The incidence of cancers is on the rise worldwide. Daily scientific advancements and availability of newer diagnostic and therapeutic techniques not only make earlier detection of cancers but also make them amenable to treatment. They improve survival and increase the disease-free period.
A lot of cancers are detected very early in life-in childhood, adolescence and young adulthood which are the prime years for fertility. A multidisciplinary approach in improving the quality of life of such a group of cancer survivors is to provide them an opportunity to produce their own biological child, when they are disease free, despite the disease and its associated chemotherapy and radiotherapy that have damaging effects on their the reproductive organs (ovaries and testes).
The role of the cancer specialist is paramount in such a scenario.The guidelines published by the American Society of Clinical oncology in 2006 states that the treating oncologist should include in their counseling the need for fertility preservation before therapy. They should educate the patient regarding the impact of cancer treatments on the future reproductive potential of the patient and refer them to a reproductive medicine specialist for fertility preservation. This would be based on the nature, aggressiveness, intended surgery including chemotherapy and radiotherapy and prognosis of cancer. Cancers like lymphomas, leukemia, breast cancer etc can be addressed and fertility preserving treatments given either before or in the time intervening between two therapeutic modalities.
Options of fertility preservation are available for both the sexes.
In men, the option of semen cryopreservation or semen freezing is available in which semen collected by masturbation is frozen in the laboratory and used in future IVF process when fatherhood is desired.
For women, the options available are as follows–
- For young girls and women without partners, the options available are oocyte freezing and ovarian tissue freezing. For oocyte freezing, the patient’s ovaries are stimulated to make eggs using artificial hormones and the eggs once mature are collected under anaesthesia and frozen in the laboratory for future IVF use whenever motherhood is desired. The advanced regimens available to make eggs are safe and cause no delay in initiating the actual cancer treatment.The results of ovarian tissue freezing, although considered experimental, have the advantage of keeping the fertility window open for a longer duration of time.
- For women with partners, the option of embryo cryopreservation is available. As already explained, the woman’s ovaries are stimulated to produce eggs and the eggs thus obtained are mixed with the partner’s sperm in the IVF laboratory to make embryos which are frozen to be used in future whenever parenthood is desired.
To sum up,
- Cancers with a good prognosis and survival, early in life should be managed by a multidisciplinary team approach which should include a reproductive medicine specialist to keep the future fertility needs in mind
- Safe regimens for ovarian stimulation are available that do not worsen the existing disease
- Time to start the cancer therapy is not delayed as newer regimens to stimulate the ovaries are available that can be started randomly irrespective of the woman’s menstrual cycle
- Fertility preservation can be seen as a means to improve the quality of life of a cancer survivor by producing his/her own biological child.
Hypertension or high blood pressure is a health condition that can result in irreversible complications and sometimes even death if left unchecked. A condition that commonly occurs in smokers, older people, overweight or inactive people, alcoholics or people with fatty diets, hypertension is influenced by poor lifestyle and diet choices. Salt is one of the biggest enemies when it comes to blood pressure, followed by excessive stress and other factors such as chronic kidney disease or thyroid issues. It is possible to effectively control the blood pressure by eating mindfully, and doing so will spare the heart from overworking itself to the point of no return.
Dr. Raja Selvarajan, shares the following list of super foods that help keep blood pressure in check
The high potassium content found in bananas help counter the ill effects of sodium, one of the most common causes of high blood pressure. Similarly, other foods rich in potassium contribute towards good heart health and reduce the risk developing heart disease. One to two bananas per day give the body the potassium it requires.
This green leafy super food is rich in folate, contains potassium and magnesium, and is full of antioxidants, all of which contribute towards maintaining blood pressure levels. Spinach can easily be enjoyed in salads or sandwiches or in the form of the much loved dishes like palak paneer.
A staple in the Indian kitchen, garlic is a hero when it comes to reducing high blood pressure. Rich in sulfur, with anti-inflammatory properties, garlic helps the arteries relax while also fighting the fat deposits in the heart, thereby lowering blood pressure.
Tomatoes contain an antioxidant called Lycopene that helps combat high blood pressure. It also has carotenoids that lower the risk of developing heart disease. Tomatoes can easily be enjoyed be consumed as part of a salad, as soup or as juice.
Contrary to popular belief, nuts such as almond are good for controlling blood pressure. Almond contains ‘good fat’ and protein, which helps reduce cholesterol and hypertension. Monounsaturated fat in almonds help ease inflamed arteries. These nuts can be munched on as an evening snack.
6. Olive Oil
Olive oil is rich in antioxidants called polyphenols and oleic acids that help control blood pressure. Olive oil can be drizzled over salads and pastas in order to reap its benefits. Olive oil is generally in two forms- Virgin and extra virgin. One has to be extra careful in choosing the oil.
People with Chronic kidney disease (CKD) or associated diseases should be careful in the consumption of high potassium food. Stringent dietician/ Doctor Supervision is a must for such patients.High blood pressure does not present with obvious symptoms and can go by undetected until it is too late. With enough care and precaution, hypertension can easily be avoided.
(Please Note: In case of comorbidities, consult your physician or expert dietician for further advice.)
Cigarette smoking is injurious to health is a phrase that is associated with smoking but a warning that is almost always ignored. Apart from the hazardous effects on your health, smoking can wreak havoc on your skin as well. Cigarette smoke has carbon monoxide that takes away the oxygen in the skin and nicotine reduces blood flow leaving the skin dry and lifeless. Smoking cigarettes also stripes away nutrients like vitamin C that help repair and reverse skin damage. Here are some other issues that smoking can cause so make sure that you quit smoking now.
Sagging skin under your eyes
If you smoke regularly, you are likely to suffer from withdrawal symptoms and lack of sleep is a natural side effect. Smokers are likely to lose sleep compared to non smokers as nicotine dependence can mean that you do not rest.
While psoriasis is an autoimmune skin issue, if you smoke the risk of having a scaly skin condition goes up. Studies have indicated that people who smoke a pack of cigarettes for 10 years, the psoriasis risk goes up by 20% and if you have been smoking for 11–20 years the risk is 60% higher.
If you smoke regularly, you will develop wrinkles on your face sooner and premature aging sets in. This is because smoking speedens up aging as it hampers blood supply that keeps skin tissue supple. The elasticity of the skin is lost and small red lines due to dilation of blood vessels causes aging as well. In fact wrinkles appear around the mouth and eyes very often in smokers.
Nicotine in cigarettes causes vasoconstriction which is a condition where the blood vessels become narrow. This can limit oxygen-rich blood flow to the tiny vessels on your face and any wounds will take longer to heal as there is slower growth and regeneration of blood cells. Also any scars will be larger and appear redder and also heal slowly.
As cigarette smoke contains carbon monoxide, wrinkles, gray tones and dullness is common in people who smoke. As the flow of oxygen is reduced, blood flow is restricted causing dry and discoloured skin. Also Vitamin C that helps in repairing skin damage, is depleted in smokers and natural glowing tone is reduced.
Research also indicates that the damaging effect of smoking on the skin gets magnified when it comes in contact with the sun’s UV rays. This dual effect of sunlight exposure and smoking can cause the skin to seem lifeless.
Smoking causes oxidative stress and reduced oxygen causes tissue ischaemia and blood vessel occlusion on the skin. This reduces immunity and causes metallo-proteinase MMP-1 an enzyme that reduces collagen.
Poor skin health
People who smoke have higher risk of clotting of blood cells.
Inputs by Dr Shushma, is a young Dermatologist and Cosmetologist.