Wednesday, May 18, 2016

Severe Bloating from Fibroids



When fibroids become enlarged, they may press on the surrounding organs, including the bowel. This sometimes leads to constipation, resulting in slower bowel movements and blocked intestines. A woman may feel bloated or complain of a feeling of 'fullness'. If you do experience constipation as a result of fibroids, you may consider a stool softener.

Where a fibroids diagnosis has not be given, but you continue to experience abdominal bloating, constipation and weight gain, ask your doctor for a pelvic examination. These are also signs of ovarian cancer.

Some women may have uterus the size of a 4 to 5 month pregnancy with several large fibroids. The upper abdomen will get severely bloated and tight at times. You will feel like it is going to blowup when the pressure gets severe. Size of the fibroid can be very large fibroid making women's uterus the size of a full term pregnancy.

Some patients experience inconsistency in the sizes of fibroids. "I can put on a pair of pants in the morning, and they'll be too tight by the end of the afternoon if I'm on my feet too much. Yesterday, I scrubbed my bathtub and felt horrible for the rest of the day. One day constipation... the next diarrhea. Today I hurt all the way from my lower back all the way to my thighs... it's really gotten much worse in the last couple of weeks. And feeling like "something is going to drop out of me...." said one of the patients. 

I too feel really "full" at times. But I have found with moving or walking a bit it "moves" and the pain is easier. Not sure if this makes sense. My fibroids have my uterus about 4 months pregnant size. I also am finding I need to go to the bathroom more often, possibly pressing on my bladder now. And I too have had the diarrhea for "no reason". Mentioned another patient. 

Treatment 


Small fibroids do not usually require any treatment. If fibroids are small, they will be monitored regularly and treated only if they grow in size. If a fibroid causes a significant amount of pain, over-the-counter or prescription pain relievers may be used to reduce the severity of the pain. Low dose birth control pills may also be used to maintain hormonal balance and stop the growth of fibroids, according to Women's Health. A medication called a gonadotropin releasing hormone agonist may be given to decrease the size of fibroids. If medications are ineffective or the symptoms of fibroids interfere with daily life, surgery may be needed.

A myomectomy is used to remove only the fibroids from the affected area of the uterus. If there are a large number of fibroids present, a hysterectomy, which is the removal of the entire uterus, may be necessary.

Removal of the uterus renders the patient unable to bear children (as does removal of ovaries and fallopian tubes) and has surgical risks as well as long-term effects, so the surgery is normally recommended when other treatment options are not available or have failed. It is expected that the frequency of hysterectomies for non-malignant indications will fall as there are good alternatives in many cases. The video below shows how a large intramural fibroid was removed by Dr Vijayavel.


Thursday, May 12, 2016

Women's cancer : Ovarian cancer

 

Overview 


Ovarian cancer accounts for approximately 3 percent of all women's cancer and is the fifth leading cause of cancer-related death among women in the United States. In 2014, it is estimated that nearly 22,000 women will be diagnosed with ovarian cancer in the United States, and approximately 14,000 will die of the disease. Ovarian cancer incidence rates declined by nearly 1 percent annually from 1987 to 2011; mortality rates fell an average of 1.6 percent each year from 2001 to 2010. White women have higher incidence and mortality rates than women of other racial/ethnic groups. To avoid these cancers, it's important to understand them.

The most common type of ovarian cancer is called ovarian epithelial cancer. It begins in the tissue that covers the ovaries. Cancer sometimes begins at the end of the fallopian tube near the ovary and spreads to the ovary. Cancer can also begin in the peritoneum and spread to the ovary. The stages and treatment are the same for ovarian epithelial, fallopian tube, and primary peritoneal cancers.

Another type of ovarian cancer is ovarian germ cell tumor, which is much less common. It begins in the germ (egg) cells in the ovary. Ovarian low malignant potential tumor (OLMPT) is a type of ovarian disease in which abnormal cells form in the tissue that covers the ovaries. OLMPT rarely becomes cancer.

Cancers of the ovaries, fallopian tubes, and primary peritoneum are the fifth leading cause of cancer death in women in the U.S. These cancers are often found at advanced stages. This is partly because they may not cause early signs or symptoms and there are no good screening tests for them.

This cancer usually occurs in women over age 50 but can affect younger women. It causes more deaths than any other women's cancer of the female reproductive system and is the leading cause of death from gynecologic cancer in the developed world. Its cause is unknown. 

Ovarian Cancer Symptoms 


Symptoms include:
  • Bloating or pressure in the belly
  • Pain in the abdomen or pelvis
  • Feeling full too quickly during meals
  • Urinating more frequently 
These symptoms can be caused by many conditions that are not cancer. If they occur persistently for more than a few weeks, report them to your health care professional.
  

Prevention


Each time you ovulate, your ovaries are damaged by the egg as it breaks through the surface of the ovary and is released into your reproductive system.

The cells that make up the surface of your ovaries divide and multiply rapidly to repair the damage caused by the egg. It's this rapid cell growth that can occasionally go wrong and result in ovarian cancer.

Anything that stops the process of ovulation can help to minimise your chances of developing ovarian cancer. This includes:
  • pregnancy and breastfeeding
  • the contraceptive pill
  • hysterectomy surgery (removal of the ovaries)
  • Tubal ligation is having the fallopian tubes tied surgically to prevent pregnancy.
  • A salpingectomy, which is the removal of the fallopian tubes, is also sometimes recommended for women with a risk of ovarian cancer. 
You cannot control some things that put you at risk for ovarian cancer, such as your family history or inheriting gene changes. But you can make some personal choices that lower your risk of cancer and other diseases.

  • Eat a healthy diet with plenty of fruits, vegetables, and whole grains.
  • Be active. Talk with your doctor about what kinds of activity and how much activity would be good for you.

If you are at a very high risk because of your family history, you may want to have gene testing. Women at very high risk because of inherited genes may want to have surgery to remove their ovaries and fallopian tubes. This is usually done between the ages of 35 and 40, or when women are finished having children. Having this surgery greatly reduces a woman's risk for ovarian cancer, but it will cause a woman to start menopause early, which may have other risks.  

Angiogenesis


Researchers are working on therapies that target the way ovarian cancer grows. A process called angiogenesis involves the formation of new blood vessels to feed tumors. A drug called Avastin blocks this process, causing tumors to shrink or stop growing (seen in the illustration here). Avastin is approved for other cancers, but ovarian cancer researchers are still testing this therapy, which can have serious side effects. 

According to the American Cancer Society, eating right, being active, and maintaining a healthy weight are important ways to reduce your risk of cancer as well as other diseases. For the American Cancer Society's for diet and fitness, please visit www.cancer.org.