Arthritis-friendly home accommodations

Arthritis is a medical term used to describe a group of disorders that affect the joints and muscles in the human body. There are more than a hundred different forms of arthritis, each affecting one or more parts of the body. Rheumatoid arthritis and osteoarthritis are the most common types of this disease. Areas such as hands, elbows, feet, spine and knees fall prey to arthritis. What are the symptoms of arthritis? Inflammation, pain in joints, and inability to freely move the joints, are some of the most common symptoms of arthritis. Other (less common) symptoms include loss of appetite, weight loss, painful swelling and inflammation, fever and anemia.
Joint arthritis damages the cartilage, which is a fluid-like substance that holds a lubricant to facilitate movement. Being a form of chronic disease, arthritis stays with the patient for years. One must understand that arthritis is a complex degenerative disorder that can affect people at any stage of life. Anti-inflammatory drugs and other medications can provide temporary relief to patients. However, a healthy, disciplined lifestyle, which includes healthy food and regular exercise, can help arrest the development of arthritis.
Genetics, age and weight are some of the main causes of arthritis. For old people suffering with Rheumatoid arthritis or osteoarthritis, Arthritis-friendly home accommodations can provide the necessary facilities for treatment. These are not just old age-homes. These are special apartments for aged men and women suffering with acute arthritis. There are several Boston Apartments that have been specially designed for senior citizens suffering with arthritis.
Is there a natural cure for arthritis? The good news is that there are natural treatments and remedies that can control the growth of arthritis to a great extent. Low acid diet, for example, can provide immediate relief from joint pain. The Internet abounds in articles pertaining to arthritis, its symptoms, and various treatments.

For women with breast cancer

Breast cancer is a very important health problem in the United States and various other countries around the world. Breast cancer occupies second rank as the leading cause of cancer deaths among women in America. Until recently cancer of the breast topped the list of leading causes of cancer deaths in women, it still occupies an unenviable second position, second only to lung cancer. If skin cancer is excluded, cancer of the breast is the commonest cancer among women living in America. According to the WHO, more than 1.2 million women get the new diagnosis of breast cancer every year in the world. These numbers represent tremendous challenges posed by breast cancer within the United States of America and across the world.

Breast cancer claims the top position as the leading cause of deaths from cancer among women aged between 40 and 55 years. Breast cancer can occur in males too; with about 1450 new cases of male breast cancer diagnosed every year in the United States. It is comforting to note that the deaths from breast cancer among women of all ages have declined in US by 2.8 percent for every year from 1990 to 2000. The declining mortality rates may be attributed to the successful screening programs and progress in various therapy modalities of breast cancer.

Why is involvement of arteries and veins important in the treatment of pancreatic cancer?

The location of the pancreas deep within the abdomen places it close to numerous large blood vessels that are necessary for life (see “Where is the pancreas?” post).  As a result, cancers of the pancreas do not need to grow very large before invading these vessels and this poses a significant treatment problem. There are two main arteries in the area of the pancreas and these are called the celiac artery and the superior mesenteric artery. The celiac artery gives rise to the splenic artery and the hepatic artery and supplies blood to the liver, pancreas, spleen and stomach. The superior mesenteric artery gives rise to numerous branches that supply the small bowel, part of the colon and the pancreas. The venous system in this area is the portal vein and its tributaries. It drains blood from most of the gastrointestinal track back to the liver and ultimately to the heart through the hepatic veins. Pancreatic cancers that invade these major blood vessels are classified as Stage III which includes two subcategories – “border-line resectable” and “locally advanced, unresectable”.

Cancers that are found to completely surround one of the main arteries as determined by CT scan (“encasement”) are typically considered to not be operable (locally advanced, unresectable). An attempt at removal of such cancers has a very high probability of leaving a portion of the tumor behind (R2 resection) and thus the surgery will confer no survival benefit while potentially subjecting the person to debilitating side effects. Patients with locally advanced, unresectable pancreatic cancer will often undergo radiation and chemotherapy in hopes of shrinking the tumor away from the artery. Unfortunately, significant shrinkage of the tumor that converts it to removable occurs only 10% of the time. A tumor that grows next to one of the main arteries but does not surround it (“abutment”) is considered borderline resectable. In this case there is a good chance it can be removed without cutting though the tumor and, at worst, leaving only a few tumor cells behind (R1 resection). In most centers, including ours, patients with borderline resectable pancreatic cancer will receive radiation therapy prior to surgery in order to kill the cancer cells in the periphery of the tumor. This takes about 6 weeks and increases the likelihood of leaving no cancer behind at the margins (R0 resection). Unlike Stage III locally advanced pancreatic cancer, most patients with Stage III borderline resectable cancer will go on to have their tumor removed by surgery. The main exception to proceeding to surgery in borderline resectable patients is in the event the cancer grows further or develops distant metastases while receiving the chemotherapy and radiation therapy.

The assessment of whether or not a tumor is removable based on invasion of the main veins is very different than that of the arteries. Basically, any degree of involvement of the vein from abutment to encasement is considered to be borderline resectable as long as the tumor involves a portion of the vein that can be reconstructed once that section is removed. For example, if the tumor grows in the mid-portion of the vein (called the portal vein – superior mesenteric vein confluence), the tumor must be taken out with the vein attached and the two end of the vein can be reconnected to restore flow. If the same size tumor grows lower down on this vein (towards the feet), it will involve the portion of the vein that braches like numerous limbs of a tree. Removal of the vein in this area would leave the surgeon with one main “trunk” at the top and numerous “small braches” at the bottom. There would be no way to reconnect the ends. Thus for venous involvement, if it grows at a location in which the surgeon can technically remove the tumor and reconstruct the vein it is called Stage III borderline resectable. If removal and reconstruction is not possible it is called Stage III locally advanced. As described above for the arteries, patients with stage III cancers will most likely receive radiation therapy and most of those in the borderline resectable category will go on to surgery, while only 10% locally advanced will have significant tumor shrinkage.

There are numerous exceptions to this general algorithm based on feature that are unique to each individual patient. The complexity of the many treatment options underscores the need to be evaluated by an experienced team of specialists. We have found that this is best accomplished through a multidisciplinary clinic where patients are evaluated by all of the specialists in a single day. If you would like to learn more about this clinic please feel free to contact us at 410-933-PANC. We will be able to answer your questions and schedule a clinic appointment for you at your request.