Scalp cooling device to reduce hair loss during chemotherapy

Hair loss during chemotherapy can be a huge psychological and physical blow to a lady. Today, we tried the Paxman scalp cooling device on two of our chemotherapy patients. This device leads to vasoconstriction of the scalp vessels and reduces hair loss during chemo.

Studies done using the device report a 70% reduction in hair loss with Paclitaxel based chemotherapy ( used for breast cancer, ovarian cancer) and a 30% reduction in hair loss with adriamycin (used for breast cancer) based chemotherapy.

 

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The magic of a healthy doctor-patient relationship

The relationship between doctors and their patients has received philosophical and spiritual attention since the time of Hippocrates and still remains a keystone of care. But, unfortunately over the years, this special relationship has undergone a drastic transition. The onus for this actually lies on both the parties. On one hand, increasing number of litigations and the irrational use of social media has made the doctor fraternity more cautious while on the other, many patients claim that doctors treat them as consumers and the healing touch and warmth has gone.

Bobby Fischer once said “Nothing is so healing as the human touch”. As a doctor, it’s very important to counsel & interact with patients, so that their fears regarding the disease can be alleviated.

As a cancer surgeon, I feel that a healing touch is as important as a good surgical hand. Every doctor should make a sincere effort to strike a healthy relationship with their patients.

May the force be with you!!

 

 

 

(This was a card I recently received from one of may patient’s, whom I had treated for cancer)

Is it sexual harassment? 

Just got a very interesting message from a patient of mine:
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Should I call it sexual harassment ? Whenever I tell people I have breast cancer👙 they look at my breasts and keep guessing which one 🤔
While I do not bother to look at others kidney, prostate or rectum.

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These warriors are already battling this dreaded illness and they need our full support but the society just makes them more conscious of their disease.
Would love to know your views regarding this.

Free Breast Cancer OPD – Early detection is the best protection!!

 

 

Early detection is your Best Protection!!

 

breast cancer

 

 

Initiative by:

Dr. Rohan Khandelwal

Department of Breast Diseases & Cancer Care

W Pratiksha Hospital, Gurgaon

How to interpret an ER/PR report in Breast Cancer

All human cells have some receptors present on their surface. Normal human breast cells respond to the female hormones i.e. estrogen & progesterone, therefore they carry estrogen (ER) and progesterone receptors (PR).

Like healthy breast cells, majority of the breast cancer cells also possess ER & PR receptors. Every breast cancer is different and knowing the fact whether the breast cancer is positive for ER, PR receptors, has an important bearing on the management of the patient’s disease. If a patient’s breast cancer shows these receptors, then they can be subjected to hormonal therapy, which can control the tumor growth by blocking these receptors.

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Sometimes during the course of treatment, the breast cancer cells which are ER, PR positive initially can lose the receptors and become ER, PR negative and they stop responding hormonal therapy. Rarely, the opposite of this is true as well.

Considering this background, it is important that a lady knows how to interpret the hormone receptor status report & understand the implications in breast cancer management based on this report.

Most laboratories used a special method to stain these receptors known as IHC (immunohisto-chemistry). Each lab has their own way of analyzing these receptors, which is why I am covering the most commonly used methods:

  • A percentage that tells you how many cells out of 100 stain positive for hormone receptors.You will see a number between 0% (none have receptors) and 100% (all have receptors).

 

  • Allred score between 0 and 8. This system looks at what percentage of cells test positive for hormone receptors along with the intensity of staining. This information is then combined to score the sample on a scale from 0 to 8. The higher the score, the more receptors were found and the easier they were to see in the sample.

 

  • Positive or negative report

 

Different labs have different cutoff points for calling the cancer either positive or negative. For example, if less than 10% of your cells — or fewer than 1 in 10 — stain positive, one lab might call this a negative result. Another lab might consider this positive, even though it is a low result. Some studies have shown that even cancers with low numbers of hormone receptors may respond to hormonal therapy. A score of “0” means that the patient is hormone receptor negative and will not benefit from hormonal therapy.

Some points to remember

Once the report is declared, your oncologist with discuss your hormone receptor report with you and these are some points, which will help you in understanding your report:

  • ER+/PR+:Majority (65%) of the Breast cancers are ER, PR positive and these patients are candidates for hormonal therapy.
  • ER positive but PR negative OR ER negative but PR positive:Around 10-13% patients fall in these two categories. Despite one of the receptors being negative, these patients are still candidates for hormonal therapy.
  • ER-/PR-:Around 20% patients fall in this category and they are not considered to be candidates for hormonal therapy.

 

If your test result is positive for ER/ PR, you should discuss the role of hormonal therapy with your oncologists. Hormonal therapy helps in preventing the recurrence of disease in patients with localized breast cancer whereas it keeps the tumor growth under control in patients with metastatic breast carcinoma.

 

Article by:

Dr. Rohan Khandelwal

Consultant, Breast Onco-Surgeon

W Pratiksha Hospital,

Gurgaon, India

Multifocal vs. Multicentric Breast Cancer

multifocal vs multicentric

Multifocal breast cancer is defined as the presence of two or more tumor foci within a single quadrant of the breast or tumor foci within 5 cms of each other.

Multicentric breast cancer is defined as the presence of two or more tumor foci within different quadrants of the same breast or tumor foci separated by more than 5 cms.

With the advent of better imaging modalities, these tumors are being detected more frequently and it is important to understand their impact on the surgical management.

Patients with multifocal breast cancer are eligible for breast conservation surgery (BCS; provided no other contraindications for this procedure are present) whereas BCS is avoided in patients with multicentric tumors. 

Another point of interest to both the patients and the doctors is that the diagnosis of a multicentric or a multifocal tumor does not affect the overall survival of the patient.