Category Archives: Oncology

Oncology

ANAEMIA

Anaemia can be defined as decreased haemoglobin counts or reduced red blood cell counts or reduced oxygen carrying capacity of blood, due to “loss of” or “abnormality of” red blood cells or haemoglobin.

Normal Heamoglobin Counts

  • 6 months to 5 years of age > 11g/dl
  • 5 years to 12 years of age > 11.5g/dl
  • 12years to 16 years of age > 12g/dl
  • Adult Females (non-pregnant) > 12g/dl
  • Adult Females (pregnant) > 11gm/dl
  • Adult Males > 13g/dl

CAUSES OF ANAEMIA

  • Blood losss
  • Excessive Red Blood Cell destruction
  • Heamoglobinopathies
  • Hypovitaminosis B12
  • Hypoferremia
  • Anaemia of Chronic diseases
  • Autoimmune haemolytic anaemia
  • Inflamatory bowel diseases
  • Hypervolemia or water retention due to sodium or other salts.
  • Genetic hereditary conditions like Thalasemia
  • Certain cancers
  • Kidney diseases
  • Reduced erythropoetin production
  • Excessive RBC destruction
  • Impaired RBC production
  • Certain infections like malaria which causes RBC destruction.
  • Certain drugs which causes RBC destruction eg. Quinine causes chinchonism.
  • Bone Marrow lesions and pathologies
  • Etc.

CLASSIFICATION OF ANAEMIA

There are many types of anaemias. It can be broadly classified into 7 categories depending upon their causes

Anaemia due to

  1. Blood Loss
  2. Hemolysis
  3. Impaired or abnormal Erythropoesis
  4. Hypervolemia
  5. Chronic Diseases
  6. Nutritional deficiency

Based on RBC morphology it can be classified into 3 groups

  • Microcytic
  • Macrocytic
  • Normocytic

FEW COMMON and RARE TYPES OF ANAEMIA

  • Iron Deficiency Anaemia
  • Aplastic Anaemia
  • Megaloblastic Anaemia
  • Pernicious Anaemia
  • Sideroblastic Anaemia
  • Autoimmune Hemolytic Anaemia
  • Myelodysplastic Syndrome
  • Thalasemia
  • Fanconi Anaemia
  • Congenital Dyserythropoetic Anaemia
  • Daimond-Blacfan Anaemia
  • Myelopthisis
  • Anaemia of Prematurity
  • Erythroblastopenia or Pure Red Cell Aplasia
  • Hereditary Spherocytosis
  • Hereditary Elliptocytosis

SYMPTOMS

  • Weakness
  • Lethargy
  • In children it affects growth in general
  • Somnolence, Drowziness in day time
  • Disturbed sleep at night
  • Pallor, general pale appearance of skin, mucous membranes and eyes.
  • Dyspnoea on Exertion.
  • Reduced Immunity, tendency to catch infections and slow recovery and healing.
  • Bodyaches
  • Cyanosis in severe cases
  • Palpitations
  • Tachycardia
  • Low blood pressure
  • Chest pain
  • Depression
  • Craving for indigestible things , PICA
  • Cold clammy extremities
  • Oedematous swelling of extremities, dependent oedema
  • Angina or cardiac failure in severe cases
  • Will impact general growth and repair of all the vital organs and tissue of the body.

HOMEOPATHIC MEDICINES FOR ANAEMIA

Depending upon the cause of anaemia and general constitution of the patient, one of the following medicines may be called for duty by a homeopathic physician.

  • Ferrum Metallicum
  • Ferrum Phosphoricum
  • Cinchonna Officinalis
  • Natrum Muriatic um
  • Arsenicum Album
  • Abrotanum
  • Hamamelis Verginiana
  • Pulsatilla Nigricans
  • Janosia Ashoka
  • Crotalus Horridus
  • Lachesis
  • Acidum Phosphoricum

LYMPHOMA

LYMPHOMA – Malignant neoplasm of lymphoid tissue is called Lymphoma.

They are type of blood cancers where in there is abmormal cell-proliferation of Lymphoid Tissue.

Lymphomas and Leukemias both fall under a broader category “Malignant Neoplasms of Lymphoid and Heamatopoetic Tissue” or cancer of Lymphocytes”. Wherein unlike Leukemias, the term Lymphomas is precisely restricted only to the Tumours of Lymphoid tissue.

Types of Lymphoma

  • Hodgkin’s Lymphoma
  • Non Hodgkin Lymphoma
  • Multiple Myeloma
  • Immunoproliferative diseases

RISK FACTORS

Hodgkin’s Lymphoma

  • Hereditary
  • Epstein Barr Virus Infection

Non Hodgkin’s Lymphoma

  1. Autoimmune Conditions
  2. HIV infection/AIDS
  3. Human T-Lymphotropic Virus Infection
  4. Immunosupressive Medication
  5. Exposure to certain Pesticides
  6. Tobacco Smoking

SIGN’s AND SYMPTOM’s

  • Lymphadenopathy
  • Pel-Ebstein Fever – Intermittent Fever of around 38C lasting for 1-2weeks and relapsing again after days to weeks
  • Weight loss of more than 10% within 6 months.
  • Profuse perspiration especially at night.
  • Anorexia – loss of appetite
  • Weakness and fatigue
  • General Pruritus
  • Dyspnoea on slightest exertion

Ann Arbor Staging System

Principle Stages

  • StageI – Single Lymphnode and surrounding area involved
  • StageII – Two areas involved a lymph node and another area and both are on the same side of daiphram either above or below
  • StageIII – Affected areas on both the sides of daiphram with one organ or region near lymphnode or spleen
  • StageIV – Diffused and disseminated with more than one Extra-Lymphatic organ involved incliding Liver, Bone Marrow, nodular involvement of Lungs.

Modifiers

  • A or B – type symptom – When patient has following three constitutional symptoms then patient is categorised into B-type symptoms 1) Pel-Ebstein Fever. 2) Weight loss and 3)Night Sweats. When there are no above mentioned combination of B-type constitutional symptoms present then patient is categorised into A type.
  • S ” – Disease with Slpeen involvement is denoted with S modifier.
  • ” E” – When disease involves extranodal region that is region surrounding the lymphnodes it is denoted with E modifier.
  • “X” – X is denominated when the largest bulky deposit region is more than 10cm or if more 35% area of chest is occupied by mediastenum on X-Ray.

Nature of Stage

  • Clinical Staging “C.S.” – C.S. Mentioned when staging is done based on clinical examination and test.
  • Pathological Staging “P.S.” – When Staging is done based on pathological findings through invasive techniques like surgical excision etc its Mentioned as P.S.

DIAGNOSIS

Biopsy of Lymph node to confirm Lymphoma.

Further to classify Lymphoma:

  • Immunophenotyping
  • Flow Cytometry
  • Fluorescence in-situ Hybridisation.

CT scan and PET scans helps us evaluate extent of spread of the condition and its staging.

HOMEOPATHIC MEDICINES FOR HODGKIN’s LYMPHOMA and NON- HODGKIN’s LYMPHOMA

  • BARYTA CARBONICA
  • CALCAREA CARBONICA
  • CINCHONNA OFFICINALIS
  • CALCAREA FLOURICA
  • CONIUM MACULATUM
  • PHYTOLACCA
  • BARYTA MURIATICUM
  • TUBERCULINUM
  • CALCAREA PHOSPHORICA
  • CALCAREA CARBONICA

LEUKEMIA

Abnormal proliferation of blood cells due to defective medullary heamatopoetic stem cells is called leukemia.

In Layman terms, defective bone marrow causes uncontrolled multiplication and abnormal growth of cells that are components of blood causing blood cancer.

TYPES AND CLASSIFICATION

Based on speed of progression and maturity level of most cells most of the Leukemia can be categorised into

  • Acute – Fast progressing takes weeks to few months, Most of the cells are blast cells (immature cells), Requires immediate treatment, Commonly seen in children.
  • Chronic – Relatively slow progressing takes months to years, has relatively mature cells, patient usually inder observation before commencing any aggressive treatment, Common in elderly people.

There are some leukemia which do not follow fixed pattern also presentation of symptom may vary in different individual and also there are cases where in they change the classical course of and speed of progression.

Based on types of cells involved, most of the Leukemia can be categorised into

  • Lymphoid (Lymphocytic) – Precursors of Lymphocytes are involved. It is further classified as per which lymphocytes are involved wether B-cells or T-cells.
  • Myeloid(Non-Lymphocytic) – Precursors of RBC, Non-Lymphocyte WBC and Platelets are involved.

A Lymphoid or Myeloid leukemia can Either Acute or Chronic as described below

  1. Acute – Lymphoblastic(ALL)
  2. Chronic – Lymphocytic (CLL)
  3. Acute – Myeloid (AML)
  4. Chronic – Myeloid (CML)

ACUTE

Acute Lymphoblastic Leukemia (ALL) –

When there are multiple mutations in the locus, that control cell proliferation, cell maturation and cell death of precursor cells of Lymphocytes called Lymphoblast then this results in ALL. ALL can be of T cell type or B cell type.

Genes associated with ALL –

  • KMT2A – Infant ALL – onset before 10yr of age
  • ARID5B
  • CKDN2A
  • CKDN2B
  • TP53
  • GATA3
  • PIP4K2A
  • IKZF1
  • CEBPE
  • PAX5 – Inherant Autosomal Dominant
  • ETV6 – Inherant Autosomal Dominant

Certain syndromes that increases risk of ALL

  • Down’s Syndrome
  • Bloom Syndrome
  • Fanconi Anaemia
  • X-Linked agamaglobulinaemia
  • Neurofibromatosis Type 1
  • Li-Fraumani Syndrome
  • Paroxysmal Nocturnal Heamoglobinuria
  • Severa Combined Immunodeficiency
  • Costmann Syndrome
  • Ataxia Telangiectasia
  • Schwachmann Daimond Syndrome

SUBTYPES OF ALL

  • Precursor B-cell ALL
  • Precursor T-cell ALL
  • Mature B-cell ALL(also called Burkitts Leukemia due to its similarity with Burkitts Lymphoma)
  • Acute Biphenotypic Leukemia.

Acute Myeloid Leukemia (AML)

It is an acute Non-Lymphocytic type of malignanacy which involves myeloblast cells(precursor of monocytes and granulocytes).

In AML there is mutation of genes that mature and differentiate the myeloblast cell will arrest maturation and differentiation and the cell will freeze in undifferentisted immature state and when this type of mutations combined with mutations in genes controlling proliferation in same cell will result in clonning of immature undifferentiated cells resulting in AML

Genes associated with AML

Subtypes of AML

Subtypes of AML are classified based on staging of maturation i.e. at which stage the msturation of the cell is arrested and how is the general behaviour of cells and which genes are involved.

  • Undifferentiated Acute Myeloblastic Leukemia
  • Acute Myeloblastic Leukemia with Minimal Maturation
  • Acute Myeloblastic Leukemia with Maturation
  • Acute Pro-Myelocytic Leukemia (APL)
  • Acute Myelomonocytic Leukemia
  • Acute Myelomonocytic Leukemia with Eosinophilia
  • Acute Monocytic Leukemia
  • Acute Erythroid Leukemia
  • Acute Megakaryoblastic Leukemia

Adult T-Cell Leukemia

Blast Crisis of CML

CHRONIC

Chronic Lymphocytic Leukemia (CLL)

  • B-cell Pro-Lymphocytic Leukemia(B-PLL)
  • T-Cell Pro-Lymphocytic Leukemia(T-PLL), T-PLL doesnt completely fit into this category.

Hairy-Cell Leukemia(HCL)

Large Granular Lymphocytic Leukemia(LGLL)

Chronic Myeloid Leukemia (CML)

  • Chronic Granulocytic Leukemia
  • Juvenile CML
  • Chronic Neutrophillic Leukemia
  • Chronic Myelo-Monocytic Leukemia(CMML)
  • Atypical CML (aCML)

Chronic Eosinophillic Leukemia

Few other types, preleukemias and syndromes that cannot be classified in above category

  • Clonal Eosinophilia
  • Other Myelodysplastic Syndromes
  • Other Myeloproliferative Syndromes

CAUSES

Leukemia is caused due to mutations in genes that are associated with proliferation, differentiation, growth, maturation and cell death of blood cells. With different types of mutations responsible for different types of leukemia.

These genetic mutations can be inherited or acquired due to multiple reasons of which few known risk factors are

  • Exposure to certain chemicals (e.g. benzene, petrochemicals, hair-dyes, agent orange herbicide, certain insecticides)
  • Radiation – ionising radiations and doubtedly non-ionising radiations too.
  • Smoking and tobacco use.
  • Prior alkylating chemotherapy for some other form of malignancy.
  • Viruses – Human T-cell Lymphotropic Virus – 1 HTLV-1 is associated with Adult T-cell Leukemia and Hepatitis C is associated with CLL
  • Diseases and Syndromes – Down’s Syndrome, Kline Felter syndrome, Fanconi Anaemi, Ataxia-Telangiectasia or Louis-Bar Syndrome, Myelodysplastic syndrom, Myeloproliferation syndrome.

Few of these factor are seen responsible for specific type of cancer (eg HTLV1 causes Adult T-cell Leukemia, Tobacco and Down’s Syndrome increases risk of AML).

SIGNS AND SYMPTOMS

Symptoms may vary in different types of leukemia, different individuals and different stages of disease.

  • Tired feeling
  • Paleness due to anaemia
  • Shortness of breath
  • Headache, lethargy, stiffness of neck
  • Loss of appetite
  • Weight loss
  • Tendency to catch infection too frequently
  • Fever usually due to secondary infections
  • Painful long bones
  • (Heamorrhagic diathesis) easily bleeds and frequent ecchymosis and petechiae (bruises).
  • Painless lymphomegaly (Enlarged lymphnodes)
  • Hepatospleenomegaly – can easily palpate liver and spleen due to its increased size.
  • Fibrosis of bone marrow
  • Chloroma or Leukemia Cutis or myeloid sarcoma or granular sarcoma or extramedullary myeloid tumour
  • Swollen painfull and bleeding gums
  • Sweet’s Syndrome
  • Pitting Oedema
  • Enlarged Testis
  • Mediastinal mass
  • Cranial nerve Paralysis if CNS is involved
  • Increased blood cell count , WBC or RBC or Platelets, depending on type with most if the cells immature and lacking differentiation.

DIAGNOSIS

  • Complete Blood Count
  • Bone Marrow Biopsy
  • Lymph Node Biopsy

HOMEOPATHIC TREATMENT WITH INDICATED HOMEOPATHIC MEDICINES

  • Arsenicum Album
  • Phosphorus
  • Hekla lava
  • Lachesis
  • Benzinum
  • Carica Papaya
  • Cinchonna Officinalis
  • X-ray
  • Thuja Occidentalis
  • Syphillinum
  • Baryta Carbonica
  • Calcarea Phosphorica
  • Ruta Graveolens
  • Calcarea Fluorica
  • Calcarea Carbonica
  • Symphytum Officinalis
  • Hyocyamus Niger
  • Medhorrhinum

UNDER CONSTRUCTION

MYCOSIS FUNGOIDES

Mycosis Fungoides is a type of Non-Hogkin Lymphoma. It is the most common type of Cutaneous T-Cell Lymphoma(CTCL).

Mycosis Fungoides is a misnomer which means “Mushroom-like fungal disease” but by no means it is a fungal condition. It is a type of blood cancer caused due to unusual expression of Skin-associated CD4 T-Cells. This cancer affects skin and produces various lesions on skin and rarely metastatise in other tissues.

It is a fatal condition with 10year survival rate of less than 70% which is even less in elderly.

It usually appears in people above 20years of age and is more common after age of 50yrs , males are affected more than females, the disease tends to be more fatal in black race. Survival rate has been found good in married white women.

CAUSES

Causes of Mycosis Fungoides remains unclear

No hereditary or genetic factors have been found associated to the disease.

It is considered to be non-contagious but some studies suggest that Human T-cell Lymphotropic Virus is associated with this condition.

SYMPTOMS

Initially disease shows symptoms that are not distinguishing and in most of the cases it resembles psoriasis or eczema. Even on biopsy it can not be diagnosed easily in early stages. Even in later stages multiple biopies are required to establish diagnosis.

Disease presentation begins from skin as exfoliating, pruritic, erythodermic eruptions resembling to Eczema or Psoriasis and is almost always mistaken initially in most cases. These eruptions tends to appear first on buttocks in vast majority of cases and then spreads throughout the body. Pruritus is present in only 20% of all the cases. In later stages tumourous and ulcerative lesions may also appear. Disease usually in most cases starts appearing at around age of 45-50 and is a slow prohressing condition with and its usually around age of 60+ that mist patient starts presenting symptoms of later stages like tumours, generalised pruritus and erythrodrema and ulceration. Though in many cases it may start as early as age of 20 and rarely before 20yrs of age. The diseases is classified into three stages

Stages of Mycosis Fungoides

Mycosis fungoides is divided into three stages viz.

  1. Pre-Mycotic
  2. Mycotic
  3. Tumourous

Pre Mycotic Stage

It starts appearing on skin at this stage as erythematous, pruritic, exfoliating skin eruptions.

On biopsy it cannot be diagnosed at this stage as histopsthology shows pattern of non specific dermatosis with epidermal psoriasiform changes.

Mycotic Stage

In Mycotic stage Infiltrative Plaques starts appearing as slightly raises or wrinkled spots.

On histopathology polymorphs and few atypical lymphoid cells are seen inflamatory infiltrates in dermis. When this cells are seen lined up.in epidermal basal layer without spongiosis then its confirmatory finding to establish diagnosis of mycosis fungoides.

Tumorous Stage

Nodular overgrowths are seen on skin ranging from few milimeters to centimeters scattered throughout the body along with plaques and patches. Usually it appears on the same place where the plaques and patches are. Also there is erosion of the tumours and ulcerations is seen in many cases over the tumour and plaques.

On histopathology they show medium sized lymphocytes with cerebroid nuclei expands dermis.

DIAGNOSIS OF MYCOSIS FUNGOIDES

Diagnosis is based primarily on histopathological findings of the skin lesions

Clinically patients showing features suggestive of or doubted mycosis fungoides are closely monitored over the time untill biopsy confirms. Multiple boipsies of various lesions might be required at every progressing stage untill confirmed, as its very difficult to estsblish diagnosis in initial stafe wether clinically or histopathologically as it resembles psoriasis or eczema.

On histopathology following findings are required to establish diagnosis of mycosis fungoides

  • Band-like lymphocyte infiltrate in superficial papillary dermis
  • Epidermotropism
    • Cerebroid T-cells in dermal and epidermal infiltrate
  • Pautriers Microabscesses – though not present in most cases but is characteristic finding of mycosis fungoides where in the epidermal infiltrate shows atypical lymphocytes arranged in aggregates of four or more.

HOMOEOPATHIC MEDICINES FOR MYCOSIS FUNGOIDES

  • Thuja Occidentalis
  • Syphillinum
  • Antimonium Crudum
  • Arsenicum Album
  • Ars Sulph Flavum
  • Phosphorus
  • Argentum Nitricum
  • Hepar Sulphuris
  • Sulphur
  • Silicea

UTERINE FIBROID

Uterine fibroid is the most common benign (non cancerous) tumor that grow in the wall of the uterus.
Uterine fibroids are also known as leiomyomas or myomas. They usually form in the child bearing age of a women.
Fibroids range in size from a size of a seedling undetectable to human eye to bulky masses that can enlarge the uterus.
There can be a single firbroid to multiple ones.

LOCATION AND CLASSIFICATION OF UTERINE FIBROIDS:

Most fibroids grow on the walls of the uterus. The major classification of fibroid is as follows.,

INTRA MURAL FIBROIDS :
Intra mural fibroids are usually located within the walls of the uterus and are the most common type of fibroids. Intra mural fibroid grow as a small nodule in the muscular wall of uterus, it may expand inwards. They are asympto.atic unless they are larger in size.

SUB-MUCOSAL FIBROIDS :
Sub mucosal fibroids are located in the muscle beneath the endometrium of uterus. Even small lesions in this location may bleed.

SUB-SEROSAL FIBROIDS :
They are located on the surface of the uterus. They can grow outward from the surface and remain attached by a small piece of tissue, they are also known as pedunculated fibroid.

CERVICAL FIBROID :
Cervical fibroid are usually located at the walls of the cervix.

CAUSES OF UTERINE FIBROIDS :

Uterine fibroids are common now a days, as many as one in five women may have fibroids during thier child bearing years.

Factors which cause Fibroid are.,

AGE : Fibroids become more common as women age., especially during 30’s and 40’s. After menopause fibroids usually shrink.

FAMILY HISTORY : Having a positive history of fibroid in family increases the risk of fibroid.

HORMONAL FACTOR : During the reproductive years the oestrogen and progesterone levels are higher. These hormones stimulate the development of uterine lining, can promote the growth of uterine fibroids due to various reasons.

OTHER FACTORS
Early menarche, Use of birth control pills, Obesity.

SIGNS AND SYMPTOMS OF UTERINE FIBROID

Most women with uterine fibroids are initially asymptomatic, but some women can present with the following symptoms :

  • Heavy bleeding and painful periods.
  • Low back pain.
  • Pressure pain or fullness in lower abdomen.
  • Constipation.
  • Enlarged abdomen.
  • Painful intercourse.
  • Frequent urination.
  • Complications during pregnancy.

DIAGNOSIS OF UTERINE FIBROID

Uterine fibroids are frequently found incidently during a routine pelvic examination.
Irregularities in the shape of uterus.
Lastly most of women present with some symptoms which suggest the presence of fibroid.

HOMEOPATHIC MANAGEMENT IN TRATMENT OF UTERINE FIBROID :

Homeopathic medicines help to manage the symptoms of uterine fibroids as well as help to resolve them.
Homeopathic medicines are selected based on detailed case analysis and individualisation of the patient.
Few indicated homeopathic remedies in Uterine fibroid are :

FRAXINUS AMERICANA :
Fraxinus americana is most significant and indicated remedy in case of uterine fibroid. The patient presents with bearing down sensation in pelvis from uterine fibroid. Copious bleeding, with severe cramps and chilliness during menses.

THALASPI BURSA :
Thalaspi bursa is another indicated remedy in case of uterine fibroid. Patient presents with complaints of frequent menstruation. Violent uterine colic, cramping pain in abdomen. Low back pain during menses, menstrual bleed is profuse with presence of clots.

TRILLIUM PENDULUM :
Trillium pendulum is indicated in uterine fibroid cases with severe mentrual cramps with low back pain. The pain may radiate from back to hip. Profuse intermenstrual bleeding. Bleeding every 2 weeks.

CALCAREA CARBONICA :
Indicated in case of uterine fibroids. Usually suited to women who are over weight, fair flabby, menses are profuse due to uterine fibroid. Great chilliness. Vertigo during menses. Severe pain in abdomen and back.

SABINA OFFICINALIS :
Sabina is indicated in uterine fibroids, profuse menstrual bleeding along with clots. Slight motion increases menstrual bleeding. Pain from saccrum to pubis. Pain better by lying on the back. Pain may extend to the thighs.

USTILAGO:
Indicated in uterine fibroid where menstrual bleeding is dark red, clots are usually present. Uterine bleeding is stringy in nature. Pain in lower back and abdomen.

SEPIA:
Indicated in case of uterine fibroids. Griping , bearing down pains during menses. Menses start early and are copious. Fainting spells and chilliness during menses. Indicated in painful intercourse in uterine fibroid cases.

FERRUM METALLICUM: Indicated remedy for fibroid in uterus which result in anaemia from excessive menstrual flow.
Pale watery uterine bleed. Labour like pains in abdomen and back. Weakness and fatigue present.

AMMONIUM CARB:
Indicated in case of fibroid uterus. Profuse menstrual flow, blood looks black in colour and clotted. Extreme pain in abdomen and back radiating to thigh.

ERIGERON CANADENSIS:
Indicated remedy in case of fibroid uterus. Indicated mostly for frequent urination , with severe pain. Excessive menstrual bleed which is bright red in colour.

PYOGENIC GRANULOMA

What is Pyogenic Granuloma?

PYOGENIC GRANULOMA also called GRANULOMA TELANGIECTATICUM or LOBULAR CAPILLARY HEAMANGIOMA is relatively a common benign vascular lesion of skin and mucosa and appears as an overgrowth of tissue.

It is usually a small, round, bloody red in color.

They are also known as Lobular capillary haemangioma or granuloma telangiectaticum.

They grow rapidly at first and then remain a constant size, they rarely exceed 1cm in diameter.

What causes Pyogenic Granuloma?

The following factors have a possible role in their development

Some cases develop at the site of a recent minor injury, such as a pin prick.

Staphylococcus aureus is frequently present in the lesion.

Hormonal changes in the body during pregnancy can also be the cause of Pyogenic Granuloma.

Certain drugs and medications are known to cause pyogenic granuloma

SIGNS AND SYMPTOMS

The appearance of Pyogenic Granuloma is usually a small red, round, oozing and bleeding bump.

Younger lesions bleed easily because they are rich in blood vessels. These lesions can be painful.

The lesions arise on various regions of the body such as eyelids, face, tongue, lips, arms, hands and feet.

EYELID: The condition gives rise to reddish pink vascular bumps over the eyelid and is said to be caused due to a rich blood supply from conjunctiva.

TONGUE: These growths arise on lateral side of the tongue, it may arise due to trauma from dentures.

LIP: Arises as a solitary growth on the lip.Growth generally appears on the lower lip.

FINGERS:The growths are common on hands and fingers.

FACE: Growths arising on face are generally multiple in number and looks like small red or reddish purple lumps

FEET: These bumps arise in the nail bed of a toe with an accompanying ingrown toe nail.

DIAGNOSIS

Pyogenic Granuloma can be diagnosed based on its appearance.

HOMEOPATHIC MANAGEMENT

Commonly Used Homeopathic Medicines for Pyogenic Granuloma

SYPHILLINUM

Syphillinum is mostly indicated in case of pyogenic granuloma, where the patient presents with abnormal growths with pain. Indicated in case of chronic erruptions. Suited to person with pale and fine textured skin, who are slender. Presents with marked prostration and debility.

HEPAR SULPH

Hepar sulph is indicated in pyogenic granuloma. Specially suited to lymphatic and phlegmatic individuals. Excessive sensitiveness of parts is a leading indication. Chilly sensation. Indicated in csae of vascular lesions of the skin, they are bright red in colour which tend to bleed.

SILICEA

Silicea is mainly indicated in cases like pyogenic granulomas. Patient presents with vascular lesions of the skin where the suppurations continue and wound refuse to heal. Discharge is thin bloody. The lesion are benign and granulomatous.

THUJA OCCIDENTALIS

Thuja is indicated in case pyogenic granuloma as it is used in bleeding growths, spongy tumours, warts. Thuja has main action on the skin. The lesions have tendency to bleed easily and presents with pain. Complaints worse at night.very sensitive to touch.

RUTA GRAVEOLENS

Ruta is indicated in case of pyogenic granuloma. The patient presents with small rounded vascular lesions which tend to bleed easily. Very anxious and low spirited with mental dejection. Presents with neuralgia, burning stinging pain.

CALCAREA FLOURICA

Indicated in case of pyogenic granuloma. Vascular lesions which tend to bleed and are painful. Indicated in abnormal grwoths. There is great depressio . Sensitiveness to cold. Mostly indicated in blood tumors.

Homeopathic Approach in case of Pyogenic Granuloma

In Homeopthy we not only consider the signs and symptoms of the patient but treat the patient holistically, based on individualisation.

Similarly considering the symptoms-similarity, individuality and total of the patient, below is an example of one of our cases of pyogenic granuloma at Dr SHAH’s HOMOEOPATHY this case responded well to homeopathic medicine Syphillinum and got completely resolved with selected potency of 200C of the said remedy.

pyogenic granuloma
Pyogenic Granuloma Before treatment

Pyogenic Granuloma
During Homeopathic treatment Pyogenic Granuloma becoming dark and dry

PYOGENIC GRANULOMA
DURING HOMEOPATHIC TREATMENT  PYOGENIC GRANULOMA BECOMING DARKER DRIER AND SHRINKING IN SIZE

DURING TREATMENT – SEE THE LARGE FRAGMENT OF PYOGENIC GRANULOMA HAS GOT DETACHED AND HAS INTERMINGLED IN HAIR NEAR INDEX FINGER

Pyogenic Granuloma
During Homeopathic Treatment at Dr Shah’s Homeopathy

Pyogenic Granuloma resolved after detaching and shrinking completely now only a small dark spot can be seen at the site.

Pyogenic Granuloma
Pyogenic Granuloma- After Treatment – Cured completely after Homeopathic Treatment By Dr DEEPAN P SHAH at Dr Shah’s Homoeopathy.

ORAL MUCOCELE cured with Homeopathy

What is Oral Mucocele?

Oral Mucocele is a cyst formed due to collection of salivary gland secretion.

It is pearly translucent occasionally with bluish discoloration usually measuring from 1-8mm in diameter. The deeper cysts may appear as a nodule and may not have translucent pearly appearance as in superficial cyst.

It appears on lower lip on sides.

When it appears on floor of mouth below tongue its termed as ranulla.

They are painless most of the time.

It usually lasts for few days to years.

It may frequently rupture and reappear again at same site.

It may also cause ulcerations.

Oral Mucocele
Oral Mucous retention cyst

Oral Mucocele, Mucous Retention Cyst, Mucous Extravasation Phemenon
Oral Mucocele, Mucous Retention Cyst, Mucous Extravasation Phemenon

Oral Mucocele results from

  • Ruptured Salivary Gland Duct this results into mucous extravasation phenomenon.
  • Obstructed Salivary Gland Duct this results into mucous retention cyst.

Rupture or Obstruction can be due to

  • Infection that can potentially obstruct or damage the salivary gland and its duct.  which can be due to many factors most common being poor oral and dental hygiene.
  • Injury on lower lip which can damage salivary gland duct may result innto oral mucocele tje most common form of injury is due to bitting lips by one own teeth.
  • Tumours that may obliterate obstruct or rupture or damage salivary glands and its ducts in any form may result in to mucocele in oral mucosa

HOMEOPATHIC TREATMENT FOR ORAL MUCOCELE

The underlying cause needs to be evaluated, exclude the probability of infection, malignancy. Patient needs to be guided for proper oral hyegiene, any habbit like bitting teeth should be avoided.

Following are the common Homeopathic  medicines used in treatment of Oral Mucocele

  • Silicea
  • Thuja
  • Variolinum
  • Calcarea flourica
  • Mercurious Solubilis
  • Syphyllinum
  • Antimonium Tartaricum
  • Antimonium Crudum
  • Apis Mellifica
  • Ranunculus bulbosus

Selection from the above medicines should be strictly done as per symptom similarity basis under consultation of homeopathic practitioner.

BPH BENIGN PROSTATIC HYPERPLASIA

BPH or Benign Prostatic Hyperplasia is a disease of males. It is a non-malignant(non-cancerous) enlargement of prostate glands.

Anatomical and Physiological basics of Prostate Gland

Prostate is an exocrine gland about the size of walnut and weight about 7-14gms with median of 11gms it lies below urinary bladder surrounding the urethra with its glandular duct opening in prostatic part of urethra.

It is partly Glandular and partly Muscular. The Glanduloalveolar part produces alkaline prostatic fluid and the Muscular part helps to ejaculate this fluid into prostatic part of Urethra to mix it with sprems produced by testes and form the semen.

Externally it seems to be divided into 4 lobes

  • Anterior lobe or isthemus,
  • Posterior lobe
  • Right and left Lateral lobes
  • Median lobe or middle lobe

The cut section of prostate doesnt show distribution as that of lobe pattern as seen externaly also the morphological distribution is different at different age so in pathology its divided into zones rather than studying in lobes.

  • Peripheral Zone
  • Central Zone
  • Transition Zone
  • Anterior Fibromuscular zone

Pathophysiology of Benign Prostatic Hyperplasia BPH

As the men age the production of Aromatase and 5 alpha reductase increases.

Both Aromatase and 5 alpha reductase converts Androgens(male hormones) into Oestrogen and Dihydroxytesterone. Which results into reduced levels of testosterone and increased levels of Dihydroxytesterone and Oestrogen. Oestrogen stimulates growth of prostatic cells and Dihydroxytesterone a powerful anabolic hormone synergestically aids in to the action of oestrogen in growth of prostatic cells.

In which not only the stromal cells but also glandular cells undergo hyperpalsia. Although stromal hyperplasia is more predominant than the glandular, contadicting this the lateral and median lobe that have more glandular tissue and they are seen to enlarge more compared to anterior which has comparatively lesser glandular tissue.

BPH is closely associated with malignancy and its usually found in transition zone.

Risk Factors for Benign prostatic Hypertrophy BPH

  • Aging
  • Genetic and Familial predesposition
  • Smoking and alcohol
  • Sedentary and Stressful lifestyle
  • Obesity and Metabolic syndrome
  • Diabetes and hypertention
  • Abuse or frequent use of Anabolic hormones and aphrodisiac drugs.

Symptoms of Benign Prostatic Hypertrophy BPH

  • Patient typically presents with symptoms of lower urinary tract symptoms like
  • Stangury.
  • Slow and feeble stream of urine.
  • Frequent Urge to urinate.
  • Retention of urine.
  • Urge to urinate soon after passing it once
  • Post void terminal dribbling of urine
  • Intermittent stream of urine
  • Sensation as if some urine is left back, which he ineffectually tries to clear it up.
  • Involuntary passing of urine.
  • Nocturnal Enuresis.
  • Lack of confidence to hold urine on urge to pass
  • May show complications like urinary bladder stones, freqient urinary tract infections which may potentially damage bladder spincter or kidney, retention of urine.
  • Bleeding in urination or per rectum is a sign of severity and needs urgent intervention to rule out the cause and need proper eveluation for presence of malignancy

Diagnosis of Benign Prostatic Hypertrophy BPH

  • Per rectal examination to check any enlargement in size by palpating prostate per rectum.
  • Sonography shows enlarged glands and size shape and echotexture are to some extent helpful indicator of malignancy
  • PSA test -Prostate Specific Antigen if elevated it indicates probablilty of malignancy though not specific but many its most of the times elevated in patient with malignancy but it is not specific to it as patients without malignancy also many times shows elevated levels but in maligmamt cases its much more frequent.
  • PSA should not be done few days after sonography as its observed that PSA levels tend to alter after sonography.
  • Biopsy to rule out malignancy in cases where the USG report shows unusually enlarged prostate or abnormal shape or echotexture or changes in surrounding tissues or elevated PSA levels or in patients with unusual symptoms.
  • CT scan may be required in severe cases with complications and or doubt of malignancy.

Homoeopathic Medicines for Benign Prostatic Hypertrophy BPH

  • Sabal Serrulata
  • Chimaphilla
  • Conium Maculatum
  • Phytolacca Decandra
  • Kalium Muriaticum
  • Ustillago
  • Baryta Carbonica
  • Baryta Muriaticum
  • Calcarea Fluorica

CANCER

Cancer

Cancer is a disorder caused due to accumulation of mutations in genome. Usually these mutatuions are at more than one Locus. Typically genes which are responsible for controlled growth, maturation and differentiation of the cell are affected. This causes irregular and uncontrolled growth and multiplication of the cells, where most of the cells do not mature properly and also they lack differentiation.

Such cells starts growing abnormally and starts infilterating adjecent tissues and later starts migrating to other sites through lymphatics and blood vessels and infiltrates tissues at other site in body this is phenomenon called Metastasis.

As these cells are abnormal in growth and maturation majority of the cells of same tissue have abnormally different character due to which the tissue starts functioning abnormally and can not retain its normal structure as well.

This genetic anomaly can be a germ line defect or can be acquired due to life style or enviromental insults on the genome.

Most common known causes of cancer are

Tobacco

Its a well established fact that tobacco in any form causes cancer, almost 20% of cancer patient have tabocco as cause of cancer.

Ionising Radiations

Patient usually gets exposed to ionising radiations when he is subjected to radiological investigations for medical purpose or in region with high radioactivity due to previous contamination of the region with ionising radiation producing source or high intensity wireless communication system emitting radiations.

Non Ionising radiations

Exposure to heat of sun and its Ultra Violet radiations on regular basis for prolonged period of time, this type of exposure usually causes skin cancers like melanoma.

Obesity

Cancer show strong association with obesity in its incedence and progression.

Faulty Diet high salt diet causes Gastric cancers. similarly too spice and oily diet more of processed food and maida are also associated with malignancies of gastro-intestinal system.

Infections

Certain virus causes cancer in humans like Human papiloma virus, Hepatitis B virus, Hepatitis C virus, Epstein-Barr Virus, Human T cell Leukemia virus.

Certain bacterias like Helicobacter Pylori are strongly associated with Gastric Carcinoma.

Sedentary life style

It is found that person having sedentary lifestyle with lack of exercise have shown inceased incidence and progression of cancer and vice a versa regular exercise reduces chances of cancer and in those who are affected shows regression or slowing down of progression of cancer

Pollution

Now a days with industralisation air water earth food everything is polluted or adulterated with carcinogens beyond our human body’s capability to tolerate or adapt which has caused increase in incidence of cancer especially in industrailsed areas.

Exposure to benzene or other carcinogens.

Types Of Cancers Based On Cell Type

Carcinoma

Cancer derived basically from Epithelial Cells which line the inner and oter linning of organs and they originate from endoderm, ectoderm and mesoderm

They are further divided into

  • Adenocarcinoma

    Carcinoma in which microscopic features like cytology, tissue architecture, molecular products corresponds to Glandular cells and tissue pattern

  • Squamous Cell Carcinoma

    This type of Carcinoma microscopically shows cellular differentiating features resembling to squamous epithelium.

  • Adenosquamous Carcinoma

    This type of Carcinoma shows mixed pattern of Adenocarcinoma and Squamous cell carcinoma where each of the type comprises atleast 10% of tumour volume.

  • Undifferentiated or Anaplastic Carcinoma

    These types are high grade carcinomas where there is gross lack of cytological or histological differentiation compared to other differentiated carcinomas  this includes many Pseudo Sarcomatous subtypes like  Sarcomatoid Carcinoma, Spindle-Cell Carcinoma, Giant-Cell Carcinoma, Pleomorphic Carcinoma. Many a times Carcinoma and true Sarocoma co-exist e.g. Carcinosarcoma and Pulmonary Blastoma.

  • Small-Cell Carcinoma

    They are smaller in sizeand have less of cytoplasm with component of polygonal or spindle shape cells.

  • Large-Cell Carcinoma

    These types of carcinomas shows excess of cytoplasm filled – Large Monotonous round or polygonal cells.

  • Carcinoma of Unknown Primary(CUP)

    Where the lesion has transformed cells whose origin and developmental lineage is unknown but they show some typical cellular Histological and Molecular character of Epithelial Cells.

  • Carcinoma in Situ

    Epithelial cells not cancerous but significantly abnormal  to fall in transition phase but not exactly Carcinoma.

Sarcoma

Cancer derived from Non Heamatopoeitic Messenchymal Cells that is Messenchymal Cells which are outside bone marrow

Lymphoma 

Cancer originating from Heamotopoeitic cells that arise from bone marrow and mature in Lymphnodes.

Leukemia

Cancer originating from Heamotopoeitic cells that arise from bone marrow and mature in Blood.

Blastoma

Cancer derived from precursor or intermediate cells forms and embryonic tissue.

Germinoma

Cancer derived from Pluripotent cells mostly present in Testes and Ovaries.

Genetics of Cancer

We can broadly divided genes involved in cancer in two types of sets viz

  • Oncogene Genes – Genes Responsible for Growth Maturation and Division of cells
  • Tumour Supressor Genes – Genes that inihibit the growth of cells

Any mutation in the above class of genes which alters their activity may result into transformation of normal cell into malignant cancerous cell. Typically such cells shows many mutations at various Loci.

WARTS Cure in Homeopathy

Wart cured in 35days at Dr SHAH’s HOMOEOPATHY By Dr DEEPAN P SHAH

 

943310_301080240022807_1933191514_nBEFORE TREATMENT217588_301080410022790_1774124210_nDURING TREATMENT944428_301080050022826_1719619970_n35 DAYS AFTER TREATMENT

10 BEST MEDICINES FOR WARTS IN HOMOEOPATHY

  1. THUJA
  2. ANTIM CRUDE
  3. CAUSTICUM
  4. SABINA
  5. MEDHORRHINUM
  6. CINABERIS
  7. SILICEA
  8. CALCAREA CARBONICA
  9. X RAY
  10. STAPHYSAGRIA