Endoscopy: A Diagnostic and Therapeutic Tool

Endoscopy - A Diagnostic & Therapeutic Tool | Evercare Hospital Chattogram

Endoscopy is a medical procedure that involves the insertion of a long, flexible tube with a camera and light at the end, called an endoscope, into the body to view the internal organs. It is a valuable diagnostic and therapeutic tool used by gastroenterologists to examine and treat conditions of the digestive system.

Diagnostic Endoscopy:

Gastrointestinal symptoms are common, and endoscopy is often used to diagnose conditions like acidity, indigestion, abdominal pain, vomiting, difficulty in swallowing, bleeding from the mouth, and foreign body ingestion. These symptoms can be caused by a variety of conditions, and endoscopy helps identify the underlying problem. During the procedure, the doctor can take tissue samples for biopsy, remove polyps, and look for any abnormalities that may be present.

Therapeutic Endoscopy:

In addition to diagnostic use, endoscopy is also used therapeutically to treat various conditions of the digestive system. Some of the procedures performed using endoscopy include:

Ulcer bleeding treatment by clipping/injection/diathermy: Endoscopic techniques can be used to stop bleeding from ulcers by clipping, injecting medication, or using diathermy to seal the ulcer.

Endoscopic variceal band ligation:

This procedure is used to treat bleeding varices, which are enlarged veins in the esophagus or stomach.

Foreign body removal:

Endoscopy can be used to remove foreign objects, such as coins or bones, that have been swallowed.

Esophageal stent placement for cancer of the food pipe:

Stents can be placed in the esophagus to help keep it open and allow food to pass through in cases of cancer-related narrowing.

Duodenal stent placement for cancer/stricture of duodenum:

Stents can also be placed in the duodenum, the first part of the small intestine, to treat narrowing caused by cancer or strictures.

Esophageal/stomach dilation for cases of post-corrosive ingestion/stricture:

Ingesting corrosive substances can cause damage to the esophagus or stomach, leading to strictures. Endoscopic dilation can help relieve the narrowing and improve swallowing.

Placement of Ryles tube for feeding purposes:

Endoscopy can be used to place a Ryles tube, which is a thin, flexible tube that passes through the nose or mouth and into the stomach. It is used for feeding purposes in cases where the patient cannot eat normally.

Percutaneous endoscopic gastrostomy (PEG) for long-term feeding:

In cases where a patient needs long-term feeding, a PEG tube can be inserted through the abdominal wall and into the stomach using endoscopy.

Polypectomy (endoloop):

Endoscopic techniques can be used to remove polyps, which are growths on the inner lining of the intestine. The endoloop is a device used to remove larger polyps by looping a wire around them and cutting them off.

In conclusion, endoscopy is a versatile tool that can be used for both diagnostic and therapeutic purposes. It is a safe and effective way to examine and treat conditions of the digestive system. If you are experiencing any gastrointestinal symptoms, speak to your doctor to see if endoscopy may be the right choice for you.

Dr. Sandeep Dhavan
MBBS,MD (Medicine), DM (Gastroenterology) (PGIMER-Chandigarh, India)
Senior Consultant at Evercare Hospital Chattogram
Gastroenterology & Hepatology

Kidney Disease: Importance, Function, and Health

Kidney Disease

How to Keep Your Kidneys Healthy

World Kidney Day is an annual global awareness campaign that aims to raise awareness about the importance of kidney health and the potential impact of kidney diseases. In honor of this day, it is important to understand more about the kidneys, their function, and ways to keep them healthy.

The kidneys are two bean-shaped organs located in the back of the abdominal cavity. They play a crucial role in filtering waste products and excess fluids from the blood, which are then excreted from the body as urine. Additionally, the kidneys help regulate blood pressure, produce hormones, and maintain electrolyte balance.

How to Prevent Kidney Disease

Unfortunately, kidney disease is a significant health issue that affects millions of people worldwide. Some of the most common causes of kidney disease include diabetes, high blood pressure, and family history of kidney disease. Symptoms of kidney disease may include fatigue, swelling in the legs and ankles, frequent urination, and foamy urine.

Early detection and treatment of kidney disease can help slow or even stop the progression of the disease. Treatment options may include medication, lifestyle changes, and in some cases, dialysis or kidney transplant.

Preventative measures can also be taken to keep the kidneys healthy. These measures may include maintaining a healthy diet, staying hydrated, exercising regularly, and avoiding smoking and excessive alcohol consumption.

In conclusion, World Kidney Day is an important reminder of the essential role that the kidneys play in maintaining overall health and wellbeing. By understanding the function of the kidneys, the risk factors for kidney disease, and the ways to keep the kidneys healthy, we can work towards reducing the burden of kidney disease and promoting better kidney health.

Dr. Mohammad Faizur Rahman
MBBS, MCPS, MD (Nephrology)
Senior Consultant- Nephrology
Evercare Hospital Chattogram

Awareness is the key to Prevent Suicide

Awareness is the key to Prevent Suicide

Awareness is the key to Prevent Suicide

Suicide…the last act of a depressed, dejected and despondent being, which they choose as a last resort to solve their life’s problems. But is suicide really a solution? Although the body can be freed from worldly pain through suicide, can the soul?

According to statistics from the WHO, there is an average of 1 suicide every 40 seconds all over the world. This means while you’re taking a sip of your cup of tea, , somewhere in the world someone is voluntarily taking a vacation from life. Even Bangladeshi statistics for suicide are quite alarming. According to sources, a total of 14,436 people died due to suicide in Bangladesh last year alone, which is 70% more than the total number of deaths due to corona in the first year of the country’s corona epidemic. But as much as we have been able to stay aware and take precautions for the corona epidemic and other physical problems, have we been equally aware and prepared to resist this silent killer called suicide?

The first important step in preventing suicide is to find out the reasons why a person chooses this path. Suicide is usually the ultimate manifestation of some mental disorder, one of which is depression. Sufferers of depression, often failing to achieve any dreams or goals, feel that their lives are meaningless at some point; as a result, they seek salvation through suicide. People may also choose this extreme approach due to stress, relationship problems, fear of loss of respect, family problems, physical pain, drug addiction and psychological abuse. According to WHO statistics, suicide rates are higher among people under the age of 30. Men are more vulnerable than women. On the other hand, apart from these regular reasons, the financial crisis caused due to the ongoing coronavirus epidemic, tension in relationships and depression caused by loneliness, the tendency of people to commit suicide has increased significantly.

There are several signs shown by a person at risk of suicide, which can largely help in predicting their decision. This is because suicidal tendencies don’t develop overnight. On the contrary, after a long period of time, the person loses his will to live when depression and shame accumulate in their mind. During this time, various negative thoughts are seen in the speech and activities of the person. Self-hatred, guilt, feeling like a burden to others etc. emerge in their conversations. Such people tend to be restless, get easily irritated by everything and distance themselves from friends and family. They even start searching online for various suicide execution plans.

A suicidal person’s thoughts usually go round and round in circles, and at some point, they unknowingly push themselves towards suicide. Therefore, a person at risk of suicide can mostly be helped by family members and close friends. In many cases, a suicidal person has communicated his or her thoughts directly or indirectly to those close to them through social media. Therefore, it is important to discuss with loved ones as soon as any such symptoms are seen. They need to be convinced that suicide is not a solution to the problem and that it is possible to find alternative ways to solve it. In addition, any deadly and dangerous material should be kept out of the reach of these vulnerable people. Above all, the person at risk should be referred to psychiatrists and psychologists as soon as possible. This is because proper care and counselling can help turn a suicidal person away from this path.

Loving yourself and those you love, and a little attention and care from your loved ones can prevent this silent killer called suicide. Negative thoughts like suicide can be eradicated only by making life meaningful and enjoyable through social values, mutual harmony and understanding. This requires education, discussion and above all, awareness. So let us be aware and help others to be aware. Let awareness be the key to prevent suicide.

এভারকেয়ার হসপিটালের জরুরি বিভাগ নিয়ে জরুরি কিছু কথা

এভারকেয়ার হসপিটালের জরুরি বিভাগ

প্রশ্ন: জরুরি বিভাগে কোন ধরনের অসুস্থতা বা শারীরিক সমস্যা নিয়ে আসা রোগীর সংখ্যা বেশি?

ডা. ঋভু রাজ চক্রবর্তী: জরুরি বিভাগে সাধারণত মেডিকেল বা সার্জিক্যাল সব ধরনের রোগীরাই আসে। তবে হার্ট এবং পেটে ব্যথাজনিত সমস্যা নিয়ে আসা রোগীদের সংখ্যা কিছুটা বেশি থাকে। যদিও বিগত কয়েকমাস ধরে জরুরি বিভাগে আসা রোগীদের মধ্যে প্রায় ৯৫ শতাংশই ছিল করোনাক্রান্ত রোগী, এবং আমরাও তাদের যথাযথ সেবা প্রদানের চেষ্টা করেছি। তবে সরকার কর্তৃক ভ্যাকসিন সুবিধা চালুর পর থেকে ধীরে ধীরে এই সংখ্যা অনেকাংশেই কমে এসেছে এবং এখন তা প্রায় নেই বললেই চলে।

প্রশ্ন: রোগীকে হাসপাতালে নিয়ে আসা পর্যন্ত সময়ের মধ্যে রোগীর আত্মীয়-স্বজনদের জরুরী চিকিৎসা সেবা বিষয়ে কী ধরনের জ্ঞান থাকা দরকার বলে আপনি মনে করেন?

ডা. ঋভু রাজ চক্রবর্তী: এটি অতি গুরুত্বপূর্ণ একটি প্রশ্ন। আমরা অনেকেই রোগবালাইকে অবহেলা করে থাকি এবং সঠিক সময়ে চিকিৎসা গ্রহণের ক্ষেত্রে অনীহা প্রকাশ করি। আবার দেখা যায় চিকিৎসকের পরামর্শ বাদ দিয়ে আত্মীয়স্বজন বা বন্ধুবান্ধবরা মাঝে মধ্যে বিভিন্ন ঔষধ খেতে উপদেশ দিয়ে থাকে, যা সত্যিই দুঃখজনক। কাছের কেউ অসুস্থবোধ করলে সকলের উচিত বিশেষজ্ঞের পরামর্শ গ্রহণ করা এবং প্রয়োজনবোধে রোগীকে হাসপাতালে নিয়ে যাওয়া।

পাশাপাশি রোগীকে হাসপাতাল আনা-নেওয়ার ক্ষেত্রে অ্যাম্বুলেন্স ব্যবহারের চেষ্টা করা, জরুরী প্রয়োজনে অ্যাম্বুলেন্সের যোগাযোগ নাম্বার সাথে রাখা। আমাদের একটু অসচেতনতা এবং অসতর্কতাই আমাদের প্রিয়জনদের জন্য বিপদ ডেকে আনতে পারে। তাই এসকল বিষয়ে সকলের সচেতন থাকা প্রয়োজন।

প্রশ্ন: জরুরি বিভাগে নিয়ে আসা সব রোগীই কি গুরুতর রোগী? নাকি প্রাথমিক পর্যবেক্ষনের পর নির্ধারণ করা হয় তিনি গুরুতর রোগী কি না?

ডা. ঋভু রাজ চক্রবর্তী: বর্তমানে দেখা যায় যে রোগীরা হালকা অসুস্থবোধ করলেই হাসপাতালে আসছে, যা সত্যিই প্রশংসনীয়। কারণ রোগবালাইকে অবহেলা করার মানুষের চিন্তাভাবনা ধীরে ধীরে পরিবর্তন হচ্ছে। তবে আপনার প্রশ্নের উত্তরে বলবো যে অবশ্যই অধিকাংশ রোগীই গুরুতর অবস্থায় থাকে না। আমাদের কাছে আসার পর যথাযথ পর্যবেক্ষণের মাধ্যমে আমরা রোগীর অবস্থা নির্ণয় করি এবং প্রয়োজনীয় ব্যবস্থা গ্রহণ করি।

প্রশ্ন: অনেকের মধ্যেই এই ধারণা কাজ করে যে ‘ইমার্জেন্সিতে সবচেয়ে দ্রত সেবা পাওয়া যায়’- এ ধারনাটির বিষয়ে আপনার মন্তব্য কী?

ডা. ঋভু রাজ চক্রবর্তী: বাংলাদেশের ইমার্জেন্সি ডিপার্টমেন্ট বা জরুরি বিভাগগুলো অন্যান্য দেশের চেয়ে অনেকাংশেই পিছিয়ে। যার কারণে এর সম্পর্কে সাধারণ মানুষের ধারণাও সীমিত। তবে একটা বিষয় মাথায় রাখতে হবে যে ‘ইমার্জেন্সি’ হাসপাতালেরই একটি বিভাগ এবং প্রতিটি বিভাগেরই নিজস্ব চিকিৎসা পদ্ধতি থাকে। জরুরি বিভাগে চিকিৎসক, নার্স এবং অন্যান্য কর্মীরাও দায়িত্ব পালন করে। এখানে যথাযথ পর্যবেক্ষণের মাধ্যমে রোগীর জন্য কি করণীয় তা নির্ধারণ করা হয়।

টা সত্য যে জরুরি বিভাগে যত দ্রুত সম্ভব চিকিৎসা প্রদানের ব্যবস্থা করা হয় তবে অনেক ক্ষেত্রে রোগ বা রোগের অবস্থা নির্ধারণে সময় লাগতে পারে। উল্লেখ্য যে, এভারকেয়ার চট্টগ্রামে সম্প্রতি ‘ওয়ান স্টপ’ জরুরী সেবা সুবিধা চালু হয়েছে।

প্রশ্ন: ‘বিচলিত না হয়ে ধৈর্য ধরে বিপদ মোকাবেলা করা শ্রেয়’- জরুরী স্বাস্থ্যসেবা বিষয়ে কথাটি আপনার দৃষ্টিতে কতটা গুরুত্বপূর্ণ?

ডা. ঋভু রাজ চক্রবর্তী: অবশ্যই যখন আপনার কাছের কেও অসুস্থ থাকবে, আপনি বিচলিত হয়ে পড়বেন এবং তার দ্রুত আরোগ্য কামনা করবেন। তবে কখনও কখনও রোগ নির্ণয়, চিকিৎসার প্রাক-পরবর্তী সময়কাল ইত্যাদি কাজে সময় ব্যয় হয়। সেক্ষেত্রে রোগীর স্বজনদের অবশ্যই ধৈর্য এবং আস্থা রাখতে হবে। তাহলে আমাদের কাজ যেমন সহজ হবে, তেমনি রোগীর যথাযথ চিকিৎসা প্রদানেও আমরা সক্ষম হবো।

প্রশ্ন: জরুরি বিভাগ থেকে সুস্থ হয়ে বাড়ি ফেরা রোগীদের আপনারা কী পরামর্শ দিয়ে থাকেন?

ডা. ঋভু রাজ চক্রবর্তী: যেসকল রোগীদের আমাদের ‘হোম-কেয়ার’-এর পরামর্শ দেই তারা হাসপাতাল থেকে বাড়ি যাওয়ার পরও তাদের সাথে আমাদের হেলথ কেয়ার বিভাগ, হেলথ কমিউনিকেশন বিভাগ এবং কাস্টমার কেয়ার বিভাগের সার্বক্ষণিক যোগাযোগ থাকে। তাই বলা যায় যে রোগীরা বাড়িতে গিয়েও হাসপাতালের তত্বাবধায়নে থাকেন এবং ফোন অথবা ভিডিও কলের মাধ্যমে আমাদের চিকিৎসকবৃন্দ প্রয়োজনীয় তাদের পরামর্শ দিয়ে থাকেন। এছাড়া জরুরী প্রয়োজনে তাদের ঠিকানায় আমাদের অ্যাম্বুলেন্স সুবিধাও দেওয়া হয়।

প্রশ্ন: এভারকেয়ার চট্টগ্রামের জরুরি বিভাগ অন্যান্য হাসপাতাল থেকে কোন বিষয়ে আলাদা ও কেন?

ডা. ঋভু রাজ চক্রবর্তী: এভারকেয়ার হসপিটাল চট্টগ্রাম’ই দেশের একমাত্র হাসপাতাল যাদের কম্প্রিহেন্সিভ ইমার্জেন্সি ডিপার্টমেন্ট বা পূর্ণাঙ্গ জরুরী বিভাগ আছে। এখানে বিভাগের নিজস্ব চিকিৎসক নার্স সহ স্বাস্থ্যকর্মীরা সার্বক্ষণিক সেবাদানে নিয়োজিত থাকে। এছাড়া চট্টগ্রামে সম্প্রতি ‘ওয়ান স্টপ’ জরুরী সেবা চালু হয়েছে এবং বাংলাদেশের জন্য এই ধারণাটি সম্পূর্ণ নতুন। এখানে মেডিকেল, সার্জিক্যাল, কার্ডিয়াক ও পেডিয়াট্রিক সহ সকল রোগের সেবা পাওয়া যাবে। এই সুবিধাগুলোর কারণেই এভারকেয়ার চট্টগ্রাম অন্যান্য হাসপাতাল থেকে আলাদা এবং বাড়তি সুবিধাসম্পন্ন।

প্রশ্ন: এভারকেয়ার হসপিটাল চট্টগ্রামের মানসম্পন্ন স্বাস্থসেবা, দেশের চিকিৎসা খাত সম্পর্কে জনগণের দৃষ্টিভঙ্গি কতটা পরিবর্তন করতে পেরেছে বলে আপনি মনে করেন?

ডা. ঋভু রাজ চক্রবর্তী: এটি একটি গুরুত্বপূর্ণ প্রশ্ন। এই করোনা মহামারীতে দেশের স্বাস্থ্যখাত লক্ষ্যণীয় প্রশংসা কুড়িয়েছে এবং দেশের সকল চিকিৎসক, নার্স সহ সংশ্লিষ্ট সকল স্বাস্থ্যকর্মীদের প্রতি জনগণের আস্থা আরও দৃঢ় হয়েছে বলে আমি মনে করি। এবং এই প্রশংসার এক বলিষ্ঠ ভাগীদার এভারকেয়ার হসপিটাল চট্টগ্রাম। কারণ উন্নত প্রযুক্তিসম্পন্ন এই হাসপাতালে বিভিন্ন জটিল রোগের চিকিৎসা করা হচ্ছে এবং লক্ষ্যণীয় সফলতাও আমরা অর্জন করেছি।

বিদেশমুখী না হয়ে যাতে করে দেশের মাটিতেই সকলে বিশ্বমানের চিকিৎসা লাভ করে, আমরা সেই নিশ্চয়তাই দিচ্ছি। তাই বলার অপেক্ষা রাখে না যে এভারকেয়ার চট্টগ্রাম দেশ্র স্বাস্থ্যখাত সম্পর্কে জনগণের দৃষ্টিভঙ্গি পরিবর্তনে দারুণ ভূমিকা রেখেছে।

ডা. ঋভু রাজ চক্রবর্তী
জেনারেল সার্জারি অ্যান্ড ট্রমাটোলজি
এভারকেয়ার হসপিটাল চট্টগ্রাম

Heart disease: the new concern for young people

Heart Disease - Causes, Symptoms, Prevention | Evercare Hospital Chattogram

In today’s world, heart disease, cardiac arrest or heart attack is considered to be one of the leading causes of death. At one time, it was thought that only the elderly were at risk of heart attacks. That notion is now deemed irrelevant due to the current situation, where young and middle-aged people are now suffering from heart attacks.

Around 20 million people worldwide die from cardiovascular disease each year, accounting for about 32% of global deaths. 60% of these deaths are due to heart attacks; coronary heart disease accounts for three-quarters of deaths in low- and middle-income countries in South Asia. In developing countries like Bangladesh, the risk of death due to heart disease is about 14.31%. In the last 10 years, the death rate due to heart attacks has increased 35 times for men and 48 times for women in Bangladesh. What is most alarming, however, is that incidents of heart attacks are gradually increasing among the younger generation.

Although common, many people may not know what a heart attack is or why it happens. For their convenience, I would like to convey the information that Myocardial Infarction, heart attack or whatever you may call it, is a medical complication when blood flow to the heart suddenly stops due to an obstruction. Plaque, also known as a block, is usually formed by the accumulation of fat and cholesterol in blood vessels. It is one of the main causes of a heart attack. Simply put, a blocked artery blocks the flow of oxygenated blood to a part of the heart, which results in a heart attack. If the blocked artery cannot be reopened quickly, the part of the heart that was supplied blood by that artery stops working, leading to death.

Symptoms usually appear days or weeks before a heart attack. If a doctor is consulted, the risk of death decreases with proper treatment; but in case of a sudden heart attack, the risk of death is quite high. A sudden heart attack is undoubtedly a large shock for the body and there is no specific age at which it occurs. Rather, the risk increases when there are inconsistencies in your lifestyle, consumption of unhealthy food, genetic problems, stress etc. But to think that it is asymptomatic because it occurs suddenly is the wrong assumption to make. Some of the symptoms of a sudden heart attack are constant pain or pressure in the chest, which lasts for a few minutes and can happen intermittently; you may feel pain while working, and then feel better while taking a rest. Besides this, nausea, indigestion, excessive sweating, fatigue etc. are some common symptoms of a sudden heart attack; but it is not the same case for everyone. On the other hand, another possible cause of death due to heart attack is post-Covid heart problems. Many who have recovered from Covid-19 have experienced blood clotting problems, which increases the risk of heart attacks.

It is true that the risk of heart attack increases as you get older. It also goes without saying that the risk skyrockets if there are problems with the heart and blood vessels.

Except nowadays, incidents of heart attacks are increasing at a significant rate even at a young age. The last 10 years of Global statistics show that heart attack rates among young and middle-aged adults have increased by 2% per year. According to doctors, inconsistent changes in modern lifestyles and physical inactivity are the two major reasons for increased problems in the heart and blood vessels. Incidents of heart attacks among young people are increasing day by day due to excessive smoking, lack of physical activity, not enough sleep, weight gain, excessive anxiety, eating unhealthy food, especially fat and cholesterol-rich food, diabetes, unhealthy lifestyle, hereditary causes etc. – but what is the best way to cure it?

The answer is very simple. Young or old, a heart attack can be life-threatening for anyone. Even if it doesn’t result in death, it can cause serious damage to your health. So, you need to get used to a lifestyle that does not increase the risk of heart problems. Eat food that does not clog blood vessels. Do things that keep your body active. The steps you can take to maintain this are to keep heart-friendly healthy food in your diet, exercise daily, avoid drugs and tobacco products, keep yourself cheerful, and if there is a history of a heart attack in your family, get screened from a young age. Even if not immediately, the risk of heart attack will decrease gradually.

Every living being must taste death; but a premature death is something no one desires. Heart attacks have become one of the leading causes of premature deaths among young people in recent times. So, everyone must be aware, and become interested in living a healthy life to prevent deaths due to heart attacks.

Identifying Breast Cancer and Keeping it At Bay

Breast Cancer

When cells in one’s breasts begin to grow abnormally and uncontrollably, the disease is called breast cancer, a leading cause of cancer in women all over the world. Approximately 1 in every 8 women worldwide is expected to develop breast cancer during her lifetime. Only 1% of breast cancer patients are biologically male.

Although exact countrywide statistics are not presently available to us, it is clear from hospital data that the number of breast cancer patients in Bangladesh is increasing on a yearly basis. There are numerous reasons for the increased number of breast cancer incidences in Bangladesh. Thanks to wider availability of common diagnostic facilities, we are seeing a higher number of breast cancer diagnoses.

Risk Factors for Breast Cancer

There are some risk factors which may be managed in order to avoid breast cancer. Men and women who heavily drink alcohol are both at greater risk of developing breast cancer. Women who are physically inactive are more likely to develop breast cancer, as are overweight and obese women, particularly after menopause. Also after menopause, if a woman has been taking hormone replacement therapy for a long period of time, the risk of breast cancer is higher.

A woman’s reproductive history might also pose a significant risk factor for breast cancer. If she has been taking certain contraceptive pills for a long time, bore a child after 30 years of age, is intentionally childless, or did not breastfeed any children she bore, she is at greater risk of breast cancer.

Besides these, there are some risk factors which, unfortunately, cannot be changed. Being a woman, especially one older than 50 years, is the biggest risk factor for breast cancer development (and in fact, most cases of breast cancer are found in women over the age of 50). Genetic mutations, inherited changes to certain genes such as BRCA 1 and BRCA, make breast cancer more likely for women at an earlier age when they are premenopausal.

Another risk factor we can not change is early age of starting menstrual cycle (i.e. before 9 years of age) and late menopause (i.e. menstruation till 55 years).

Symptoms of Breast Cancer

It’s important for any woman, and even men, to know the signs which might indicate the presence of breast cancer. Note that while different people have different symptoms, some may not have any symptoms at all.

Look for signs that your breasts might be afflicted by cancer. If one finds a new lump in the breast or armpit (axilla), experiences itching or swelling of part of the breast, notices irritation or dimpling of breast skin, experiences pain or notices redness or flaking of the nipple, observes that the size/shape of the breast has changed, or secretes any nipple discharge other than milk (such as blood), one might have breast cancer.

Breast Cancer Screening

During a breast cancer screening, a woman’s breasts are checked for cancer before there are signs or symptoms of the disease. During a screening, breast cancer is detected at an early stage to ensure that the cure rate can be high with the help of appropriate preventive treatments. As breast cancer incidence among Bangladeshi women is highest between the ages of 45 to 74 years, it is a good practice to do a screening mammogram test every 2 years.

How Breast Cancer is Diagnosed

The diagnosis of breast cancer can be undertaken in multiple ways. The following tests can help to detect breast cancer: breast ultrasonography, diagnostic mammogram, breast MRI (when and if needed), biopsy (core needle biopsy/open biopsy for histopathological diagnosis, and FNAC.

FNAC is used for cytological diagnosis and carried out if the lump size is very small, usually less than 1cm, making it impossible to use a biopsy needle. FNACs tests can give false negative results, in up to 15% of cases. Another disadvantage is that immunohistochemistry tests are usually not done from FNAC specimens.

Another way of diagnosing breast cancer is through immunohistochemistry (IHC). Carrying out IHC tests helps us to find out the type of cancer, oncologists can decide on the treatment options and the future of the patient can be predicted. IHC tests measure ER (Estrogen Receptor) status, PR (Progesterone Receptor) status, HER2 (Human Epidermal Receptor 2) status, Ki67 status, P53 status.

Treatment of Breast Cancer

After breast cancer has been detected, it can be treated in several ways. It depends on the type of breast cancer and on how far it has spread. People with breast cancer often get more than one kind of treatment. Treatment options for breast cancer include surgery, chemotherapy, radiotherapy, hormone therapy, targeted therapy, and immunotherapy.

How to Lower the Risk of Breast Cancer

Predicting the onset of breast cancer might be difficult. However, there are certain steps one can take in order to lower their risk of developing breast cancer. By maintaining a healthy weight, exercising regularly, abstaining from consuming alcohol or limiting alcohol intake, avoiding certain oral contraceptive pills, foregoing Hormone Replacement Therapy (HRT) and breastfeeding one’s child, one might hope to keep breast cancer at bay.


Radiotherapy or Radiation Therapy During Breast Cancer

Radiation Therapy



Radiotherapy or radiation therapy is the use of high-energy x-rays, protons or other particles to eliminate cancer cells. Fast-growing cells such as cancer cells are more sensitive to the effects of radiation therapy than normal cells.

Breast cancer can be treated through radiation therapy in different ways

EBRT — External Beam Radiotherapy or external radiation: A device delivers radiation from outside the patient’s body to the breast. This is the most common type of radiation therapy used for breast cancer.

Internal Radiotherapy or internal radiation (brachytherapy): An object that delivers temporary radiation to the patient’s breast is placed in the place where the cancer was, after surgery to remove the cancer.

Radiation therapy can be used to treat breast cancer at almost every stage. Radiation therapy is an effective way to reduce the risk of breast cancer recurrence after surgery. Additionally, it is also commonly used to ease symptoms caused by cancer that has spread to other parts of the body (metastatic breast cancer).

Radiation after Lumpectomy:

If there is any breast tissue left after breast cancer surgery, it is called a Lumpectomy or Breast Conservation Surgery or Breast-conserving. After this surgery, radiation is recommended to eliminate the cancer cells. Adding radiation after a lumpectomy greatly reduces the risk of cancer returning to the affected breast. Lumpectomy combined with radiation therapy is often referred to as Breast Conservative Therapy. This type of treatment is just as effective as the removal of all breast tissue or a mastectomy.

Radiation after mastectomy:

Radiation may also be used after mastectomy. In this case, the decision is made based on the patient’s pre-operative cancer status and the post-mastectomy biopsy report.

In the past, radiation therapy or radiotherapy was given for a long time – for almost 5 to 6 weeks, but now there are also options for giving radiotherapy for 3 weeks or even just 1 week.

If the breast cancer has spread to other parts of the body, which we call metastasis, radiation therapy may be recommended to help reduce the cancer and control symptoms such as pain.

Side effects from radiation therapy can manifest in a variety of ways depending on the type of treatment and which tissues are being irradiated. Side effects are usually most noticeable from the third week or towards the end of radiation treatment. Some side effects of radiation treatment for breast cancer are:

Mild to moderate fatigue Skin irritation, such as itching, redness, peeling or blistering Swelling of the breast Swelling of the arm (lymphedema) etc. if the lymph nodes under the arm are treated. However, most of the side effects go away or subside after a few days, and advanced treatments are likely to reduce the side effects.

A radiation oncologist is a doctor who specializes in treating cancer with radiation. The radiation oncologist prescribes the appropriate therapy for the patient, monitors the progress of the treatment and provides necessary treatment for side effects if necessary. Radiation oncology medical physicists and dosimetrists also perform calculations and measurements related to radiation dose and delivery. A radiation technologist administers treatment to a patient using a radiation therapy machine. A radiation oncology nurse or physician’s assistant answers questions about treatments and side effects and helps manage the patient’s health during treatment. Therefore, it is “teamwork” and with the participation of all the people mentioned above, radiation therapy is successfully completed.

Currently in our country, many hospitals organize tumour boards before starting any cancer treatment. A tumour board is a very important topic in cancer treatment. This is because a tumour board includes an operation doctor, a radiotherapy doctor, a medical oncologist i.e. chemotherapy doctor, a histopathologist i.e. who reports on biopsies, a radiologist i.e. who reports CT scan-MRI and other members. Their objective is to prescribe an international standard treatment pathway for the patient. After that, according to the advice of the doctors on the tumour board, neoadjuvant therapy is sometimes used to reduce the size of the tumour during the treatment of breast cancer and then proceed to surgery. In many cases the operation is done before everything else. Sometimes treatment is started through Hormone Therapy Treatment. However, before starting treatment with Hormone Therapy, it is necessary to know the status of hormone receptors by immunohistochemistry along with a biopsy. This is how a patient is treated for cancer through surgery, chemotherapy, radiotherapy, hormone therapy and sometimes immunotherapy. Due to unprecedented advancements in medical science, now our country has all kinds of treatment options for breast cancer patients. You just need to find the right doctor and the right hospital.