Health Tips: Cancer

About Cancer:

1) Cancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body.Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die, and new cells take their place.Sometimes this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor.

2) Cancer begins when a cell begins dividing uncontrollably. Eventually these cells form a visible mass or tumor. This initial tumor is called the “primary” tumor. Cells from the primary tumor can break off and lodge elsewhere in the body where they then grow into secondary tumors. This process is called “metastasis” and a cancer which has spread to other organs is called “metastatic.” When cancer spreads to another organ, the type of cancer remains the type of the primary tumor. Thus cancer that started in the colon and spread to the liver is still colon cancer. It is not “liver cancer”. Similarly breast cancer that has spread to the bone is not “bone cancer”, it is metastatic breast cancer.

Types of Cancer

1) Bladder Cancer

2) Breast Cancer

3) Leukemia

4) Lung Cancer

5) Ovarian Cancer

6) Prostate Cancer

7) Bone

8) Brain

9) Skin

10) Eye

Primary and Secondary Brain Tumors: A tumor that begins in the brain is called a primary brain tumor. In children, most brain tumors are primary tumors. In adults, most tumors in the brain have spread there from the lung, breast, or other parts of the body.

When this happens, the disease is not brain cancer. The tumor in the brain is a secondary tumor. It is named for the organ or the tissue in which it began.Treatment for secondary brain tumors depends on where the cancer started and the extent of the disease.

WHAT IS LUNG CANCER?

Lung cancer is the leading cancer killer in both men and women. There were an estimated 164,100 new cases of lung cancer and an estimated 156,900 deaths from lung cancer in the United States in 2000.

 The rate of lung cancer cases appears to be dropping among white and African-American men in the United States, while it continues to rise among both white and African-American women.

There are two major types of lung cancer: non-small cell lung cancer and small cell lung cancer. Non-small cell lung cancer is much more common. It usually spreads to different parts of the body more slowly than small cell lung cancer. Squamous cell carcinoma, ademocarcinoma, and large cell carcinoma are three types of non-small cell lung cancer. Small cell lung cancer also called oat cell cancer, accounts for about 20% of all lung cancer.

WHAT CAUSES LUNG CANCER?

 Smoking is the number one cause of lung cancer. Lung cancer may also be the most tragic cancer because in most cases, it might have been prevented — 87% of lung cancer cases are caused by smoking. Cigarette smoke contains more than 4,000 different chemicals, many of which are proven cancer-causing substances, or carcinogens. Smoking cigars or pipes also increases the risk of lung cancer.

 The more you smoke and the longer you smoke, the greater your risk of lung cancer. But if you stop smoking, the risk of lung cancer decreases each year as abnormal cells are replaced by normal cells. After ten years, the risk drops to a level that is one-third to one-half of the risk for people who continue to smoke. In addition, quitting smoking greatly reduces the risk of developing other smoking-related diseases, such as heart disease, stroke, emphysema and chronic bronchitis.

About Bone Cancer:

Cancers of the bone can be primary or secondary cancers. Your doctor will tell you whether your cancer started in the bones (primary bone cancer) or started elsewhere in the body and spread to the bones (secondary bone cancer). The two diseases are quite different and this booklet is only about primary bone cancer. CancerBACUP has a separate booklet on secondary bone cancer.

Many types of primary bone cancer affect children and young adults and this booklet has been written for parents of children with bone cancer as well as teenagers and adults with the disease. CancerBACUP and the UKCCSG (United Kingdom Children’s Cancer Study Group) have produced a revised version of the UKCCSG booklet, A parent’s guide to children’s cancers.

We can’t advise you about the best treatment for yourself or your child because this information can only come from your own doctor, who will be familiar with your full medical history.

What Causes Skin Cancer?

Sunburn and Sunlight

Very simply, sunburn and UV light can damage your skin, and this damage can lead to skin cancer. There are of course other determining factors, including your heredity and the environment you live in. However, both the total amount of sun received over the years, and overexposure resulting in sunburn can cause skin cancer. Most people receive 80% of their lifetime exposure to the sun by 18 years of age. The message to parents from this is to protect your children.

Tanning is your skin’s response to UV light. It is a protective reaction to prevent further injury to your skin from the sun. However, it does not prevent skin cancer.

Remember, skin cancer is very slow to develop. The sunburn you receive this week may take 20 years or more to become skin cancer.

What is Skin Cancer?

Skin cancer is a disease in which cancer (malignant) cells are found in the outer layers of your skin. Your skin protects your body against heat, light, infection, and injury. It also stores water, fat, and vitamin D.

The skin has two main layers and several kinds of cells. The top layer of skin is called the epidermis. It contains three kinds of cells: flat, scaly cells on the surface called squamous cells; round cells called basal cells; and cells called melanocytes, which give your skin its color.

 About Breast Cancer:

If you are diagnosed with breast cancer, the most important thing for you to remember is that it is not a hopeless condition. Early detection and modern therapy with a combination of surgery, radiation, drugs, or hormones can help many patients.

According to the National Cancer Institute, when breast cancer is found early and is still localized, the relative survival rate (when measured at 5 years) is 91 percent.

Although the incidence of breast cancer is increasing — one out of eight women will develop breast cancer — mortality rates have remained fairly stable over the past several years due to early detection and improved treatment.

Benign Breast Conditions

What are benign breast conditions?

The breast is made up of two main types of tissue:

1) glandular tissue – the lobules and ducts of the breast

2) stromal tissue – the fatty tissue and supporting ligaments

These tissues in any area of the breast can undergo changes that cause diseases or disorders, such as breast cancers or benign (non-cancerous) breast conditions.

The most common of the benign breast conditions are:

1) fibrocystic changes

2) benign breast tumors

3) breast inflammation

Benign breast conditions are very common. According to the American Cancer Society, these conditions can be found in nine out of ten women.

What are symptoms of benign breast conditions?

Benign breast conditions are usually not life-threatening, but may cause symptoms, such as:

1) pain

2) lump or swelling

3) tenderness

4) skin irritation or dimpling

5) nipple pain or retraction (turning inward)

6) redness or scaliness of the nipple or breast skin

a discharge other than breast milk

Although rarely, some benign conditions are associated with a later risk of developing breast cancer.

 Breast evaluation procedures:

It is important to determine whether the problems are due to benign breast conditions or breast cancer.

What you can do:

Follow the routine three-step plan for breast health.

See your doctor as soon as you notice any change in your breasts.

What your physician may do:

Perform a complete physical examination to:

locate any lump and feel its texture, size, and relationship to the skin and chest muscles

look for changes in the nipples or the skin of the breast

check lymph nodes under the armpit and above the collarbones

Request imaging tests, including:

diagnostic mammography to look for masses and calcifications

breast ultrasound to further evaluate information from the physical examination or mammography

Request a laboratory microscopic examination of discharge from nipples.

Request a ductogram x-ray of the nipples.

Request a biopsy of tissue removed from the suspicious area.

 What are the types of biopsy?

image-guided biopsies – those aided by ultrasound or other imaging techniques, including:

fine needle aspiration – a very fine needle is guided into the suspicious area and a small sample of the tissue is removed.

core needle biopsy – a larger needle is guided into the lump to remove a small cylinder of tissue.

surgical biopsy – a surgical procedure is used to remove all or part of a lump.

How are benign breast conditions treated?

Specific treatment for benign breast disease will be determined by your physician(s) based on:

1) your overall health and medical history

2) extent of the disease

3) your tolerance for specific medications, procedures, or therapies

expectations for the course of the disease

4) your opinion or preference

Treatment is usually based on treating the symptoms, and may include medications, diet changes, or minor surgical procedures.

Health Tips: Asthma

Get flu shots for everyone in family:

Asthmatics are at a greater risk of suffering asthma attacks when they are around others with colds or the flu, or when they contract a cold or the flu. Other than school, the home is one of the most common places to catch a cold. Remember, 90% of colds are caught while inside, so it is also important to have an air cleaner inside.

 

Allow fresh air:

Allow fresh air to enter your home. Super-insulated homes have 200% higher allergen level than ordinary homes. This is due to the natural air-cleansing agents found in fresh air that are lacking in indoor air. However, it is not always possible to have your windows and doors open. Plus, if you live in a polluted area, this will do you no good. In which case, use an air purifier that recreates these natural air-cleansing agents.

 

Create a school asthma care management team :

Create a school asthma care management team for your child, if your child has asthma. Asthma is the leading cause of school absenteeism. Plus, school is one of the harshest environments for children with asthma. Include teachers, counselors, etc. on this team. Meet with them and explain your child’s condition. Describe your child’s medications along with its side effects.

 

Provide them with phone numbers where you and other guardians can be reached:

You and other asthma care mgmt. team members should collaborate to help your child avoid environments with inadequate ventilation, animals, chemicals. Rigorous exercise may also want to be avoided.

 

  • Use perfumes, candles, nail care products, and sprain medications moderately, if at all.
  • Keep your basement dry and clean. Basements are prime breeding grounds for molds and fungi.
  • Wash rugs and furniture often.
  • Discard moldy and mildewed items.
  • Do not use wood burning stoves or fireplaces.
  • Replace or remove moldy and dusty wallpaper, buy solid wood furniture instead of plastic furniture, and wipe walls and hard floors with a damp cloth regularly.
  • Install air conditioning in your home if you haven’t already, and keep windows closed during high pollen season. But do have windows that open since outdoor air can refresh the air in your home.
  • One way to decrease your child’s odds of contracting asthma is to breastfeed he or she for at least the first 4 months. According to the American Lung Association, this will substantially reduce their risk of getting asthma.
  • When outside in the cold air, keep a scarf wrapped around your mouth and nose. This will warm up the air you breath.
  • Eat foods high in magnesium.
  • Eat onions. They reduce inflammation.
  • Drink lots of water.

Avoid using aerosols, floor polish/wax, insecticides, pesticides, and other chemical solutions. Use biologically-based housecleaners and pesticides.

 

Up to 80% of children with asthma are allergic to one or more of the following: pollen, dust mites, mold, pet dander. Always be mindful of ways to minimize these allergens in your home and other environments. Effective ways to reduce these allergens include air cleaners, regular dusting/vacuuming/etc., and removing the source when possible.

 

Avoid odors and chemicals from photography, ceramic glazes, and oil painting.

If possible, replace carpet with vinyl, hardwood, or tile flooring.

 

Avoid mattresses and furniture made from foam rubber or polyurethane. Use 100% cotton mattresses.

Avoid air cleaners that rely on a filter to clean the air, such as a HEPA unit.

 

They cannot remove smaller pollutants such as allergens and cigarette smoke, and the filters need to be replaced often, and are expensive to do so. Instead, use an air purifier that uses nature’s most powerful air cleansing agents to clean the air (negative ions and ozone).

 

Some ion and ozone generators produce oxides of nitrogen as a byproduct of using glass plates, which can act as an irritant and leaves a pungent metallic odor. Make sure the air purifier you buy does not create oxides of nitrogen.

 

There are many air purifiers that produce only ozone, or only negative ions. Find an air purifier that produces both for maximum effectiveness in cleaning the air in your home.

And for the final tip, no pets. Pets will substantially add to the floating particulate level in your home. They contribute dander, hair, and contaminates emanating from their feces

Health Tips: AIDS

AIDS–Acquired Immunodeficiency Syndrome–is caused by HIV, the Human Immunodeficiency Virus. HIV impairs your immune system, making it less resistant to diseases and infections.

HIV is transmitted through exposure to the bodily fluids of someone infected with HIV. This exposure most commonly occurs during unprotected sex, by sharing needles, through blood transfusions, or by contact with open wounds. Babies born to women with HIV can also become infected.

It’s not a “gay thing.” HIV infections among all teenagers and young adults are increasing. Also, nearly one-fourth of AIDS cases among adolescents and adults under age 25 stem from injection drug use.

Alcohol and drugs affect your self-control. Alcohol and illicit drugs lower your inhibitions and impair your judgment. Drinking and drug use can lead to risky behaviors you’re less likely to do if sober, including having unprotected sex. This increases your risk for exposure to HIV/AIDS and other sexually transmitted diseases (STDs).

Any drug use increases the risks for HIV/AIDS. Non-injection drugs also contribute to the spread of HIV/AIDS when users trade sex for drugs or money or when their judgment and decision-making skills are impaired.

KNOW THE SIGNS:

How can you tell if you or someone else may already have HIV? If you have not shared a needle or had unprotected sex, it is very unlikely that you have HIV. The only way to be certain is to be tested. Most people with HIV do not have any visible symptoms for many years. Once symptoms do begin to show, some of the more common ones include:

  • Rapid weight loss
  • Profuse night sweats
  • Ongoing, unexplained fatigue
  • Swollen lymph glands
  • Diarrhea that lasts longer than a week
  • White spots or blemishes in the mouth or throat
  • Pneumonia

Do not assume you are infected if you have any of these symptoms. Each of these symptoms can easily be related to other illnesses. Again, the only way to determine for sure whether you are infected with HIV is to be tested.

What can you do to help someone whose substance abuse problem is putting them at risk for HIV/AIDS? Be a real friend. You might even save a life. Encourage your friend to stop using substances or seek professional help.
TIPS FOR USING YOUR MEDICINES SAFELY AND SMARTLY:

Ask your doctor and your pharmacist for the exact times you should take a medicine and what effects-good and bad-to expect from it.

Tell each doctor you see, and your pharmacist, about other medicines you’re taking, both prescription and over-the-counter. Some cause side effects when they bump into each other.

Write down the name of each drug and a daily schedule of doses. Put a check mark on the list each time you take the medicine.

Stick to the dose on the label. More is not better-it may be harmful.

Tell your doctor or pharmacist if a medicine gives you new symptoms or makes you feel worse.

When you take antibiotics: Take the full course, even if you start feeling better before all the pills are gone. When people stop too early, infections often come back.

Never start or stop taking medicine without telling your doctor.

Never take medicine prescribed for someone else. Never share your medicines with anyone else.

Throw away leftover medicine if the label date shows it has expired.

AIDS is a condition that, in one way or another, has impact on us all. Continuing community education is of vital importance.

 

The Malice of Malnutrition

These days, it seems like most people are aware of the effects of malnutrition. Charities like World Vision and Medecins Sans Frontieres have done a great job in publicising the shocking visual impact of a malnourished child, and as a result many people consider feeding these children a key goal for the charity and medical fields.

Here in Bangladesh, conservative estimates put child malnourishment at around 65% – one of the highest counts in the world. Of that number, 60% are so severely malnourished that they are now stunted and will not recover a normal pattern of growth, even if they were now to undergo an aggressive feeding strategy.

Unfortunately, it’s not as simple a question as just making sure that families have enough food. That in itself is too simple an idea. As much as we would all love to ensure that all the villages have self-sustaining food sources, such as rice and potato crops, inclement weather and water contamination often prevent this.

These factors contribute to the malnutrition of entire families. According to data compiled by the US Library of Congress, 45% of rural families and 76% of urban families survive below the acceptable level of caloric intake. This means that malnourished women give birth to malnourished children – tragically setting their babies up for traumatic health experiences for life.

A stunning 40% of Bangladesh’s population is children. With such a high proportion experiencing malnutrition, education attainment is much lower than it is in other developing countries. This will continue to have significant economic impact – without education, employment opportunities are limited, in turn keeping people in the poverty that made them malnourished. It is indeed a vicious cycle, and without serious intervention will be difficult to break.

While we are doing everything we can to educate people on the importance of hygiene and to facilitate food access to the communities we work in, it’s an uphill battle. The total government expenditure on healthcare in Bangladesh is just 3% of the country’s GDP, and for every 10,000 people in the population, there are just 4 hospital beds. It’s simply not a priority in the power structures of this country.

We will continue to update you as regularly as we can on the work we are doing. Thank you for your ongoing support and messages of encouragement – they keep us going!

Microfinance and Medicine

It’s only been a few years since the term ‘micro finance’ was introduced into the world’s vernacular. It’s a curious idea – lending a tiny amount of money to someone on the other side of the world, interest-free, so they can get themselves on their feet.

Astounding, really. That an amount like $25USD can be enough for a family to pull themselves out of poverty, or finance a life-changing course of medication or treatment.

The World Bank recently released a report called ‘Voices of the Poor’, “gathered views from more than 60 000 poor people and reported that ill-health and inability to access medical care emerged as key factors inducing and resulting from poverty. In a subsequent publication, Dying for change, thousands of interviewees most frequently identified illness – even ahead of losing a job – from among 15 causes of a downward slide into poverty.”

We can certainly attest to this being the case. People living in rural areas, who are scraping by on a tiny income from extremely demanding physical work, often fall victim to ill-health – and their security instantly evaporates around them.

If you are sick or injured and can’t work, you are essentially ruined. For the hundreds of thousands of families who live hand to mouth in Bangladesh, sick leave is just not an option. It doesn’t exist, and there’s always someone ready and willing to take your place if you can’t keep up.

That’s why micro finance is such a godsend to these developing countries. It gives people a lifeline, a glimmer of hope. More than anything tangible, it buys them time. They can recover, regain their strength and return to the workforce, without calamity crashing down on them.
Already we are seeing changes in the communities we are operating in thanks to microfinance. Reproductive health and child nutrition have improved, diarrhoea and malaria are down, and we are confident that we will see reductions in the cycle of domestic violence and STDs as more women gain their freedom through microloans too.

Traditional Vs Modern Medicine in Bangladesh

Something we are constantly bumping up against here is the widespread belief in traditional medicine.

Bangladesh has an incredibly long history of traditional medicine. The country is home to a huge variety of medicinal plants, herbs and spices, and animal parts are often incorporated into ‘medicines’.

Ayurvedic medicine and Unani medicine are also widely practised and trusted in. Allopathic medicine, the modern practice used by all the members of Doctors in Bangladesh, is often seen as a last resort.

Most of the doctors working for our organisation have found that a large number of their patients will either:

  • Try traditional medicine before coming to them (often making the problem worse),
  • Disregard advice in favour of traditional treatment
  • Avoid seeing the doctors altogether!

Traditional treatments are usually a blend of ‘folk’ treatments with religious and spiritual procedures. A study by the Geneva Health Forum found that even when there are clinics or hospitals immediately available, at least 50% of the Bangladeshi population will still opt for traditional treatments.

This means we’ve really got our work cut out for us!

Not only do we need to make sure our facilities are open and appropriately staffed at all times, as well as being affordable, but we need to better communicate our value to our communities.

We need to show that even though you may experience side effects from allopathic medicine, it’s still more effective than traditional treatments that don’t provoke any response from the body.

We also need to continue to build trust, cultural understanding and respect with our communities. The better we do this, the more likely people will be to seek us out.

The Hygiene Issue

Any doctor working in a foreign territory will tell you that they face many challenges. These are social and cultural challenges, as well as environmental ones.

The biggest challenges my colleagues and I face here, though?

Convincing people of the importance of hygiene.

In the West, people are so hygienic that you might call them ‘germophobes’. Here in Bangladesh, most people don’t even think about germs!

On one hand, they can’t afford too. Thinking about all the germs you are being exposed to all the time will send you on a one-way trip to crazy town. But on the other hand, it’s important to strike a balance between that terror and absolute disregard.

This is what we are constantly trying to educate patients. We are working with local schools and workers guilds to make hygiene a standard part of the Bangladeshi day.

Teaching kids to wash their hands after going to the bathroom is a good start. Washing them again before eating is another step. Not sharing food if you’re sick, and not letting animals near your food is another big one.

According to the World Health Organization, hygiene education is one of the biggest factors in reducing preventable infections all over the world.

Often, friends and family back home express surprise (and sadly, disgust) when they hear that many Bangladeshi people don’t associate poor hygiene with disease.

This is a bit unfair. It’s not their fault that they haven’t had the education we have. There simply isn’t the cultural emphasis on cleanliness, because it’s not practical. Bangladesh is still struggling with the supply of dirty drinking water, let alone worrying about whether people are washing their hands before cooking a meal.

It’s up to us to educate our patients in a culturally sensitive way about how they can overcome the hygiene challenges their environment presents.

This is why we are trying to make it a standard part of the education and work systems. The more often people hear how important hygiene is, the more aware we hope they will become.

 

Don’t Go In The Water

Well, monsoon season (or ‘rainy season’ to the ever-unphased locals) is nearly upon us.

For Doctors in Bangladesh, this is the toughest time of year. We are inundated with people showing up dehydrated and grey from cholera, or covered in the rosy spots of typhoid.

According to the Pulitzer Center, we are operating in the most densely populated country in the world. Two thirds of the sewage here is left untreated, and often finds its way onto the streets and fields.

Come monsoon season, all this sewage gets mixed up with the storm water, carrying a double whammy of germs to people already extremely vulnerable to all kinds of diseases.

On top of this, the recent discovery of arsenic and manganese in the main water supply means that people are largely at the mercy of unscrupulous landlords and water vendors who will say they are providing clean drinking water – but are often lying to make a quick buck off a desperate populace.

It sounds bleak, and to be honest, it is.

We are trying to remain optimistic that the bright minds of the new generations will find a sustainable solution to these huge problems.

At this point, our best options continue to be purification stills, purification tablets and various other evaporation and ozonation technologies (as are commonly found in Thailand and other parts of Asia).

Currently, we must continue to rely on the support of readers and sponsors to help our patients and the communities we work in. Doctors of Bangladesh would like to extend our heartfelt gratitude for your generosity and we hope to do you proud in all our work.

 

The Flying Menace

Recently Bill Gates released a great image showing how deadly mosquitoes are – more deadly than any other creature in the world (by volume of infection, at least).

As you may know, Mr Gates and his wife are champions of reducing mosquito-borne diseases, especially malaria and dengue fever.

Here in Bangladesh, we are being ever-vigilant about mosquitoes. It is a very high priority for us to educate our clients and the local communities about avoiding mosquito bites as much as possible.

By doing this, and by distributing mosquito nets and repellants, we hope to control the incidence of malaria, dengue fever, and Japanese encephalitis.

Fortunately, the NHS in the UK has recommended that most of Bangladesh is now low-risk for malarial infection, with the exception of the south-eastern region of Chittagong, which is still high-risk.

Unfortunately, many parts of the country are still high-risk for Japanese encephalitis, and the CDC considers Bangladesh an endemic area for dengue fever.

In that the weather is so warm at the moment (36 degrees Celsius in Dhakar at the time of writing!), we really have our work cut out for us.

We are always encouraging the locals to cover up as much as possible, and to avoid being outdoors at dawn and dusk, as this seems to be when the mosquitoes are hungriest.

However, in agricultural areas, and even in industrial areas where the working days start early and finish late, this is not always practical. The best we can do is emphasise the use of mosquito nets, repellants and wearing thick materials to deflect any bites.

This is only going to get more important as the monsoon season arrives and mosquito breeding territories proliferate, so we will be sure to update you – hopefully with good news!

 

 

What We’ve Been Up To

Well, it’s been a long time since this site has been updated!

To be honest, we’ve been a bit overwhelmed. Last year there were violent protests in Dhaka, unseasonably cold weather, and we had a major building collapse which killed over a thousand people and injured many more.

Alarmingly, we have also seen an increase in the number of people contracting the deadly Nipah virus. We have been desperately trying to spread education on how to prevent contracting this virus, as the fatality rate so far is 100%.

Between all those things and the usual demands of treating our thousands of patients, there hasn’t been time for just about anything else.

The exception to this is the good fortune we have had in dealing with Massage World in the USA. They have been very generous in their sponsorship of our efforts.

With their contributions we have been able to extend our vaccination program and hygiene education programs into more rural areas.

We have also had an influx of contact from interested massage therapists who have heard about us on the Massage World site, offering to send their secondhand massage tables for use in our clinics. This is very generous and we are delighted at their kindness.

Massage World’s involvement now means that we will update this blog more regularly in an effort to be transparent with how we are utilising their sponsorship.

In the short term, summer is upon us. Due to the intense heat and humidity we will be focusing on helping our patients “disease-proof” themselves and their families.

As always in the very hot weather, and on into the monsoon season, the incidence of water-borne diseases like typhoid and cholera increases significantly, as do cases of vector-borne viruses such as dengue and rabies.