Day: March 28, 2024

#Tests and scans

Capsule endoscopy

March 28, 2024March 29, 2024 By Dr. Ahmed Hafez

A capsule endoscopy looks at the inside of your bowel. This is also called a video capsule endoscopy or PillCam. You swallow a capsule that contains a small disposable camera. The capsule is the size of a vitamin pill. The camera takes thousands of pictures as it travels along your gut. The camera sends the pictures wirelessly to a data recorder that you wear on your waist. The test is complete once the capsule has passed through your bowel and out into the toilet. A doctor or specialist nurse looks at the pictures from the data recorder to help find out the

#Tests and scans

CT urogram

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

A CT urogram is a test using a CT scan and special dye (contrast medium) to look at the urinary system. The contrast medium helps show up the urinary system more clearly. You have a CT scan of your: kidney bladder tubes that connect the kidneys to your bladder (ureters) A CT scan uses x-rays to take detailed pictures of your body from different angles. A computer then puts them together to make a 3 dimensional (3D) image. CT stands for computed (axial) tomography. It can see details like the soft tissues and blood vessels. You usually have a CT urogram in the x-ray (radiology) department as

#Tests and scans

CT scan

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

A CT scan is a test that uses x-rays and a computer to create detailed pictures of the inside of your body. It takes pictures from different angles. The computer puts them together to make a 3 dimensional (3D) image. CT (or CAT) stands for computed (axial) tomography. You usually have a CT scan in the x-ray (radiology) department as an outpatient . A radiographer operates the scanner. The whole appointment can take up to an hour and a half depending on which part of your body they are scanning. You might have a CT scan combined with another test such as

#Tests and scans

CT colonography

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

CT (computed tomography) colonography is a test that uses CT scans to check the large bowel (colon) and back passage (rectum). It’s also called a virtual colonoscopy. You have this test as an outpatient in the CT scanning (or radiology) department at the hospital. A radiographer or specialist doctor (radiologist) carries out the test. It usually takes around 30 minutes but you should expect to be in the department for about an hour or so. Why do I need a CT colonography? You usually have this test to help find the cause of your symptoms. Before your test You need

#Tests and scans

Bronchoscopy

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

A bronchoscopy is a test to look at the inside of the breathing tubes (airways) in your lungs. You might have this test to allow your doctor to: look for the cause of your symptoms help your doctor see any areas that look abnormal on an x-ray or scans take samples of cells These samples might be a tissue sample called a biopsy. Or your doctor might take some cells by using a small brush or using a liquid to collect them. To have the test your doctor puts a narrow, flexible tube called a bronchoscope down your windpipe (trachea)

#Tests and scans

Breast ultrasound scan

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

A breast ultrasound scan is a test that uses high frequency sound waves to create a picture of the inside of the breast. The ultrasound scanner has a probe that gives off sound waves. The probe looks a bit like a microphone. The sound waves bounce off the tissues in your breast, and the probe picks them up. The probe links to a computer that turns the sound waves into a picture on the screen. A specialist healthcare professional called a sonographer usually does the test. When you might have a breast ultrasound scan You might have a breast ultrasound: as a first

#Tests and scans

Breast biopsy

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

A breast biopsy means having a sample of breast tissue taken to look at under a microscope. It is the only way to find out whether you have breast cancer or other breast conditions. Types of breast biopsy There are different types of breast biopsy. The type of biopsy you have depends on a number of factors such as: how big the abnormal area is where it is Before having a biopsy, you have scans such as a mammogram and breast ultrasound scan . Your doctor looks at the results of the scans and decides on the best type of

#Tests and scans

Brain angiogram

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

An angiogram is an x-ray that can show blood vessels. A specialist doctor called a neuroradiologist injects a dye (contrast medium) and then takes x-ray images of your brain. They look at your brain on the x-ray screen to see: which blood vessels supply the tumour if the tumour is near any major blood vessel This test is also called cerebral angiography. Why you might have it You might have a brain angiogram if: your tumour is growing very deep inside your brain you have a type of brain tumour called meningioma Preparing for your brain angiogram You usually go into hospital on the morning

#Tests and scans

Bone scan

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

A bone scan looks for changes in your bones. Before the test you have a radioactive tracer injection into your bloodstream. You have this through a tube (cannula) into a vein in your hand. It takes 2 to 3 hours for the tracer to go around the body. To have the scan you lie down on a couch while the scanner takes pictures. The scan takes 30 minutes to an hour. It is painless and you can go home after the scan. The body gets rid of the tracer through your urine over the next day. A bone scan shows

#Tests and scans

Bone marrow test

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

What is a bone marrow test? A bone marrow test is a way of testing cells from your bone marrow. Bone marrow is the spongy tissue inside your bones that makes blood cells. Why do I need it? To find out whether there are any cancer cells in the bone marrow. You might also have one to check whether treatment is working. How do you have it and how long does it take? You have a local anaesthetic injection to numb a small area on your hip. The doctor puts a needle into your hip to suck out some bone

#Tests and scans

Bone density scan (DEXA, DXA)

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

DEXA scan stands for dual energy x-ray absorptiometry. It’s also called a bone densitometry scan. It uses low dose x-rays to take measurements to work out the strength (density) of your bones. You have a DEXA scan in the x-ray (radiology) or nuclear medicine department of the hospital. A radiographer does the scan. It takes about 10 – 20 minutes. You’re not enclosed in a small place as the machine has an arm that hangs over the scanning couch. Why might you have a DEXA scan? You might have this scan if you’re having or have had cancer treatment that

#Tests and scans

Bone biopsy

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

A bone biopsy is where a surgeon takes a small sample of bone and sends it to the laboratory for a specialist doctor to look at under a microscope. They can find out whether an abnormal area of bone is cancer or not. You have this test in the interventional radiology department or operating theatre with the help of an x-ray. The x-ray shows the surgeon where exactly to place the biopsy needle. It is a minor procedure. You have it under local or general anaesthetic. Why you might have a bone biopsy You have this test if your doctor

#Tests and scans

Blood tests for cancers

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

Blood tests can: check your general health, including how well your liver and kidneys are working check numbers of blood cells help diagnose cancer and other conditions Your blood sample is sent to the laboratory for analysis. This shows the different types of cells, chemicals and proteins in the blood. Preparing for your blood tests You can eat and drink normally before most blood tests. For fasting blood tests you need to stop eating and drinking beforehand. Your doctor will tell you for how long. What happens? You sit or lie down to have the test. A doctor, nurse or phlebotomist (person

#Medical articles

Biopsy of the eye

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

Your eye specialist (ophthalmologist) might take a sample (biopsy) of your eye. You have a sample of fluid or tissue removed from your eye and looked at under a microscope. A biopsy is not used that often for melanoma of the eye. A specialist can usually use other tests (such as an examination or ultrasound) to help diagnose this type of eye cancer. If you do have a biopsy, you might have a fine needle aspirate or vitreous biopsy. You are more likely to have a biopsy if your eye specialist thinks you have lymphoma. Fine needle aspirate biopsy A

#Tests and scans

Biopsy for pancreatic cancer

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

A biopsy means taking a sample of tissue and sending it to the laboratory so it can be looked at under a microscope. There are different ways of taking biopsies to check for pancreatic cancer. But not everyone with a likely diagnosis of pancreatic cancer will have a biopsy. Why do I need a biopsy? The most sure way of diagnosing pancreatic cancer is by taking a biopsy and looking at it under a microscope. Your doctor takes a biopsy by putting a needle into the area of suspected cancer. Doctors don’t usually take biopsies from the pancreas if they think

#Tests and scans

Biopsy

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

A biopsy means taking a sample of tissue so that it can be looked at under a microscope. This is the only way to be certain if an abnormal area is cancer or not. You may also have a biopsy to find out more about the cancer. This includes what type of cancer it is and how fast it is growing. You can have a biopsy from almost anywhere in your body. This includes your skin, organs and other structures. Your doctor takes a sample of the abnormal area and sends the sample to the laboratory. This is where a doctor called

#Tests and scans

Barium x-ray

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

A barium x-ray is a test to look at the outline of any part of your digestive system . Barium is a white liquid that shows up clearly on an x-ray. Once it is inside the body, it coats the inside of the oesophagus , stomach or bowel. This then shows the outline of the organs on the x-ray. If there is a tumour, it shows up as an irregular outline extending out from the wall of the affected part of the body. Barium liquid does not do you any harm and passes through your digestive system so you don’t absorb

#Tests and scans

Anal examination (anoscopy) and biopsy

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

A specialist doctor examines your anus with a thin tube called an anoscope. Your doctor can take a sample of tissue (a biopsy) from any abnormal areas. Women might have an internal examination of the vagina as well. This is because it is close to the anal canal. Why you might have an anal examination and biopsy You might have an anal examination and biopsy to help diagnose anal cancer. Or to find out more about the size and position of anal cancer (the stage). Preparing for the anal examination and biopsy It’s normal to feel anxious about this test but it usually

#What is cancer?

Cancer grades

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

What does the grade of a cancer mean? You may hear your doctor talk about the grade of your cancer. Tumour grade describes a tumour in terms of how abnormal the tumour cells are. This is compared to normal cells. It also describes how abnormal the tissues look under a microscope. The grade gives your doctor some idea of how the cancer might behave. A low grade cancer is likely to grow more slowly and be less likely to spread than a high grade one. Doctors can’t be certain exactly how the cells will behave. But the grade is a

#What is cancer?

Stages of cancer

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

What cancer staging is Staging is a way of describing the size of a cancer and how far it has grown. When doctors first diagnose a cancer, they carry out tests to: check how big the cancer is whether it has spread into surrounding tissues whether it has spread to other parts of the body Cancer staging may sometimes includes the grade of the cancer. This describes how similar a cancer cell is to a normal cell. Why staging is important Staging is important because it helps your treatment team to know which treatments you need. Doctors may recommend a

#What is cancer?

Types of cancer

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

The main types of cancer Our bodies are made up of billions of cells. The cells are so small that we can only see them under a microscope. Cells group together to make up the tissues and organs of our bodies. They are very similar. But vary in some ways because body organs do very different things. For example, nerves and muscles do different things, so the cells have different structures. There are more than 200 types of cancer and we can classify cancers according to where they start in the body, such as breast cancer or lung cancer. We can also group

#Rheumatology

Osteoarthritis

March 28, 2024March 28, 2024 By Sama Mohamed

Overview Osteoarthritis is characterised by progressive synovial joint damage resulting in structural changes, pain and reduced function. It is the most common form of arthritis. Individuals are affected differently, but pain and functional limitation can significantly affect quality of life. The hands, knees and hips are commonly affected by this condition that leads to cartilage loss and subsequent remodelling of bone. Management includes addressing modifiable risk factors, analgesia and joint replacement surgery. Epidemiology It is estimated that 8.75 million people aged 45 or older in the UK have sought treatment for osteoarthritis. In England, 4.11 million aged 45 or older suffer with

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#Rheumatology

Gout

March 28, 2024March 28, 2024 By Sama Mohamed

Overview Gout is a crystal arthropathy resulting from excess levels of uric acid leading to precipitation in joints and other tissue. Gout is the most common inflammatory arthritis across the world. The overall prevalence of gout is increasing, estimated at 2.49% in the UK. It is more common in the elderly and has a male predominance with a male to female ration of 4.3:1. A caricature by James Gillray, an 18th century artist Risk factors High uric acid levels, or hyperuricaemia, is the single most important risk factor for the development of gout. Hyperuricaemia Alcohol Obesity Male gender Age Renal disease Dyslipidaemia Chemotherapy Diabetes mellitus People

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#Rheumatology

Giant cell arteritis

March 28, 2024March 28, 2024 By Sama Mohamed

Overview Giant cell arteritis is a sight-threatening vasculitis characterised by inflammation of medium and large sized arteries. Giant cell arteritis (GCA), otherwise known as temporal arteritis, is a type of vasculitis. Vasculitis refers to inflammation of blood vessels. It is considered a medical emergency because without prompt recognition and treatment it can lead to visual loss. In the UK, the annual incidence is estimated at 20 per 100,000 people. The peak onset occurs in patients aged 70-79 and the condition is rarely seen before the age of 50. The condition is more prevalent in white Northern European patients and is 2-3

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#What is cancer?

Why some cancers come back

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

Why cancer might come back Cancer might come back some time after the first treatment. This idea can be frightening. There are different reasons for why cancer might come back. These reasons are: the original treatment didn’t get rid of all the cancer cells and those left behind grew into a new tumour some cancer cells have spread elsewhere in the body and started growing there to form a tumour After surgery Cancer can come back after surgery because: some cancer cells were left behind during the operation some cancer cells had already broken away from the primary cancer but were too small to see. These are called micrometastases.

#Rheumatology

Eosinophilic granulomatosis

March 28, 2024March 28, 2024 By Sama Mohamed

Overview Eosinophilic granulomatosis with polyangiitis is a small to medium vessel vasculitis. Eosinophilic granulomatosis with polyangiitis (EGPA) is one of the anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitides (AAV) that is characterised by allergic rhinitis, asthma, and prominent peripheral blood eosinophilia. Among the three AAVs (see below), EGPA is the least common with a prevalence in Europe between 10.7-14.1 cases per million population. The mean age of diagnosis is around 40 years old and there is no gender predominance. ANCA associated vasculitis AAV is an umbrella term for three conditions: Microscopic polyangiitis (MPA) Granulomatosis with polyangiitis (GPA): previously known as Wegener’s granulomatosis Eosinophilic

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#Rheumatology

Ankylosing spondylitis

March 28, 2024March 28, 2024 By Sama Mohamed

Overview Ankylosing spondylitis is a chronic, multi-system inflammatory disorder characterised inflammation of the sacroiliac joints and axial skeleton. Ankylosing spondylitis (AS) is considered a chronic, multi-system inflammatory disorder that is characterised by chronic lower back pain. AS is one of the spondyloarthropathies (SpA) that refers to a diverse group of conditions associated with the HLA-B27 gene. The condition causes inflammation of the sacroiliac joints and axial skeleton that presents as chronic back pain, morning stiffness, and eventually spinal deformity in long-standing cases. Spondyloarthropathies AS is one of the SpAs that are a diverse group of conditions associated with the HLA-B27 gene. AS

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#Rheumatology

Amyloidosis

March 28, 2024March 28, 2024 By Sama Mohamed

Overview Amyloidosis refers to the extracellular deposition of fibrils that contain a variety of proteins. An amyloid fibril is simply the assembly of insoluble protein fibres that are composed in a way that is resistant to degradation. This composition is known as a beta-pleated sheet. These deposits of amyloid fibrils are extracellular (i.e. occurring outside of cells) and may be seen in different tissues and organs. Hepatic amyloid. Seen as amorphous, acellular pink material on H&E stain Image courtesy of Nephron. Wikimedia commons The problem with amyloid is that deposition in tissue can lead to organ dysfunction. When organ dysfunction is caused by

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#What is cancer?

Genes, DNA and cancer

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

DNA and genes Inside almost every cell in your body is a structure called the nucleus. This is the control centre of the cell. Inside the nucleus are 23 pairs of chromosomes. These are long strings of DNA. DNA stands for deoxyribonucleic acid (pronounced dee-oxy-rye-bow-nu-clay-ik acid). Each string of DNA looks like a twisted ladder. Scientists call this a double helix. You have more than 2 metres of DNA inside every cell. But is very tightly coiled up so it all fits. DNA is like a code containing all the instructions that tell a cell what to do. It is made up of genes. Humans have around

#Women - coping with sex hormone symptoms

Sex hormones, heart problems and diabetes in women

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

Some cancer treatments lower the amount of sex hormones in the body. The main female sex hormones are oestrogen and progesterone. Low levels of these hormones may increase your risk of heart problems and diabetes. Hormone therapy and the risk of heart problems There is some evidence to suggest that aromatase inhibitors may increase the risk of heart problems. Aromatase inhibitors are a type of hormone therapy used to treat breast cancer. The group of aromatase inhibitors includes: anastrozole (Arimidex) exemestane (Aromasin) letrozole (Femara) Research into hormone therapies and heart problems Evidence shows that before the natural menopause, oestrogen

#Women - coping with sex hormone symptoms

Sleep problems and sex hormone symptoms in women

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

Some cancer treatments can lower the levels of sex hormones in the body. The main female sex hormones are oestrogen and progesterone. Low levels of sex hormones can cause hot flushes or anxiety, making sleep difficult. Coping with other symptoms can feel worse if you are not sleeping well. On average most adults need around 7 to 9 hours of sleep a day. But some people may need more while others manage with less. Sleeplessness (insomnia) Insomnia is when you have difficulty falling asleep or staying asleep at night. An occasional night without sleep will make you tired the following day.

#Women - coping with sex hormone symptoms

Sex hormones and weight changes in women

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

Some cancer treatments lower the amount of sex hormones in the body. Low levels of sex hormones can sometimes make you put on weight. What are the sex hormones? Hormones are natural substances made by the glands of our hormone (endocrine) system. They are carried around our body in our bloodstream. The main female sex hormones are oestrogen and progesterone. The main male sex hormone is testosterone. Sex hormones and weight changes After the menopause the way that fat is distributed around the body changes. Extra weight tends to build up around the waist, rather than on the hips and

#Women - coping with sex hormone symptoms

Urinary problems in women

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

Some cancer treatments lower sex hormone levels in the body. The main female sex hormones are oestrogen and progesterone. Low levels of these sex hormones can sometimes cause urinary problems in women, including infections and incontinence. The importance of oestrogen An important function of oestrogen is to help to keep the wall of the urethra elastic and the pelvic floor muscles healthy. The urethra is the tube that takes urine from the bladder to the outside of the body. The pelvic floor muscles surround the lower part of the bladder and urethra. When the amount of oestrogen in the body

#Women - coping with sex hormone symptoms

Mood changes and sex hormones in women

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

Some cancer treatments lower the levels of sex hormones in the body. Low levels of sex hormones can sometimes cause mood changes. Hormones and mood changes Hormones are natural substances made by the glands of our hormone (endocrine) system. They are carried around our body in our bloodstream. The main male sex hormone is testosterone. The main female sex hormones are oestrogen and progesterone. There is evidence that a fall in oestrogen levels can cause mood changes. This could be due to the cancer treatment, the menopause , or both. The causes of mood changes can be difficult to assess

#Women - coping with sex hormone symptoms

Bone loss and osteoporosis in women

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

Hormone therapy treatments can lower the levels of sex hormones in the body. The main female sex hormones are oestrogen and progesterone. Lower levels of these hormones can increase bone loss. Bone loss (osteoporosis) and ageing Our bones start to thin around our late thirties. This is part of the natural ageing process. The bones go through a stage called osteopenia. This is when they start to become thinner. Osteoporosis is when the bones become more brittle and thinner. Having thinner bones makes them more at risk of breaking (fracture). After the menopause the levels of the sex hormone oestrogen

#Women - coping with sex hormone symptoms

Thinking and memory changes in women

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

Some cancer treatments lower the amount of sex hormones in the body. Low levels of sex hormones can cause problems with concentration, thinking, and memory. What are the sex hormones? Hormones are natural substances made by the glands of our hormone system. They are carried around our body in our bloodstream. They act as messengers to carry signals between one part of the body and another. The main female sex hormones are oestrogen and progesterone. Hormone therapy to treat breast cancer can work in one of two ways: lowering the levels of oestrogen blocking the effect of oestrogen on cancer cells

#Women - coping with sex hormone symptoms

Sex and sex hormone symptoms in women

March 28, 2024March 28, 2024 By Dr. Ahmed Hafez

Some cancer treatments lower the amount of sex hormones in the body or stop the body producing them altogether. The hormones most commonly affected in women are oestrogen and progesterone. Lower levels of these might affect your sex life. Symptoms can include: a loss of sex drive (also called a low libido) vaginal dryness Loss of interest in sex (libido) In women, the hormones progesterone and oestrogen play a part in sex drive. But not everyone who has low hormone levels has a loss of interest in sex. For most people, the cause is a combination of factors including: your

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