient's life.
Liver transplantation
Removal of the entire liver (total hepatectomy) and liver transplantation can be used to treat liver cancer. However, there is a high risk of tumor recurrence and metastases after transplantation.
Other Therapies
Other therapeutic approaches include:
* Hepatic artery embolization with chemotherapy (chemoembolization).
* Alcohol ablation via ultrasound-guided percutaneous injection.
* Ultrasound-guided cryoablation.
* Immunotherapy with monoclonal antibodies tagged with cytotoxic agents.
* Gene therapy with retroviral vectors containing genes expressing cytotoxic agents.
Prognosis
Liver cancer has a very poor prognosis because it is often not diagnosed until it has metastasized. Fewer than 10% of patients survive three years after the initial diagnosis; the overall five-year survival rate for patients with hepatomas is around 4%. Most patients with primary liver cancer die within several months of diagnosis. Patients with liver cancers that metastasized from cancers in the colon live slightly longer than those whose cancers spread from cancers in the stomach or pancreas.
Alternative and complementary therapies
Many patients find that alternative and complementary therapies help to reduce the stress associated with illness, improve immune function, and boost spirits. While there is no clinical evidence that these therapies specifically combat disease, activities such as biofeedback, relaxation, therapeutic touch, massage therapy and guided imagery have no side effects and have been reported to enhance well-being.
Several other healing therapies are sometimes used as supplemental or replacement cancer treatments, such as antineoplastons, cancell, cartilage (bovine and shark), laetrile, and mistletoe. Many of these therapies have not been the subject of safety and efficacy trials by the National Cancer Institute (NCI). The NCI has conducted trials on cancell, laetrile, and some other alternative therapies and found no anticancer activity. These treatments have varying effectiveness and safety considerations. (Laetrile, for example, has caused deaths and is not available in the U.S.) Patients using any alternative remedy should first consult their doctor in order to prevent harmful side effects or interactions with traditional cancer treatment.
Coping with cancer treatment
Side effects of treatment, nutrition, emotional well-being, and other issues are all parts of coping with cancer. There are many possible side effects for a cancer treatment that include:
* constipation
* delirium
* fatigue
* fever, chills, sweats
* nausea and vomiting
* mouth sores, dry mouth, bleeding gums
* pruritus (itching)
* affected sexuality
* sleep disorders
Anxiety, depression , feelings of loss, post-traumatic stress disorder, affected sexuality, and substance abuse are all possible emotional side-effects. Patients should seek out a support network to help them through treatment. Loss of appetite before, during, and after a treatment can also be of concern. Other complications of coping with cancer treatment include fever and pain.
Clinical trials
There are many clinical trials in place studying new types of radiation therapy and chemotherapy, new drugs and drug combinations, biological therapies, ways of combining various types of treatment for liver cancer, side effect reduction, and quality of life. Information on clinical trials can be acquired from the National Cancer Institute at <http://www.nci.nih.gov> or (800) 4-CANCER.
Prevention
There are no useful strategies at present for preventing metastatic cancers of the liver. Primary liver cancers, however, are 75% to 80% preventable. Current strategies focus on widespread vaccination for hepatitis B, early treatment of hereditary hemochromatosis (a metabolic disorder), and screening of high-risk patients with alpha-fetoprotein testing and ultrasound examinations.
Lifestyle factors that can be modified in order to prevent liver cancer include avoidance of exposure to toxic chemicals and foods harboring molds that produce aflatoxin. Most important, however, is avoidance of alcohol and drug abuse. Alcohol abuse is responsible for 60% to 75% of cases of cirrhosis, which is a major risk factor for eventual development of primary liver cancer. Hepatitis is a widespread disease among persons who abuse intravenous drugs.
See Also CT-guided biopsy; Hepatic arterial infusion; Immunologic therapy; Alcohol consumption
Resources
BOOKS
Berkow, Robert, et al., eds. "Hepatic and Biliary Disorders:Neoplasms of the Liver." In The Merck Manual of Diag nosis and Therapy. Rahway, NJ: Merck Research Laboratories, 1997.
Dollinger, Malin. Everyone's Guide to Cancer Therapy. Kansas City: Somerville House Books Limited, 1994.
Friedman, Lawrence S. "Liver, Biliary Tract, & Pancreas." InCurrent Medical Diagnosis & Treatment 1998. Stamford, CT: Appleton & Lange, 1997.
Isselbacher, K.J., and J.L. Dienstag. "Tumors of the Liver and Biliary Tract." In Harrison's Principles of Internal Medi cine. Fauci, Anthony S., et al., eds. New York:McGraw-Hill, 1998.
Loeb, Stanley, et al., eds. "Liver Cancer." In Professional Guide to Diseases. Springhouse, PA: Springhouse Corporation, 1991.
Rudolph, Rebecca E., and Kris V. Kowdley. "Cirrhosis of the Liver." In Current Diagnosis 9. Conn, Rex B., et al., eds. Philadelphia: W. B. Saunders Company, 1997.
Way, Lawrence W. "Liver." In Current Surgical Diagnosis & Treatment. Stamford, CT: Appleton & Lange, 1994.
PERIODICALS
El-Serag, H.B. "Epidemiology of Hepatocellular Carcinoma"Clinics in Liver Disease (February 2001): 87-107.
Macdonald, G.A. "Pathogenesis of Hepatocellular Carcinoma"Clinical Liver Disease (February 2001): 69-85.
Yu, M.C., et al. "Epidemiology of Hepatocellular Carcinoma"Canadian Journal of Gastroenterology (September 2000):703-9.
Tuesday, December 28, 2010
Glowing skin begins at home
If you don't find over-the-counter moisturisers effective, take the 'kitchen way' to good skin. Dig into your food shelf, or make a run to the grocer's - the secrets to a glowing complexion can be homemade and inexpensive...
Add 4-5 drops of jojoba oil with an equal amount of coconut oil and rose water. Apply after washing your face, or bathing. This moisturiser not only provides intense hydration, it also leaves a pleasant, lingering
fragrance.
Mix equal amounts of glycerine and rose water. To this, add a few drops of lime juice to dilute it. If used regularly overnight, this moisturiser not only tackles patchy, chapped and dry skin, it gives you a glowing complexion, and removes dark spots and freckles.
Mix 1tsp each of almond and milk powder with 2tbsp glycerine and 1tbsp each of lemon juice and almond oil. Apply this mix once a week - this will provide you enough hydration to be able to go through the rest of the week with lighter formulations.Lemon or orange juice, blended with olive oil, is a tried-tested-trusted way of moisturising - your skin benefits from the healing properties of olive and the Vitamin C from the citrus fruits.
Overnight, massage mayonnaise on your face and neck - it undoes the harm caused to your skin by sun,cold and pollution through the day.
Aloe vera creams not only work as a good moisturiser, they also have anti-aging properties. Heat one part of aloe vera gel with an equal amount of water. Let it boil until it turns creamy. This rich moisturiser is good for dry, rough, sunburned skin, chapped lips and elbows.
Coconut oil is rich in vitamins and lipids that soften the skin. Cocoa butter smoothens the damaging effects of the sun and other external factors. Combined with coconut oil, it protects the skin from dry cold.
Add 4-5 drops of jojoba oil with an equal amount of coconut oil and rose water. Apply after washing your face, or bathing. This moisturiser not only provides intense hydration, it also leaves a pleasant, lingering
fragrance.
Mix equal amounts of glycerine and rose water. To this, add a few drops of lime juice to dilute it. If used regularly overnight, this moisturiser not only tackles patchy, chapped and dry skin, it gives you a glowing complexion, and removes dark spots and freckles.
Mix 1tsp each of almond and milk powder with 2tbsp glycerine and 1tbsp each of lemon juice and almond oil. Apply this mix once a week - this will provide you enough hydration to be able to go through the rest of the week with lighter formulations.Lemon or orange juice, blended with olive oil, is a tried-tested-trusted way of moisturising - your skin benefits from the healing properties of olive and the Vitamin C from the citrus fruits.
Overnight, massage mayonnaise on your face and neck - it undoes the harm caused to your skin by sun,cold and pollution through the day.
Aloe vera creams not only work as a good moisturiser, they also have anti-aging properties. Heat one part of aloe vera gel with an equal amount of water. Let it boil until it turns creamy. This rich moisturiser is good for dry, rough, sunburned skin, chapped lips and elbows.
Coconut oil is rich in vitamins and lipids that soften the skin. Cocoa butter smoothens the damaging effects of the sun and other external factors. Combined with coconut oil, it protects the skin from dry cold.
Monday, December 20, 2010
Get Cheap Flights to Mumbai
Get Cheap Flights to Mumbai
the rapidly increasing number of cheap flights to India has brought down the fares for tickets to India by a considerable extent. Earlier, when there were only a handful of airlines making way to Indian airports from international destinations, those willing to explore this much talked about country had no choice but to wait till enough money has been accumulated to book flights to India. However, now with the gala entry of umpteenth number of carriers to India, the eagerly waiting travellers are wasting no time to make the most of the cheapest flights to India.At the same time you can also avail Mumbai cheap flights or discounted airfares from overseas. Atlanta to Mumbai, New York to Mumbai, Boston to Mumbai, Denver to Mumbai, Detroit to Mumbai, Houston to Mumbai, Philadelphia to Mumbai, Orlando to Mumbai, Chicago to Mumbai, San Francisco to Mumbai are among the many flights from several locations in Europe. Virgin Atlantic Airlines, Delta Airlines, United Airlines, British Airways, Etihad Airways, Emirates, Kuwait Airways, KLM and many other European airlines offer discounted airfares for flights to Mumbai throughout the year.
If you are keen for some shopping and marketing than places like Crawford Market, Fashion Street, linking Road etc can offer you nearly all the brands and the same time provide you with the experience of road shopping too.
When to go
It is best to avoid the rainy months of June to September. The town, during monsoons seems to be a brimming pothole. The finest time to vacation Mumbai is between October and April. So you could manage a comfortable trip to the beautiful land by taking any of the numerous flights to Mumbai that moves all year long. So catch hold of the cheapest flight to Mumbai and go there to rejoice the colors, essence and quality of a destination so exceptional and lively.
Saturday, November 20, 2010
Warning: Stress Can be Hazardous to your Skin
| Warning: Stress Can be Hazardous to your Skin |
| by Vasu Nargundkar |
 Unfortunately, stress has become an ubiquitous presence in our lives. At work, in our relationships, driving through rush-hour traffic - most of us take it for granted that there is nothing unusual about stressful situations occurring on a regular basis, day after day.Like termites undermining a structure, stress works insidiously to undermine body, mind and emotions. But the results can become all too obvious, by showing up on your skin. While dermatologists are still debating whether stress actually causes skin disorders, they seem to agree that stress definitely triggers or aggravates skin conditions such as Acne, Hives, Eczema, Psoriasis, Rosacea, Warts, cold sores and Blisters. "And that matches the Ayurvedic perspective," says Vaidya Rama Kant Mishra, world-renowned Ayurvedic dermatologist. "Ongoing day-to-day stress adversely impacts your immune system. This makes your body susceptible to attack, like fertile ground in which seeds take root easily. The skin is an organ, widely connected to the rest of the physiology as well as the mind. It is natural that like the rest of you, your skin is also affected by stress." And even if stress does not actually show up on your skin as one of these conditions, it is one of the chief contributors to an increased population of free radicals in the body, which, in turn, has been discovered to be a major cause of premature aging. Emotional or mental trauma can cause you to screw up your face or frown or pout, and constant muscular contractions can eventually become permanent fine lines and wrinkles. The "fight-or-flight" mechanism is the body's built-in way of responding to stress. In times of "fight-or-flight," the flow of blood (and nutrients) is directed to the areas of the body considered vital for responding to the stress and withdrawn from areas considered non-essential, such as the skin. So is the flow of oxygen, making it difficult for the skin to "breathe." When "fight-or-flight" situations become frequent, the skin is consistently starved of both blood and oxygen, making it dull and lifeless, less supple, less hydrated and more prone to clogged pores and breakouts. "Stress does not only impact the immune system, it also undermines digestion," says Vaidya Mishra. "And imperfect digestion adversely affects skin health, and, indeed your overall health, in two ways - first, your body does not absorb all the nutrients from the foods you eat and second, undigested impurities tend to accumulate in the body faster than the body can get rid of them." Authentic, All-Natural, Ayurvedic Solutions The holistic system of Ayurveda advocates a well-balanced approach to stress management and skin health. "Ayurveda has a definition of beauty that goes much deeper than the skin, to a healthy body, a serene mind and a positive attitude," says Vaidya Mishra. "Your skin is like a mirror - it reflects everything that is going on within your body and mind. Pay attention to keeping your mind, body and emotions balanced, and the results will show up as a clear, glowing complexion." Here are some guidelines from Vaidya Mishra: 1. Diet Diet is important, says Vaidya Mishra, and not just in Ayurveda but in every system of well-being. For example, researchers say that skipping meals and too much caffeine can stimulate the production of adrenaline, which can cause the skin pores to clog up. "Eat foods that are alive with the intelligence of Nature," recommends Vaidya Mishra. A balanced diet and proper eating habits help keep the body and mind performing at optimal levels, enhancing resistance to stress and providing deep nourishment to the skin to combat the effects of day-to-day stress. Make sure you include plenty of cooked leafy greens, several servings of fruits and vegetables, high-protein grains and lentils, some dairy and healthy fats like Ghee or olive oil in your daily diet. Fruits and vegetables rich in antioxidants can help scavenge free radicals generated by stress. Cook with spices that are appropriate for the season and for your skin and your physiology. Spices can help cleanse the channels of the body and help the body assimilate nutrients from foods; some spices, such as turmeric, have anti-inflammatory and anti-allergic properties that could be useful to keep skin clear and healthy. 2. Sleep An adequate amount of quality sleep can help recharge and rejuvenate the body, making it more resilient. Lack of sleep can lead to tired lifeless skin and circles under the eyes. Calming aromatherapy or a relaxing massage or bath before bed will help release the pent-up stress of the day and get you ready for a good night's sleep. 3. Exercise Exercise is considered a great stress-buster by many of today's health and fitness experts. Ayurveda concurs, provided you don't overdo it. Breathing exercises, called Pranayama in ayurveda, are excellent for reducing stress. Yoga postures and walking are also recommended forms of exercise that work at relaxing the mind as well as toning the body. 4. Daily Massage The daily warm oil self-massage is recommended as a luxurious way to balance the body, mind and emotions as well as lubricate the skin, making it supple and lustrous. Use a fragrant aroma massage oil for the dual benefits of massage and aromatherapy, or use a specially blended herbalized massage oil for personal balance. 5. De-Stress Relaxation techniques can help you withstand stress better and also help relax facial muscles and skin. The Transcendental Meditation technique, practiced for 20 minutes twice daily, has been proven to significantly reduce the effects of stress. Listen to soft soothing music, take a stroll in the moonlight, enjoy the company of friends, diffuse an uplifting aroma. Actively practicing relaxation for short periods several times a day can raise your resistance levels over time. It's unlikely that stress will cease to be a part of our lives any time soon. Prudence dictates taking measures to safeguard yourself from its damaging effects. Disclaimer: Information provided in this article is for the sole purpose of imparting education on Ayurveda and is not intended to diagnose, treat, cure or prevent any disease. If you have a medical condition, please consult your physician. |
Neem: A Natural Boon for Diabetics
| Neem: A Natural Boon for Diabetics |
| by Dr. Savitha Suri |
 Neem is household name in India when home remedies are concerned. Ayurveda acharyas have quoted lengthy verses in praise of neem. In my clinical practice I have obtained positive feed backs from diabetic patients after using preparations and home remedies of neem. Here are few home remedies of neem which may help diabetic patients.For Uncontrolled Blood Sugar Please note that following a strict diet is very important to keep this condition under control. Uncontrolled blood sugar leads to erectile dysfunction, low sperm count, low libido, and heart and kidney problems. Collect 2-3 tea spoons of fresh neem flowers and tender neem leaves. Soak them overnight and crush it in blender with little water. Squeez the juice and mix ½ cup of water. Drink this in empty stomach in morning. Neem flowers and neem leaves can be collected during blossoming season and dried powder of this mixture can be used when the season ends. Take care to dry this mixture in hot sun and store in cool dry place. Skin Infection Diabetics usually experience frequent skin infections due to bacteria, fungus and yeast. Applying a pack of crushed neem leaves once in a week help to prevent these infections. Collect fresh neem leaves and blend it to a fine paste. Apply this paste as body pack and wash it off after 20 minutes. Dried neem powder can be used if fresh neem leaves are not available. Mix plain water to dried neem powder and allow it to soften for 15 minutes before applying. This body pack may cause dry skin. Apply moisturizer after bath to overcome dryness of skin. Add few drops of neem oil to bathing water. This helps to keep the microbes away. In Diabetic Foot When you have fungal infection between toes wash your feet with luke warm water and dry completely with a soft towel (pat dry). Take care to dry thoroughly between toes. Apply neem oil at night between toes and wash it off with luke warm water and mild soap in morning. Repeat the same in morning. |
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