General Surgery and Urology - Best Private Hospital in Dubai Al Mankhool | IMH Dubai

Self-Examination.. an easy tool for early detection of testicular cancer

Testicular cancer is the most common cancer for men aged between 15 and 45 Fortunately, it’s one of the most treatable cancers and with good survival rates. The incidences of testicular cancers are increasing in incidence worldwide. It is important to identify testicular cancer early to improve the chances for successful treatment.

This cancer may not cause noticeable symptoms until a late stage. That is why self-examination is so important – it is often the only way to catch testicular cancer at an early stage .

The most common symptom is

  • a painless lump
  • swelling appearing on the testicles.

 

Until proven otherwise, any lump or firm part of the testicle should be considered a potential tumor. The testicle may also seem to be larger than usual. Other symptoms include a dull ache or a feeling of heaviness in the scrotum. Unfortunately, it is common for men not to reveal about these signs for up to an average of 5 months. Since the tumor can spread during that time, it is vital to reach out to your doctor right away.

 

The factors that increase the risk of testicular cancers are

  • Undescended testicles
  • Family history
  • previous history of testicular cancer

 

Men with undescended testicles are about three times more likely to develop testicular cancer than men whose testicles descend at birth or shortly after. Generally men are unaware about the disease and they have a psychological inhibition for self-examination. Monthly testicular self-examination helps us to Identify changes in testicle early and should be done after a warm shower,when the skin of the scrotum is relaxed. Stand in front of the mirror and look for any swelling on the skin of the scrotum and then examine each testicle separately.

Hold your testicle between your thumbs and fingers and roll it gently between your fingers.

Look and feel for any hard lumps or nodules or any change in the size,shape, or consistency of your testicles.
It’s normal for one testicle to be slightly larger than the other, and for one to hang lower than the other. If you have any concerns, get an expert opinion from your specialist.

Testicular cancer is diagnosed by

  • the physical examination
  • ultrasound
  • blood tests that measure tumor markers.

 

Surgical removal of the involved testicle is the first line of treatment followed by chemotherapy and radiotherapy depending on the stage of the disease. Around 95 % of all men with testicular cancer make a full
recovery after receiving treatment. Testicular cancer treatment can cause infertility. Patients may consider sperm banking (freezing sperm and storing it) if they want children after their testicular cancer treatment. Other
side effects are due to radiation and chemotherapy.

Follow-up is necessary because testicular cancer may recur. Follow-up treatment involves regular tumour marker blood tests and possibly CT scans.A quantitative study conducted in the UAE in efforts to test the level of awareness regarding general knowledge on testicular cancer and self- examination practices among residents revealed that nearly 50% either never or rarely self-examined. This study suggested that the general public in the region currently possesses little information regarding the symptoms, risk groups and self-examination practices Monthly testicular self-examination is a good tool to pick up changes in testicle early and thus detecting cancer in the initial stage. Programs for improving the level of awareness regarding the disease and importance of testicular self-examination is highly recommended.

 

Dr. Shameer Hameed

MBBS, MS (General Surgery), DIP. LAP, MCh (Urology) FECSM (Sexual Medicine)

Specialist Urologist writes in Khaleej times and now available in our blog.

 

testicular cancer
testicular cancer

Minimally Invasive Therapy (Lasers) in Treatment of Anorectal Disorders

Anorectal disorders are a group of medical disorders that occur at the junction of the anal canal and rectum. These disorders are very common in the UAE population due to the local climatic changes and lifestyle choices. Almost 50% of  all people experience this problem at least once in their lives by the age of 50. 75% of these disorders will worsen and progress if not treated at the right time.

The 4 most common problems encountered by people are hemorrhoids,anal fistula,anal fissure and pilonidal sinus.Almost 50% or more of patients seen by a Surgeon in his daily practice constitute these problems.Most of these disorders occur due to wrong diet ( lack of fibre and fluids), wrong lifestyle( less physical activity),constipation,laxative misuse, weak connective tissues and other causes. Of these, hemorrhoids are the most common and constitute around 60 to 65% of cases.

People who suffer from these problems present with bleeding while passing stools,painful stools,discharge,itching,swelling and at times fever.

Minimally Invasive Therapy (Lasers)It is important for these people to see a Surgeon at the earliest to enable an accurate diagnosis and initiate early treatment to prevent further complications. Over the counter medications  and creams are of limited use as almost all of these conditions present with more or less the same complaints, however the treatment is completely different for each one of them.

A proper history,physical examination by a Surgeon and relevant lab and other radiological tests may be required for a proper diagnosis and treatment of these conditions.

Till now, only traditional methods of surgery were available to treat these conditions causing a lot of pain, bleeding,large wounds and prolonged healing times for the patient. This prevented a lot of patients from seeking medical advice and undergoing treatment at the right stage.

However, with new developments in the field of surgery and  rapid advances in technology, new minimally invasive modalities are now available for treating these conditions. Of these, Lasers offer the most effective, safe and reliable method for treatment.Lasers have a tremendous benefit over an open operation in that they are painless, almost bloodless, have a short operative time of 15 to 20 minutes, cause no anal narrowing or loss of stool control,have no muscle or skin damage, no need for insertion of stitches or other foreign bodies and subsequently have much faster healing time. Patients can return to their normal work and activities in 4 to 5 days time.

Treatment Of Anorectal DisordersThese however, need to be performed by experienced Surgeons who have undergone extensive training in this specialty and have the know how and technical expertise.

Patients who suffer from these disorders should take full advantage of this new option available  to them with the host of benefits it offers. So, my advice to those with these problems is “ Act now ,don’t suffer in silence!”

Varicose Vein

19705Varicose veins are swollen, twisted, and enlarged veins that you can see under the skin. They are often red or blue in color. They usually appear in the legs, but can occur in other parts of the body.

Causes

Normally, one-way valves in your leg veins keep blood moving up toward the heart. When the valves do not work properly, they allow blood to back up into the vein. The vein swells from the blood that collects there, which causes varicose veins. Smaller varicose veins that you can see on the surface of the skin are called spider veins.
Varicose veins are common, and affect more women than men. They don’t cause problems for most people. However, in some people, they can lead to serious conditions, such as leg swelling and pain, blood clots, and skin changes.
Risk factors include:
• Older age
• Being female (hormonal changes from puberty, pregnancy, and menopause can lead to varicose veins, and taking birth control pills or hormone replacement can increase your risk)
• Being born with defective valves
• Obesity
• Pregnancy
• History of blood clots in your legs
• Standing or sitting for long periods of time
• Family history of varicose veins

Symptoms

• Fullness, heaviness, aching, and sometimes pain in the legs
• Visible, swollen veins
• Mild swelling of feet or ankles
• Itching
Severe symptoms include:
• Leg swelling
• Leg or calf pain after sitting or standing for long periods
• Skin color changes of the legs or ankles
• Dry, irritated, scaly skin that can crack easily
• Skin sores (ulcers) that don’t heal easily
• Thickening and hardening of the skin in the legs and ankles
• Bleeding from ruptured veins

Diagnosis

Your doctor will examine your legs to look for swelling, changes in skin color, or sores. Your doctor also may:
• Check blood flow in the veins
• Rule out other problems with the legs (such as a blood clot)
• Do a colour scan for the leg veins

Treatment

Your doctor may suggest that you take the following self-care steps to help manage varicose veins:
• Wear compression stockings to decrease swelling. These stockings gently squeeze your legs to move blood up towards your heart.
• Do not sit or stand for long periods. Even moving your legs slightly helps keep the blood flowing.
• Raise your legs above your heart three or four times a day for 15 minutes at a time.
• Care for wounds in you have any open sores or infections. Your health care provider can show you how.
• Lose weight if you are overweight.
• Get more exercise. This can help you keep off weight and help move blood up your legs. Walking or swimming are good options.
• If you have dry or cracked skin on your legs, moisturizing may help. However, some skin care treatments can make the problem worse. Talk to your health care provider before using any lotions, creams, or antibiotic ointments. Your provider can recommend lotions that can help.
If your condition is severe, your doctor may recommend the following treatments:
• Laser therapy. Strong bursts of light are projected on smaller varicose veins, making them disappear.
• Sclerotherapy. Salt water or a chemical solution is injected into the vein. The vein hardens and disappears.
• Ablation. Heat is used to close off and destroy the vein. The vein disappears over time.
• Microphlebectomy. Small surgical cuts are made in the leg near the damaged vein. The vein is removed through one of the cuts.
• Bypass. Surgery reroutes blood flow around the blocked vein. A tube or blood vessel taken from your body is used to make a detour around, or bypass the damaged vein.
• Angioplasty and stenting. A procedure opens a narrowed or blocked vein. Angioplasty uses a tiny medical balloon to widen the blocked vein. The balloon presses against the inside wall of the vein to open it and improve blood flow. A tiny metal mesh tube called a stent is then placed inside the vein to prevent it from narrowing again.
Varicose veins tend to get worse over time. Taking self-care steps can help relieve achiness and pain, keep varicose veins from getting worse, and prevent more serious problems.

When to Contact a Medical Professional

Call your health care provider if:
• Varicose veins are painful
• They get worse or do not improve with self-care, such as by wearing compression stockings or avoiding standing or sitting for too long
• You have a sudden increase in pain or swelling, fever, redness of the leg, or leg sores
• You develop leg sores that do not heal

ABDOMINOPLASTY (TUMMY TUCK)

Hanging abdomen with an apron is unsightly and uncomfortable for any woman. Not able to wear the dress of their choice is so depressing to anyone. The self esteem gets down with every morning seeing the self profile. But they can be happy that there is a sure way out.
Causes of hanging abdomen
1) Overweight or obesity : General adiposity (excess fat) as part of increase in Body Mass Index can cause an increase in abdominal circumference. The ideal BMI is 18-23. Once it is above 23 till 27.5 it is overweight and 27.5 onwards is obesity. BMI is calculated as weight in Kg/Ht in M2 e.g. If a person has 100kg weight and 2m height, BMI= 100kg/ 2m x 2m=25 Kg/M2

2) Truncal Obesity (Abdominal obesity) : Increasing abdominal obesity is more dangerous than the overall increase in weight. Ideally, the abdominal circumference at umbilical level should be below 80 cm in women. The increase in BMI and abdominal circumference leads to various medical illness like Diabetes, hypertension (increase in blood pressure), dyslipedemia (increase in cholesterol), sleep apnoea (breathing difficulty/ snoring with respiratory arrest), PCOS (Polycystic ovarian disease) and fatty liver. It also increase the risk of cancers of breast and ovary.

3) Divarication Recti (separation of muscles of abdominal wall) : This happens mainly and commonly following pregnancy when there is excessive stretch of abdominal wall muscles making it fall apart from the midline. This leads to bulging of abdomen and patient will have a state similar to pregnancy look. This is highly distressing to any woman. The abdominal bulge will be such that it projects out and comes anterior than breast level in a profile view.

4) Ventral hernia : muscle defect with herniation/ projection of abdominal contents in to the sac formed at the muscle weakness. The intestines or omentum get trapped in this defect and can cause life threatening problems.

5) Sagging fat and skin : The lower abdominal wall fat and skin is redundant (extra) and hangs down in an unsightly manner. The skin sagging may be unrelated to the muscle weakness. The pulling down of the abdominal wall by the weight of this apron itself will be causing discomfort and muscle weakness. The disfigurement in these patients is unexplainable.

Assessment
Patients need to consult a surgeon who is well-versed with the problem and its corrective measures. Detailed physical examination with abdominal girth, height, weight, BMI, BP, Pulse, oxygen saturation to be checked. The co-existing problems like diabetes, hypertension, snoring, respiratory difficulty with walking, menstrual irregularities, stress incontinence and psychological problem (mainly depression).
The psychological impact of these illness on the patient is very significant. They will be always worried about and other is depression seeing the bad body contour every day. Being not able to wear the dress they like and not able to move around comfortably also keeps them introverts and less sociable. Many jobs also demand people with normal BMI and body shapes. Even promotions are jeopardized by these abnormalities. The associated medical problems and the need for medication for the same will also be making patients uncomfortable and dissatisfied in life.

Treatment Options
Those who have increased BMI should be advised for weight reduction. To a good extend it is possible by diet regulations and exercise. There are some drugs available to reduce weight but it helps in reducing weight around 4-5 kg only. Those with higher BMI will be benefitted by intra-gastric balloon placement or by bariatric surgery of which sleeve gastrectomy is the best. Abdominal obesity also gets controlled to a great extent by these procedures.
Divarication of recti (the separation of muscle in the central abdomen), the ventral hernia and sagging skin with fat (the abdominal apron) needs tummy tuck (abdominoplasty). The exercises to tone the abdominal wall, weight reduction or application of any kind of solutions or application of slim devices like vibrators are not going to give any kind of benefit to these patients.
The procedure of tummy tuck involves a pre-hospitalization checkup including blood tests. Ultrasound abdomen is performed to rule out any other surgical problem in abdomen like an ovarian cyst or gall bladder stones which can be talked at the same time. The necessary consultations will also be done with other specialists as needed.
The operation is done under anaesthesia, either general or regional, so that patient will be comfortable. The incision will be made at the lowest skin crease of abdomen to give excellent cosmetic outcome. The skin and subcutaneous fat will be mobilized. The muscles which are far apart will be brought together. In case of hernia a net like material (mesh) will be used to give additional strength. The excess fat and skin will be removed and wound closed. The wound closure is also done in a careful manner with no stitches outside. This also will add to the perfect healing with very minimal scar. The scar will be completely hidden by the smallest of dress.
Patient needs to be in hospital for 2-3 days and can resume normal activities after that. All kinds of job can be started within two weeks time. Wearing an abdominal binder during this period will give additional comfort.
The outcomes are such great that patients get immediate results and regain self esteem. The profile changes and any modern dress will suit the person. The medical issues related to the divarication like dragging pain in abdomen and backache due to the abnormal posture and weight of ventral hernia will also get resolved. In those with higher BMI and sagging abdomen the procedure to reduce weight (sleeve gastrectomy) is done along with the tummy tuck thereby avoiding scars of the bariatric surgery and unnecessary second hospitalization. Combination of these procedures is an innovative method developed at our centre to give maximal benefit for patient with superior quality of life.

Feedback:
Dear Dr Padmakumar

My tummy tuck (abdominoplasty) was done in september 2013. I was very uncomfortable and had very strong inferiority complex due to my sagging abdomen and hernia. My friends are asking me ” oh you are pregnant again”. After my tummy tuck surgery , ” I can’t believe , all tummy had gone and I was flying in heights”.

Now am happy that I can wear any kind of dress I wish and my confidence level increased.

Thank you all doctors “you are all so special in my life”

Mrs. Liji Chandran

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Dr. R. Padmakumar MBBS, DNB, MNAMS, DipALS, FAIS
Specialist Surgeon , International Modern Hospital, Dubai

Senior Consultant Surgeon & Medical Director, Sunrise Hospital, Cochin (Specialist in Laparoscopy, Hernia, Cancer, Endoscopic Thyroid Surgery,
Thoracoscopy, Obesity and Diabetic Surgery)

GC Member – Association of Surgeons of India
National President Elect – Indian Hernia Society
Jt. Secretary – Indian Association of Endocrine Surgeons
Founder Member – Obesity and Metabolic Surgery Society of India &
Association of Minimal Access Surgeons of India
International Faculty of IASGO on Hernia and Diabetic Surgery
International Faculty of IFSO on Ileal Interposition (Diabetic Surgery)

Mob : +919447230370 (India) ; 00971567581025 (UAE)
Email : drrpadmakumar@gmail.com
Websites:
www.drrpadmakumar.com
www.diabetescuresurgery.com
www.obesitysurgeonkerala.com
www.endoscopythyroid.com

Abdominoplasty or Tummy Tuck

Abdominoplasty or “tummy tuck” is a cosmetic surgery procedure used to make the abdomen thinner and more firm. The surgery involves the removal of excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia of the abdominal wall. This type of surgery is usually sought by patients with loose or sagging tissues after pregnancy or major weight loss.

Even individuals of otherwise normal body weight and proportion can develop an abdomen that protrudes or is loose and sagging. The most common causes of this include:

  • Aging
  • Heredity
  • Pregnancy
  • Prior surgery
  • Significant fluctuations in weight

abdominoplasty tummy tuck-International-modern-hospital

Procedures

Abdominoplasty operations vary in scope and are frequently subdivided into categories. Depending on the extent of the surgery, a complete abdominoplasty can take from 1 to 5 hours. A partial abdominoplasty (mini-tuck abdominoplasty) can be completed between 1 to 2 hours.

Reconstruction of the umbilicus (belly button) following an abdominoplasty surgery. The original umbilicus is sutured into a new hole created by the surgeon.

Complete abdominoplasty

In general, a complete (or full) abdominoplasty follows these steps:

  1. An incision is made from hip to hip just above the pubic area.
  2. Another incision is made to free the navel from the surrounding skin.
  3. The skin is detached from the abdominal wall to reveal the muscles and fascia to be tightened. The muscle fascia wall is tightened with sutures.
  4. Liposuction is often used to refine the transition zones of the abdominal sculpture.
  5. A dressing and sometimes a compression garment are applied and any excess fluid from the site is drained.

 

Full abdominoplasty consisting of musculofascial plication abdominal dermal lipectomy, suction-assisted lipectomy of hips.

Partial abdominoplasty

A partial (or mini) abdominoplasty proceeds as follows:

  1. A smaller incision is made.
  2. The skin and fat of the lower abdomen are detached in a more limited fashion from the muscle fascia. The skin is stretched down and excess skin removed.
  3. Sometimes the belly button stalk is divided from the muscle below and the belly button slid down lower on the abdominal wall.
  4. Sometimes a portion of the abdominal muscle fascia wall is tightened.
  5. Liposuction is often used to contour the transition zone.
  6. The flap is stitched back into place.

The completely sutured area where nearly 100 square centimeters of skin was removed during a combination abdominoplasty and liposuction procedure (also known as a “lipo-tuck”). Note the “neo”-umbilicus (belly button) that was reattached to a newly created hole.

Extended abdominoplasty

An extended abdominoplasty is a complete abdominoplasty plus a lateral thigh lift. The resulting scar runs from the posterior axillary line (when placing your open hands on your hips, the thumbs lie along the posterior axillary line.) The operation does all of the abdominal contouring of a complete abdominoplasty and allows further improvement of the flank (waist), as well as smoothing the contour of the upper lateral thigh.

High lateral tension tummy tuck

This is an advanced technique that takes a little more than four and half hours to perform. Conventional abdominoplasty tightens muscles in a vertical line. In this new method, known as high lateral tension abdominoplasty, in addition to vertical-line tightening, muscles are tightened horizontally. The final result with this technique is a dramatically flat abdomen with significantly better-defined waistline.

Floating Abdominoplasty or FAB Technique

This new technique, also known as an extended mini abdominoplasty, allows for tightening and shaping through a smaller incision that isn’t placed around the belly button. Through this smaller incision, excess skin is removed and the belly button is temporarily detached, floating above the muscles during this process. The muscles are tightened and reshaped from sternum to pubic area. The skin is then tightened and the belly button is reattached, or moved down one or two cm if desired. Liposuction may also be performed to achieve desirable results.

Circumferential abdominoplasty

A circumferential abdominoplasty is an extended abdominoplasty plus a buttock lift. The resulting scar runs all the way around the body, and the operation is also called a Belt Lipectomy or Body Lift. This operation is most appropriate for patients who have undergone massive weight loss.

Combination procedures

An abdominoplasty is a component of a lower body lift and can be combined with liposuction contouring, breast reduction, breast lift, or occasionally hysterectomy, depending on the reason for the hysterectomy. A popular name for breast enhancement procedures performed in conjunction with an abdominoplasty is a “mommy makeover”. Recent literature in MEDLINE also has noted implementation of barbed suture in these procedures.

Recovery

  • Depends on the problem to be treated, surgical technique(s), and other factors. Can take one to four weeks and patients are advised to take at least a portion of this recovery time off from work.
  • Heavy activity especially is best avoided during this time.
  • Initially there may be bruising and discomfort.
  • A supportive abdominal binder or compression garment can minimize swelling / bruising, and support the repaired tissues. This compression garment is also effective in helping the skin in the treated area conform to its new shape.
  • Patients are advised to avoid all forms of nicotine for a month or longer prior to surgery and also during the recovery period.
  • Full recovery takes 3–6 months, with further fading of scars thereafter. Scars may appear red and prominent at first, but with proper care, they heal into a thin, silvery line.

Who Are the Best Candidates For a Tummy Tuck?

A tummy tuck is suitable for men and women who are in good health.

Women who have had several pregnancies may find the procedure useful for tightening their abdominal muscles and reducing skin.

A tummy tuck is also an option for men or women who were once obese and still have excess fat deposits or loose skin around the belly.

Dr. Rohit Kumar
Specialist General Surgeon
Laparoscopic Surgeon

Comparision – Laparoscopic Surgery Vs Open Surgery

Laparoscopic surgery or keyhole surgery is minimally invasive surgery that is associated with several advantages over traditional open surgery

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Dr. Rohit Kumar
Specialist General Surgeon
Laparoscopic Surgeon

What Is Minimally Invasive Surgery?

WHAT IS MINIMALLY INVASIVE SURGERY?

Minimally invasive procedures use advanced technologies to avoid the need for the large incisions used in traditional open surgery. The development of these techniques has been an important advance for the benefit of patients and is useful for the treatment of many conditions. “Laparoscopic surgery” is a specific type of minimally invasive surgery, but the term is sometimes used to refer to minimally invasive surgery in general.

What is a laparoscopy?

Laparoscopy is a procedure to look inside your abdomen by using a laparoscope. A laparoscope is like a thin telescope with a light source. It is used to light up and magnify the structures inside the abdomen. A laparoscope is passed into the abdomen through a small incision (cut) in the skin. A laparoscopy enables a doctor to see clearly inside your abdomen.

What is laparoscopic surgery?

laparoscopic surgery also called minimally invasive surgery (MIS), bandaid surgery, or keyhole surgery, is a modern surgical technique in which operations are performed far from their location through small incisions (usually 0.5–1.5 cm) elsewhere in the body.

There are a number of advantages to the patient with laparoscopic surgery versus the more common, open procedure. Pain and hemorrhaging are reduced due to smaller incisions and recovery times are shorter. The key element in laparoscopic surgery is the use of a laparoscope, a long fiber optic cable system which allows viewing of the affected area by snaking the cable from a more distant, but more easily accessible location.

In addition simply to looking inside, a doctor can use fine instruments which are also passed into the abdomen through another small incision in the skin. These instruments are used to cut, trim, biopsy, grab, etc, inside the abdomen. Some commonly performed operations include:

  • Removal of the gallbladder : This is sometimes called a laparoscopic cholecystectomy, or ‘lap choly’ for short. It is now the most common way for a gallbladder to be removed.
  • Removal of the appendix.
  • Weight loss surgery/ Bariatric Surgery
  • Hernia surgery
  • Removal of spleen, kidney, adrenal gland, thyroid gland
  • Removal of patches of endometriosis.
  • Removal of parts of the intestines.
  • Female sterilisation.
  • Treating ectopic pregnancy.
  • Taking a biopsy (small sample) of various structures inside the abdomen which can be looked at under the microscope and/or tested in other ways.

 

In general, compared with traditional surgery, with laparoscopic surgery there is usually:

  • Less pain following the procedure.
  • Less risk of complications.
  • A shorter hospital stay and a quicker recovery.
  • A much smaller scar.
  •  

How is it done?

Laparoscopy and laparoscopic surgery are usually done whilst you are asleep under general anaesthesia. The skin over the abdomen is cleaned. The surgeon then makes a small incision (cut) about 1-2 cm long near to the navel (belly button). Some gas is injected through the cut to ‘blow out’ the abdominal wall slightly. This makes it easier to see the internal organs with the laparoscope which is gently pushed through the incision into the abdominal cavity. The surgeon then looks down the laparoscope or looks at pictures on a TV monitor connected to the laparoscope.

If you have a surgical procedure, one or more separate small incisions are made in the abdominal skin. These allow thin instruments to be pushed into the abdominal cavity. The surgeon can see the ends of these instruments with the laparoscope and so can perform the required procedure.

When the surgeon has finished, the laparoscope and other instruments are removed. The incisions are stitched and dressings are applied.

Dr. Rohit Kumar
Specialist General Surgeon
website:laparoscopy

Aggressive prostate cancer can be caused by vitamin D deficiency…..

“Aggressive prostate cancer caused by vitamin D deficiency” scientists now declare

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Men with suboptimal or deficient levels of vitamin D are much more likely than other men to develop prostate cancer, according to a new study conducted by the U.S. National Institutes of Health (NIH). Researchers from NorthwesternUniversity ,Chicago found that vitamin D deficiency can increase the risk of aggressive prostate cancer in some men, highlighting the need for increased focus on natural sunlight exposure and supplementation.

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The study, published in the journal Clinical Cancer Research, suggests that vitamin D may play an important role in how prostate cancer starts and spreads, although it does not prove a cause-and-effect relationship. Vitamin D seems to regulate normal differentiation of cells as they change from stem cells to adult cells. And it regulates the growth rate of normal cells and cancer cells

The research was based on an assessment of more than 600 men from around the Chicago area who came from varying ethnic backgrounds. Each of the men had elevated PSA levels or some other risk factor associated with prostate cancer going into the study, and each was evaluated for vitamin D deficiency prior to undergoing a prostate biopsy.

After adjusting for external factors that may have influenced the results, including things like diet, obesity, smoking status and family history, the researchers determined that vitamin D levels are inversely associated with prostate cancer risk. This means that, for each unit of decrease on the vitamin D scale, there is a corresponding increase on the prostate cancer risk scale, and this increase is even more pronounced among certain ethnic groups.

Vitamin D deficiency is more common and severe in people with darker skin and it could be that this deficiency is a contributor to increased incidence of prostate cancer and cancer progression among African-Americans.Vitamin D deficiency could be a biomarker of advanced prostate tumor progression in large segments of the general population.

The latest prostate cancer discovery demonstrates the need  to pay closer attention to vitamin D intake.Vitamin D, the sunshine vitamin is an essential Vitamin that is a part of the steroid hormone superfamily.Hormone sources include both dietary intake and conversion from an inactive to active Vitamin D in the skin through sunlight exposure.

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Most foods that contain vitamin D only have small amounts, so it’s almost impossible to get what your body needs just from food. Because there are only small amounts of vitamin D in food there are only two sure ways to get enough vitamin D:” “Exposing your bare skin to sunlight to get ultraviolet B (UVB)” and taking vitamin D supplements.”Normal vitamin D levels are in the range of 30 to 80 nanograms per milliliter (ng/ml).

VITAMIN D AS A DETERMINANT OF PROSTATE CANCER RISK ALSO COMES FROM SEVERAL EPIDEMIOLOGIC OBSERVATIONS:

1. Men living in Northern latitude with less exposure to sunlight-derived UV exposure, have a    higher mortality rate from Cancer Prostate.

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2. Prostate Cancer occurs more frequently in older men, in whom Vitamin D deficiency is more common both because of less UV exposure and age related declines in hydroxylases responsible for synthesis of active Vitamin D.

3. African-American, whose skin Melanin block UV radiation and inhibit activation of Vitamin D, has the highest worldwide incidence and mortality rates for Prostate Cancer.

4. Dietary intake of dairy products rich in calcium, which depresses serum level of Vitamin D, is associated with higher risk of Prostate Cancer.

5. Native Japanese, whose diet is rich in Vitamin D derived from fish have a low incidence of Prostate Cancer.

It is recommended that more men should be screened for vitamin D deficiency, since minor deficiencies can be asymptomatic.  A  good rule of thumb for  health maintenance is to spend at least 15 minutes out in the sun every day without sunscreen during the summer, or to supplement with at least 5,000 international units (IU) of vitamin D3.

Dr. Shameer Hameed
MBBS, MS (General Surgery),Dip Lap, MCH (urology)
Specialist Urologist

 
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