Timely prenatal genetic counselling can prevent thalassemia

There are about 40 million carriers of thalassemia in India making it the world’s thalassemia capital. Over 1,00,000 thalassemia majors are under blood transfusion every month. On World Thalassemia Day awareness needs to be created on the fact that prenatal counselling and tests can help in early detection and making informed decisions. Thalassemia refers to a spectrum of genetic blood disorders, involving the absence of or errors in genes responsible for producing haemoglobin. People with this condition produce lesser amounts of healthy haemoglobin throughout their life, and their bone marrow may even stop producing healthy red blood cells after a certain time. Speaking about this, researcher said, “There is a myth that thalassemia is acquired from contact. However, it is an inherited condition, meaning that either one of the parents is a carrier. Ignorance about thalassemia and lack of awareness delays diagnosis due to which people end up transferring faulty genes to their children. Even if there is one parent with traits of thalassemia minor, the chances of having a child with thalassemia minor are about 50%. The probability becomes 25% if both parents are carriers of thalassemia minor. It is imperative to get newborns tested at birth. Women planning to conceive must also undergo tests to detect whether they carry thalassemia traits.”

Some symptoms of thalassemia include weakness, fatigue, slow growth, pale appearance, abnormal swelling, abnormal bone structure (especially on the face and skull), heart problems, and iron overload. Adding his inputs, the Dr. said, “”Indians are still not aware of the importance and necessity for preventive health checkups. Thus, people suffering from genetic disorders such as thalassemia unknowingly pass it on to their children. In pregnant women, prenatal tests help detect this condition before birth. In case one or both the parents have this condition, it is a good idea to consult the doctor to address the risk appropriately. Prevention and early detection are perhaps the most feasible and cost-effective ways to control this disease. The need of the hour is an integrated plan of action including mass screening for carriers before marriage and before conception.” “The government must also make sustained efforts to issue directives that will help make blood transfusion and related drugs and treatment free or low cost for such patients in primary care centres.  As with any other disease, we need immediate policies which can ensure access to genetic counselling and detection right at the outset. There is also a need to ensure that all those with thalassemia have access to the oral chelating drugs. The government also needs to weigh the possibility of making oral chelators free for those who cannot afford them”, added a Dr. Thalassemia usually requires lifelong treatment with blood transfusions and medication. The main treatment methods are: blood transfusions, removing excess iron or chelation therapy, stem cell or bone marrow transplants, and treating other problems. In addition, efforts must also be directed towards motivating gynaecologists and pathologists to ensure that every pregnant woman goes through the HbA2 test before 14 weeks of pregnancy as this can help in the timely diagnosis of thalassemia.

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.                                                                                                                                                                                                        PS- THOSE INTERESTED IN RECIPES ARE FREE TO  VIEW MY BLOG-                                                                                           https://gseasyrecipes.blogspot.com/  

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Breast Cancer: Combating Cancer-Related Fatigue

Cancer-related fatigue is common in cancer patients. Fatigue is often confused with tiredness. Tiredness happens to everyone -- it's a feeling you expect after certain activities or at the end of the day. Usually, you know why you are tired and a good night's sleep solves the problem.

Fatigue is a daily lack of energy; an unusual or excessive whole-body tiredness not relieved by sleep. It can be acute (lasting a month or less) or chronic (lasting from one month to six months or longer). Fatigue can prevent you from functioning normally and impacts your quality of life.

Cancer-related fatigue (CRF) is one of the most common side effects of cancer and its treatment. It is not predictable by tumour type, treatment or stage of illness. Usually, it comes on suddenly, does not result from activity or exertion, and is not relieved by rest or sleep. It may continue even after treatment is complete.

What Causes CRF?

The exact reason for CRF is unknown, but it may be related to the disease process or its treatments.

The following cancer treatments are commonly associated with fatigue:

• Chemotherapy. Any chemotherapy drug may cause fatigue. Patients frequently experience fatigue after several weeks of chemotherapy, but this varies among patients. In some patients, fatigue lasts a few days, while others say the problem persists throughout the course of treatment and even after the treatment is complete.
• Radiation therapy. Radiation therapy can cause cumulative fatigue (fatigue that increases over time). This can occur regardless of the treatment site. Fatigue usually lasts from three to four weeks after treatment stops but can continue for up to two to three months. 
• Hormone therapy can cause fatigue by depriving the body of estrogen. It can last throughout the course of treatment or longer.
• Bone marrow transplant. This aggressive form of treatment can cause fatigue that lasts up to one year.
• Biological therapy. Interferons and interleukins are cytokines, natural cell proteins that are normally released by white blood cells in response to infection. In high amounts, these cytokines can lead to persistent fatigue.
• Combination therapy. More than one cancer treatment at the same time or one after the other also increases the chances of developing fatigue.

What Other Factors Contribute To Fatigue?

Other factors which may contribute to fatigue include:

• Tumour-induced "hyper-metabolic" state. Tumour cells compete for nutrients, often at the expense of normal cells. In addition to fatigue, weight loss and decreased appetite are common effects.
• Decreased nutrition from the side effects of treatments (such as nausea, vomiting, mouth sores, taste changes, heartburn, or diarrhoea) can cause fatigue.
• Cancer treatments can cause reduced blood cell counts that can lead to anaemia, a blood disorder that occurs when there is not enough haemoglobin, a substance in red blood cells that enables the blood to transport oxygen through the body. When the blood cannot transport enough oxygen to the body, fatigue can result.
• If the thyroid gland is under-active, metabolism may slow down so that the body does not burn food fast enough to provide adequate energy. This is a common condition in general, but may also happen after radiation therapy to the lymph nodes in the neck.
• Medicines used to treat side effects such as nausea, pain, depression, anxiety and seizures can cause fatigue.
• Less physical activity and mobility problems can lead to fatigue in older people.   Younger people in treatment sometimes overexert themselves and bring on fatigue.
• Hormonal changes related to medicine, including cancer medicines, can cause fatigue.
• Chronic, severe pain increases fatigue.
• Stress can worsen feelings of fatigue. Stress can result from dealing with the disease and its "unknowns," as well as from worrying about daily accomplishments or trying to meet the expectations of others. Fatigue often results when patients try to maintain their normal daily routines and activities during treatment. Modifying your activities can help conserve energy.

Depression and fatigue often go hand-in-hand, but it may not be clear which started first. One way to sort this out is to try to understand your depressed feelings and how they affect your life. If you are depressed all the time, were depressed before your cancer diagnosis, or are preoccupied with feeling worthless and useless, you may need treatment for depression.

ps- this is only for information, always consult you physician before having any particular food/ medication/exercise/other remedies.

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BONE MARROW TRANSPLANT -what it is, why done, procedure, indications, risks, prognosis

What is bone marrow transplant?

Bone marrow transplant is a procedure in which healthy bone marrow is transplanted into a patient whose bone marrow is not functioning properly. Problems in bone marrow are often caused by chemotherapy or radiation treatment for cancer. This procedure can also be done to correct hereditary blood diseases. The healthy bone marrow may be taken from the patient prior to chemotherapy or radiation treatment (autograft), or it may be taken from a donor (allograft).

What is bone marrow?

Bone marrow is the soft, sponge-like material found inside bones. It contains immature cells called stem cells that produce blood cells. There are three types of blood cells: white blood cells, which fight infection; red blood cells, which carry oxygen to and from organs and tissues; and platelets, which enable the blood to clot.

Why is it done?

If a patient develops a disease of the blood cells, especially cancers such as leukaemia, he may require high doses of chemotherapy to destroy the cancer. However, this also destroys normal blood cells. Alternatively, hereditary or acquired disorders may cause abnormal blood cell production. In these cases, transplantation of healthy bone marrow may save a patient's life. Transplanted bone marrow will restore production of white blood cells, red blood cells, and platelets.

What is the procedure?

Bone marrow transplant patients are usually treated in specialised centres and the patient stays in a special nursing unit (a bone marrow transplant unit) to limit exposure to infections. The hospitalisation period is from 4 to 6 weeks, during which time the patient is isolated and under strict monitoring because of the increased risk of infection and/or bleeding. Donated bone marrow must match the patient's tissue type. It can be taken from the patient, a living relative (usually a brother or a sister), or from an unrelated donor. Donors are matched through special blood tests called HLA tissue typing. Bone marrow is taken from the donor in the operating room while one is unconscious and pain-free (under general anaesthesia). Some of the donor's bone marrow is removed from the top of the hip bone. The bone marrow is filtered, treated, and transplanted immediately or frozen and stored for later use. Then, transplant material is transfused into the patient through a vein and is naturally transported back into the bone cavities where it grows to replace the old bone marrow. Alternatively, blood cell precursors, called stem cells, can be induced to move from the bone marrow to the blood stream using special medications. These stem cells can then be taken from the bloodstream through a procedure called leukapheresis. The patient is prepared for transplantation by administering high doses of chemotherapy or radiation (conditioning). This serves two purposes. First, it destroys the patient's abnormal blood cells or cancer. Second, it inhibits the patient's immune response against the donor bone marrow (graft rejection). Following conditioning, the patient is ready for bone marrow infusion. After infusion, it takes 10 to 20 days for the bone marrow to establish itself. During this time, the patient requires support with blood cell transfusions.

What are the indications?

Bone marrow transplant may be recommended for: Bone marrow deficiency disease caused by: abnormal red blood cell production, such as thalassaemia or sickle cell disease  aggressive cancer treatments (chemotherapy, radiation therapy), especially for leukaemia or lymphoma  lack of normal blood cell production (aplastic anaemia) Immune system disorders (immunodeficiency) such as:  congenital neutropenia  severe combined immunodeficiency syndrome Bone marrow transplant is not recommended for: patients with heart, kidney, lungs, or liver disorders  patients with other diseases that may limit survival

What are the risks?

The risks for any anaesthesia are: reactions to medications  problems breathing Chemotherapy given prior to bone marrow transplant (conditioning) can cause significant toxicity, such as mouth sores, diarrhoea, liver damage, or lung damage. While waiting for bone marrow to grow, the patient is at high risk for infection as also bleeding. The major problem with bone marrow transplants (when the marrow comes from a donor, not the patient) is graft-versus-host disease. The transplanted healthy bone marrow cells may attack the patient's cells as though they were foreign organisms. In this case, drugs to suppress the immune system must be taken, but this also decreases the body's ability to fight infections. Other significant problems with a bone marrow transplant are those of all major organ transplants - finding a donor and the cost. The donor is usually a sibling with compatible tissue. The more siblings the patient has, the more chances there are of finding a compatible donor.

What is the prognosis?

Bone marrow transplant prolongs the life of a patient who would otherwise die. Relatively normal activities can be resumed as soon as the patient feels well enough and after consulting with the doctor.

The patient will require attentive follow-up care for 2 to 3 months after discharge from the hospital. It may take 6 months to a year for the immune system to fully recover from this procedure.