Liver cancer, also known as hepatocellular carcinoma (HCC), is a formidable adversary that poses significant challenges to patients and healthcare providers alike. As a leading cause of cancer-related mortality worldwide, comprehending the intricacies of liver cancer, including its signs, causes, and treatment modalities, is paramount. In this informative guide, we'll delve into the nuances of liver cancer, shedding light on its manifestations, etiology, diagnostic procedures, and therapeutic interventions. Offering insights into this complex disease, Dr. Bhuvan, a distinguished Consultant in Medical Gastroenterology & Hepatology, underscores the importance of early detection and multidisciplinary management in combating liver cancer.

Signs and Symptoms: 

Liver cancer often presents with nonspecific symptoms in its early stages, making it challenging to detect. However, as the disease progresses, individuals may experience:

• Abdominal pain or discomfort, particularly in the upper right quadrant.
• Unexplained weight loss or loss of appetite.
• Jaundice, characterized by yellowing of the skin and eyes.
• Fatigue and weakness.
• Swelling in the abdomen or legs.
• Nausea and vomiting.
• Enlarged liver or palpable mass.

Causes: 

Several factors contribute to the development of liver cancer, with chronic liver disease being the most significant risk factor. Key etiological factors include:

• Chronic viral hepatitis B or C infection.
• Cirrhosis, often resulting from long-term alcohol consumption, viral hepatitis, or nonalcoholic fatty liver disease (NAFLD).
• Exposure to aflatoxins, carcinogenic substances produced by molds found in certain foods.
• Nonalcoholic steatohepatitis (NASH), a severe form of fatty liver disease.
• Hemochromatosis, a genetic disorder characterized by excessive iron absorption.

Procedure: 

Diagnosing liver cancer typically involves a combination of imaging studies, blood tests, and biopsy procedures. Common diagnostic tests may include:

• Ultrasound: Used to visualize the liver and detect any abnormalities or masses.
• Computed Tomography (CT) Scan: Provides detailed cross-sectional images of the liver and surrounding structures.
• Magnetic Resonance Imaging (MRI): Offers high-resolution images for evaluating liver tumors and assessing disease extent.
• Blood Tests: Measure levels of liver enzymes, alpha-fetoprotein (AFP), and other markers indicative of liver function and cancer activity.
• Biopsy: Involves the removal of a tissue sample from the liver for pathological examination to confirm the presence of cancer cells.

Treatment: 

The choice of treatment for liver cancer depends on various factors, including the stage of the disease, tumor size, location, and overall health status of the patient. Treatment options may include:

• Surgery: Surgical resection or liver transplantation may be recommended for localized tumors.
• Ablation Therapy: Techniques such as radiofrequency ablation (RFA) or microwave ablation (MWA) can destroy cancerous tissue using heat energy.
• Transarterial Chemoembolization (TACE): Delivers chemotherapy drugs directly to the tumor site via the hepatic artery, followed by the blockage of blood flow to the tumor.
• Targeted Therapy: Drugs targeting specific molecular pathways involved in cancer growth, such as sorafenib or lenvatinib, may be prescribed for advanced-stage liver cancer.
• Immunotherapy: Stimulates the body's immune system to recognize and attack cancer cells, offering a promising approach in the treatment of advanced HCC.

Conclusion:

Liver cancer presents formidable challenges, but with early detection, multidisciplinary management, and advances in treatment modalities, significant strides can be made in improving patient outcomes and quality of life. By raising awareness, advocating for screening programs, and investing in research, we can strive towards better prevention, early diagnosis, and more effective therapies for liver cancer. Together, we can combat this formidable foe and offer hope to those affected by this devastating disease.

Have you been feeling very tired lately? Do you feel breathless when you go down the stairs to run some errands? If yes, the one thing that might come to your mind is that you have some respiratory problems. But have you ever thought that these could be the symptoms of any Cardiovascular Disease?

Chronic Respiratory Disease and Heart Disease are two completely different conditions. But both can make you short of breath when you do something physical, like climbing stairs, or walking for a long distance. Both can make you fatigued, and dizzy and there are many other symptoms that they have in common.

Cardiac Diseases cause breathlessness and fatigue when the heart is unable to pump sufficient blood through the body.

If you are facing these symptoms, it is important that you visit your doctor and get yourself tested to get to the core of your problem. It is better to consult a professional instead of taking matters into your own hands, or worse, neglect it completely. Such prominent symptoms must not be overseen. They must be acknowledged, addressed and treated.

It becomes even more important to get yourself checked if you show any of these symptoms started recently with the COVID-19 pandemic in its full rage. The symptoms that are common in Chronic Heart and Respiratory Diseases are also found in COVID-19. Therefore, there could be a possibility that you are infected by the Coronavirus, hence getting yourself tested becomes extremely essential.

Symptoms that are common in all the three conditions include:

• Shortness of breath
• Cough
• Shortness of breath
• Chest pain
• Fatigue

You must be extremely vigilant when it comes to tracing these symptoms. By neglecting them you’ll not only pose a threat to yourself but your family as well. There is no reason for you to be scared and hide these symptoms. In fact, the earlier they are diagnosed the lesser the threats they prove to be.

If you already suffer from any Cardiovascular or Respiratory Disease, you ought to protect yourself from being infected by the novel Coronavirus. If you show any of the symptoms mentioned above, you must quarantine yourself in your house and inform the healthcare officials immediately.

Dr Ravindranath Reddy,

Senior Consultant & HOD Cardiology Department, BGS Gleneagles Hospital

Disclaimer: The views and opinions expressed in this article belong solely to the author. They do not reflect the opinions or views of the organization.

People across the world are staying home to minimize the transmission of the Coronavirus. On the other hand, doctors and healthcare professionals prepare to do the exact opposite. The nature of the job puts them at a high risk of being exposed and infected by the virus. Many healthcare workers and doctors have been infected and some have even lost their lives, but that hasn’t stopped others from continuing to work, treating and taking care of the infected.

The major reason behind doctors being infected is the lack of personal protective equipment (PPE), not only in India but across the globe. Doctors are helpless and bound to use equipment that may not meet the requirements due to the scarcity of proper PPE. The general population is buying the N95 masks thinking that’ll help them stay extra protected. They need to understand that the doctors need these masks more than they do as they are exposed to the virus.

Apart from that, the other risk factor for healthcare workers is, treating asymptomatic infected patients without taking the necessary precautions, which leaves them more exposed to infection. If patients with COVID-19 are not identified or diagnosed quickly, they not only pose a threat to the doctors but all the other people around them, including their families. Hence, it is important that if you show any symptoms, even the slightest ones, inform the healthcare authorities or visit your nearby COVID hospital instantly.

To help reduce the chances of doctors getting infected, what is being done is that most of the patients who are symptomatic, or have a history of fever, cough, sore throat, history or contact of travel are not being treated at the hospital. They need to go for a COVID test and stay in isolation for two weeks. If they don’t show any symptoms till then or are tested negative, they are moved to the normal hospital ward to continue with the treatment.

As a doctor, I want to use this opportunity to request you all to inform the healthcare authorities about your condition if you’re showing any symptoms, instead of sitting back home and ignoring it. You are not only putting your life in danger but your family members in danger too. Doctors are risking their lives for you, all you can do is be honest about your condition and practice the preventive measures proposed.

Dr Revanth

Consultant Oncologist, Gleneagles Hospital, Lakdikapul

Disclaimer: The views and opinions expressed in this article belong solely to the author. They do not reflect the opinions or views of the organisation.

None of us ever imagined that a virus would hit the world so hard even after such advanced technologies and so much progress made in the medical field. The dark ages are gone, but here we are, fighting with a pandemic that has no well-tested cure as yet. The uncertainty and lack of research-backed information about the disease have made things worse. If you find yourself panicking and being anxious now, it is normal.

Children often catch a cold very easily, thanks to their mischievous and notorious activities. The symptoms of COVID-19 are so similar to the common cold and flu that most of the time it’s hard to set the two apart, especially in the initial stages, and this can cause stress in parents. Due to so much exposure to the media, even kids are getting extremely scared and stressed over their health.

Though there are studies that suggest children are at lower risk as compared to older adults, it is only wise to protect the little ones from any potential threat. At times like these, you not only need to take care of your child’s physical health but also their psychological health. Here’s everything you need to know about the threats COVID-19 poses to your children and what you can do about it.

Children And COVID-19

Children and adults, both show similar symptoms of COVID-19 like fever, cough, body aches, etc. Some cases have also reported vomiting and Diarrhea in kids. The threat of COVID-19 in kids is not known yet. However, studies from China suggest that the mortality rates in children are low, but that doesn’t mean they are completely out of danger.

Precautions

Listed below are the precautionary measures proposed by the authorities that everybody must practice.

• Clean hands frequently using soap and water or alcohol-based hand sanitizer.
• Avoid people who are sick (coughing and sneezing).
• Wash hands thoroughly before eating and after coughing or sneezing.
• Clean and disinfect high-touch surfaces daily in household common areas (like tables, hard-backed chairs, doorknobs, light switches, remotes, toys, handles, desks, toilets, and sinks).
• Stay home as much as possible.
• If you as a parent are leaving the house to buy essentials or for work, make sure you wash your hands thoroughly before going close to your kids.

Helping Children Deal with COVID Anxiety

Be A Role Model: Children follow the footsteps of the adults around them. Your reactions and the way you deal with these situations will determine the way your kids deal with them. Be aware of how you talk about this pandemic. The way you discuss or react to COVID-19 can increase or decrease your child’s fear.

Talk And Discuss: With so much exposure to the media, your children might have a lot of questions about the current situations. Let them know that they can come to you with any questions or doubts. Listen to them, it’s really important. Try to resort to their fears and explain to them the complications and solutions available.

Reassurance: Remind your little ones that your family is healthy, and that you are there to keep them safe. Listen to their thoughts and fears and provide reassurance.

Explain Social Distancing: Children probably don’t fully understand why parents/guardians aren’t allowing them to be with friends, or why the schools are shut long before the vacation period. Tell your child that your family is following the guidelines given by the authorities and the importance of it. If your child is old enough to understand statistics and scientific terms, talk to them in more detail.

Focus On The Positive Side: Celebrate more family time. Play fun games together and watch television shows and movies together. Do other things like cooking and household chores. Teach your children new hobbies. Tell them stories about their childhood, and your childhood, make new memories and lighten the mood around you.

Dr Bhaskar,

Consultant Pediatrician, BGS Gleneagles Hospital

Disclaimer: The views and opinions expressed in this article belong solely to the author. They do not reflect the opinions or views of the organization.

COVID-19 is spreading rapidly across the world making everyday life difficult. Citizens of many countries are asked to stay home in an attempt to contain the spread of the Coronavirus. There is panic in public as they are not fully educated about how this virus works. All that everybody is concentrating on is the number of people infected, the death tolls and whether the vaccine or the treatment is out yet. As a doctor, I want people to know that the spread of this virus was very quick which did not give the experts a lot of time to research and work on a cure. However, efforts are still being made. There are experts working day and night to find a solution. Finding the cure to a new disease and preparing the vaccines and medicines require time, as we must be sure that it is safe and effective, and it won’t be too long before we find a solution.

Worrying and stressing yourself over all these things won’t help. Be focused on protecting yourself instead. We’ll talk about the precautions you must take to avoid the chances of being infected, but before that let’s understand how this Coronavirus spreads.

COVID-19 is an airborne disease, which means that the virus that causes this disease (Coronavirus) transmits through the air. The droplets generated when an infected person coughs or sneezes contain this virus. Now, when these droplets fall on you, you get infected directly. The indirect way of you being infected is when these droplets fall on any metal or plastic surface and then you happen to touch that surface. It could be a door-knob, table, public transport handles, any public place, etc. The virus stays active on a plastic or metal surface for a long period. If you wash or sanitize your hands quickly, the chances of you being infected are reduced, but if you touch your face, nose, or mouth with that infected hand, you can get in trouble, as this is how the virus gets inside your body.

To prevent the spread of this virus, practising respiratory hygiene is extremely important. This is what you must do:

• Masks: Everybody must wear a mask. It doesn’t need to be a surgical mask, a normal double-layered cloth mask is good enough. It prevents the spread of the virus and also prevents you from touching your face.
• Washing Hands: Washing your hands frequently with soap and water is another important step. Wash your hands once every hour with the exact 7 steps of handwash proposed. Make sure you wash them thoroughly, especially before eating and after touching doorknobs or any metal or plastic surface.
• Avoid Touching Face: Humans tend to touch their faces 23 times an hour. There is a high chance that you might touch your face after touching an infected surface. Therefore, you must be very conscious of not touching the face.
• Sanitize: When you are travelling, you may not have soap and water available around you, so it’s better to carry a hand sanitizer and keep sanitizing your hands frequently. Use a sanitizer with 65% - 70% amount of alcohol in it.
• Washing Mask: Like we do not repeat our clothes every day without washing them, it is important to wash the masks as well. Every individual must have 3 cloth masks. Wash the mask as soon as you get back home and let it dry under the sun. Using a clean, fresh mask every time you step out reduces the chances of you being infected even more.
• Cover Your Mouth While Coughing: Cover your mouth with a tissue or handkerchief while sneezing or coughing, or cover it with your elbow.
• Train Kids: Train your child to practice these precautions. Make them wear a mask too if they are leaving the house. Let them continue wearing their masks even after the schools reopen, at least until a cure is developed.
• Seek Medical Assistance: If you see any symptoms in you like, cough, high fever, breathlessness, etc. inform the healthcare authorities instantly and isolate yourself until you hear from them again.

Dr Tapaswini Krishna

Consultant – Pulmonology, Gleneagles Hospital, Lakdikapul

Disclaimer: The views and opinions expressed in this article belong solely to the author. They do not reflect the opinions or views of the organisation.

The period of pregnancy is exciting for most women. However, due to health complications and other reasons, it can also be slightly stressful, it is especially worse if it’s during an epidemic or a pandemic. The anxiety and stress are much more than usual. Right now, COVID-19 has all of us on the edge, and you are bound to be more apprehensive if you are an expectant mother.

Experts are trying their best to learn more about the new Coronavirus, its impact on our daily lives and multiple other aspects. Healthcare professionals are working hard as well, they are planning with mothers on how to protect themselves and their newborns amid this widespread virus.

Pregnancy changes the Immune System of a woman, making her more susceptible to infections. And COVID-19 spreads easily, affecting the Lungs and airways. However, no evidence or study shows it is more harmful to a pregnant woman than to a regular person, but it’s better to be safe than sorry.

Precautions for Pregnant Women

Though we don’t know for a fact whether pregnant women can pass the disease to their fetus, if they are affected by the Coronavirus, it is still wise to take precautions. I would recommend that you try and avoid even the smallest possibility of getting sick. If you are pregnant, you need to follow the hygiene protocols more than anyone else.

Avoid crowds. Stay home as much as possible. Stay away from sick people. If you have to be a part of a crowd, or if you have guests over, maintain a distance of six feet to prevent any chances of any kind of illness.

Wash your hands frequently with soap and water or an alcohol-based hand rub. Sanitize it now and then. Avoid touching your face.

Eat well. Make sure you are getting all the required nutrients to keep your Immune System healthy. Call your doctor if you are coughing or having any kind of symptoms.

Managing Stress

You’ll be stressed with everything that is going around you, but you need to know that your mindset affects your baby, so try and manage it. Talk to your friends and family, mostly virtually at this point, but do talk about everything that bothers you.

Try and divert your mind from everything. Stay away from fake news that runs through social media, they can create panic. Restrict your source of information to credible sources.

Develop a new hobby. Invest your time learning to do something new, learn a new language, read more, or simply do something that makes you happy. This will help you get your mind off all the havoc and give you some peace, which is important.

Protecting Your Newborn If You Are Sick

If you get infected by the Coronavirus near your delivery date, there are special precautions that your doctors can help you with. Though experts have not yet shown any evidence of the virus being transmitted during pregnancy, it can occur after birth when infants are in close contact with someone who has the illness. Therefore if the mother is ill with COVID-19, it is wise to keep the infant in isolation. Breastfeeding can be continued by the infected mother by taking all precautions before feeding the baby like hand sanitization and wearing a mask, another alternative is using a Breast pump and giving the baby expressed Breast milk if the woman is suffering from a bad cough or if they are scared of exposure to baby through direct Breastfeeding.

Keep yourself hydrated and fit - Eat healthy, green leafy vegetables, and sprouts, increase protein intake, have a balanced diet, and avoid oily snacks when at home. Keep a watch on fetal movements regularly. If you have decreased fetal movements, pain, bleeding, or watery discharge then report to the hospital immediately.

You must have dreamt about the day you gave birth to your baby. If you’re due date is any time soon, then your postpartum period is going to be more isolated and avoid visitors during these times. You need to be strong and be prepared for everything that is to come. Eat healthily, get enough sleep, take your medications on time, talk to your partner and family, and practice all the preventive measures.

“Don’t worry, this too shall pass and together we can fight this sensibly.”

Dr Padmapriya,

HOD Obstetrics and Gynaecology, Gleneagles Health City, Chennai

Disclaimer: The views and opinions expressed in this article belong solely to the author. They do not reflect the opinions or views of the organization.

Coronavirus is a public health concern as it has affected many people in India. Prime Minister Narendra Modi called for a nationwide lockdown to contain the novel Coronavirus. The Coronavirus can significantly affect the mental health of people as social distancing and self-isolation are recommended. This suggests that our social activities will no longer be available to us. That is the time when boredom may strike, and one may also get bogged down mentally.

Due to the nature of the spread of the virus, one can get excessively worried about catching the disease. There is a fine line between precaution, worrying and fear of getting infected. When this ‘normal fear’ becomes profound, it can lead to various anxiety disorders, like Panic Disorder, Obsessive Compulsive Disorder (OCD), Depression, Post Traumatic Stress Disorder (PTSD) and rarely Paranoid Disorder. Here’s some mental well-being advice for you and your loved ones.

This is how Coronavirus can take a toll on your mental well-being

Loneliness: It is a no-brainer that social distancing can help curb the spread of Coronavirus. But, do you know that it can lead to loneliness, which can also trigger a depressive episode?

Anxiety: There may be anxiety in people related to Coronavirus. They may feel what if someone in the family gets sick? Or what if the spread of Coronavirus doesn’t stop? Will I get grocery or their supply will run out?

Obsessive Compulsive Disorder (OCD): During the outbreak of Coronavirus, it is easy to get obsessed about the prevention of this disease. One may repeatedly wash hands to get rid of the germs & may continuously clean the house. One may also worry that he/she is dirty.

Paranoia: Being exposed to negative information can lead to paranoia. One may also feel overwhelmed and scared.

Follow these coping - strategies to enhance your mental well-being

Physical fitness is something that all of us need to maintain in the current pandemic situation. Physical activity is a must for all, and we must remain active even while we are restricted indoors. It might sound bizarre, but engaging in household chores like cleaning, dusting, mopping, gardening, etc. will help you stay fit and burn calories. Combine your regular chores with yoga/exercises like surya-namaskar, pranayama or any other form for better results.

Meditation during these times will boost your mental and psychological strength, which in turn will help your Immune System grow stronger and prevent disease.

Eating Healthy

Have a positive outlook and remain optimistic, although this is easier said than done. Avoid getting into a negative frame of mind. Accept that this is a temporary phase affecting the whole world.

• Exercising can release a ‘happy hormone’ which can have feel good effect. Cleaning, and de-cluttering your house can be a useful exercise.
• Eat a balanced diet of fresh fruits and vegetables. Avoid overeating, and stay well hydrated.
• Avoid smoking and alcohol.
• Get a good night’s sleep. Reduce screen time (blue rays can cause Insomnia), so lessen the use of gadgets/TV.
• Keep in touch with your family members and friends over the phone. Also, spend quality time with your family.
• Play indoor games like cards, ludo etc., listen to music or read books.
• Try relaxation techniques like meditation and yoga that can help in reducing stress.

Avoid rumours: They can be disturbing as they rob your peace of mind. Rumours can set in panic attacks too. Perhaps decide on a specific time to check in with the news and only rely on genuine information. Avoid forwarding unreliable information!

So, do not distress, but de-stress!

Dr Santosh Bangar,

Clinical Psychologist, Gleneagles Hospital, Mumbai

Disclaimer: The views and opinions expressed in this article belong solely to the author. They do not reflect the opinions or views of the organization.